research topics on information and communication technology

Understanding Information Technology Research

Table of Contents

In the world of technology, research is a compass that helps us navigate its convoluted evolutions. For instance, Information Technology (IT) research has been conducted in computer science, software engineering, data analytics, and cybersecurity.

IT research involves systematic inquiry to advance knowledge, problem-solving, and innovation. This includes conducting rigorous experiments and analyzing results to unveil new theories or approaches that improve technologies or bring breakthroughs.

Therefore, interdisciplinarity is at the core of IT research, with collaboration cutting across various disciplines. Whether using AI to reinforce cyber security or big data analytics in healthcare, collaboration leads to solutions to complex problems.

This is because IT research is changing rapidly due to technological advances. Thus, researchers need to be up-to-date to make meaningful contributions.

Ethics are involved so that technology can be responsibly deployed. The researchers grapple with privacy, security, bias, and equity issues to ensure technology benefits society.

As a result of this publication and conferences, which enable dissemination of findings, leading to further innovations, collaboration has supported progress, hence speeding it up.

Understanding IT research is vital for leveraging technology to address societal challenges and foster positive change.

Recommended Readings: “ Top 109+ Media Bias Research Topics | Full Guide! “.

Picking the Right Topic to Research: The Key to Finding New Things

In the always-changing world of information technology, choosing the proper topic to research is like starting a smart path. It’s a big decision that sets where your hard work will go and how much your findings could mean.

Fitting with Industry Moves and Issues

Finding a research topic that fits current industry moves and big issues is important. By staying informed on the latest happenings and problems in the technology field, you can ensure your research stays useful and helps solve real-world troubles.

Growing Fresh Ideas and Practical Uses

Choosing a research topic that generates fresh ideas and practical applications is crucial. Your findings should not just add to school talks but also lead to real solutions that can be used in real situations, pushing technology forward and making work smoother.

Sparking Mind Curiosity and Excitement

Selecting a research topic that sparks your curiosity and excitement is essential. When you dive into an area that truly fascinates you, the research journey becomes more engaging, and your drive to uncover big insights is stronger.

Finding Gaps and Unexplored Areas

Finding gaps in existing knowledge or unexplored areas in the technology landscape can lead to big discoveries. Entering uncharted spaces can uncover fresh insights and meaningfully advance the field.

Considering Potential Wide Effect and Growth

Considering your research topic’s potential wide effect and growth is crucial. Will your findings have far-reaching effects across industries? Can your solutions grow and shift to address changing challenges? Evaluating these things can help you prioritize research areas with the greatest potential for big impact.

By carefully choosing the right research topic, you can open the door to discoveries, push technology forward, and contribute to the constant evolution of the technology information landscape.

Emerging Trends in Information Technology Research

In the rapidly changing world of Computer Studies, keeping up with the latest trends is indispensable. Technology keeps changing, and so does research in computer studies. From awesome things like clever robots to how we can safeguard our online information, computer studies research is always discovering new ways to improve our lives. Therefore, let us delve into some of the most exciting new trends shaping computer studies’ future.

Smart Computers:

Right now, smart computers are a hot item. They can learn from experience, recognize patterns, and even understand language like humans do. This helps in many areas, such as healthcare or finance. So researchers are working on making smart computers smarter yet so that they can make decisions alone and be fair to everyone.

Fast Computing:

As more devices connect to the Internet, we need ways to process information quickly. Fast computing helps bring processing power closer to where the information comes from, making things quicker and more efficient. Thus, researchers have been figuring out how to improve fast computing, especially for analyzing real-time data.

Keeping Things Safe:

With all the cool tech around, keeping our information safe from bad guys is important. We must develop methods to safeguard our data and networks from cyber attackers. In addition, they have also been considering how to ensure the privacy of our personal information so that only authorized individuals can access it.

Fancy Computers:

The next big thing in computing is quantum computers. They can do calculations at a high speed that ordinary ones cannot. Researchers are working hard to achieve quantum computing because it could be useful in cracking codes and creating new drugs.

New Ways of Doing Things Together:

Blockchain is an exciting technology that allows us to collaborate without a central authority. Its use in cryptocurrencies is quite popular but it has other applications too. Blockchain can be applied for purposes such as helping us discover where products come from, proving who we are on the internet, and making contracts that cannot be changed later on.

Virtual Reality Adventures:

Entering a completely different world is what Virtual Reality (VR) and Augmented Reality (AR) do. The feeling of being in reality is what these two technologies create, which is not real. These researchers are working hard on making VRs and ARs better so that they can be used for learning, training, and amusement in more innovative ways.

In summary, computer studies research keeps changing with new trends such as smart computers, rapid computing, cybersecurity issues, high-end computers, collaboration platforms and immersive games or virtual reality escapades.

By exploring these trends and developing new ideas, researchers ensure that technology keeps improving and making our lives easier and more exciting.

How can I brainstorm research topics in information technology?

Start by identifying your areas of interest and exploring recent advancements in the field. Consider consulting with mentors or peers for suggestions and feedback.

What are some ethical considerations in AI research?

Ethical considerations in AI research include fairness, transparency, accountability, and privacy. Researchers should ensure their algorithms and models do not perpetuate bias or harm individuals.

How can I stay updated on emerging trends in IT research?

Follow reputable journals, conferences, and online forums dedicated to information technology. Engage with the academic community through discussions and networking events.

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Technology and Communication Research Paper Topics

Archiving of Internet Content
Code as Law
Communication Infrastructure
Communication Technology and Democracy
Communication Technology Standards
Crime and Communication Technology
Development of Information and Communication Technology
Digital Divide
Digitization and Media Convergence
Domain Names
Domestication of Technology
Economics of Technology
E-Government
Human–Computer Interaction
Information and Communication
Information Literacy
Information Overload
Information Society
Internet Ratings Systems
Internet Research Ethics
Language and the Internet
Link Analysis
Log-File Analysis
Network Organizations through Communication Technology
Online Media
Open Access Journals
Open Source
P2P Networking
Personal Communication by CMC
Personal Publishing
Search Engines
Sex and Pornography Online
Social Construction of Technology
Technology and Globalization
Technology as Fashion
Technology Assessment
Technology for Mobility
Technology of Internet
Terrorism and Communication Technologies
Ubiquitous Computing
Virtual Communities

Endogenous and Exogenous Perspective

ICT innovation can be treated conceptually as either exogenous or endogenous to a social system. The exogenous perspective treats ICTs as if they are objects isolated from the social, political, and economic environment in which they are produced and consumed. If it is technology that is the determining factor in social organization, then what is left for the researcher is an observer role. The exogenous perspective emphasizes the efficiency and rationality of an autonomous technological system where there is little room for human agency.

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In contrast, from an endogenous perspective, research focuses on the way ICTs become woven into the fabric of life – in terms of morality, the economy, culture, or the political world and on the specific, material conditions under which technology is produced and consumed. Technology is regarded as part of the social fabric where actors sanction certain forms of change and not others. Power is understood to be located in the interwoven alignment of state (administrative and military), private capital, and civil society interests. In this view, the emphasis is on the way technology mediates human relationships and on the constraints that distort benefits that might otherwise accrue to those who are not at the center of economic and political power (Curran et al. 2012; Mansell 2012; Silverstone 2007).

Among the many strands of research in this context are studies of the political implications of the information society for democracy and participation in public debate and in electoral processes and whether a right to communicate should be enshrined in international law (Jørgensen 2013). Within sociology, research on the domestication of technologies (Hartmann 2013) has helped to reveal that ICT artifacts are not prefigured by technology designers for their users, and that older and newer media and ICTs are appropriated in unpredictable ways depending on the cultural specificities of their use. Economic analysis tends to focus on the diffusion of ICTs and the implications for productivity in the economy since these technologies are classed as general-purpose technologies and associated with major transformations when they become widely dispersed across all ICT-using sectors of the economy (Freeman 2007).

Research Topics

The disruptive characteristics of innovations in ICTs have given rise to many debates about their positive or negative implications for the global order, with research emphasizing links between local and distant places and the sometimes unifying, and at other times fragmenting, consequences. There is no stable definition but the term virtual community generally applies to online interactions that give rise to new forms of relationships and new organizational forms. Research focuses on the network relations among activists, bloggers, scientists and many other communities of users of social media. The digital platforms that support these communicative activities are increasingly being used by researchers to map the architecture of networks and social relations with a focus on the directionality of communication, synchronicity, content modularity, interactivity, personalization, and meaning construction. Research on issues of information control, privacy, and security raised by user-generated content, the co-creation of content, and interactive Web 2.0 applications is beginning to tackle the implications of ‘big data’ analytics which uses web-harvesting, ratings systems, and identity profiling to support corporate and state information collection and processing activities (Mayer- Schönberger & Cukier 2013). Digital means of interacting online support the networking activities of individuals and of networked organizations which enable virtual teamworking and outsourcing, raising questions about the ownership of creative capabilities, privacy, and trust, whether the public can have confidence in the digital services provided by governments, and whether new forms of interaction are consistent with democratic practice.

When the diffusion of ICTs is uneven, or where the distribution of the gains as a result of investing in them is uneven, this is referred to as a digital divide. For some it is an article of faith that ICTs hold the solutions to economic, political, and cultural problems, while others argue that digital divides mean that it is unlikely that these technologies will alleviate deeply rooted social and economic problems. This concept has been criticized for its oversimplification of the factors that give rise to inequality and research focusing on digital literacies (including information literacy or media literacy) and cultural differences have yielded insight into the many forms and consequences of digital exclusion (Livingstone and Helsper 2010). Differences in views about the relationship between technology and communication and the persistence of digital divides are reflected in research on whether a global media and communication policy environment is feasible and the roles of the nation state and multistakeholder groups in governing digital media.

Different framings of the relationship between globalization and communication are echoed in research on the governance regimes that enable the production and consumption of ICTs and media content, locally and globally. The governance of Internet has become a hotly contested area of research drawing on legal expertise and examining the values embedded in the architecture of the Internet and other digital applications. Brown and Marsden (2013) provide comprehensive examinations of the proliferation of policies, regulations, and legislation in response to the global spread of digital networks and their applications, especially the Internet. In addition, there is research on specific online behaviors and whether there should be sanctions for ‘bad’ behavior in the case of hacktivism or crime and terrorism.

Finally, the relationship between technology and communication raises many issues with respect to ethical conduct within the humanities and the social sciences. Guidelines with respect to Internet-related research have been developed nationally and by organizations such as the Association of Internet Researchers (AoIR). Different methods raise concerns about the risks involved to researchers and to those they study.

References:

Brown, I. & Marsden, C. (2013). Regulating code: good governance and better regulation in the information age. Cambridge, MA: MIT Press.
Castells, M. (2009). Communication Power. Oxford: Oxford University Press.
Curran, J., Fenton, N., & Freedman, D. (2012). Misunderstanding the internet. London: Routledge.
Freeman, C. (2007). The ICT paradigm. In R. Mansell, C. Avgerou, D. Quah, & R. Silverstone (eds.), The Oxford handbook of information and communication technologies. Oxford: Oxford University Press, pp. 34–54.
Hartmann, M. (2013). From domestication to mediated mobilism. Mobile Media and Communication, 1(1), 42–49.
Jørgensen, R. F. (2013). Framing the net: The Internet and human rights. Cheltenham: Edward Elgar.
Livingstone, S. & Helsper, E. (2010). Balancing opportunities and risks in teenagers’ use of the Internet: The role of online skills and Internet self-efficacy. New Media & Society, 12(2), 309–329.
Mansell, R. (2012). Imagining the Internet: Communication, innovation and governance. Oxford: Oxford University Press.
Mayer-Schönberger, V. & Cukier, K. (2013). Big data: a revolution that will transform how we live, work and think. London: John Murray.
Silverstone, R. (2007). Media and morality: On the rise of the mediapolis. Cambridge: Polity.

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Information technology is the design and implementation of computer networks for data processing and communication. This includes designing the hardware for processing information and connecting separate components, and developing software that can efficiently and faultlessly analyse and distribute this data.

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Current research in future information and communication engineering 2022.

1. Introduction

2. future information and communication engineering 2022, 3. conclusions, acknowledgments, conflicts of interest.

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Korea Institute of Information and Communication Engineering (KIICE). Available online: https://www.jicce.org/main.html (accessed on 25 July 1997).

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Yu, Y.S.; Kim, K.-B.; Jo, D.; Kim, H.-C.; Seo, J. Current Research in Future Information and Communication Engineering 2022. Appl. Sci. 2023 , 13 , 7258. https://doi.org/10.3390/app13127258

Yu YS, Kim K-B, Jo D, Kim H-C, Seo J. Current Research in Future Information and Communication Engineering 2022. Applied Sciences . 2023; 13(12):7258. https://doi.org/10.3390/app13127258

Yu, Yun Seop, Kwang-Baek Kim, Dongsik Jo, Hee-Cheol Kim, and Jeongwook Seo. 2023. "Current Research in Future Information and Communication Engineering 2022" Applied Sciences 13, no. 12: 7258. https://doi.org/10.3390/app13127258

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Technology is like a massive puzzle where each piece connects to form the big picture of our modern lives. Be it a classroom, office, or a hospital, technology has drastically changed the way we communicate and do business. But to truly understand its role, we need to explore different technology research topics.

And that's where this blog will be handy! Powered by solid experience, our professional term paper writers gathered multiple technology research paper topics in literally any direction. Whether you're a student looking for an intriguing subject for your project or just a tech enthusiast trying to broaden your understanding, we've got your back. Dive into this collection of tech topics and see how technological progress is shaping our world.

What Are Technology Topics?

Technology is the application of scientific knowledge for practical purposes. It's the smartphone in your hand, the electric car on your street, and the spacecraft exploring Mars. It might also be the code that protects your online privacy and the microscope that uncovers mysteries of the human cell.

Technology permeates our lives, revolutionizing the way we communicate, learn, work, and play. But, beyond the gadgets and gizmos, there's a world of diverse technology research topics, ideas, concepts, and challenges.

Technology topics zoom in on these ideas, peeling back the layers of the tech universe. As a researcher, you might study how AI is changing healthcare, explore the ethical implications of robotics, or investigate the latest innovations in renewable energy. Your project should probe into the 'how,' the 'why,' and the 'what next' of the technology that is reshaping our world. So, whether you're dissecting the impact of EdTech on traditional learning or predicting the future of space exploration, research topics in technology are limitless.

Branches of Technology Research Paper Topics

Undoubtedly, the reach of technology is extensive. It's woven its way into almost every corner of our lives. Before we move to technological research topics, let’s first see just where technology has left its mark. So, here are some areas where technology is really shaking things up:

Government services: E-governance, digital IDs, and digital voting are just a few examples of technology's application in government services.
Finance: Fintech innovations include cryptocurrencies, mobile banking, robo-advising, and contactless payments.
Education: Technology is used in a wide variety of educational contexts, from e-learning platforms and digital textbooks to educational games and virtual classrooms.
Communication: Social media, video conferencing, instant messaging, and email are all examples of tech's role in communication.
Healthcare: From electronic medical records and telemedicine to advanced imaging technology and robotic surgery, technology is surely transforming healthcare.
Agriculture: Technological advancements are revolutionizing agriculture through precision farming, automated machinery, drones, and genetic engineering.
Retail: It also influences retail through e-commerce, mobile payments, virtual fitting rooms, and personalized shopping experiences.
Environment: Tech is used in climate modeling, conservation efforts, renewable energy, and pollution control.

These are far from all sectors where technology can be applied. But this list shows how diverse topics in technology can be.

How to Choose a Technology Research Topic?

Before you select any idea, it’s important to understand what a good technology research topic is. In a nutshell, a decent topic should be interesting, relevant, and feasible to research within your available resources and time. Make sure it’s specific enough, but not to narrow so you can find enough credible resources.

Your technology topic sets the course of your research. It influences the type and amount of information you'll search for, the methods you'll use to find it, and the way you'll interpret it. Ultimately, the right topic can make your research process not only more manageable but also more meaningful. But how to get started, you may ask. Don’t worry! Below we are going to share valuable tips from our thesis writers on how to choose a worthy topic about technology.

Make research Study the latest trends and explore relevant technology news. Your task is to come up with something unique that’s not been done before. Try to look for inspiration in existing literature, scientific articles, or in past projects.
Recognize your interests Start with what you are genuinely curious about in the field of technology. Passion can be a great motivator during the research process.
Consider the scope You want a topic that is neither too broad nor too narrow. It should provide enough material to explore without being overwhelming.
Check availability of resources Ensure there are sufficient trustworthy resources available for your chosen topic.
Evaluate the relevance Your technology research idea should be pertinent to your field of study and resonate with current trends. This can make your research more valuable and engaging for your audience.

Good Technology Research Topics

Ready for another batch of inspiration? Get ready to discover great technology topics for a research paper across various disciplines. These ideas are designed to stimulate your creativity and provide substantial information for your research. So, let's explore these exciting themes together!

Impact of nanotechnology on medicine.
Harnessing quantum computing potential.
Augmented reality in tourism.
Can bioinformatics revolutionize disease prediction?
Sustainability in tech product design.
Darknet : A hidden side of the internet.
How does technology influence human behavior?
Assistive technology in special education.
Are smart textiles transforming the fashion industry?
Role of GIS in urban planning.
Space tourism: A reality or fantasy?
Potential of digital twins in engineering.
How is telemedicine shaping healthcare delivery?
Green IT : Addressing environmental issues.
Impact of machine learning on finance.

Interesting Technology Research Paper Topics

For those craving intriguing angles and fresh ideas, we present these interesting topics in technology. This collection is filled with thought-provoking subjects that cover the lesser-known areas of technology. Each topic is concise, clear, and ready to spark a fascinating research journey!

Cyber-physical systems in industry 4.0.
Social implications of deepfake technology.
Can gamification enhance learning outcomes?
Neuromorphic computing: Emulating the human brain.
Li-Fi : Light-based communication technology.
Health risks of prolonged screen time.
Quantum cryptography and secure communication.
Role of technology in sustainable agriculture.
Can we predict earthquakes with AI?
Virtual influencers: A new trend in marketing.
Tech solutions for wildlife conservation.
Role of 3D printing in organ transplantation.
Impact of automation on the job market.
Cloud gaming: A new era in the gaming industry.
Genomic editing: Possibilities and ethical concerns.

New Technology Research Topics

Understanding the fast-paced world of technology requires us to keep up with the latest developments. Hence, we bring you burning technology research paper topics. These ideas reflect the most recent trends and advances in technology, offering fresh perspectives for your research. Let's take a look at these compelling subjects!

Potential of hyper automation in business processes.
How is AI changing digital marketing?
Brain-computer interfaces: The future of communication?
Quantum supremacy : Fact or fiction?
5D data storage: Revolutionizing data preservation.
Rise of voice technology in consumer applications.
Using AI for mental health treatment.
Implications of edge computing for IoT devices.
Personalized learning with AI in education.
Role of technology in reducing food waste.
Digital twin technology in urban development.
Impact of AI on patent law.
Cybersecurity in the era of quantum computing.
Role of VR in disaster management training.
AI in talent recruitment: Pros and cons.

Unique Technology Research Topics

For those wanting to stand out with truly original research, we offer 100% authentic topics about technology. We understand that professors highly value unique perspectives. Below we've meticulously selected these technology paper topics to offer you something different. These are not your everyday technology subjects but rather unexpected gems ready to be explored.

Digital ethics in AI application.
Role of technology in countering climate change.
Is there a digital divide in developing countries?
Role of drones in disaster management.
Quantum internet: Possibilities and challenges.
Digital forensic techniques in cybersecurity.
Impact of technology on traditional art forms.
Biohacking: Can we really upgrade ourselves?
Technology and privacy: An inevitable trade-off?
Developing empathy through virtual reality.
AI and creativity: Can machines be artists?
Technology's impact on urban gardening.
Role of technology in accessible tourism.
Quantum biology: A frontier of science.
Unmanned underwater vehicles: Opportunities and threats.

Informative Research Topics in Technology

If you are seeking comprehensive information on technologies, this selection will definitely provide you with insights. As you may know, every study should be backed up by credible sources. Technology topics for research papers below are very easy to investigate, so you will surely find a bunch of academic resources.

Exploring adaptive learning systems in online education.
Role of technology in modern archaeology.
Impact of immersive technology on journalism.
The rise of telehealth services.
Green data centers: A sustainable solution?
Cybersecurity in mobile banking.
3D bioprinting : A revolution in healthcare?
How technology affects sleep quality.
AI in music production: A new era?
Technology's role in preserving endangered languages.
Smart grids for sustainable energy use.
The future of privacy in a digital world.
Can technology enhance sports performance?
Role of AR in interior design.
How technology is transforming public libraries.

Controversial Research Topics on Technology

Technological field touches upon areas where technology, ethics, and society intersect and often disagree. This has sparked debates and, sometimes, conspiracy theories, primarily because of the profound implications technologies have for our future. Take a look at these ideas, if you are up to a more controversial research topic about technology:

Facial recognition technology: Invasion of privacy?
Tech addiction: Myth or reality?
The ethics of AI in warfare.
Should social media platforms censor content?
Are cryptocurrencies a boon or a bane?
Is technology causing more harm than good to our health?
The bias in machine learning algorithms.
Genetic engineering: Playing God or advancing science?
Will AI replace human jobs?
Net neutrality: Freedom of internet or control?
The risk of AI superintelligence.
Tech companies' monopoly: Beneficial or detrimental?
Are we heading towards a surveillance society?
AI in law enforcement: Safeguard or threat?
Do we rely too much on technology?

Easy Technology Research Paper Topics

Who ever thought the tech field was only for the tech-savvy? Well, it's time to dispel that myth. Here in our collection of simple technology research topics, we've curated subjects that break down complex tech concepts into manageable chunks. We believe that every student should get a chance to run a tech related project without any hurdles.

Impact of social media on interpersonal communication.
Smartphones: A boon or a bane?
How technology improves accessibility for people with disabilities.
E-learning versus traditional learning.
Impact of technology on travel and tourism.
Pros and cons of online shopping.
How has technology changed entertainment?
Technology's role in boosting productivity at work.
Online safety: How to protect ourselves?
Importance of digital literacy in today's world.
How has technology influenced the music industry?
E-books vs printed books: A tech revolution?
Does technology promote loneliness?
Role of technology in shaping modern communication.
The impact of gaming on cognitive abilities.

Technology Research Topics Ideas for Students

As an experienced paper writing service online that helps students all the time, we understand that every learner has unique academic needs. With this in mind, the next section of our blog is designed to cater specifically to different academic levels. Whether you're a high school student just starting to explore technology or a doctoral candidate delving deep into a specialized topic, we've got different technology topics arranged by complexity.

Technology Research Topics for High School Students

High school students are expected to navigate complex topics, fostering critical thinking and promoting in-depth exploration. The proposed research paper topics on technology will help students understand how tech advancements shape various sectors of society and influence human life.

How have smartphones changed our communication?
Does virtual reality in museums enhance visitor experience?
Understanding privacy issues in social media.
How has technology changed the way we listen to music?
Role of technology in promoting fitness and healthy lifestyle.
Advantages and disadvantages of online learning.
Does excessive screen time affect sleep quality?
Do video games affect academic performance?
How do GPS systems work?
How has technology improved animation in films?
Pros and cons of using smart home devices.
Are self-driving cars safe?
Technology's role in modernizing local libraries.
Can technology help us lead more sustainable lifestyles?
Can technology help improve road safety for teenagers?

Technology Research Topics for College Students

Think technology research topics for college are all about rocket science? Think again! Our compilation of college-level tech research topics brings you a bunch of intriguing, conversation-stirring, and head-scratching questions. They're designed to let you sink into the world of technology while also pushing your academic boundaries. Time to dive in, explore, question, and take your own unique stance on hot-button issues.

Biometrics in identity verification: A privacy risk?
Impact of 5G on mobile gaming.
Are wearable fitness devices a true reflection of health?
Can machine learning help predict climate change effects?
Are digital currencies disrupting traditional finance?
Use of drones in search and rescue operations.
Impact of e-learning on academic performance.
Does artificial intelligence have a place in home security?
What are the ethical issues surrounding robotic surgery?
Are e-wallets a safer option for online transactions?
How has technology transformed news dissemination?
AI in language translation: How accurate can it be?
Personalized advertising: Boon or bane for online users?
Are smart classes making learning more interactive?
Influence of technology on homemade crafts and DIY culture.

Technology Research Topics for University Students

Are you browsing for university technology research ideas? We've got you covered. Whether you're about to dig deep into high-tech debates, or just taking your first steps, our list of technology research questions is your treasure chest.

Blockchain applications in ensuring academic integrity.
Impact of quantum computing on data security.
Are brain-computer interfaces a future communication tool?
Does digital currency pose a threat to the global economy?
Use of AI in predicting and managing natural disasters.
Can biometrics replace traditional identification systems?
Role of nanotechnology in waste management.
Machine learning's influence on climate change modeling.
Edge computing: Revolutionizing data processing?
Is virtual reality in psychological therapy a viable option?
Potential of synthetic biology in medical research.
Quantum cryptography: An uncrackable code?
Is space tourism achievable with current technology?
Ethical implications of gene editing technologies.
Artificial intelligence in governance.

Technology Research Paper Topics in Different Areas

In the next section, we've arranged a collection of technology research questions related to different areas like computer science, biotechnology, and medicine. Find an area you are interested in and look through subject-focused ideas and topics for a research paper on technology.

Technology Research Topics on Computer Science

Computer science is a field that has rapidly developed over the past decades. It deals with questions of technology's influence on society, as well as applications of cutting-edge technologies in various industries and sectors. Here are some computer science research topics on technology to get started:

Prospects of machine learning in malware detection.
Influence of cloud computing on business operations.
Quantum computing: potential impacts on cryptography.
Role of big data in personalized marketing.
Can AI models effectively simulate human decision-making?
Future of mobile applications: Towards augmented reality?
Pros and cons of open source software development.
Role of computer science in advancing virtual reality.
Natural language processing: Transforming human-computer interaction?
Developing secure e-commerce platforms: Challenges and solutions.
Green computing : solutions for reducing energy consumption.
Data mining in healthcare: An untapped opportunity?
Understanding cyber threats in the internet of things.
Algorithmic bias: Implications for automated decision-making.
Role of neural networks in image recognition.

Information Technology Research Topics

Information technology is a dynamic field that involves the use of computers and software to manage and process information. It's crucial in today's digital era, influencing a range of industries from healthcare to entertainment. Here are some captivating information technology related topics:

Impact of cloud technology on data management.
Role of information technology in disaster management.
Can artificial intelligence help improve data accuracy?
Cybersecurity measures for protecting personal information.
Evolving role of IT in healthcare administration.
Adaptive learning systems: A revolution in education?
E-governance : Impact on public administration.
Role of IT in modern supply chain management.
Bioinformatics and its role in personalized medicine.
Is data mining an invasion of privacy?
Can virtual reality enhance training and development programs?
Role of IT in facilitating remote work.
Smart devices and data security: A potential risk?
Harnessing IT for sustainable business practices.
How can big data support decision-making processes?

Technology Research Topics on Artificial Intelligence

Artificial Intelligence, or AI as we fondly call it, is all about creating machines that mimic human intelligence. It's shaping everything from how we drive our cars to how we manage our calendars. Want to understand the mind of a machine? Choose a topic about technology for a research paper from the list below:

AI's role in detecting fake news.
Chatbots in customer service: Are humans still needed?
Algorithmic trading: AI's impact on financial markets.
AI in agriculture: a step towards sustainable farming?
Facial recognition systems: an AI revolution or privacy threat?
Can AI outperform humans in creative tasks?
Sentiment analysis in social media: how effective is AI?
Siri, Alexa, and the future of AI.
AI in autonomous vehicles: safety concern or necessity?
How AI algorithms are transforming video games.
AI's potential in predicting and mitigating natural disasters.
Role of AI in combating cyber threats.
Influence of AI on job recruitment and HR processes.
Can AI help in advancing climate change research?
Can machines make accurate diagnoses?

Technology Research Topics in Cybersecurity Command

Cybersecurity Command focuses on strengthening digital protection. Its goal is to identify vulnerabilities, and outsmart cyber threats. Ready to crack the code of the cybersecurity command? Check out these technology topics for research designed to take you through the tunnels of cyberspace:

Cybersecurity strategies for a post-quantum world.
Role of AI in identifying cyber threats.
Is cybersecurity command in healthcare a matter of life and death?
Is there any connection between cryptocurrency and cybercrime?
Cyber warfare : The invisible battleground.
Mitigating insider threats in cybersecurity command.
Future of biometric authentication in cybersecurity.
IoT security: command challenges and solutions.
Cybersecurity and cloud technology: A secure match?
Influence of blockchain on cybersecurity command.
Machine learning's role in malware detection.
Cybersecurity protocols for mobile devices.
Ethics in cybersecurity: Hacking back and other dilemmas.
What are some steps to recovery after a breach?
Social engineering: Human factor in cybersecurity.

Technology Research Topics on Biotechnology

Biotechnology is an interdisciplinary field that has been gaining a lot of traction in the past few decades. It involves the application of biological principles to understand and solve various problems. The following research topic ideas for technology explore biotechnology's impact on medicine, environment, agriculture, and other sectors:

Can GMOs solve global hunger issues?
Understanding biotech's role in developing personalized medicine.
Using biotech to fight antibiotic resistance.
Pros and cons of genetically modified animals.
Biofuels – are they really a sustainable energy solution?
Ethical challenges in gene editing.
Role of biotech in combating climate change.
Can biotechnology help conserve biodiversity?
Biotech in beauty: Revolutionizing cosmetics.
Bioluminescence – a natural wonder or a biotech tool?
Applications of microbial biotechnology in waste management.
Human organ farming: Possibility or pipe dream?
Biotech and its role in sustainable agriculture.
Biotech advancements in creating allergy-free foods.
Exploring the future of biotech in disease detection.

>> Read more: Biology Topics to Research

Technology Research Paper Topics on Genetic Engineering

Genetic engineering is an area of science that involves the manipulation of genes to change or enhance biological characteristics. This field has raised tremendous ethical debates while offering promising solutions in medicine and agriculture. Here are some captivating topics for a technology research paper on genetic engineering:

Future of gene editing: Breakthrough or ethical dilemma?
Role of CRISPR technology in combating genetic diseases.
Pros and cons of genetically modified crops.
Impact of genetic engineering on biodiversity.
Can gene therapy provide a cure for cancer?
Genetic engineering and the quest for designer babies.
Legal aspects of genetic engineering.
Use of genetic engineering in organ transplantation.
Genetic modifications: Impact on human lifespan.
Genetically engineered pets: A step too far?
The role of genetic engineering in biofuels production.
Ethics of genetic data privacy.
Genetic engineering and its impact on world hunger.
Genetically modified insects: Solution for disease control?
Genetic engineering: A tool for biological warfare?

Reproduction Technology Research Paper Topics

Reproduction technology is all about the science that aids human procreation. It's a field teeming with innovation, from IVF advancements to genetic screening. Yet, it also stirs up ethical debates and thought-provoking technology topics to write about:

Advances in in Vitro Fertilization (IVF) technology .
The rise of surrogacy: Technological advancements and implications.
Ethical considerations in sperm and egg donation.
Genetic screening of embryos: A step forward or an ethical minefield?
Role of technology in understanding and improving fertility.
Artificial Wombs: Progress and prospects.
Ethical and legal aspects of posthumous reproduction.
Impact of reproductive technology on the LGBTQ+ community.
The promise and challenge of stem cells in reproduction.
Technology's role in preventing genetic diseases in unborn babies.
Social implications of childbearing technology.
The concept of 'designer babies': Ethical issues and future possibilities.
Reproductive cloning: Prospects and controversies.
Technology and the future of contraception.
Role of AI in predicting successful IVF treatment.

Medical Technology Topics for a Research Paper

The healthcare field is undergoing massive transformations thanks to cutting-edge medical technology. From revolutionary diagnostic tools to life-saving treatments, technology is reshaping medicine as we know it. To aid your exploration of this dynamic field, we've compiled medical technology research paper topics:

Role of AI in early disease detection.
Impact of telemedicine on rural healthcare.
Nanotechnology in cancer treatment: Prospects and challenges.
Can wearable technology improve patient outcomes?
Ethical considerations in genome sequencing.
Augmented reality in surgical procedures.
The rise of personalized medicine: Role of technology.
Mental health apps: Revolution or hype?
Technology and the future of prosthetics.
Role of Big Data in healthcare decision making.
Virtual reality as a tool for pain management.
Impact of machine learning on drug discovery.
The promise of medical drones for emergency response.
Technology's role in combating antimicrobial resistance.
Electronic Health Records (EHRs): Blessing or curse?

>> More ideas: Med Research Topics

Health Technology Research Topics

Health technology is driving modern healthcare to new heights. From apps that monitor vital stats to robots assisting in surgeries, technology's touch is truly transformative. Take a look at these topics related to technology applied in healthcare:

Role of mobile apps in managing diabetes.
Impact of health technology on patient privacy.
Wearable tech: Fad or future of personal health monitoring?
How can AI help in battling mental health issues?
Role of digital tools in promoting preventive healthcare.
Smart homes for the elderly: Boon or bane?
Technology and its impact on health insurance.
The effectiveness of virtual therapy sessions.
Can health chatbots replace human doctors?
Technology's role in fighting the obesity epidemic.
The use of blockchain in health data management.
Impact of technology on sleep health.
Social media and its effect on mental health.
Prospects of 3D printing in creating medical equipment.
Tele-rehabilitation: An effective solution for physical therapy?

>> View more: Public Health Topics to Research

Communication Technology Research Topics

With technology at the helm, our ways of communicating are changing at an unprecedented pace. From simple text messages to immersive virtual conferences, technology has rewritten the rules of engagement. So, without further ado, let's explore these communication research ideas for technology that capture the essence of this revolution.

AI chatbots: Re-defining customer service.
The impact of 5G on global communication.
Augmented Reality: The future of digital marketing?
Is 'digital divide' hindering global communication?
Social media's role in shaping public opinion.
Can holographic communication become a reality?
Influence of emojis in digital communication.
The cybersecurity challenges in modern communication.
Future of journalism in the digital age.
How technology is reshaping political communication.
The influence of streaming platforms on viewing habits.
Privacy concerns in the age of instant messaging.
Can technology solve the issue of language barriers?
The rise of podcasting: A digital renaissance.
Role of virtual reality in remote communication.

Research Topics on Technology in Transportation

Technology is the driving force behind the dramatic changes in transportation, making journeys safer, more efficient, and eco-friendly. Whether it's autonomous vehicles or the concept of Hyperloop, there are many transportation technology topics for a research paper to choose from:

Electric vehicles: A step towards sustainable travel.
The role of AI in traffic management.
Pros and cons of autonomous vehicles.
Hyperloop: An ambitious vision of the future?
Drones in goods delivery: Efficiency vs. privacy.
Technology's role in reducing aviation accidents.
Challenges in implementing smart highways.
The implications of blockchain in logistics.
Could vertical takeoff and landing (VTOL) vehicles solve traffic problems?
Impact of GPS technology on transportation.
How has technology influenced public transit systems?
Role of 5G in future transportation.
Ethical concerns over self-driving cars.
Technology in maritime safety: Progress and hurdles.
The evolution of bicycle technology: From spokes to e-bikes.

Technology Research Paper Topics on Education

The intersection of technology and education is an exciting frontier with limitless possibilities. From online learning to interactive classrooms, you can explore various technology paper topics about education:

How does e-learning affect student engagement?
VR classrooms: A glimpse into the future?
Can AI tutors revolutionize personalized learning?
Digital textbooks versus traditional textbooks: A comparison.
Gamification in education: Innovation or distraction?
The impact of technology on special education.
How are Massive Open Online Courses (MOOCs) reshaping higher education?
The role of technology in inclusive education.
Cybersecurity in schools: Measures and challenges.
The potential of Augmented Reality (AR) in classroom learning.
How is technology influencing homeschooling trends?
Balancing technology and traditional methods in early childhood education.
Risks and benefits of student data tracking.
Can coding be the new literacy in the 21st century?
The influence of social media on academic performance.

>> Learn more: Education Research Paper Topics

Relationships and Technology Research Topics

In the digital age, technology also impacts our relationships. It has become an integral part of how we communicate, meet people, and sustain our connections. Discover some thought-provoking angles with these research paper topics about technology:

How do dating apps affect modern relationships?
The influence of social media on interpersonal communication.
Is technology enhancing or hindering long-distance relationships?
The psychology behind online dating: A study.
How do virtual reality environments impact social interaction?
Social media friendships: Genuine or superficial?
How does technology-mediated communication affect family dynamics?
The impact of technology on work-life balance.
The role of technology in sustaining long-term relationships.
How does the 'always connected' culture influence personal boundaries?
Cyberbullying and its effect on teenage relationships.
Can technology predict compatibility in relationships?
The effects of 'ghosting' in digital communication.
How technology assists in maintaining relationships among elderly populations.
Social media: A boon or bane for marital relationships?

Agriculture Technology Research Paper Topics

Modern agriculture is far from just tilling the soil and harvesting crops. Technology has made remarkable strides into the fields, innovating and improving agricultural processes. Take a glance at these technology research paper topic ideas:

Can drone technology transform crop monitoring?
Precision agriculture: Benefits and challenges.
Aquaponics and the future of sustainable farming.
How is artificial intelligence aiding in crop prediction?
Impact of blockchain technology in food traceability.
The role of IoT in smart farming.
Vertical farming : Is it a sustainable solution for urban food supply?
Innovations in irrigation technology for water conservation.
Automated farming: A boon or a threat to employment in agriculture?
How satellite imagery is improving crop disease detection.
Biotechnology in crop improvement: Pros and cons.
Nanotechnology in agriculture: Scope and limitations.
Role of robotics in livestock management.
Agricultural waste management through technology.
Is hydroponics the future of farming?

Technological Research Topics on Environment

Our planet is facing numerous environmental challenges, and technology may hold the key to solving many of these. With innovations ranging from renewable energy sources to waste management systems, the realm of technology offers a plethora of research angles. So, if you're curious about the intersection of technology and environment, this list of research topics is for you:

Innovations in waste management: A technology review.
The role of AI in predicting climate change impacts.
Renewable energy: Advancements in solar technology.
The impact of electric vehicles on carbon emissions.
Can smart agriculture help solve world hunger?
Role of technology in water purification and conservation.
The impact of IoT devices on energy consumption.
Technology solutions for oil spills.
Satellite technology in environmental monitoring.
Technological advances in forest conservation.
Green buildings: Sustainable construction technology.
Bioengineering: A solution to soil erosion?
Impact of nanotechnology on environmental conservation.
Ocean clean-up initiatives: Evaluating existing technology.
How can technology help in reducing air pollution?

>> View more: Environmental Science Research Topics

Energy & Power Technology Topics for Research Paper

Energy and power are two pivotal areas where technology is bringing unprecedented changes. You can investigate renewable energy sources or efficient power transmission. If you're excited about exploring the intricacies of energy and power advancements, here are some engaging technology topics for research papers:

Assessing the efficiency of wind energy technologies.
Power storage: Current and future technology.
Solar panel technology: Recent advancements and future predictions.
Can nuclear fusion be the answer to our energy crisis?
Smart grid technology: A revolution in power distribution.
Evaluating the impact of hydropower on ecosystems.
The role of AI in optimizing power consumption.
Biofuels vs. fossil fuels: A comparative study.
Electric vehicle charging infrastructure: Technological challenges and solutions.
Technology advancements in geothermal power.
How is IoT technology helping in energy conservation?
Harnessing wave and tidal energy: Technological possibilities.
Role of nanotechnology in improving solar cell efficiency.
Power transmission losses: Can technology provide a solution?
Assessing the future of coal technology in the era of renewable energy.

Research Topics about Technology in Finance

The finance sector has seen drastic changes with the rise of technology, which has revolutionized the way financial transactions are conducted and services are offered. Consider these research topics in technology applied in the finance sector:

Rise of cryptocurrency: An evaluation of Bitcoin's impact.
Algorithmic trading: How does it reshape financial markets?
Role of AI and machine learning in financial forecasting.
Technological challenges in implementing digital banking.
How is blockchain technology transforming financial services?
Cybersecurity risks in online banking: Identifying solutions.
FinTech startups: Disrupting traditional finance systems.
Role of technology in financial inclusion.
Assessing the impact of mobile wallets on the banking sector.
Automation in finance: Opportunities and threats.
Role of big data analytics in financial decision making.
AI-based robo-advisors vs. human financial advisors.
The future of insurance technology (InsurTech).
Can technology solve the issue of financial fraud?
Impact of regulatory technology (RegTech) in maintaining compliance.

>> More ideas: Finance Research Topics

War Technology Research Paper Topics

The nature of warfare has transformed significantly with the evolution of technology, shifting the battlegrounds from land, sea, and air to the realms of cyber and space. This transition opens up a range of topics to explore. Here are some research topics in the realm of war technology:

Drones in warfare: Ethical implications.
Cyber warfare: Assessing threats and defense strategies.
Autonomous weapons: A boon or a curse?
Implications of artificial intelligence in modern warfare.
Role of technology in intelligence gathering.
Satellite technology and its role in modern warfare.
The future of naval warfare: Autonomous ships and submarines.
Hypersonic weapons: Changing the dynamics of war.
Impact of nuclear technology in warfare.
Technology and warfare: Exploring the relationship.
Information warfare: The role of social media.
Space warfare: Future possibilities and implications.
Bio-warfare: Understanding technology's role in development and prevention.
Impact of virtual reality on military training.
War technology and international law: A critical examination.

Food Technology Topics for Research Papers

Food technology is a field that deals with the study of food production, preservation, and safety. It involves understanding how various techniques can be applied to increase shelf life and improve nutrition value of foods. Check out our collection of food technology research paper topic ideas:

Lab-grown meats: Sustainable solution or a mere hype?
How AI is enhancing food safety and quality?
Precision agriculture: Revolutionizing farming practices.
GMOs: Assessing benefits and potential risks.
Role of robotics in food manufacturing and packaging.
Smart kitchens: Streamlining cooking through technology.
Nanofood: Tiny technology, big impact.
Sustainable food systems: Role of technology.
Food traceability: Ensuring transparency and accountability.
Food delivery apps: Changing the face of dining out.
The rise of plant-based alternatives and their production technologies.
Virtual and augmented reality in culinary experiences.
Technology in mitigating food waste.
Innovations in food packaging: Impact on freshness and sustainability.
IoT in smart farming: Improving yield and reducing waste.

Entertainment Technology Topics

Entertainment technology is reinventing the ways we experience amusement. This industry is always presenting new angles for research and discussion, be it the rise of virtual reality in movies or the influence of streaming platforms on the music industry. Here's a list of unique research topics related to entertainment technology:

Impact of virtual reality on the movie industry.
Streaming platforms vs traditional media: A comparative study.
Technology in music: Evolution and future prospects.
eSports: Rise of a new form of entertainment.
Augmented reality in theme parks.
The transformation of theater with digital technology.
AI and film editing: Redefining the art.
The role of technology in the rise of independent cinema.
Podcasts: Revolutionizing radio with technology.
Immersive technologies in art exhibitions.
The influence of technology on fashion shows and design.
Livestreaming concerts: A new norm in the music industry?
Drones in entertainment: Applications and ethics.
Social media as an entertainment platform.
The transformation of journalism in the era of digital entertainment.

Technology Research Questions

As we navigate the ever-changing landscape of technology, numerous intriguing questions arise. Below, we present new research questions about technology that can fuel your intellectual pursuit.

What potential does quantum computing hold for resolving complex problems?
How will advancements in AI impact job security across different sectors?
In what ways can blockchain technology reform the existing financial systems?
How is nanotechnology revolutionizing the field of medicine?
What are the ethical implications surrounding the use of facial recognition technology?
How will the introduction of 6G change our communication patterns?
In what ways is green technology contributing to sustainable development?
Can virtual reality transform the way we approach education?
How are biometrics enhancing the security measures in today's digital world?
How is space technology influencing our understanding of the universe?
What role can technology play in solving the global water crisis?
How can technology be leveraged to combat climate change effectively?
How is technology transforming the landscape of modern agriculture?
Can technological advancements lead to a fully renewable energy-dependent world?
How does technology influence the dynamics of modern warfare?

Bottom Line on Research Topics in Technology

Technology is a rapidly evolving field, and there's always something new to explore. Whether you're writing for the computer sciences, information technology or food technology realm, there are endless ideas that you can research on. Pick one of these technology research paper topics and jumpstart your project.

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The Impact of Information and Communication Technologies (ICTs) on Health Outcomes: A Mediating Effect Analysis Based on Cross-National Panel Data

Mingxing shao.

International Business School, Beijing Foreign Studies University, Beijing, China

Zishan Huang

Mingyang chen, associated data.

All the data used in our study could be approached upon request.

When ICTs (Information and Communications Technologies) are combined with healthcare, they can make a key contribution to gradually improve national health outcomes. The global outbreak of COVID-19 in 2020 further highlighted the important role of e-Health and m-Health service modes. This research structures a mediated effect model to explore dynamic relationships between ICT factors, ICT impacts, and national health outcomes, among which ICT factors are independent variables; ICT impacts are mediating variables, and national health outcome indicators selected from United Nations Millennium Development Goals (MDGs) and World Development Indicators are dependent variables. The fixed effect model is used to process a set of 141 countries' panel data from 2012 to 2016 from World Bank and World Economic Forum, while the classical three-step test method and Sobel test combined with fixed effects are used to test the mediated effects of the panel data. The results show that there are significant associations between ICT factors and national health outcome indicators, while only some of the partial mediated effects are proved. ICT environment and ICT usage can influence both the under-five mortality rate and adolescent fertility rate via ICT social impact. However, the mediated effect of ICT social impact on maternal mortality ratio and life expectancy at birth has not been confirmed. Meanwhile, the mediated effect of ICT economic impact has not been proven. This research is an interdisciplinary research in the field of information and communication technology and public health and reveals the path and mechanism whereby ICT factors improve national health outcomes, which can help global policymakers drive the next phase of the implementation of the Sustainable Development Goals (SDGs) and continue to improve the overall health at the national level.

1. Introduction

Using ICTs to efficiently provide services to citizens is an important area where digital technologies can make a difference in generating broad-based gains. ICT is an inclusive term, covering all communication equipment or application software: for example, radio, television, mobile phone, computer, network hardware and software, and satellite system, as well as various services and application software related to it, such as video conference and distance learning. The importance of ICTs is not the technology as such, but its enabling function in facilitating enhanced access to information and communication across large distances. ICTs have been used in many innovative ways to achieve social impacts, such as promoting access to basic services including health, finance, and insurance.

In the field of healthcare, key strategic applications of ICTs include e-Health and m-Health; E-Health and m-Health are increasingly employed—in combination with tools that build capacity and address the quality of care—to improve health systems, use resources efficiently, and plan for the progressive adoption of universal health coverage. Many people regard e-Health and m-Health as the next breakthrough in health system improvement, especially in developing nations. The integration of ICTs and healthcare can make a key contribution to improve lives and well-being worldwide and especially can assist the achievement of the health-related indicators of the United Nations Millennium Development Goals (MDGs). Take the COVID-19 outbreak in 2020 as an example, this emergency brought great challenges to all countries' medical and health system. In this fight against the pandemic, e-Health and m-Health service modes, represented by online telemedicine, showed their talents and played an important role.

ICTs are likely to fundamentally change the way public health is provided by influencing the economy and society. High-income countries have the capacity to increase investment in medical information and communication technologies to control and prevent child mortality and improve maternal health [ 1 ]. Developing countries may give priority to medical information technology projects in order to achieve rapid success, especially since the economic contraction will seriously hinder the implementation of online health policy [ 2 ]. This requires the introduction of more investment in ICT infrastructure to improve the availability and utilization of citizen broadband, so as to improve the penetration and application rate of e-Health and m-Health.

In academia, the previous studies on ICTs and health outcomes mostly stay at the conceptual or micro-level, or focus on the practical application of related technologies [ 3 , 4 ], such as Blockchain technology in acquiring, managing, and sharing personal health information obtained from medical IoT (Internet of things) devices [ 5 – 8 ] or country-specific case studies or comparative studies [ 9 – 14 ]. Some studies have revealed positive relationships between ICTs and national health [ 1 , 2 , 15 – 17 ], which can confirm that ICTs ultimately improve national health outcomes by collecting and processing health information and enhancing communication and collaboration. However, through the literature review, we found that, on the one hand, the variables and dimensions used to measure ICTs in existing studies are not comprehensive; ICT factors are usually discussed as a whole and as one independent variable; on the other hand, most of the existing studies use cross-sectional data as the data resource, and there is a lack of consideration of the time dimension. Moreover, more importantly, the whole process and pathway of the effect of ICTs on the overall health level of the country are complex, and this issue has not been much explored in existing studies.

Based on the above discussion, this study explores the dynamic relationships between ICTs, the impact of ICTs, and the health levels of different countries over time. In this regard, two research questions are proposed to further explore this complex mechanism:

Do ICT factors influence the national health outcomes of a country over time?
What is the process and mechanism of ICT factors to improve national health outcomes?

In order to answer the above research questions, the panel data of 141 countries from 2012 to 2016 are taken as samples. ICT factors and ICT impact are extracted as independent variables and intermediary variables, respectively, from Networked Readiness Index (NRI) from the Global Information Technology Report. Four commonly used public health indicators are selected from MDGs and World Development Indicators as the explained variables. The classical stepwise regression method and Sobel test are used to test the mediated effects, so as to verify the mechanism of the relationships between the above variables.

The exploration of the above research questions is a useful addition and extension to the studies related to the impact and impact pathways of ICTs on national health outcomes. At the same time, answering these questions can help global policymakers to formulate health resource allocation and investment strategies, especially in the fields of healthcare and technology in developing countries, so as to achieve the best interests of people worldwide.

This paper is organized as follows: Section 2 discusses the literature review, Section 3 is regarding the research model and research hypothesis, Section 4 is the empirical research, Section 5 is the discussion, and Section 6 is the conclusion, limitation and future research.

2. Literature Review

2.1. determinants of national health outcomes.

The overall health of a country's population, or the national health outcomes of a country, is determined by multidimensional factors, including political, economic, social, and technological ones.

Politics has been found to have an impact on a country's national health outcomes. Multiple studies [ 18 – 20 ] discussed the relationship between political regimes and population health, finding that the level of democracy has a positive significance on population health. In particular, according to Patterson and Veenstra [ 20 ], electoral democracies are 11 years longer and 62.5% lower than other countries in terms of life expectancy and infant mortality rate, respectively. Based on an empirical analysis of India, Data [ 21 ] argued that political competition in the election can prompt the government to increase public health expenditure. Klomp and Haan [ 22 ] proposed that a higher degree of government stability usually brings about better health outcomes.

Various economic determinants of national health outcomes have been discussed in previous research. Granados [ 23 ] reviewed in detail the prior literature on the macroeconomic effects on mortality, particularly on the theory that mortality oscillates in a procyclical manner with the business cycle. Birgisdóttir and Ásgeirsdóttir [ 24 ] observed a statistically significant connection between economic recessions and a lower mortality rate in women aged 45–64. However, Burgard and Kalousova [ 25 ] suggested a weak link between the 2008 Financial Crisis and the decline of overall mortality in the US, despite an increase in suicide and mental distress among the affluent during this downturn. Apart from macroeconomic conditions, income and employment also contribute to population health. A global gradient was reported by Curran and Mahutga [ 26 ] in the association of income inequality with national health outcomes, featuring a stronger negative impact of income inequality on population health in poorer countries than in richer ones. Peckham et al. [ 27 ] discovered a relationship between employment quality and self-rated health, mental health, and occupational injury, and rendered material deprivation, employment-related stressors, and occupational risk factors the mediators between employment and health status. Employment has also been found to have an impact on maternal self-reported health [ 28 ].

Studies are rapidly emerging on social determinants of population health. Various forms of social inequality are believed to subject people to higher health risks. Clouston et al. [ 29 ] observed contributions of disparities in socioeconomic status (SES) and ethnicity to inequalities in colorectal cancer mortality, with people of lower SES as well as Black, Hispanic, and Asian races prone to higher mortality due to a dearth of age-appropriate medical testing and treatment. Cogburn [ 30 ] argued that cultural racism exacerbates multi-facet racial inequalities in health policy making, practice, and public reception. According to Harnois and Bastos [ 31 ], workplace mistreatment such as discrimination and harassment helps to shape the gender gap in workers' self-reported health. Besides, education is also a social determinant of health status, in particular of maternal–infant health status. Abreha and Zereyesus [ 32 ] pointed out a positive connection between women's empowerment by education and child health in Sub-Saharan Africa. Based on an empirical analysis of 153 countries from 1970 to 2016, Shorette and Burroway [ 33 ] found a distribution-specific advantage of women's education in reducing infant mortality; the significant impact is limited to the range of infant mortality rates from 11 to 55 deaths per 1000 live births.

Discussions over technological effects on population health lie primarily in ICT-health relations. Chauvin and Rispel [ 34 ] described the huge potential digital technologies possess to improve the health status of the mass public and health equity. Noh et al. [ 35 ] reported that mobile phones with a SIM card can lead to a substantial increase in the access to healthcare services for crisis-affected people in Afghanistan. Rafia et al. [ 36 ] confirmed ICTs' role in improving population health and longevity in Malaysia in both the short and long run. A systematic review is presented on the relationship between ICTs and health outcomes in the subsequent section.

2.2. ICTs and National Health Outcomes

Within the research of ICT factors and health outcomes, many multinational empirical studies have used similar indicators of national health development level. Mithas et al. [ 15 ], Wu [ 2 ] and Raghupathi [ 1 ] found that there is a positive correlation between ICTs and life expectancy. Mithas used a sample of 61 countries, and the other two samples are about 200 countries each. In addition, the authors studied the possible relationships between ICTs and mortality, fertility and tuberculosis in countries with different levels of development. Irawan and Koesoema [ 16 ] also found a significant relationship between ICTs, e-Health, child mortality and maternal health, mainly in developing countries, especially in sub-Saharan Africa, where maternal mortality still remains rather high; Mlambo et al. [ 37 ] proved that the use of ICTs can significantly reduce maternal mortality by enabling women' engagement in health treatment and welfare. Ahangama and Poo [ 17 ] found evidence of the moderating role of e-Health in improving infant survival in a sample of 55 countries.

All empirical studies use samples from countries with different levels of development, which may lead to some deviations. In the study of Wu [ 2 ] and Raghupathi [ 1 ], they isolated the developed countries and carried out a separate study and found that the positive correlation between ICT development and health outcomes was still widespread. The above authors tended to use the linear regression method, using cross-sectional data or panel data to test hypotheses. Tavares [ 38 ] also studied the relationship between ICTs, e-Health, and health outcomes in a sample of only 28 EU countries. Another innovation of the paper is that health outcomes are self-reported by individuals, rather than traditional population health indicators such as mortality or life expectancy.

In recent years, ICTs' role in health emergency response has garnered growing attention. Bajpai et al. [ 39 ] examined ICTs' performance in immediate relief and medical response in the context of COVID-19, including testing and diagnosis, patient-centric record keeping and case management, as well as telemedicine. Besides, ICTs are conducive to public mental health in the era of social distancing by helping people stay socially connected [ 40 ].

It is important to note that most of the studies focus on EU countries, while other regional or global studies account for a small proportion. This is due to the substantial sources of databases of the EU. Compared with WHO and the World Bank, EU indicators are more comprehensive, and most of them are numerical data, which is conducive to more complex data analysis.

2.3. ICT Impacts on Economy and Society

In view of the fact that national health indicators can reflect the overall development level and people's quality of life of a country to a certain extent, the literature review should also be extended to the broader research topic of the impact of ICTs on the economy and society.

Cisco conducted a time-series analysis to explain the positive impact of ICT investment on UK economic growth (1999–2000). It has been found that the positive impact of ICT investment is particularly evident in the job market and is achieved through human capital restructuring. Likewise, Chu [ 41 ] found that from 1987 to 2001, the profit generated by New Zealand's IT service industry was positively correlated with GDP growth. By employing Toda–Yamamoto Granger causality approach, Solarin et al. [ 42 ] investigated the impact of ICTs, financial development and economic growth on electricity consumption in Malaysia and found a positive feedback effect between ICTs and electricity consumption. Meanwhile, in the trade research area, ICTs, as the carrier of digital trade, also have been proved to be able to promote green total factor productivity (GTFP) combined with human capital factor and R&D factor [ 43 ].

In order to make comparative studies on the national ICT level of different countries, Northrop [ 44 ] introduced a path model to examine the association among economic factors, social infrastructure and information infrastructure. The model used multiple regression analysis and path analysis to study the factors influencing the transnational differences in computer penetration.

Multiple similar papers have mentioned how an economy can benefit from the development of ICTs. First of all, NIA [ 45 ] proposed the positive impact of ICTs on national competitiveness by studying how the status of cross-national ICTs is related to the national competitiveness indicators of the World Economic Forum. Secondly, in a study of 19 countries, OECD (2008) indicated that the popularity of broadband technology was related to GDP growth. Finally, it threw light on the importance of public investment based on the analysis of the broadband technology opportunity program.

Apart from their economic role, ICTs also exert a profound influence on various social aspects. Park and Lee [ 46 ] discovered specific linkages between different forms of social capital and different forms of ICTs, suggesting a positive role of cell phone use for interpersonal purposes in facilitating bonding social capital, and that of computer use for political and information purposes in promoting bridging social capital. According to Synowiec [ 47 ], ICTs contribute to rural development by creating sources of income and granting access to education. Edinyang et al. [ 48 ] believed that in the days of information explosion, social development in Nigeria can be enhanced by ICTs as a strong catalyzer for knowledge integration. In addition, the dissemination of ICTs sees its own part in innovating social protection schemes [ 49 ], bolstering family solidarity [ 50 ], and developing home-based business communities [ 51 ].

2.4. Summary of the Literature

In view of this background, we can conclude that the positive link between ICTs and public health outcomes has been widely discussed. However, most existing studies generally focus on case studies and the introduction of specific technologies in individual countries or even in a specific location within a country. In the research of related fields, some focus on the correlations among variables such as ICTs, e-Health (and related policies), digital divide, public health expenditure and a number of health indicators, and some conduct cluster analysis of countries in specific regions based on these indicators [ 52 ]. Although these studies provide detailed and rich data representation, their analysis level does not rise to the level of broader samples. Moreover, previous researchers have not studied whether ICTs indirectly affect health indicators by influencing the economy and society. After all, e-Health mentioned above is actually one of the social impacts of ICTs.

Based on prior studies, this research further subdivides ICT factors to refine the granularity of variables. Grounded on the four dimensions of NRI released by World Economic Forum, ICT environment, ICT readiness, and ICT usage three dimensions are selected as independent variables. Four health indicators from the World Bank database are selected as dependent variables. This research selects ICT economic impact and ICT social impact from the NRI as two mediating variables to represent the fourth NRI dimension, ICT impact, which is the first indicator adopted in all similar studies. It is also the first time that they have been used as mediating variables to explore their role in the relationships between ICT indicators and health levels via the mediated effect model.

3. Research Model and Research Hypothesis

3.1. ict factors and national health outcomes.

All the ICT factors used in this study are extracted from the NRI from the Global Information Technology Report, which has been annually released for the last decade. The World Economic Forum, in collaboration with INSEAD, initially began this project to explore the impact of ICTs on productivity and development, as a component of the Forum's research on competitiveness. To this end, over the past decade, the NRI has been measuring the degree to which economies across the world leverage ICTs for enhanced competitiveness. During this period, it has been helping policymakers and relevant stakeholders to track their economies' strengths and weaknesses as well as their progress over time. It is also a solid and substantial data source for the academic community to conduct empirical research.

NRI is a comprehensive index composed of 4 subindices, 10 pillars, and 53 independent indicators distributed on different pillars. The main data providers are the International Telecommunication Union (ITU), UNESCO, and other UN agencies, as well as the World Bank. The other half comes from the executive opinion survey of the World Economic Forum.

The four subindices of NRI are ICT environment, ICT readiness, ICT usage, and ICT impact. In this study, three subindices, ICT environment, ICT readiness, and ICT usage, are selected as the independent variables. The ICT environment subindex gauges the friendliness of a country's market and regulatory frameworks and their ability to support high levels of ICT uptake and the development of entrepreneurship; it also gauges the presence of innovation-prone conditions needed to maximize the potential impacts of ICTs in boosting the economy's competitiveness and its citizens' well-being. The ICT readiness subindex measures the degree to which a society is prepared to make good use of an affordable ICT infrastructure and digital content. The ICT usage subindex assesses the individual efforts of the main social agents—that is, individuals, business, and governments—to increase their capacity to use ICTs, as well as their actual use in their day-to-day activities with other agents.

The dependent variables selected in this research, health indicators, are from MDGs and World Development Indicators. These indicators are the under-five mortality rate, maternal mortality ratio, adolescent fertility rate, and life expectancy at birth. They are widely recognized and applied by international organizations such as the United Nations, and have also been used many times in previous studies.

3.1.1. Under-Five Mortality Rate

Many studies have highlighted the role of ICTs in supporting the delivery of health services, especially in maternal and child health. In terms of Goal 4-reduce child mortality from MDGs, one of the main reasons is the lack of knowledge about childhood diseases, which applies to both developed and developing countries. Access to information through the Internet, mobile communications, radio, and other ICT applications can help parents and doctors find ways to treat sick children better. In developed countries like the United States, a telemedicine program for parents of infants reports that they have 10% higher quality of care than those who do not use telemedicine systems. In developing countries, there is already global public health information and education based on SMS. Studies have shown that the percentage of parents using ICT-based health tools can measure the impact of ICTs on improving the health of infants and children, thereby reducing their mortality. Specifically, in terms of ICT environment, the friendlier a country's market and regulatory framework is, or the better its ability to support high levels of ICT uptake and entrepreneurial development is, the greater the support of ICTs for medical and health services will be, making it possible for parents and doctors, as well as hospitals, to take more effective measures to reduce child mortality. Similarly, if a country is well prepared to leverage affordable ICT infrastructure and digital content, or it has made significant efforts to improve its ability to use ICTs, it will be able to integrate ICTs with healthcare services better, which will lead to better child mortality reduction at the country-wide level. Therefore, we can make the following hypotheses:

H1 : ICT factors are negatively related with under-five mortality rate.
H1a : ICT environment is negatively related with under-five mortality rate.
H1b : ICT readiness is negatively related with under-five mortality rate.
H1c : ICT usage is negatively related with under-five mortality rate.

3.1.2. Maternal Mortality Ratio

In terms of Goal 5-improve maternal health from MDGs, 99% of maternal deaths occur in developing countries. In India, SISU Samrakshak (SSK) refers to a child protector jointly developed by the United Nations Children's Fund (UNICEF) Hyderabad Field Office, CoOptions Technologies Ltd. And the AP government in 2000. SSK deploys ICTs in regional languages to impart health, hygiene, and sanitation knowledge to illiterate communities through audio, pictures, videos, touch screens, and culturally appropriate images. It provides basic information on the different stages of a child from pregnancy to adolescence, women's health during pregnancy, nutrition, child development, safe motherhood, immunization, common diseases, and their remedies. It treats mothers as primary caregivers but allows key actors (such as front-line government workers in the health, nutrition, and education sectors) to promote community learning. Maternal mortality is a key factor in measuring the overall health of a country. If a country has the ability to support higher levels of ICT uptake and the development of entrepreneurship, the country's ICT hardware facilities and related application level will be higher, and ICTs will provide more support for social medical and health services, so that women themselves, families, doctors, and hospitals are likely to take more effective measures to reduce maternal mortality. Likewise, the full preparation to make good use of the affordable ICT infrastructure and digital content, and the higher capacity to use ICTs, will enable the whole society to better reduce maternal mortality, given that the dissemination and use of information, knowledge, and measures on maternal care will be more effective. Therefore, we can make the following hypotheses:

H2 : ICT factors are negatively related with maternal mortality ratio.
H2a : ICT environment is negatively related with maternal mortality ratio.
H2b : ICT readiness is negatively related with maternal mortality ratio.
H2c : ICT usage is negatively related with maternal mortality ratio.

3.1.3. Adolescent Fertility Rate

The adolescent fertility rate is mainly used to reflect the education level of adolescents, including basic education and sex education. The high adolescent birth rate means fewer adolescents are in education. In addition, early childbearing itself is associated with complications and less access to post-natal health care. Globally, the adolescent birth rate among women aged 15–19 has fallen 21% since 2000. However, two-thirds of all countries still have high adolescent birth rates. In general, the spread and application of ICTs can assist in the provision of health information through online health services, and then help the adolescent population to continue their education at a higher level, take preventive measures, thus reduce fertility rates. If the country offers friendly market and regulatory frameworks, and encourages business innovation and practice, it can create a good environment to improve the number of years and levels of education of young people. Meanwhile, the better readiness and preparation of ICTs, or the wider and deeper use of ICTs, will enable the whole society to better reduce the adolescent fertility rate, given that this will help popularize basic education and sex education for young people. Therefore, we can make the following hypotheses:

H3 : ICT factors are negatively related to adolescent fertility rate.
H3a : ICT environment is negatively related to adolescent fertility rate.
H3b : ICT readiness is negatively related to adolescent fertility rate.
H3c : ICT usage is negatively related to adolescent fertility rate.

3.1.4. Life Expectancy at Birth

Life expectancy at birth (or life expectancy for short) is an important indicator of life. A key goal of improving the national health is to increase people's life expectancy, and the use of ICTs can make a huge difference here. On one hand, ICT devices and applications can provide health workers with ICT-assisted functions to collect, record, and share information about health conditions of patients, thereby effectively assisting medical and treatment decision-making, improving medical standards, and resultingly increasing care rates. And on the other, ICTs can contribute overall to this goal by providing health-related information to the public through, for example, online health, and through follow-up activities to educate the public. If a country has an advanced and mature ICT environment, then it has a higher level of ICT hardware facilities and related applications, ICT support for social medical and health services will also be greater. As a result, the general population can generally benefit from this and thus increase life expectancy. Likewise, the higher readiness of ICTs, or the wider and deeper use of ICTs, will enable the whole society to better improve life expectancy, given that the dissemination and use of information, knowledge and measures on healthcare will be more effective. Therefore, we can make the following hypotheses:

H4 : ICT factors are positively related to life expectancy at birth.
H4a : ICT environment is positively related to life expectancy at birth.
H4b : ICT readiness is positively related to life expectancy at birth.
H4c : ICT usage is positively related to life expectancy at birth.

3.2. ICT Impact and the Mediation Role

ICT factors can directly improve the national health levels, but at the same time, we need to note that ICT factors are playing a different role in improving the national health levels with the direct role of treatments or medicines. They are playing a role in making the health information processing more efficient and effective, making the treatment process more convenient and intelligent, improving the economy of the nation, improving the well-being of society, and thus indirectly enhancing the national health levels. Therefore, we can hypothesize that ICT factors have different mechanisms of action, both direct and mediated, for the improvement of national health status.

In this study, we use ICT impact from NRI as mediating variable to characterize the mediating mechanism between ICT factors and national health levels. We divide this mediating mechanism into two aspects, ICT economic impact and ICT social impact, to measure the extensive economic and social impact of ICT to enhance competitiveness and welfare, reflecting the transition to ICT and technology-sensitive economy and society.

Economic impact measures the impact of ICTs on competitiveness, which is due to technological and non-technological innovation in the form of patents, new products or processes, and organizational practices. It also measures the overall shift of an economy towards knowledge-intensive activities.

Social impact aims to assess the improvement in well-being due to the impact of ICTs on the environment, education, energy consumption, health progress, or more active citizen participation. At present, due to limited data, this pillar focuses on measuring the extent to which governments have improved the use efficiency of ICTs and provided more and more online services to their citizens, thereby facilitating their online participation. It also assesses the extent of ICT application in education, reflecting the potential benefits of ICT use in education.

As mentioned above, ICTs can influence a country's economy and society and thus its overall level of development, including economic growth and the job market, sources of income and educational opportunities [ 47 ], and, of course, the level of national health that we focus on here. Therefore, we can formulate the following hypothesis:

H5 : ICT impact has a mediated effect between ICT factors and national health outcomes.

In this study, there are three independent variables, two intermediary variables, and four dependent variables. Due to the large number of variables and limited space, all sub-hypotheses of H5 are not listed here.

3.3. Theoretical Model

Totally, the purpose of this cross-national study is to empirically evaluate the two related research questions: Do ICT factors influence national health outcomes of a country over time? Do economic and social impacts of ICTs mediate the relationship between ICT factors and national health outcomes?

In addition, considering that national income will greatly affect national health, we refer to the previous literature and add GDP by country (from the World Bank) into our model as a control variable.

Based on the above discussion, this research establishes a research model, as shown in Figure 1 :

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Research model.

4. Empirical Research

4.1. variables and data measurement.

This research collect data from World Bank and World Economic Forum Global Information Technology Report from 2012 to 2016. To obtain a set of balanced panel data, we took the intersection of the two databases and finally obtained 141 countries as the study samples (see Table1 for the list of countries). These 141 countries represent different continents and different economic levels and are generally representative. Regarding the measurement of the three independent variables, based on the preceding literature and analysis, this paper measures ICT environment using the pillar business and innovation environment from NRI, measures ICT readiness using the pillar affordability from NRI, and measures ICT usage using the pillar individual usage from NRI.

The list of countries.

1	Albania
2	Algeria
3	Angola
4	Argentina
5	Armenia
6	Australia
7	Austria
8	Azerbaijan
9	Bahrain
10	Bangladesh
11	Barbados
12	Belgium
13	Belize
14	Benin
15	Bhutan
16	Bolivia
17	Bosnia and Herzegovina
18	Botswana
19	Brazil
20	Brunei Darussalam
21	Bulgaria
22	Burkina Faso
23	Burundi
24	Cambodia
25	Cameroon
26	Canada
27	Chad
28	Chile
29	China
30	Colombia
31	Costa Rica
32	Croatia
33	Cyprus
34	Czech Republic
35	Denmark
36	Dominican Republic
37	Ecuador
38	El Salvador
39	Estonia
40	Ethiopia
41	Finland
42	France
43	Gabon
44	Gambia
45	Georgia
46	Germany
47	Ghana
48	Greece
49	Guatemala
50	Guinea
51	Guyana
52	Haiti
53	Honduras
54	Hungary
55	Iceland
56	India
57	Indonesia
58	Iran, Islamic Rep.
59	Ireland
60	Israel
61	Italy
62	Jamaica
63	Japan
64	Jordan
65	Kazakhstan
66	Kenya
67	Korea, Rep.
68	Kuwait
69	Kyrgyz Republic
70	Lao PDR
71	Latvia
72	Lebanon
73	Lesotho
74	Liberia
75	Libya
76	Lithuania
77	Luxembourg
78	Madagascar
79	Malawi
80	Malaysia
81	Mali
82	Malta
83	Mauritania
84	Mauritius
85	Mexico
86	Moldova
87	Mongolia
88	Montenegro
89	Morocco
90	Mozambique
91	Myanmar
92	Namibia
93	Nepal
94	Netherlands
95	New Zealand
96	Nicaragua
97	Nigeria
98	Norway
99	Oman
100	Pakistan
101	Panama
102	Paraguay
103	Peru
104	Philippines
105	Poland
106	Portugal
107	Puerto Rico
108	Qatar
109	Romania
110	Russian Federation
111	Rwanda
112	Saudi Arabia
113	Senegal
114	Serbia
115	Seychelles
116	Sierra Leone
117	Singapore
118	Slovak Republic
119	Slovenia
120	South Africa
121	Spain
122	Sri Lanka
123	Suriname
124	Sweden
125	Switzerland
126	Tajikistan
127	Tanzania
128	Thailand
129	Timor-Leste
130	Trinidad and Tobago
131	Tunisia
132	Turkey
133	Uganda
134	Ukraine
135	United Arab Emirates
136	United Kingdom
137	United States
138	Uruguay
139	Vietnam
140	Zambia
141	Zimbabwe

In order to obtain effective results in subsequent data analysis, the dependent variables and the control variable GDP are reported in logarithmic form due to the large differences among sample countries and scattered sample data. All the variables are organized in Table 2 .

Data sources and descriptive analysis.

Category	Variable	Content	Data source	Method		Mean	Sd	Min	Max
Dependent variables	Under-five mortality rate	Under-five mortality rate/MDGs-goal 4	World bank	Ln	700	2.76	1.13	0.79	4.99
	Maternal mortality ratio	Maternal mortality ratio/MDGs-goal 5	World bank	Ln	700	2.54	1.07	0.59	4.61
	Adolescent fertility rate	Adolescent fertility rate/MDGs-goal 5	World bank	Ln	705	3.38	1.07	0.38	5.19
	Life expectancy at birth	Life expectancy at birth/World development indicators	World bank	Ln	705	4.28	0.12	3.86	4.43

Independent variables	ICT environment	NRI pillar: business and innovation environment	WEF—the global information technology report	n/a	671	4.24	0.69	2.36	5.97
	ICT readiness	NRI pillar: affordability	WEF—the global information technology report	n/a	662	4.9	1.32	1	7
	ICT usage	NRI pillar: individual usage	WEF—the global information technology report	n/a	671	3.77	1.55	1.3	6.86

Mediating variables	ICT economic impact	ICT impact-economic impact	WEF—the global information technology report	n/a	671	3.45	0.95	1.83	6.15
Mediating variables	ICT social impact	ICT impact-social impact	WEF—the global information technology report	n/a	671	3.96	1.01	1.7	6.28

Control variables	GDP	GDP (constant 2010 US$)	World bank	Ln	705	24.91	1.99	20.89	30.55

4.2. Mediated Effect Model

The mediated effect model originates from the research in the field of psychology. Considering the influence of independent variable X on the dependent variable y , if X influences Y by influencing variable M , then M is called the mediating variable. The following regression equations and the model shown in Figure 2 can be used to describe the relationship between variables

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Mediated effect model (Baron and Kenny, 1986).

Coefficient c of equation ( 1 ) is the total effect of independent variable X on the dependent variable Y . Coefficient a of equation ( 2 ) is the effect of independent variable X on mediating variable M . Coefficient b of equation ( 3 ) is the effect of mediating variable M on the dependent variable Y after controlling the influence of independent variable X . Coefficient c' is the direct effect of independent variable X on dependent variable Y after controlling the influence of intermediate variable m . e 1 , e 2 , and e 3 are residuals.

The most commonly used method to test the mediated effect is causal step regression [ 53 , 54 ]:

Test coefficient c of equation ( 1 ). If coefficient c is not significant, then there is no need for the mediation test.
Test coefficient a of equation ( 2 ) and coefficient b of equation ( 3 ), which is called the joint significance test [ 55 ]. If coefficient c is significant as well as coefficients a and b , then the mediated effect is significant, and proceed to step iii. If a or b or both are not significant, the Sobel test is performed to further determine whether there is a mediated effect.
Test coefficient c' of equation ( 3 ). If c' is significant, the mediated effect is partial; otherwise, it is complete.

The mediated effect model is used as the main mechanism in this paper, in which three ICT factor variables are independent variables (X), two ICT impact variables are mediating variables (M), and four national health outcome variables are dependent variables (Y). At the same time, the balanced panel data of 141 countries from 2012 to 2016 are used in this paper, so the mediation test of panel data will be performed.

4.3. Data Analysis

The panel data analysis and corresponding mediated effect analysis are conducted in STATA. Considering individual differences between different countries, this study adopts fixed effect model to verify panel data. All the results are shown in Tables Tables3 3 3 – 6 .

Associations between ICT factors and national health outcomes.

Variables	(1)	(2)	(3)	(4)
Variables	Under-five mortality rate	Maternal mortality ratio	Adolescent fertility rate	Life expectancy at birth
ICT environment	−0.0575	−0.0547	−0.0680	0.00243
ICT environment	(0.0134)	(0.0128)	(0.0168)	(0.00256)
ICT readiness	−0.00257	−0.00312	0.00680	0.000210
ICT readiness	(0.00258)	(0.00246)	(0.00325)	(0.000493)
ICT usage	−0.0661	−0.0708	−0.0555	0.00406
ICT usage	(0.00639)	(0.00611)	(0.00804)	(0.00122)
GDP	−0.425	−0.346	−0.234	0.0850
GDP	(0.0342)	(0.0327)	(0.0431)	(0.00654)
Constant	13.84	11.67	9.667	2.130
Constant	(0.835)	(0.798)	(1.051)	(0.160)
Observations	660	660	662	662
R-squared	0.626	0.618	0.364	0.438
Number of id	140	140	141	141

Standard errors in parentheses ∗∗∗ p < 0.01, ∗∗ p < 0.05, ∗ p < 0.1

Associations between ICT factors and ICT Impacts.

Variables	(5)	(6)
Variables	ICT economic impact	ICT social impact
ICT environment	0.257	0.373
ICT environment	(0.0497)	(0.0772)
ICT usage	0.00795	0.233
ICT usage	(0.0237)	(0.0369)
GDP	0.00485	0.852
GDP	(0.127)	(0.197)
Constant	2.176	−19.79
Constant	(3.105)	(4.817)
Observations	662	662
R-squared	0.074	0.334
Number of id	141	141

Mediated effect model (MV is the ICT economic impact).

Variables	(7)	(8)	(9)	(10)
Variables	Under-five mortality rate	Maternal mortality ratio	Adolescent fertility rate	Life expectancy at birth
ICT environment	−0.0644	−0.0592	−0.0725
ICT environment	(0.0137)	(0.0131)	(0.0173)
ICT usage	−0.0665	−0.0711	−0.0556	0.00411
ICT usage	(0.00637)	(0.00610)	(0.00804)	(0.00121)
ICT economic impact	0.0270	0.0175	0.0172	-0.00651
ICT economic impact	(0.0119)	(0.0114)	(0.0149)	(0.00224)
GDP	−0.424	−0.346	−0.234	0.0850
GDP	(0.0341)	(0.0327)	(0.0431)	(0.00649)
Constant	13.76	11.62	9.630	2.145
Constant	(0.832)	(0.798)	(1.051)	(0.159)
Observations	660	660	662	662
R-squared	0.630	0.619	0.365	0.447
Number of id	140	140	141	141

Mediated effect model (MV is the ICT social impact).

Variables	(11)	(12)	(13)	(14)
Variables	Under-five mortality rate	Maternal mortality ratio	Adolescent fertility rate	Life expectancy at birth
ICT environment	−0.0520	−0.0504	−0.0617
ICT environment	(0.0136)	(0.0130)	(0.0172)
ICT usage	−0.0627	−0.0681	−0.0515	0.00388
ICT usage	(0.00662)	(0.00633)	(0.00833)	(0.00127)
ICT social impact	−0.0147	−0.0116	−0.0169	0.000749
ICT social impact	(0.00759)	(0.00727)	(0.00958)	(0.00146)
GDP	−0.412	−0.336	−0.220	0.0843
GDP	(0.0347)	(0.0333)	(0.0438)	(0.00666)
Constant	13.55	11.44	9.334	2.145
Constant	(0.846)	(0.810)	(1.066)	(0.162)
Observations	660	660	662	662
R-squared	0.629	0.620	0.368	0.438
Number of id	140	140	141	141

For the first step, the associations between ICT factors and national health outcomes are tested. The association between the ICT factors and the four health indicators is summarized in Table 3 .

The results show that ICT environment has a significant negative impact on under-five mortality rate, maternal mortality ratio, and adolescent fertility rate. H1a, H2a, and H3a are confirmed, but H4a is not. The impact of ICT readiness on four national health indicators is not confirmed. ICT usage has a significant impact on the four health outcome indicators, meaning that H1c, H2c, H3c, and H4c are confirmed. Meanwhile, the influence of improving national GDP on the above four health outcome indicators is also confirmed.

Therefore, it can be proved that ICT factors have a significant role in promoting the overall national health. Improving ICT environment and ICT usage can effectively reduce under-five mortality rate, maternal mortality ratio, and adolescent fertility rate, while improving ICT usage can promote life expectancy at birth.

The hypotheses that are not confirmed in the first step will not proceed to subsequent mediation tests, and we can directly affirm that there is no mediated effect regarding these hypotheses. Therefore, the following tests will explore whether the two mediating variables, ICT economic impact and ICT social impact, have mediated effects on the relationship between ICT environment and under-five mortality rate, maternal mortality ratio, and adolescent fertility rate, and whether they can mediate between the independent variable ICT usage and the four dependent variables.

The second step is the mediation test, which should test the coefficient a in the model equation ( 2 ). Table 4 shows the relationship between ICT factors and the economic and social impact of ICTs.

It can be seen that the correlation between ICT environment and ICT economic impact, the correlation between ICT environment and ICT social impact, and the correlation between ICT usage and ICT social impact are all positively significant, that is, the coefficient “a” is significant, which can enter step 3 of the mediation test.

However, the correlations between ICT usage and ICT economic impact are not significant, so the Sobel test will be performed to further explore the possible mediated effect.

After step 2, we enter the third step of mediation test, which is to test the coefficient b and the coefficient c' in the model formula ( 3 ). Table 5 and Table 6 show the results.

Tables 5 and 6 show that when independent variables are controlled, the ICT economic impact has no significant effect on the four health indicators, meaning that their coefficient b is not significant. Therefore, all the mediated effects with ICT economic impact as the mediating variable will enter the subsequent Sobel test.

Meanwhile, we can see that when under-five mortality rate and adolescent fertility rate are dependent variables, and independent variables ICT environment and ICT usage and mediating variable ICT social impact are entered the regression model, their coefficients b and c' are all significant. Therefore, it can be directly determined that for dependent variables under-five mortality rate and adolescent fertility rate, ICT social impact has a partial mediated effect on their relationship with ICT environment and ICT usage. However, for the dependent variables maternal mortality ratio and life expectancy at birth, it is still unclear whether ICT social impact has a mediated effect, so further Sobel test is needed.

Now, we conduct a Sobel test on the above hypotheses where the mediated effect may exist but so far cannot be confirmed. During the Sobel test, we still follow the fixed effect test rule of panel data and add dummy variables representing the national individual effect into the regression model as control variables. The test results show that only ICT economic impact has a mediated effect between ICT environment and under-five mortality rate (Sobel p value = 0.377, Goodman-1(Aroian) p value = 0.0407, Goodman-2 p value = 0.0348). However, the proportion of total effect that is mediated is minus, indicating that the suppression effect occurs and the mediated effect cannot be confirmed.

In a nutshell, the partial mediated effect that has been confirmed in previous analyses is reconfirmed in the Sobel test. The proportion of the partial mediated effect and key information is summarized as follows:

The final results of the mediated effect model are displayed in Table 7 , indicating that part of H5 is proved. First, all evident mediated effects are partial mediation. This is not hard to understand. Previous research has suggested that complete mediation is rare [ 56 ]. When we conclude a complete mediation, we actually rule out exploring other mediated effects in the future [ 57 ]. Preacher and Hayes [ 58 ] called for the abandonment of the concept of complete mediation and regarded all mediated effects as partial mediation. The results of our study further verify this point.

Mediated effect result overview.

Dependent variables	Under-five mortality rate		Adolescent fertility rate
Mediating variables	ICT social impact		ICT social impact
Independent variables	ICT environment	ICT usage	ICT environment	ICT usage
Sobel Z	−1.801	−1.855	−1.654	−1.695
Sobel value	0.07163448	0.06357	0.09814432	0.09001181
Goodman-1 Z	−1.769	−1.834	−1.624	−1.676
Goodman-1 value	0.07687708	0.06662993	0.10447248	0.09375428
Goodman-2 Z	−1.836	−1.877	−1.686	−1.715
Goodman-2 value	0.06641567	0.06052563	0.09178463	0.08626387
Proportion of total effect that is mediated	0.09574541	0.0518865	0.09248442	0.07066528

Second, the results show that ICT environment and ICT usage can influence both under-five mortality rate and adolescent fertility rate via ICT social impact. In other words, ICT environment and ICT usage can reduce under-five mortality rate and adolescent fertility rate by improving the social impact of ICTs. Although it can be seen from Table 6 that the proportion of total effect that is mediated is not high, indicating the effects of the independent variables on the dependent variables are the results of a combination of multiple factors, and the ICT social impact plays a relatively weak mediating role here. At the same time, the mediated effect of ICT social impact on maternal mortality ratio and life expectancy at birth is not confirmed. The mediated effect of ICT economic impact is not confirmed either.

Based on the above studies, all the results of hypothesis testing are summarized in Table 8 :

Results of hypothesis testing.

Hypothesis	Result
H1	Partially supported
H2	Partially supported
H3	Partially supported
H4	Partially supported
H5	Partially supported

5. Discussion

5.1. icts and national health outcomes.

This paper is highly relevant to the studies of the relationship between ICT and health outcomes, especially the cross-national research methods and conclusions, which are the most crucial to enlightening this research. The unit of analysis is a national-level characteristic. Thus, the outcome of this research should be applied to the explanation of national development, not individual, within a particular country to avoid ecological fallacy.

Our results indicate that overall ICT factors substantially facilitate national public health delivery. ICT factors are usually discussed as a whole and as one independent variable in the previous literature, mostly proved conducive to promoting health outcomes. This paper, however, divides ICT factors into three detailed dimensions of ICT environment, ICT readiness, and ICT usage based on NRI and finds that not all ICT factors have a significant impact.

ICT environment shows a significant role in promoting national health outcomes, especially in reducing under-five mortality rate, maternal mortality ratio, and adolescent fertility rate. This indicates that a country can effectively promote the development of ICT infrastructure and related applications by encouraging and supporting innovation, entrepreneurship and business, which leads to greater assistance and support of ICTs for social medical and health services, bringing more widespread benefits to the population and thus effectively reducing under-five mortality rate, maternal mortality ratio, and adolescent fertility rate. Exception occurs in that ICT environment has no significant impact on life expectancy at birth. A possible reason is that what ICT environment determines is the level of maturity and advancement of a country's market and business environment, which to some extent influences the national economic development, but may make little direct impact on life expectancy at birth. Another possible reason is that the conclusions of this study are based on data from 2012 to 2016, and due to the specificity of the data from this time period, it is not yet possible to effectively prove that ICT environment has a positive effect on the life expectancy at birth of the population, so the verification of this hypothesis needs to be confirmed by data from other subsequent years.

ICT readiness measures the degree to which a society is prepared to make good use of ICT infrastructure and related applications. The empirical results of this study suggest that its impact on improving national health is only marginal and statistically insignificant. One possible reason is that ICT readiness is different from ICT usage; it simply indicates the readiness of the country and society for future ICT use, but is distinct from the direct contribution that ICT usage can bring to national health levels. Therefore, the true impact of ICT readiness on national health outcomes needs further testing.

ICT usage measures the penetration and dissemination of ICTs, including the use of hardware facilities, software applications, and data. Comparatively speaking, the use of ICTs by individuals has the most direct and effective effect on the improvement of individual health outcomes. Therefore, ICT usage has the most significant impact on reducing under-five mortality rate, maternal mortality ratio and adolescent fertility rate, as well as promoting life expectancy at birth.

In general, ICTs are playing a significant role in improving national health, especially in developing countries. When ICTs are combined with healthcare, they can make a key contribution to improve the lives and well-being of people around the world. They can also support improvements in health development. With the rapid development of ICTs and online health, relevant successful cases abound in many less developed regions of the world.

5.2. Mediated Effects

ICTs are not medicines, vaccines, or health policies, rather ICTs are technologies that enable the processing of health information much more efficiently and effectively. However, ICT factors have different acting mechanisms on health outcomes. Some ICT factors use economic influence as a mediator, some use social influence, and some may directly influence health outcomes or may use other mediating variables not included in this paper.

In terms of the empirical results of the mediated effect, the cross-comparison of the two mediating variables shows that while ICT economic impact only exerts its influence in the economic field, ICT social impact can have an effect in a broader field of people's daily life. Relevant indicators are access to basic ICT services, Internet access in schools, ICT use and government effectiveness, and people's online engagement index. ICT infrastructure first permeates through the social life of a country, and then, as the country's social life thrives, the health of its people gradually improves. This makes the influence and mediated effect of ICT social impact on national health outcomes more significant.

When ICT social impact is used as the mediating variable, ICT environment and ICT usage were the two factors with the most significant results. Both ICT environment and ICT usage can reduce under-five mortality rate and adolescent fertility rate by improving ICT social impact. That is, by improving and optimizing the country's friendliness of a country's market and regulatory frameworks, and by further popularizing usage of ICTs, it is possible to bring improvements in the well-being of the environment, education, energy consumption, or more active civic participation as a result of the use of ICTs. Thus, we can conclude that a possible path is that ICT infrastructure lays a solid foundation for the widespread dissemination of social services, including neonatal care education, government support for childbirth, and abundant Internet resources, and thus effectively improves national health outcomes. This is mainly reflected in lowering under-five mortality rate and adolescent fertility rate.

However, the mediated effect of ICT usage on maternal mortality ratio and life expectancy at birth through ICT social impact is not confirmed. Although empirical results show that ICT usage does have a direct impact on maternal mortality ratio and life expectancy at birth, there is not enough evidence to prove that this impact can have an indirect effect through ICT social impact. One possible reason is that ICT social impact is too limited to cover the major factors influencing maternal mortality ratio and life expectancy at birth. Under the NRI, ICT social impact is measured by four indicators confined to ICTs' contributions to the accessibility of basic services, Internet use for learning purposes in school, quality of government services, and the public E-participation. Maternal mortality ratio, however, is much affected by socioeconomic disparity, urban-rural differences, women empowerment, and equity, as well as social norms and culture [ 59 , 60 ], which are hardly encompassed by the NRI. Likewise, ICT social impact under the NRI overlaps little with the broad determinants of life expectancy at birth, including economy, literacy, nutritional status, and political regime [ 61 ]. Thus, limitations in the measurement of the variable ICT social impact are a possible reason for the failure of this study to effectively confirm its mediating effect between ICT use and maternal mortality ratio and life expectancy at birth.

Meanwhile, the mediated effect of ICT environment on maternal mortality ratio through ICT social impact is not confirmed. Although empirical results show that ICT environment does have a direct impact on maternal mortality ratio. One possible reason for this, in addition to the fact that the social impact of ICTs, as mentioned above, is too limited to cover the main factors influencing maternal mortality ratio, is that ICT environment, the indicator of a country's business and market environment, which gauges the normative nature of regulatory framework and the presence of innovation-prone conditions, may channel its influence primarily through corporate, market, or even political factors rather than ICT social impact.

Finally, as mentioned above, unlike that of ICT social impact, the mediated effect of ICT economic impact is not confirmed. One possible reason is that according to the data source of this study, ICT economic impact is measured by ICT impact on business model, ICT patent application, ICT impact on organizational model, and the number of knowledge-intensive jobs. It is easy to see that ICT economic impact is mainly confined to the business sector. The important impacts of ICTs are multidimensional, and while previous empirical tests show that they do affect national health outcomes, many of these impacts are not currently being translated into or reflected in business. As a result, the mediated effect of ICT economic impact in this process becomes difficult to define and measure. Although not in line with our hypotheses, we can accept that the mediated effect is relatively weak in our research paradigm. Still, we hold the possibility that the measurements of those variables can be insufficient or inappropriate and leave space for future studies.

In general, measuring the impact of ICTs is a complex task, and the development of rigorous quantitative data for this purpose is still in its infancy. It is difficult to precisely define the impact, which is one of the main obstacles, because ICTs have proved transformative in many aspects of the economy and society, affecting not only the results but also the process of providing products and services. Therefore, it is difficult and expensive to develop indicators to measure these dimensions, especially when a large number of emerging countries are involved. Moreover, even if the area of impact can be identified, it is not necessarily easy to trace a particular impact back to all its original sources. The often observed economic and social impacts are the result of a tight network of interacting factors, and ICT is only one of them. As a result, many aspects of ICT impact (such as health environment) cannot be covered, especially when these impacts are not translated into commercial activities. Therefore, the ICT impact index should be regarded as an ongoing work. With the emergence of all kinds of new data, it will continue to develop and improve new dimensions.

6. Conclusion, Limitation, and Future Research

Based on the above studies, this research clarifies that ICT factors can influence national health outcomes of a country over time and ICT social impact can play an important partial mediating role between them.

The contributions of this study can be categorized into theoretical and practical ones. Theoretically, previous studies on ICTs and health development are mostly conceptual, or remain at the micro-level, focusing on the actual operation of technology. This study raises the theoretical altitude to a micro-level, introducing a wider sample of countries from the United Nations when a large number of fellow studies only look at EU, other regional organizations or even just individual countries. Second, on top of ICT factors, we bring in ICT impacts as mediations in our model, which is an innovation in the area. We hope it can serve as a good beginning for researchers to try other theoretical models and make them more sufficient and accurate. Finally, the study aims to review the realization of MDGs (2000–2015) and provide inspiration for SDGs (2015–2030). SDGs have 17 new development goals and will continue to guide the global development work in 2015–2030 after the expiration of the 2000–2015 MDGs. The goal of sustainable development is to solve the development problems of society, economy, and environment in a comprehensive way from 2015 to 2030 and turn to the road of sustainable development. Our study can lay the foundation for future research on SDGs, as well as for the comparative study of MDGs and SDGs.

Practically, this study aims to help global policymakers formulate health resource allocation and investment strategies, especially in the fields of healthcare and technology in developing countries. As we provide a new perspective to see how ICT factors associate with its impact, developing countries can use it as a guide to get financial assistance from or cooperate with other countries or organizations to improve health deliveries from their weakest areas with the most urgent needs according to their own conditions. To promote the implementation of SDGs in the next stage, we suggest integrating and determining priorities in national development and health promotion programs and strategies, adjusting policies for basic infrastructure deployment, facilitating donor coordination and cooperation mechanisms, strengthening the participation of the private sector, and coordinating resource mobilization mechanisms.

This study has the following limitations. First of all, this study uses the secondary data research method. The data is sourced from the annual macro data released by authoritative international government organizations which always need a long cycle to collect and the completeness is not enough. Due to the redesign of the NRI system, the complete data available are only from 2012 to 2016. The NRI was suspended during 2017 and 2018 for a redesign. Data from 2019 onwards comes from a new NRI system, which is incompatible with the previous ones. Therefore, 141 countries from 2012 to 2016 are selected as samples. The total observation values of each group regression range from 660 to 662. The sample size is comparatively small. In the future, with the development of innovative technologies and the completeness of data collected by various international government organizations, ongoing tracking and research could be considered, starting with data from 2019. A before-and-after study could also be considered to further explore the ongoing changes in national health levels as ICT use and penetration increase.

Secondly, the mediated effect model in this study aims to explore the role of the economic impact and social impact of ICTs on the relationship between ICTs and national health outcomes. However, this model is still in its original stage and further correction and adjustment are needed. In addition to the mediated effect, the moderating effects should be explored, and variable selection and data sources can be constantly updated in the future.

Acknowledgments

This research was supported by the National Natural Science Foundation of China (71974018), the National Natural Science Foundation of China (71573022), the National Natural Science Foundation of China (71874018), the G20 Research Center of BFSU (G2020201003), the G20 Research Center of BFSU (G2020213001), the Fundamental Research Funds for the Central Universities (2022JJ007). The authors thank WHICEB 2021 PROCEEDINGS and experts at the conference for their help in the pre-construction of this research.

Data Availability

Conflicts of interest.

The authors declare that they have no conflicts of interest.

BRIEF RESEARCH REPORT article

Toward a new model for the successful implementation of information and communication technologies in education.

Laboratory of Modeling and Simulation of Intelligent Industrial Systems, ENSET, Hassan II University of Casablanca, Casablanca, Morocco

The design of our Information and Communication Technologies for Education (ICT4E) implementation model highlights its adaptability to local realities, considering available resources, existing technological infrastructures, and the specific needs of learners. However, it is crucial to recognize that the inherent variability of educational contexts and resource constraints can present challenges to a generalized application of the model. In addition, the rapid pace of technological change can have an impact on the ongoing training of teachers, requiring constant vigilance to maintain the relevance of their pedagogical skills. Despite these challenges, our model stands out for its adaptable approach, encouraging ongoing adjustments to respond effectively to the diversity of educational environments. In addition, the prospect of research and innovation, the promotion of interdisciplinary collaboration and the adoption of holistic evaluation are essential strategies for strengthening the robustness of our model. However, it is imperative to remain attentive to ethical considerations, the issue of equity and inclusion, and the long-term impact of integrating ICT into education. Ultimately, our model aspires to be a balanced solution, aware of the challenges and open to the developments needed to ensure the harmonious and optimal integration of ICT into today’s educational landscape.

1 Introduction

The integration of Information and Communication Technologies applied to Education (ICTE) has radically reshaped the educational landscape, opening new perspectives for rethinking, and enriching traditional teaching and learning methods ( Zafar et al., 2022 ). Faced with this rapid evolution, the need for effective integration of ICTE into pedagogical practices is becoming a crucial concern for researchers and educators alike. With this in mind, our scientific research aims to explore and compare in depth the main existing models of ICTE integration. Our aim is to highlight the successes and challenges specific to each approach, while identifying emerging best practices from these established models. By examining models such as “ADDI,” “4C/ID,” “Bate’s techno-pedagogical model,” “SAMR,” “TPACK,” and the “Triple E FRAMEWORK,” we seek to draw lessons on how these approaches have been applied in various educational contexts. This comparative analysis will enable us to better understand the specific strengths of each model, as well as the limitations that may have been identified in their implementation. However, our research will not be limited to examining these models. It will also aim to propose a new conceptual model for the integration of ICTE. The aim of this holistic approach is to transcend simple comparative analysis by integrating the lessons learned from the models studied into an innovative proposal. By proposing a new conceptual model, this intervention is positioned as an innovative contribution to the field of ICTE integration, offering a perspective that aspires to fill the gaps and offer a more adaptive and effective approach in various educational contexts.

Rapid advances in Information and Communication Technologies (ICT) in education have opened new perspectives ( Beavis et al., 2014 ), prompting reflection on how these technologies can be effectively integrated to enhance learning processes. Many researchers have developed models to guide this integration, focusing on aspects such as teacher training, program design, and learner engagement. These existing models have played a crucial role in guiding this integration, but it is now essential to evaluate them in the light of technological developments and new educational needs ( Anctil, 2023 ).

3 Methodology

Our study adopts a qualitative and quantitative methodology, distinguished by a careful analysis of context, processes and experiences. Through a literature review, we explore a diverse range of models of ICTE integration, making a careful selection of the main models ( Haseeb and Dwivedi, 2021 ). The in-depth analysis focuses on the theoretical underpinnings, concrete applications, as well as highlighting the relevant research findings for each model examined ( Lachner et al., 2024 ). These components form the basis of our proposal for an innovative model, which incorporates contemporary technological advances and responds to current educational needs.

3.1 Criteria for choosing the models

The criteria for selecting the models for this comparative study were determined according to several factors, all aimed at ensuring a complete and balanced representation of the various existing approaches to integrating ICT into contemporary education ( Buabeng-Andoh, 2019 ). To define them, we carried out a literature review to find those already used in similar studies, and we also sought the opinions of experts in the field of ICT (teachers, trainers, researchers, and decision-makers) to help us refine them and shed light on the most relevant aspects to be evaluated, as defined below:

1. Complementarity of approaches: Each model studied offers a unique approach that complements the others, covering a wide range of considerations, from educational planning to solving complex problems ( Dron and Anderson, 2023 ).

2. Recognition of popularity and relevance: The models examined are among the most widely used and recognized in the field of education, which testifies to their relevance and usefulness for practitioners and researchers ( Andler and Guerry, 2008 ).

3. Diversity of perspectives: the selected models represent a diversity of perspectives on ICTE integration, enabling different dimensions of this integration to be explored ( Tamer and Nejjari, 2022 ).

4. Consideration of contemporary educational needs: The selected models focus on connections and networks in a digital context, which is particularly relevant in today’s educational environment characterized by rapidly evolving technologies and teaching methods ( Gane et al., 2018 ).

5. Compatibility with educational reality: The models selected are recognized for their pragmatic nature and their applicability in real educational contexts, thus reinforcing their credibility and relevance ( Joulia, 2005 ).

Applying these criteria to the various models of ICTE integration proposed by researchers and practitioners, we have selected the following models to delimit our comparative study: “ADDIE,” “4C/ID,” “Bates’ techno-pedagogical model,” “SAMR,” “TPACK,” and the “Triple E Framework.”

3.2 Description of the ICTE integration model

We will therefore briefly outline the characteristics appropriate to each model examined.

1. Analysis, Design, Development, Implementation, Evaluation (ADDIE) model: Although initially designed for the development of educational programs, the ADDIE model (1970) offers a systematic approach that can be adapted to the integration of ICTE at every stage. Developed by the Center for Educational Technology at Florida State University, it is a classic framework for instructional design that guides the process of developing educational programs ( Almelhi, 2021 ).

2. Four Component for Instructional Design (4C/ID) model: Developed by Van Merriënboer and his colleagues in the 1990s, the 4C/ID model is based on the theory of cognitive development. It proposes an approach to instructional design that integrates ICT to encourage the resolution of complex problems. This model focuses on building skills and solving authentic tasks (Instituto de Educação da Universidade de Lisboa, Portugal, [email protected] and Melo, 2018 ).

3. Bates’ Techno-pedagogical model: Developed by Tony Bates (2005), this model explores the relationship between technology choice and pedagogical strategy. It highlights the need to align technology choices with pedagogical objectives and the learning context.

4. Substitution, Augmentation, Modification, Redefinition (SAMR) model: Developed by Ruben Puentedura ( Blundell et al., 2022 ), this model proposes a hierarchy of four levels for evaluating the integration of ICTE. It ranges from the simple substitution of traditional tools to more complex tasks that redefine learning. It proposes a hierarchy of levels of integration of technology in teaching and learning. Each level represents a different way of using technology, ranging from simple substitutions of traditional tools to more profound transformations of learning processes.

5. Technological Pedagogical Content Knowledge (TPACK) model: this model focuses on the intersection of three types of knowledge: technological, pedagogical, and disciplinary. It explores how this knowledge interacts to support effective teaching with ICT, linking technological knowledge (TK), pedagogical knowledge (PK), and disciplinary content knowledge (CK) ( Bedin et al., 2023 ).

6. Triple E Framework Model (Engage, Enhance, Extend): Developed by Liz Kolb, this model provides an approach to evaluating the use of technology in the classroom, focusing on engaging learners, enhancing learning, and extending educational opportunities. It guides the integration of ICT into teaching by evaluating their use according to these three criteria ( Ruzaman and Rosli, 2020 ).

3.3 Comparative study of the main models chosen

To carry out an effective comparison of these models of ICTE integration, we used a participatory methodology. We solicited the participation of 42 pedagogical actors with expertise in the field of education and technology, including 21 teachers of different subjects, seven educational inspectors, 11 school headmasters (primary and secondary), and three trainers from the Regional Center for Trades and Training (CRMEF). We began with a SWOT analysis of ICT integration models. The participants met in sub-groups of seven people, each focusing on a specific model to identify its strengths, weaknesses, opportunities, and threats. We then aggregated the results to obtain an overall view. Secondly, the educational inspectors and CRMEF trainers worked together to create a grid to measure the performance of each model. This grid assigns a score to each previously defined criterion, based on the results obtained during the SWOT analysis.

3.4 Diversification of data sources

To enrich our analysis and provide a more nuanced perspective on the integration of ICT in education, we included detailed case studies and recent empirical data. For example, a case study on a school using Puentedura’s SAMR model revealed significant improvements in student engagement and the quality of work produced. Additionally, UNESCO’s annual reports on education and technology provide recent statistics showing the increasing adoption of ICT in schools worldwide, with notable variations across geographical regions and educational levels.

3.4.1 Expansion of the sample

To generalize our findings to a broader range of educational contexts, we expanded our sample to include schools from different geographical regions, educational levels (primary, secondary, higher education), and types of schools (public, private, rural, urban). For instance, our sample includes well-funded urban schools as well as rural schools with limited resources, allowing us to compare challenges and successes across diverse contexts. This diversity helps us identify ICT integration strategies that are effective in various educational environments.

3.4.2 Integration of teacher’s and students’ perspectives

To gain a better understanding of ICT integration, we conducted in-depth interviews and focus groups with educational stakeholders: teachers, educational inspectors, school directors, and trainers at the regional center for trades and training. These interviews revealed valuable information about the daily challenges faced by teachers, such as the lack of adequate training and the need for ongoing technical support. Students, meanwhile, expressed their enthusiasm for interactive technology tools. Nonetheless, the stakeholders interviewed stressed the need for a balance between the use of ICT and traditional teaching methods.

Each of these models is evaluated according to criteria predefined by the participants in this study, namely: Pedagogical Relevance, Adaptability, Ease of Use, Learner Engagement, Accessibility, Curricular Integration, Evaluation, Professional Support, Cost, and Innovation. Table 1 summarizes the results of this study by applying a score scale of 1–5 for each criterion, where 1 represents poor performance and 5 excellent performances. In this evaluation, the numbers 1–5 represent the relative performance of each model on each criterion.

Table 1 . Comparison of ICTE integration models.

We adopted Friedman’s statistical test to analyze the data collected from the various participants in our focus groups, given that this test is the most suitable for comparing several models in relation to the same criteria on a performance scale ranging from 1 to 5 (from poor to excellent) (ordinal and non-parametric data). For statistical analysis, we used SPSS software.

The Friedman test carried out to compare the significant differences between the six selected models yielded the following results:

• Friedman statistic: 33.57.

• p value obtained: 2.90e−06 (0.0000029), this value is below the significance threshold of 0.05. This indicates statistically significant differences between at least two of the models evaluated.

5 Discussion of results

In terms of pedagogical relevance, the 4C/ID and TPACK models stand out with scores of 5 out of 5, underlining their ability to be aligned with pedagogical objectives. These models emphasize the creation of learning environments adapted to learners’ needs ( Herring et al., 2016 ). In contrast, the EEE model scores less than 3 out of 5, suggesting less relevance. In terms of adaptability, the TPACK model obtained the highest score of 5 out of 5, indicating its ability to be flexible and to adapt to different educational contexts. The 4C/ID and SAMR models also obtain solid scores of 4 out of 5, while the ADDIE model, receives a lower score of 3 out of 5, revealing average adaptability. In terms of ease of use, the 4C/ID, techno-pedagogical and TPACK models stand out with scores of 4 out of 5, highlighting their user-friendliness for teachers. In contrast, the ADDIE, SAMR and Triple EEE models scored slightly lower, at 3 out of 5. For learner engagement, the 4C/ID model scores a perfect 5 out of 5, indicating its effectiveness in engaging learners in the learning process. The ADDIE, Techno-pedagogical, SAMR and TPACK models obtain solid scores of 4 out of 5, while the EEE model has a lower score of 3 out of 5. As far as accessibility is concerned, the 4C/ID, TPACK and Techno-pedagogical models obtain high scores of 4 out of 5, showing their attention to making resources and activities accessible to all learners. In contrast, the ADDIE, SAMR and Triple E models have slightly lower scores of 3 out of 5. In terms of curricular integration, the 4C/ID, Techno-pedagogical, and TPACK models stood out with scores of 4 out of 5, indicating their effective alignment with the program objectives. On the other hand, the ADDIE, SAMR and Triple E models obtained slightly lower scores of 3 out of 5, suggesting a need to improve their curricular integration. In terms of assessment, the 4C/ID, ADDIE, Techno-pedagogical, TPACK and SAMR models score high at 4 out of 5, highlighting their ability to effectively assess learners’ learning, while the Triple E model scores slightly lower at 3 out of 5. From the point of view of professional support, the 4C/ID, Techno-pedagogical, and TPACK models obtain high scores of 4 out of 5, indicating that they offer adequate support to teachers. In contrast, the ADDIE, SAMR and Triple E models score slightly lower at 3 out of 5. In terms of costs, the 4C/ID and SAMR models stand out with scores of 4 out of 5, indicating that they are relatively profitable. The other ADDIE, Techno-pedagogical, TPACK and Triple E models have average scores of 3 out of 5. In terms of costs, the 4C/ID and SAMR models stand out with scores of 4 out of 5, indicating that they are relatively profitable. The other ADDIE, Techno-pedagogical, TPACK and Triple E models have average scores of 3 out of 5. Finally, in terms of innovation, the 4C/ID, Techno-pedagogical and TPACK models received high scores of 4 out of 5, underlining their ability to encourage educational innovation. The ADDIE, SAMR and Triple E models received slightly lower scores of 3 out of 5. We can deduce that the 4C/ID, Techno-pedagogical and TPACK models often stand out as solid choices in several categories, while the Triple E model shows lower scores suggesting a need for improvement to better meet current pedagogical needs. Indeed, these results reveal that each model has specific characteristics and performances that cannot be replaced, or used in the same way in all teaching acts. The low p value underlines the statistical robustness of this difference, suggesting that some models may be particularly effective for certain criteria, while being less effective for others. This heterogeneity calls for a strategic and differentiated approach to the choice and implementation of ICTE, depending on the objectives being pursued. Reflection on a new model for integrating ICTE is timely for improving teaching and learning in an education system that aims to change educational practices in close alignment with technologies and should therefore draw on these findings to fill the gaps identified and meet the emerging needs of contemporary education.

6 Proposal for a new model

With a view to designing a new Model for Pedagogical Integration of ICT Model (MIPTICE)’ incorporating the performance of the above-mentioned ICTE integration models, the following approach is recommended. We began with an in-depth analysis of the existing models, identifying their strengths, weaknesses, and gaps. We then defined the objectives of the new model, establishing guiding principles such as alignment with pedagogical objectives, flexibility, and accessibility. The model was designed by incorporating best practice, then tested in real environments and improved based on feedback. It aims to provide a comprehensive framework for the effective and relevant use of technology in learning.

6.1 Fundamental principles

The MIPTICE model is based on five fundamental principles that guide its design and implementation in learning environments (see Figure 1 ).

1. Pedagogical Alignment: All activities and technological resources are aligned with specific pedagogical objectives, thus ensuring the relevance of teaching and learning.

2. Flexibility and Adaptability: The MIPTICE model is designed to be flexible and adaptable to different learning contexts, allowing teachers to customize learning experiences according to students’ needs.

3. Active Engagement: The model encourages the active engagement of students in the learning process, promoting interaction, collaboration and critical thinking.

4. Universal Accessibility: The MIPTICE model ensures that all resources and activities are accessible to all learners, whatever their level of ability or specific needs.

5. Formative and Summative Assessment: The model incorporates formative and summative assessment mechanisms to regularly evaluate student progress and inform pedagogical adjustments.

Figure 1 . The five principals for implementing the MPTICE model in the Learning environment.

6.2 Model components

By following the five principles of our approach, the MIPTICE model aims to provide a comprehensive and effective framework for the integration of ICTE into education, thereby promoting rich, relevant, and engaging learning experiences for all learners. Figure 2 shows the process we have proposed for integrating ICTE into education.

Figure 2 . Presentation of the MPTICE model.

The MIPTICE model consists of:

1. Content: Content is chosen according to the learning objectives and needs of the learners. It is varied and adapted to suit different learning styles ( Noureddine, 2006 ).

2. Pedagogy: Teaching methods are learner-centered, encouraging active involvement and the construction of knowledge. They incorporate collaborative approaches, problem solving and regular feedback ( Leibold and Schwarz, 2015 ).

3. Technology: Technologies are selected based on their ability to support pedagogical objectives and enrich the learning experience. They are used in creative and innovative ways to stimulate student engagement ( McCain and Jukes, 2001 ).

4. Assessment: Assessment is built into every stage of the learning process, enabling continuous monitoring of student progress. It includes formative assessments to guide learning and summative assessments to evaluate achievement ( Nadeau-Tremblay et al., 2022 ).

5. Support: Professional support is available for teachers, including training, resources, and personalized advice. Technical support is also provided to ensure the smooth operation of the technologies used ( Sommerhoff et al., 2023 ).

6. Evaluation and Continuous Improvement: The model encourages continuous evaluation of its effectiveness, collecting data on learning outcomes, feedback from students and teachers, and the performance of the technologies used. Adjustments are made based on the results of this evaluation to continuously improve the integration of ICT in teaching and learning ( Mastafi, 2020 ).

6.3 Example of an application scenario

We propose this scenario based on the MIPTICE model for an introductory IT course for the core curriculum at secondary school: “Discovering the Fundamentals of IT” (see Table 2 ).

Table 2 . Teaching scenario based on the MIPTICE model for a computer science course.

This scenario enables students to learn about computing in an interactive and practical way, with an emphasis on active learning and the use of technology. It incorporates the principles of the MIPTICE model by offering a diversified teaching approach, using technology in a relevant way and providing personalized support for students. By following this scenario, students will develop essential computer skills and be better prepared to use technological tools in their studies and everyday life.

7 Conclusion

In conclusion, our exploration of models for integrating Information and Communication Technologies for Education (ICT4E) has highlighted the diversity of approaches and perspectives in this constantly evolving field. Each model examined has specific strengths and limitations, underlining the importance of understanding local educational needs and choosing appropriate approaches for the successful integration of ICT into teaching and learning. Through our proposal for a new model of ICTE implementation, we have sought to fill the gaps identified in existing models by integrating best practice, with an emphasis on adaptability, contextualization, and continuous evaluation. This model, called MIPTICE (Successful ICTE implementation model), offers a methodical and participative approach to guide each stage of the ICTE integration process, while considering the specificities of local educational contexts. Although our model has significant advantages, it is essential to recognize its limitations, in particular the need for constant vigilance to maintain the relevance of teaching skills in a rapidly changing environment. To overcome these limitations, it is imperative to focus on three main areas: teacher training, student support, and the reengineering of educational practices. Teacher training requires ongoing training models that keep teachers up to date with technological developments, including online training, interactive workshops, and communities of practice. In addition, pre-service training programs need to incorporate specific models for the pedagogical use of ICT to effectively prepare future teachers. As far as student support is concerned, it is essential to develop technological solutions that are accessible to all, with ICT enabling learning to be personalized by adapting content and pedagogical approaches to students’ needs. To re-engineer educational practices, it is necessary to examine hybrid teaching models combining face-to-face and online learning to determine best practices for implementing ICT. It is also essential to promote interdisciplinary collaboration between different academic and professional fields. Finally, developing assessment tools using ICT will provide real-time feedback and analysis of pedagogical data, continuously improving teaching/learning practices. The results of examining the three perspectives in practical experiments will be the subject of future publications.

8 Recommendations

The present study leads to several strategic recommendations. Firstly, researchers are advised to explore the integration and application of ICTE in recognized schools of educational psychology, particularly with regard to its impact on accepted learning styles. This approach could provide valuable insights for adapting ICTE to the needs of different apparent. It is also recommended to carry out post-hoc analyses to draw more precise and oriented conclusions about pedagogical choices or educational acts in a more targeted way.

Data availability statement

The raw data supporting the conclusions of this article will be made available by the authors, without undue reservation.

Ethics statement

Written informed consent was obtained from the individual(s) for the publication of any potentially identifiable images or data included in this article.

Author contributions

LL: Funding acquisition, Investigation, Methodology, Writing – original draft. MM: Conceptualization, Formal analysis, Writing – review & editing. SF: Supervision, Visualization, Writing – review & editing. KM: Supervision, Validation, Writing – review & editing.

The author(s) declare that no financial support was received for the research, authorship, and/or publication of this article.

Acknowledgments

Our sincere thanks go to the 42 pedagogical players, including teachers, inspectors, school principals and CRMEF trainers, for their invaluable participation and expertise, which were essential to the completion of this study.

Conflict of interest

The authors declare that the research was conducted in the absence of any commercial or financial relationships that could be construed as a potential conflict of interest.

Publisher’s note

All claims expressed in this article are solely those of the authors and do not necessarily represent those of their affiliated organizations, or those of the publisher, the editors and the reviewers. Any product that may be evaluated in this article, or claim that may be made by its manufacturer, is not guaranteed or endorsed by the publisher.

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Keywords: ICT integration, ICT4E, pedagogical skills, teaching, technologies

Citation: Lamalif L, Machkour M, Faris S and Mansouri K (2024) Toward a new model for the successful implementation of information and communication technologies in education. Front. Educ . 9:1470799. doi: 10.3389/feduc.2024.1470799

Received: 26 July 2024; Accepted: 09 September 2024; Published: 25 September 2024.

Reviewed by:

Copyright © 2024 Lamalif, Machkour, Faris and Mansouri. This is an open-access article distributed under the terms of the Creative Commons Attribution License (CC BY) . The use, distribution or reproduction in other forums is permitted, provided the original author(s) and the copyright owner(s) are credited and that the original publication in this journal is cited, in accordance with accepted academic practice. No use, distribution or reproduction is permitted which does not comply with these terms.

*Correspondence: Latifa Lamalif, [email protected]

Disclaimer: All claims expressed in this article are solely those of the authors and do not necessarily represent those of their affiliated organizations, or those of the publisher, the editors and the reviewers. Any product that may be evaluated in this article or claim that may be made by its manufacturer is not guaranteed or endorsed by the publisher.

Probing the Role of Information and Communication Technology (ICT) in Enhancing Research: An Epilogue of Accessible Research Tools

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The role of information communication technologies as a moderator of knowledge creation and knowledge sharing in improving the quality of healthcare services

Roles Conceptualization, Formal analysis, Methodology, Validation, Writing – original draft, Writing – review & editing

Affiliation School of Economics and Business, University of Ljubljana, Ljubljana, Slovenia

Roles Conceptualization, Data curation, Investigation, Project administration, Resources, Writing – review & editing

* E-mail: [email protected]

Affiliation Faculty of Economics, University of Montenegro, Podgorica, Montenegro

Roles Conceptualization, Formal analysis, Methodology, Software, Validation, Writing – original draft

Roles Supervision, Writing – review & editing

Roles Funding acquisition, Project administration, Supervision, Writing – review & editing

Simon Colnar,
Ivan Radević,
Nikola Martinović,
Anđelko Lojpur,
Vlado Dimovski

Published: August 3, 2022
https://doi.org/10.1371/journal.pone.0272346
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This study examines the role of knowledge creation, knowledge sharing and information communication technologies, which are organizational factors that influence the quality of healthcare services. In today’s knowledge-intensive environment, understanding and gaining in-depth knowledge on how to improve the quality of healthcare services is gaining in importance and recognition. Quantitative data collected in 2019 with 151 respondents employed in healthcare organizations was used. Running a series of hierarchical linear regression models, we found a significant positive relationship between knowledge creation and quality of healthcare services, and a significant positive relationship between knowledge sharing and quality of healthcare services. Empirical data additionally provides support for information communication technologies that act as a moderator both in the relationship between knowledge creation and knowledge sharing with quality of healthcare services. With our data, we provide empirical backing for the impact of knowledge creation, knowledge sharing and information communication technologies on the quality of healthcare services that are provided by Montenegrin healthcare organizations. Our paper offers theoretical and practical implications derived from our research study.

Citation: Colnar S, Radević I, Martinović N, Lojpur A, Dimovski V (2022) The role of information communication technologies as a moderator of knowledge creation and knowledge sharing in improving the quality of healthcare services. PLoS ONE 17(8): e0272346. https://doi.org/10.1371/journal.pone.0272346

Editor: Dragan Pamucar, University of Belgrade Faculty of Organisational Sciences: Univerzitet u Beogradu Fakultet organizacionih nauka, SERBIA

Received: August 2, 2021; Accepted: July 18, 2022; Published: August 3, 2022

Copyright: © 2022 COLNAR et al. This is an open access article distributed under the terms of the Creative Commons Attribution License , which permits unrestricted use, distribution, and reproduction in any medium, provided the original author and source are credited.

Data Availability: All relevant data are within the paper and its Supporting Information files.

Funding: This work was supported by the Slovenian Research Agency, Program P5-0364 – The Impact of Corporate Governance, Organizational Learning, and Knowledge Management on Modern Organization. The funders had no role in study design, data collection and analysis, decision to publish, or preparation of the manuscript.

Competing interests: The authors have declared that no competing interests exist.

1. Introduction

Information and communication technologies are identified as one of the crucial enablers of knowledge management practices and most relevant and contemporary literature suggests that appropriate technology solutions within organizations are of significant importance in relation to successful knowledge management initiatives [ 1 ]. In today’s knowledge intensive world of work [ 2 ], the concept of knowledge management is becoming increasingly important as a tool that may be vital to a higher level of organizational effectiveness. Ongoing growing importance of information communication technologies has already changed traditional forms of organizational functioning, which consequently determined the concept of knowledge management to become integral as a tool for achieving higher levels of organizational effectiveness [ 3 ]. This change in terms of the approach paradigm, emphasizes even more the role of knowledge as a determining factor of improved organizational performance [ 4 ]. In essence, this concept implies a process of efficient and effective learning, through research, exploitation and sharing of human knowledge, with a support of adequate technological advancements [ 5 ]. Previous research posits the concept of knowledge management as a determinant of organizational success [ 6 ], improved service quality [ 7 ] and as a tool that enables organizations to make internal improvements [ 8 , 9 ].

Nowadays, the field of healthcare services is continuously exposed to pressures from different stakeholders to improve the quality of its services [ 10 ]. Moreover, researchers Parand et al. [ 11 ] suggest that a number of challenges related to quality of healthcare services remain unsolved and require the attention of both academics and practitioners. Therefore, it becomes crucial to gain in-depth knowledge and understanding regarding healthcare service quality dimensions and define actions that could help healthcare services providers with improving their overall organizational effectiveness [ 12 ]. There is a wide range of industries, where the application of knowledge management can result in positive improvements of organizational performance, including healthcare services, where the knowledge of employees represents the core of providing care for patients. Moreover, an adequate knowledge management process results in the adoption of quality decisions by healthcare professionals, and in better outcomes for patients [ 13 ]. In addition, the adequate knowledge management process in healthcare organizations is also vital for raising the level of healthcare services in practice [ 14 ]. With our paper, we aim to respond to calls of researchers to enhance the knowledge regarding the concept of quality of healthcare services [ 15 ] and to gain additional understanding of knowledge management as applied in the healthcare environment [ 16 ].

In current state-of-the-art research there is a gap in considering the impact of specific organizational factors such as knowledge creation, knowledge sharing and information communication technologies on the quality of healthcare services. Additional insight is of paramount importance as it enables healthcare services providers to gain knowledge about potential activities and solutions for improving the quality of healthcare services [ 11 ]. As existing theory seems to be difficult to apply within the healthcare environment, we focus within the scope of our paper on improving the understanding and gaining further knowledge of the construct of knowledge creation, where researchers Boon Sin et al. [ 17 ] claim that knowledge creation leads to improved organizational performance, which applies also to public sector organizations, including healthcare institutions. In a similar vein, we intend to strengthen previous research by providing further insight into the impact of knowledge sharing on achieving higher levels of organizational performance [ 18 ], which is in this paper explored as the quality of healthcare services. Previous research validates the positive relationship between information communication technologies and enhanced organizational performance [ 19 ], where we aim to provide additional insight into information communication technologies and their impact on improving the quality of healthcare services.

The purpose of our paper is to add to contemporary research, by theoretically proposing a conceptual model and empirically testing the impact of organizational factors that influence knowledge management activities within the healthcare sector as part of the ongoing attempts to enhance the quality of healthcare services [ 20 ]. We investigate the relationship between knowledge creation and quality of healthcare services and knowledge sharing and quality of healthcare services. With our research, we are able to add to previous theoretical findings within the context of the knowledge management discipline that posit that individual knowledge management activities are typically in a positive relationship with organizational performance [ 21 ]. In a similar vein, we add to contemporary knowledge management theory that recognizes knowledge as a critical resource for the functioning of organizations [ 22 ], including healthcare organizations as their performance is being inextricably tied to efficient use of knowledge [ 23 ]. In addition, we explored for the potential moderating effect of information communication technologies on the aforementioned proposed relationships. We utilized a quantitative analysis of collected data from healthcare employees to test our hypotheses in healthcare institutions in Montenegro. As we obtained data for all our variables in a one-time single survey, we acknowledge that common method bias might be a methodological issue in our study. With our paper, we aim to contribute towards advancing the body of literature of quality of healthcare services and knowledge management in the context of healthcare organizations [ 24 ], where currently a gap in knowledge exists [ 15 , 25 ]. Moreover, our research offers theoretical guidance to healthcare employees that rely on information-communication technologies to cope with a continuously increasing need to manage knowledge [ 26 ] and extends the research on success determinants of knowledge management within the healthcare setting. As such, our research is one of the few studies that explore the effects of organizational factors on knowledge management initiatives in healthcare organizations as suggested by Ali et al. [ 27 ]. Similarly, our study is following the proposition of Siong et al. [ 28 ] that the role of knowledge and knowledge management is attracting increased attention from scholars and practitioners as an effort to achieve organizational excellence.

Following our overarching theory of the knowledge-based view of the organization [ 29 – 31 ], we emphasize the important role of knowledge in healthcare organizations as we propose that knowledge management is one of the primary sources that influence the functioning of such organizations and subsequently has the potential to increase the quality of healthcare services that are offered to users in practice. Previous research within the knowledge-based view of the organization [ 29 , 32 ] suggests that the presence and right utilization of knowledge has the potential to lead to higher levels of organizational performance [ 33 ]. Similarly, contemporary research of Martin and Javalgi [ 34 ] posits that the attainment and deployment of knowledge is integral for organizational performance. In addition, we aim to empirically clarify the relationship between organizational factors that impact knowledge management and its relationship with organizational performance [ 35 ].

In line with McIver and Lepisto [ 21 ], our study provides further insight into the knowledge management discipline aspect that is focused on findings that enable organizations to achieve competitive advantage in practice by managing and utilizing what they know or even what they will need to know. Such a state is particularly useful in the contemporary knowledge intensive economy. Another learning outcome for practitioners might be that knowledge-based organizations should not only blindly apply knowledge management related initiatives as they need to align them with activities on how to motivate, support and offer relevant knowledge to individual employees for knowledge initiatives to be successful. In such a situation, the role of managers is integral as they need to motivate their employees to be engaged and utilize available resources to improve their individual and organizational performance [ 36 ]. As healthcare can be considered a practice-based profession, the goal of knowledge management in practice would be aimed to add value to services and to increase social wellbeing, societal effectiveness and general welfare [ 37 , 38 ].

2. Literature review

Healthcare systems, as well as micro-level health facilities, generally depend on data and information collected by patients, medical doctors, or obtained from scientific studies [ 39 , 40 ]. In this context, management of information, knowledge creation and knowledge sharing, are key areas in the healthcare system. An improved knowledge management system contributes to better decisions of healthcare professionals and results in better treatment outcomes as a result of the healthcare provided [ 27 ]. The extent to which knowledge creation and knowledge sharing contribute to better treatment outcomes is one of the key information that we seek to obtain.

Information-communication technology systems with their support to knowledge management processes positively influence the competitiveness of organizations [ 1 ]. As internet technology enables rapid search, access, exchange and retrieval of information it is deemed as suitable for collaboration and knowledge exchange between organizational members [ 41 ]. Moreover, such systems typically support knowledge management practices as they facilitate knowledge acquisition and creation, knowledge dissemination, knowledge conversion and knowledge utilization [ 42 , 43 ]. Typically, technology is viewed an essential component and integral facilitator in any knowledge management initiative [ 44 ]. With appropriate training and education for employees, such solutions have become crucial to organizations as they carry out many tasks related to knowledge management [ 45 ].

Previous research of Lopez-Nicolas and Soto-Acosta [ 46 ] supports a significant positive impact of having an appropriate information-communication technology infrastructure on knowledge creation. In a similar vein, Sambamurthy and Subramani [ 47 ] have highlighted the critical role of information-communication technologies in shaping organizational efforts for knowledge creation. In addition, researchers Davenport and Prusak [ 48 ] and Roberts [ 49 ] posit that information-communication technology is a crucial aspect of knowledge creation due to the fact that such technologies facilitate speedy collection, storage and exchange of knowledge. While knowledge creation can be conducted without the support of information-communication technologies, such technology allows knowledge creation to be performed in a more effective manner [ 50 ]. As state-of-the-art research supports the fact that information-communication technologies are an important enabler of the knowledge creation process, such technology must be designed an utilized in a manner that it is aligned with other organizational resources, with a particular emphasis on human resources, namely employees [ 51 ].

In previous research, information-communication technology was identified as an organizational factor that influences knowledge sharing at individual and team level [ 52 ]. In contemporary research, information-communication technology has been proposed as one of the crucial enablers of knowledge sharing [ 53 ]. Information-communication technology can also have a potentially significant influence on the knowledge sharing activity [ 54 ] as it provides the infrastructure that enables the establishment, maintenance, and intensification of relationships within and among teams [ 55 ]. Contemporary information-communication technology systems that include also social networks can help employees to share their knowledge through common platforms and enable electronic storage of information and knowledge. Furthermore, information-communication technology systems can facilitate collaboration between employees and teams, and enrich their communication through various modern tools [ 44 ]. Moreover, information-communication technology can accelerate access to information and knowledge that is stored in databases to enhance the knowledge sharing process in organizations. Such technology can support knowledge sharing by enabling effective communication channels and tools and by identifying the source of information or knowledge [ 52 ]. In a similar vein, Riege [ 56 ] is of the opinion that information-communication technology enables instant access to large amounts of information and knowledge to facilitate long-distance collaboration and knowledge sharing between employees and organizations.

2.1. Knowledge creation and quality of healthcare services

Knowledge creation is a continuous process that implies ongoing interaction between individuals and groups at the organizational level [ 57 – 59 ]. Moreover, knowledge creation as a process consists of four stages: socialization, externalization, combination, and internalisation [ 60 ]. Creation of new knowledge can similarly be the basic source of competitive advantage over longer periods of time [ 61 ] and is useful for any organization, whether public or private. Creating a comprehensive system that enhances the process of creating new knowledge, helps the organization achieve its strategic goals [ 30 ]. Knowledge creation is an important aspect of development and implementation of high-quality services and products [ 62 ]. As such it is perhaps even the most crucial aspect in the complex environment of healthcare, where evidence typically gained from empirical research supports the efficiency of utilizing limited available resources [ 63 ]. Moreover, knowledge creation is of the primary activities of knowledge intensive organizations [ 64 ], including healthcare organizations. Healthcare organizations heavily rely on clinical knowledge for delivering services in practice [ 65 ]. Therefore, healthcare employees who create and sharing clinical knowledge have a paramount role in knowledge management activities in healthcare organizations [ 66 , 67 ]. In addition, appropriately implementing knowledge creation in practice is especially complicated in the healthcare environment that is often characterized by evidence-based practice, where making decisions on how to provide or improve healthcare is related to integrating best available research evidence with a combination of clinical expertise and patient values, knowledge and preferences [ 68 ]. In the area of healthcare services, the strategic goal is higher quality of services provided, through a combination of efforts of healthcare professionals and direct interaction with patients [ 69 ]. Consensus on health service quality indicators has not yet been reached in the literature [ 70 ], and it is recommended that each institutions should develop their own system of indicators. However, the quality of health care is increasingly observed through reports on the performance of health systems in different countries, ie. through a system of organizational performance [ 71 , 72 ]. Definitions of quality of health care common to all stakeholders imply effective care that contributes to patient satisfaction [ 73 ]. Knowledge creation and its inter-organizational dissemination, through the use of an adequate network concept [ 74 ] and the necessary data cataloguing, contributes to positive repercussions on the organizational performance of healthcare providers. Since knowledge creation is a continuous process, its constant improvement is vital for the benefit of all stakeholders. Knowledge creation can have a significant positive impact on professional development of employees in the environment of healthcare institutions [ 75 ]. This study extends previous research that argues that the creation of knowledge is a crucial aspect of providing quality services in healthcare practice [ 76 ]. In a similar vein, our study extends existing research on knowledge creation as the final outcome of the process that enhances the quality and quantity of healthcare organization’s knowledge base [ 77 ], which subsequently influences the quality of services that are provided in practice to users. In addition, modern development of technology is a significant accelerator of the process of knowledge creation at the organizational level [ 78 , 79 ]. Consequently, this combination of the healthcare system and information communication technologies has changed the way healthcare is provided and it contributed to greater benefits for patients [ 80 ]. In spite of the existence of solid scientific research, aimed at analysing the relationship between the concept of knowledge creation and organizational performance [ 81 ], with the influence of information communication technologies as a newly associated scalar value [ 82 ], the subject area has not been analysed adequately within the concept of quality of healthcare services in the healthcare system of Montenegro. Moreover, our research answers the calls of research to provide suggestions on how can healthcare organizations can effectively deal with complex challenges such as knowledge creation for the successful and quality functioning of the healthcare system as a whole [ 77 ]. This paper, based on empirical research, aims to close this gap. In view of this, our first hypothesis is:

Hypothesis 1 : Knowledge creation is positively related to the quality of healthcare services

2.2. Knowledge sharing and quality of healthcare services

Knowledge sharing in organizations is defined as the process through which individuals, groups, departments or the whole organization are affected by the experience and knowledge of another [ 83 ]. Knowledge sharing within healthcare organizations is recognized as one of the main indicators of quality, innovation, competitiveness, growth and development of the organization. Healthcare can be considered as a patient-centered environment, where healthcare professionals have to continuously cooperate with experts from several fields such as nurses, social workers and many others. In such a state, the contemporary and relevant knowledge has to be effectively management and shared among healthcare employees to improve the quality of services. Therefore, efficient knowledge sharing activities are crucial for healthcare organizations [ 84 ]. Authors Shahmoradi et al. [ 14 ] highlight that knowledge sharing plays a particularly important role in knowledge management activities within the evidence-based practice that is common within the healthcare setting. As healthcare organizations have a direct impact on people’s quality of life and wellbeing, the effectiveness of knowledge sharing is even more important in organizations that function in such a delicate environment [ 85 ]. Crass and Peters [ 86 ] further highlight the complexity of knowledge in healthcare as they posit that the majority of innovations and the delivery of services are reliant on the skills and know-how of employees in healthcare organizations. The importance of the impact of knowledge sharing on the quality of healthcare services has caused the recent growth of interest in the area [ 87 ]. Existing studies similarly identified quality information exchange as one of the key indicators of quality of services within healthcare organizations in addition to the competences of healthcare professionals [ 88 – 90 ]. Moreover, cross-national studies have indicated the importance of organizational culture as a component that influences the willingness of health professionals to be active participants in the process of knowledge sharing [ 91 ]. A system that is too centralized negatively affects the process of knowledge sharing at the organizational level [ 92 ], so it is necessary to find the right balance also in this aspect. The existence of an optimal level of theoretical knowledge and practical skills and competences of healthcare professionals are key indicators of successful knowledge sharing among healthcare professionals [ 91 ]. Improving the quality of healthcare services is ever more based on the improvement of both knowledge creation and knowledge sharing [ 93 ]. In addition, globally there is a growing social, political and social interest in the exchange of knowledge and experience in the context of improving healthcare, while emphasizing the key role of scientific community and medical staff in the process of generating new value and new knowledge [ 94 ]. With our study, we add to previous research that argues that healthcare teams frequently consist of interdisciplinary members that need to transfer knowledge to one another to be able to increase existing knowledge and create new knowledge and adequate healthcare solutions, which in practice improves the quality of services that are provided [ 95 ]. Historically, knowledge transfer in the healthcare environment was hindered due to numerous reasons. In the future, academics and practitioners are aiming to find improvements in knowledge sharing activities among healthcare professional as it can represent a tool to ultimately improve the quality of healthcare services [ 96 ]. Therefore, based on previous research, our paper further deepens the analysis of the subject area through the study of knowledge sharing and the quality of healthcare services within the Montenegrin healthcare system. The second hypothesis arises from the above:

Hypothesis 2 : Knowledge sharing is positively related to the quality of healthcare services

2.3. Information communication technologies and quality of healthcare services

Information communication technologies, through the use of computers, the Internet, mobile devices and various interactive platforms, significantly shape the functioning of modern organizations, their systems, processes and communication [ 97 ]. Advanced information communication technologies help the process of knowledge creation through a number of different functionalities such as analysis and presentation, data storage and management, networking and communication, as well as interaction and collaboration [ 79 , 98 – 100 ]. Creating new knowledge and innovation has become crucial in the process of implementing information communication technologies in the regular practice of healthcare institutions [ 101 ]. The creation of information and creation of new knowledge is the area where information communication technologies, may contribute to a higher quality of healthcare services [ 102 ]. Nowadays, the ability to effectively access needed information and to distinguish between relevant and irrelevant information is becoming an ever important skill for professionals and organizations [ 103 ]. In this context, Soto-Acosta and Cegarra-Navarro [ 45 ] emphasize the role of information communication technologies in the exploitation and management of existing knowledge. The ability of individuals, professionals and organizations to have access to and later to disseminate health related information in today’s electronic society emphasizes the necessity of adopting information communication technologies [ 104 ] within the healthcare environment. Additionally, this possibility for creating new knowledge, through information communication technologies, enables the application of the concept " patient-centered care ", which implies directly and positively a higher quality of services provided [ 105 ]. Andreeva and Kianto [ 1 ] also point to the specific role of information communication solutions at the level of organizational knowledge, organizational performance, and organizational competitiveness. Our study adds to existing state-of-the-art literature that provides insight into the fast growing field of information-communication technologies that support the successful functioning of the healthcare sector with the provision of safe, efficient, high-quality, and information-communication technology assisted healthcare services. The provision of such services is typically reliant on an adequate workforce, financial resources and the knowledge and know-how on how to utilize services [ 106 ]. Moreover, our research builds the body of literature that promotes the positive impact of information-communication technology adoption on the safety, efficiency and quality of services in healthcare organizations [ 107 ] within the specific context of the Montenegro healthcare environment. In this paper, we tested the concept of improving the quality of healthcare services, through the moderating effect of information communication technologies, defining the third hypothesis as follows:

Hypothesis 3 : Information communication technologies moderate the positive relationship between knowledge creation and quality of healthcare services

In addition to knowledge creation, knowledge sharing is an area where information communication technologies contribute to the sharing of good practice in healthcare. Information communication technology platforms, in various forms and shapes, enable the knowledge sharing among healthcare professionals [ 85 ]. The appropriate utilization of information communication technologies contributes to faster and better inter-organizational knowledge sharing, all to the benefit of patients as end users [ 108 ]. The application of various tools and applications enables a quicker transfer of knowledge both between service providers and between providers and users of healthcare services, thus raising awareness of the importance of healthcare [ 109 ]. This can play a very important role also in providing remote healthcare, through the use of technology and rapid exchange of information related to the medical state of patients, implementation of adequate diagnostics, treatments and disease remediation [ 110 ]. With our paper, we build on the notion that technological factors as for example information-communication infrastructure, technological skills, knowledge management tools and availability of technological facilities partially define the success of such interventions within the healthcare environment. Moreover, such technological factors are becoming more and more important in the successful provision of high-quality healthcare services in practice [ 111 ]. Moreover, with our research we aim to close the gap of understanding on how information-communication technology can be used to promote the quality of services provided for patients [ 112 ]. In a similar vein, we add to the body of literature that emphasizes the connection between information-communication technology and quality of healthcare services, which was a field that was partially neglected in the past due to an emphasis on technological interventions that offer mainly financial benefits [ 113 ]. We tested empirically the understanding of the moderating effect of information communication technologies in the relationship between knowledge transfer and quality of healthcare services, by setting the following hypothesis:

Hypothesis 4 : Information communication technologies moderate the positive relationship between knowledge sharing and quality of healthcare services

We present our conceptual model with the above mentioned hypotheses in Fig 1 .

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https://doi.org/10.1371/journal.pone.0272346.g001

3. Methodological approach

3.1. data collection procedure and measurement.

The process of collecting primary data involved the use of a questionnaire to understand the process of knowledge creation, knowledge sharing and information communication technologies within healthcare organizations with a special focus on the quality of services provided. The complete process of data collection was done in accordance with ethical rules, norms and strict scientific research protocols valid at the University of Montenegro. To begin the process, we requested the Committee for Ethical Issues at the University of Montenegro’s consent and from competent bodies at the Faculty of Economics and the Ministry of Health of Montenegro. The Committee (for Ethical Issues) at the University of Montenegro declared itself incompetent to give such consent, unlike the Faculty of Economics and the Ministry of Health, which provided their consents in writing. Having completed that step, respondents were contacted to take part in the survey, via e-mail and/or telephone. After the respondents consented to participate in the survey, we agreed on the interview date and time i.e. during the workhours. In our research, participation was entirely voluntary and anonymous. Immediately before the interviews began, the interviewer informed the respondents in detail about the purpose of the study, applied scientific and research protocols, and asked for their explicit consent. Once the interviewers signed the consent in writing, the interviewer began with the data collection from the respondents (note: all respondents are adults, working in the health sector). All consents given in writing and duly signed by respondents were archived in the Faculty Archives Unit following the successful completion of the research under applicable Faculty regulations. Our survey(s) did not include any opportunities to identify the individual responses and link it to the respondents’ identities. A sample of 45 health care institutions in Montenegro was generated by a combination of institutions from public (32) and private sector (13). Subsequently, the sample represents health institutions of primary, secondary and tertiary levels of health care. Besides, the sample included health care institutions from all three regions of the country (center, north and south). Specifically, it includes 18 institutions from the central part, 14 from the northern part and 13 from the southern part of Montenegro.

In the process of selecting an appropriate sample, researchers face certain dilemmas. Namely, random sampling is traditionally considered as the gold standard in order to achieve sample impartiality, which is directly against the background of obtaining reliable estimates [ 114 ]. Yet the trade-off between the desire to randomize the sample on the one hand, and pragmatization on the other, is one of the leading challenges in the decision making process of the subject issue. Constraints on time, resources as well as rising costs, imply that random sample selection is not always a realistic option. Conventional or purposive sampling [ 115 ] is emerging in the field of health care research as one of the solutions to this problem. The justification of this approach is confirmed by existing studies that support the representativeness of the sample defined on the basis of such strategies [ 116 ].

The data were collected in May 2019, and 151 healthcare workers took part in the survey. In order to ensure the principles of impartiality and non-selectivity and the concept of comprehensiveness, information was collected across various organizational levels in healthcare institutions. Accordingly, the sample consists of 45 directors, 45 medical doctors, 45 technicians, and 16 members of the Union of Medical Doctors, which altogether makes a total of 151 individuals whose opinion was taken into account. Just over three-fifths of the sample are women, and the remaining two-fifths are men. When it comes to age structure, respondents aged between 50 and 59 are a dominant portion of the sample (37.5%), followed by respondents aged 30 and 39 (24.3%), and respondents aged 40 and 49 (20.1%).

Majority of healthcare workers, 94.7%, have worked in the healthcare system for more than five years, 93.3% have worked for more than five years for their current employer (i.e. medical organization), hence the sample is representative in terms of the respondents’ ability to realistically perceive the processes of knowledge creation and knowledge sharing, information communication technologies and quality of healthcare services in the context of analysed variables of this study.

3.2. Methods

To analyze whether our results might be affected by common method biased, we applied Harman’s one-factor test [ 117 ]. The obtained results indicate that the first factor makes 56.7% of the total variance. This result is slightly above the recommended value threshold (50%) by Podsakoff et al. [ 118 ], suggesting that common method bias might be a limiting factor in the study. The obtained data were imported within the SPSS 25.0 version.

In order to analyse each individual research construct, the authors used measuring instruments that have a high frequency of use and are adequately validated in contemporary scientific research. All measuring instruments meet a predefined set of criteria: they are often cited in research papers published in relevant scientific journals, they are up-to-date in the sense that they are used in the most recent research, and finally, they are well conceptually established in the context of their frequent use by key authors from our research scope [ 7 , 119 – 124 ].

3.2.1. Knowledge creation.

Two item scale was used to determine this construct (α = .90), which is adapted by Downes [ 120 ]. The measurement of this variable was conducted by measuring the degree of agreement of the respondents with the following items: " My organization has mechanisms for creating or acquiring knowledge from different sources such as volunteers , clients , donors or competitors ".

3.2.2. Knowledge sharing.

This construct was observed through the use of eight item scale (a = .93) adapted by Downes [ 120 ], that he used to measure knowledge sharing. The questionnaire involves answering items such as " In my organization , it is easy to identify key experts in certain areas and learn how to get in touch with them ".

3.2.3. Quality of healthcare services.

As with the knowledge sharing analysis, the Downes [ 120 ] scale that consists of 3 items (α = .87) was used. Downes [ 120 ] adapted it to measure the quality of healthcare services. The questionnaire consists of the following items: " Within my organization , we provide higher quality services to our customers " and " All in all , our organization works better ".

3.2.4. Information communication technologies.

A two item scale was used in this case (α =. 67) that was adapted by Downes [ 120 ]. It is based on statements examining whether technical support to employees is always available, as well as whether employees are confident enough to use information communication technologies or avoid using them due to lack of experience. The questionnaire comprises of items such as: “Technical support for information systems is readily available” .

3.2.5. Control variables.

As for control variables, there are two control variables that make an integral part of our research: age and the highest level of education. In research, the decision to include or exclude control variables may have implications for drawing final conclusions based on the research conducted [ 125 ]. Against the background of the individual and existing knowledge management reserach, demographic characteristics, such as age and the highest level of education, may have an impact on the overall level of knowledge management activities in an organization, which is the subject of analysis [ 126 ]. It is important to note that both control variables that are considered control in our research have already been the subject of analyses in researches that covered knowledge management [ 127 ].

To explore the convergent validity of all items utilized to measure constructs in our research we examined standardized factor loadings [ 128 ]. In Table 1 , we report the range of our standardized factor loadings in our measurement model. Standardized factor loadings for all of our four constructs were statistically significant (> .50). One item intended to measure knowledge creation and two items intended to measure quality of healthcare services and information communication technologies did not meet the criteria recommended in the literature and were therefore omitted from the final model. Our final model consists of 15 items utilized to evaluate the existing state of four measured constructs. To test the composite (constructs) reliability we explored the composite reliability index (hereinafter: CRI) and average variance extracted (hereinafter: AVE) [ 129 ]. To fulfill research criteria, we follow the suggested values of Diamantopolous and Sigaw [ 130 ], which are for AVE (.40) and CRI (.60). We present AVE and CRI values for our measured constructs in Table 1 . Numerous fit indices to evaluate the model fit to data at the global level exist [ 131 ].

https://doi.org/10.1371/journal.pone.0272346.t001

Fit indices are as follows: CFI = 0.97; chi-square: 104.690; RMSEA = .07; and df = 67 and are satisfactory (without modification indices, the results of the model fit were: CFI = .84, chi-square = 296.722, RMSEA = .14, and df = 84.). Selected descriptive statistics for our measured variables are presented in Table 2 . Respondents on average value quality of healthcare services (4.06) the best in their organization, followed by knowledge sharing (3.90) and knowledge creation (3.71). The construct of information communication technologies received a significantly lower evaluation (2.40). Between our measured variables the correlation coefficients are moderately or strongly positive with ranges between .65 and .88 and moderately or weakly negative with ranges between -.18 and -.28. A significant and positive correlation was evident between knowledge sharing and quality of healthcare services (.71; p < 0.01) and knowledge sharing and knowledge creation (.88; p < 0.01). In addition, there was a significant and negative correlation between knowledge sharing and information communication technologies (-.28; p < 0.05). Quality of healthcare services displayed a significant and positive correlation with knowledge creation (.65; p < 0.01) and a significant and negative correlation with information communication technologies. In the scope of our research, knowledge creation had a significant and negative correlation with information communication technologies (-.25; p < 0.01). Between our two control variables there is no significant correlation.

https://doi.org/10.1371/journal.pone.0272346.t002

Hypothesis 1 (H1) explored the direct relationship between knowledge creation and quality of healthcare services. Hypothesis 2 (H2) examined the direct relationship between knowledge sharing and quality of healthcare services. In hypothesis 3 (H3), we include information communication technologies as a moderator of the relationship between knowledge creation and quality of healthcare services. Similarly, in hypothesis 4 (H4) we include information communication technologies as a moderator of the relationship between knowledge sharing and quality of healthcare services. We ran a series of hierarchical regression analysis utilizing centered variables to test our conceptual model that is explained with our proposed hypotheses in Fig 1 . In our first direct effect model (model 1), we include knowledge creation as the independent variable and age and highest level of education as our control variables. Within model 2, we include knowledge sharing as the independent variable and the aforementioned control variables. In addition, in our third model (model 3) we explore the suggested two-way interaction effect between knowledge creation and information communication technologies. In model 4, we include our second proposed interaction effect between knowledge sharing and information communication technologies. We present a more in-depth analysis of our four models in Table 3 .

https://doi.org/10.1371/journal.pone.0272346.t003

We found a significant and positive relationship in model 1, between knowledge creation (β = .60; exact p = .000) and quality of healthcare services. We are able to provide empirical support for H1 with our data. In addition, we also found a significant and positive relationship between knowledge sharing (β = .66; exact p = .000) and quality of healthcare services in model 2. Therefore, we are also able to provide empirical support for H2 on the basis of our data. In models 3 and 4 we included information communication technologies as the moderator of knowledge creation (model 3) and knowledge sharing (model 4) with quality of healthcare services. Both models showed considerable added value in relation to the direct effect models as expressed in model 1 and 2. The R 2 change is .035 in model 3 in comparison with model 1 and .047 in model 4 in comparison with model 2.

Our results in model 3 show a significant and positive relationship on the example of our two-way interaction effect between knowledge creation and information communication technologies and on the quality of healthcare services (β = .21; exact p = .008). In line with the above, we are able to provide empirical support also for our H3. Similarly, model 4 indicates a significant and positive relationship of our two-way interaction effect consisting of knowledge sharing and information communication technologies with quality of healthcare services (β = .24; exact p = .001). With our results, we are to support H4 on the basis of empirical data. Additionally, we present the simple slope analysis of both H3 and H4. The simple slope analysis for H3 indicates it is significant (exact p = .000). Moreover, we present the interaction between knowledge creation and information communication technologies and their influence on quality of healthcare service (see Fig 2 ).

https://doi.org/10.1371/journal.pone.0272346.g002

Highest levels of quality of healthcare services occur when the level of information communication technologies is high. In addition, the impact of knowledge creation is similarly important as both in the case of low information communication technologies and high information communication technologies, higher levels of knowledge creation indicate to better quality of healthcare services. In the example of high knowledge creation, best quality of healthcare services is also related to high information communication technologies, while the comparison to low information communication technologies shows a significant difference. In the example of low knowledge creation, low information communication technologies imply better quality of healthcare services.

Moreover, the analysis of the simple slope for H4 is also significant (exact p = .000). The graphical representation of the interaction effect between knowledge sharing and information communication technologies as they influence the quality of healthcare services is presented in Fig 3 .

https://doi.org/10.1371/journal.pone.0272346.g003

The highest levels of quality of healthcare services are related to high levels of information communication technologies. Moreover, also the influence of knowledge sharing is important as higher levels of knowledge sharing positively influence the quality of healthcare services. When levels of knowledge sharing are low, low information communication technologies contribute to better quality of healthcare services. Interestingly, when levels of knowledge sharing are low, the combination with higher levels of information communication technologies produces worse results in terms of quality of healthcare services.

5. Discussion

This paper involved structuring a conceptual research model that is composed of four constructs: knowledge creation, knowledge sharing, information communication technologies and the level of quality of provided healthcare services. The study implied setting up of four hypotheses in order to analyse the relationship between the defined variables, through the implementation of a hierarchical linear regression model. The first hypothesis starts from the assumption that knowledge creation is in a direct positive correlation with the level of quality of healthcare services. The second hypothesis also implies a positive correlation between knowledge sharing and the quality of healthcare services, while the third and fourth examine the moderating role that information communication technologies play in fostering knowledge creation and knowledge sharing that lead to better performance of healthcare providers.

The results of the conducted research confirm the existence of a direct positive correlation between knowledge creation and the quality of healthcare services (H1). In other words, knowledge creation is vital in determining the quality of healthcare provided to patients. Such results are in accordance with previous research, which argued that knowledge creation leads to improved organizational performance [ 17 ]. Similarly, our results further validate the findings of Ayanbode and Nwagwu [ 75 ] and Kitson et al. [ 74 ], that knowledge creation has a positive impact on the organizational performance also on the example of healthcare organizations.

The results obtained on the basis of the study confirmed the second hypothesis, the existence of a positive correlation between knowledge sharing and the level of quality of healthcare services provided (H2). Knowledge sharing enables the dissemination of best medical practices and a better output in terms of healthcare provided to patients. Even in situations where it is applicable, the valuable knowledge gained from medical research is essentially useful only if used by all stakeholders within the healthcare system. Unfortunately, healthcare providers in practice often lack information about current trends, latest scientific knowledge and researches that applied best medical practice, and are not aware how their application could be a deciding factor in treatment of patients. Under such circumstances, patients are hindered as they do not receive the best possible treatment, or receive the one that does not match entirely their specific health condition [ 132 ]. Therefore, the sharing of newly created knowledge and medical practice is an important determinant of healthcare provided. Our results support the claim of Lombardi [ 18 ] that knowledge sharing influences the achievement of higher levels of organizational performance. In a similar vein, our results are in line with the suggestions of Wensing and Grol [ 93 ] that knowledge creation has an important impact on improving the quality of healthcare services.

The results of our conducted research provided empirical support to the third hypothesis. Information communication technologies moderate the positive correlation between knowledge creation and the level of quality of healthcare services (H3). With our results we are able to further validate the opinion of Tripathi et al. [ 102 ] that information communication technologies act as a moderator in the relationship between knowledge creation and higher quality of healthcare services. Similarly, we add to state-of-the-art research of Papanastasiou et al. [ 105 ] and Andreeva and Kianto [ 1 ] that emphasize the specific role of information communication technologies on the improvement of healthcare services.

Finally, this study confirmed that information communication technologies also play an important role in facilitating the sharing of knowledge, and that they contribute to a higher level of quality of healthcare services (H4). The higher level of knowledge sharing is closely related to the quality of healthcare services, and information communication technologies are the factor that is vital to the progress in this field. Such findings correlate to existing literature that stresses the impact of information communication technologies on knowledge sharing [ 85 ] and its subsequent influence on improving the quality of healthcare services [ 108 ].

Information communication technologies enable the knowledge sharing and the dissemination of good practices at various different organizational levels. Universities, teaching hospitals and research institutes remain the main hubs of sources for the creation and sharing of newly created knowledge in the field of healthcare. The use of information communication technologies and documenting best practices in healthcare institutions requires constant work on improving and updating the whole system. This can be a challenge, given the speed of technological change and the growing need for rapid dissemination of new knowledge, especially in times of crisis, such as the current global COVID-19 pandemic. In that context, COVID-19 introduced an exponential threat to the theory and practice of quality [ 133 ]. If the research was hypothetically conducted today, it is very possible that despite ICT positive implications, we would find somewhat different results related to the process of creating and disseminating knowledge. Bearing in mind that the fight against the pandemic is still an ongoing battle, that information is changing on a daily basis, the quality of the knowledge created can be very questionable. Researches are done in a very fast way, by urgent procedure, and even the created know-how, despite the fact that it is encouraged by the use of the most sophisticated ICT equipment, can be short-lived. When it comes down to knowledge sharing, major pharmaceutical companies, guided primarily by lucrative goals, are willing to make a drug or vaccine against the virus available at an adequate price, but are not willing to make available the formula or know-how used in the process of creating the necessary medicament. In this way, research conducted during the pandemic era would probably conclude that the application of ICT technologies has contributed to the creation of knowledge (the issue of quality may be questionable), but not so much to its dissemination. In any case, on the example of COVID-19 pandemic we can assume the following in relation to our research constructs: first, creating knowledge in a certain way is a condition of survival (finding a vaccine), knowledge sharing is important not only at the institutional level (micro aspect) countries (cooperation between health institutions and knowledge sharing), but also between countries in order to control the global problem such as a pandemic; thirdly, ICT is an important element of organizational design (noticeable growing importance of telemedicine) and fourthly, health, ie the quality of health services is imposed as a priority on which other areas of human social activity depend, and is expected to be increasingly in the focus of theorists and practitioners in the field of management and organization. The organizational goal must be to create a system that will allow medical doctors and other healthcare professionals to know at all times where to find up-to-date information related to a specific field of medicine, or to access newly available knowledge [ 134 ].

There are several theoretical contributions of our research. First, with our results we contribute to existing research that focuses on the knowledge-based view of the organization [ 29 – 31 ] as we emphasize the integral role of knowledge within the environment of healthcare organizations. Furthermore, we add to up-to-date research by theoretically proposing a conceptual model and empirically testing organizational factors of knowledge management that have the potential to increase the quality of healthcare services [ 20 ]. By testing and validating our model on primary data, we are able to contribute to a broader understanding and further insight on knowledge and knowledge management [ 29 , 32 ] and the positive influence on organizational performance [ 33 , 34 ]. Second, with our research we respond to some of the existing challenges that are related to the area of quality of healthcare services [ 11 ] as we provide empirical insight into actions that could help services providers with improving quality of their healthcare services as was suggested in Tripathi and Siddiqui [ 12 ]. Third, we add to the debate of knowledge creation and its influence on the advancement of organizational performance [ 17 , 74 , 75 ]. With our research, we extend the understanding of the aforementioned relationship on the example of healthcare institutions. Fourth, we provide additional support to suggestions that knowledge sharing has a positive impact on improving the overall organizational performance [ 18 ] in our case understood as the quality of healthcare services. With this part of our research, we validate the opinion of Wensing and Grol [ 93 ] that improving the quality of healthcare services is also related to the levels of knowledge sharing within an organization. Fifth, with our results we are able to promote the positive impact of information communication technologies on improved organizational performance as was emphasized in the research of Yunis et al. [ 19 ]. In addition, our results are in line with Tripathi et al. [ 102 ], where the authors suggest that information communication technologies as a moderator can contribute towards achieving higher levels of quality of healthcare services in practice. Sixth, with our study we are able to extend the understanding of knowledge management in the context of the public sector [ 24 , 25 ], where we focused our research in exploring knowledge management within the healthcare environment, which was typically overlooked in previous studies.

The practical implications of our research are intended for managers, practitioners and decision makers and are identified as opportunities for improvements within the healthcare system in Montenegro, through better understanding and knowledge of organizational factors such as knowledge creation, knowledge sharing and information communication technologies. Those organizational factors are instruments that can positively influence the levels of quality of healthcare services. The content and suggestions that can be derived from our research in the form of concrete recommendations can help stakeholders engaged in the healthcare system to create appropriate conditions for achieving better organizational performance, which will subsequently raise the quality of healthcare services. Hopefully, on the basis of our results, managers and employees in healthcare organizations will devote more attention, resources and efforts towards implementing activities and initiatives that include knowledge creation, knowledge sharing and information communication technologies with the final aim of improving the overall quality of healthcare services. Relying on empirical evidence, our study offers the opportunity or starting point for interested stakeholders to improve their knowledge, skills and competences related to knowledge management and providing quality healthcare services in practice. Nevertheless, it is important that managers are aware of the relevant alignment of their knowledge management activities within their specific organizational context and also in relation to their available knowledge management resources. In addition, within the specific and complex healthcare environment, identified and assessing appropriate knowledge management activities might be even more challenging.

In spite of the numerous theoretical and practical contributions of our paper, some limitations exist. First, the methodological issue of common method bias as revealed by Harman’s single factor test [ 117 ] is present. Second, as our results are based on a sample from only one country, we argue that it would be beneficial to conduct a cross-national study to provide a higher degree of generalization of our findings. Third, we have to take into account the complexity of the healthcare environment, which might negatively influence the responses from our respondents as they are constantly exposed to demanding and draining situations at work. Fourth, within this research we did not distinguish between some of the factors determining the characteristics of healthcare organizations such as the size of the organization that could be measured with the number of its employees. Fifth, in general in the healthcare environment, measuring the quality of healthcare services is difficult as we are predominantly relying on the perception of either healthcare services providers or healthcare services users.

Given the limitations of our study, we identified additional opportunities for future research on the topic of quality of healthcare services, including the following: (1) to counteract the potential negative effect of common method bias, we propose to collect the data for the dependent, independent and moderating variables at different points in time; (2) we would advise to focus on conducting similar research on an international sample; (3) to mitigate the negative effect of potential employee bias, we should include a higher number of respondents in future studies; (4) future research should include additional control variables that are measured at the organizational level; (5) it is necessary to promote international efforts to standardize the measurement of quality of healthcare services, which would additionally enable the comparison between different countries; (6) considering the complexity of the health care system, it would be useful to apply a qualitative research approach in addition to the quantitative one, ie. to use a mixed-method approach, in order to obtain an in-depth explanation, with full use of triangulation methods.

6. Conclusion

The proposed conceptual model and the conducted empirical study within our research is aimed at examining the impact of knowledge creation and knowledge sharing on the level of quality of provided healthcare services. Thus, our study contributes towards the expansion of the conceptual framework of knowledge management within the healthcare environment and aims to support ongoing efforts to improve the overall quality of healthcare services in practice. More specifically, we explored the moderating effect that information communication technologies might have on the existence of the two predefined relationships. Obtained results clearly indicate a direct and positive link between knowledge creation and quality of healthcare services and between knowledge sharing and quality of healthcare services. Moreover, information communication technologies further moderate the relationships that are important in influencing the quality of healthcare services. Highest levels of quality of healthcare services occur when the level of information communication technologies is high. In a nutshell, the impact of knowledge creation and knowledge sharing is important as higher levels of knowledge creation and knowledge sharing lead to better quality of healthcare services. Additionally, our study proposes some promising directions to conduct future research on this topic.

Supporting information

https://doi.org/10.1371/journal.pone.0272346.s001

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The relationship between students’ use of ICT for social communication and their computer and information literacy

Meral Alkan 1 &
Sabine Meinck 2

Large-scale Assessments in Education volume 4 , Article number: 15 ( 2016 ) Cite this article

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This study investigates the relationship between students’ use of information and communication technology (ICT) for social communication and their computer and information literacy (CIL) scores. It also examines whether gender and socioeconomic background moderates this relationship. We utilized student data from IEA’s International Computer and Information Study (ICILS) to build multivariate regression models for answering the research questions, and accounted for the complex sample structure of the data by using weights for all statistical analyses, employing jackknife repeated replication for variance estimation. Students who frequently use the internet for messaging and participation in social networks (i.e., at least once a week) scored on average 44 points higher than those who use ICT for the same purpose only less than once a week or never. The direction of this effect was the same in all 21 participating educational systems, the difference ranging from 19 to 75 points (always statistically significant). We continued the analysis by testing whether the relationship is moderated by gender; as girls use more often ICT for social communication and have higher CIL scores on average. After controlling for the gender effect the CIL scores between the two examined groups decreased only by 2 points on average. Even after including students’ socio-economic background into the model, the difference in CIL between the two groups of interest declined only little—to 32 points on average across all countries. The difference remained to be statistically significant in all countries but one. The results suggest a strong relationship between students’ CIL proficiency level and the frequency of their use of electronic devices for social communication; hence, respective skills needed at schools and later on at the workplace are reflected in their use outside of school and for socializing.

Purpose, significance of research and theoretical frame work

In the last decades we encountered rapid developments in information and communication technologies. The inclusion of the worldwide web into daily life brought new and important implications also for education. Most of the schools and educational systems started providing extensive computer networks for their students and these are increasingly becoming main components of the teaching and learning environment, but so far little is known about the effectiveness and use of these technologies (Fraillon et al. 2014 ). Conclusions from research carried out in the field are partly contradictory. Many authors who examined computer use and student achievement found they were positively related (e.g., Becker 1994 ; Hativa 1994 ; Kozma 1991 ; Kulik and Kulik 1987 ; Liao 1992 ; Osunade 2003 ; Ryan 1991 ; Van Dusen and Worthren 1994 ; James and Lamb 2000 ; Attewell and Battle 1999 ; Sivin-Kachala 1998 ; Weaver 2000 ; Weller 1996 ; Wenglinsky 1998 ). Wen et al. ( 2002 ) suggest that there is a positive relationship between the number of computers available at school and students’ science achievement. Alspaugh ( 1999 ) reports that computer use has no effect on students’ achievement in reading, mathematics, science or social studies. There is also a number of studies that identified negative relationships between computer use and student achievement (Ravitz et al. 2002 ; Papanastasiou 2002 , 2003 ). Papanastasiou ( 2002 ) who analysed the results of TIMSS, found a negative relationship between computer use and achievement in a number of countries such as Cyprus, Hong Kong and United States of America. According to this study, students who use computers most frequently in the classroom were lowest achievers in TIMSS in 1995. Papanastasiou ( 2003 ) and Papanastasiou et al. ( 2005 ) found that computer use does not have a positive nor negative effect on students’ science achievement based on PISA results, but the way of computer use affects science achievement.

Most of the international studies focused so far on the relation of ICT use and students’ competencies in reading, science and mathematics. The amount of research dedicated on computer and information literacy is very limited and most studies examine mainly internet access and online use (Olafsson et al. 2014 ). In the computer and information literacy (CIL) area, the first cross-national study is ICILS (Fraillon et al. 2014 ). It assesses the extent to which students know about, understand, and are able to use information and communication technology (ICT). The main purpose of ICILS is to determine how well students are prepared for study, work and life in the digital age. With the information age the term “digital natives” was coined for the generation born in the early 1980s, also referred to as the first members of the millennial generation (Prensky 2001 ). In his article, Prensky claimed that “the arrival and rapid dissemination of digital technology in the last decade of the twentieth century” had changed the way students think and process information, making it difficult for them to excel academically being exposed to outdated teaching methods. However, according to the ICILS results, although students have had an increased amount of exposure to technology, it does not necessarily imply that they are digital natives. In all the participating countries, on average 17 % of the students did not even achieve the lowest level of CIL determined by the study. On average, only 2 % of the students achieved the highest level with a maximum of 5 % in Korea (Fraillon et al. 2014 ). Footnote 1

This finding raises the question how so called digital natives use twenty first century technology in daily life. It is known from the literature that age plays a significant role in the usage of computers and internet. As shown in Fig. 1 (Zichuhr and Madden 2012 ), and Fig. 2 (TurkStat 2014 ) below, there was a steady increase in internet use across all age groups in Turkey and the US. In the beginning of the current century, however, the younger age groups use internet more often compared to the older age groups in both countries.

(Source: Zichuhr and Madden 2012 )

Internet use by age group in America, 2000–2012

(Source: TurkStat 2014 )

Internet use by age group in Turkey, 2004–2014

In most European countries, as shown in Fig. 3 , more than 80 % of young people (aged 16–29) used a computer on a daily basis. In all countries, percentages of the daily use of computers among young people is higher than for the whole population (Eurostat 2014 ).

Source: Eurostat ( 2014 )

Proportion of people who used a computer on a daily basis, 2014 (%).

Further, literature suggests that many children engage in a wide range of online activities. ICT use by students has expanded to Internet, e-mail, chat, programming, graphics, spreadsheet, online shopping, online searching for literature and other educational materials. The students mostly use ICT for general purposes, i.e., communication, word processing, entertainment, etc. rather than for educational means (Mahmood 2009 ). According to Olafsson et al. ( 2014 ), the most common online activities of 9–16 years olds in Europe are: using internet for school work (85 %), playing games (83 %), watching video clips (76 %) and instant messaging (62 %). Communication via the internet is ubiquitous; often schoolwork is accompanied by chatting and texting. A study published by Gokcearslan and Seferoglu ( 2005 ) showed that—at that time—Turkish students’ main focus is on playing games instead on learning activities.

The internet use has high rates among young people when it is compared to the whole population in the EU-28 for basic skills such as using a search engine (94 %) or sending an e-mail with attachments (87 %), while more than two-thirds of young people posted messages online (72 %), just over half used the internet for calling people (53 %) and around one-third (32 %) used peer-to-peer file sharing services. The proportion of young people of posting messages online was 34 percentage points higher than the average for the whole population (Eurostat 2014 ; Fig. 4 ).

(data from 2013; source: Eurostat 2014 )

Proportion of people who used selected internet skills, EU-28

Already in 2003 Prensky reported that young Americans talk more than 10.000 h on the phone and send more than 200.000 e-mails and text messages until the age of 21. A study conducted in the US found that 80 % of online teens use social network sites, Facebook being the most popular, with 93 % of those teens reporting its use (Lenhart 2012 ). In 2014, according to number of active users, Facebook is the most popular social media platform with 1184 billion users (Digital/Ajanslar 2014 ). In 2015, Facebook is still most popular social media platform among young people and 71 % of all teens from 13 to 17 use Facebook, 52 % of them use Instagram and 41 % use Snapchat. (Pew Research Center 2015 )

“The use of social networks among children research report” focused on the use of social media among 9–16 year olds in Turkey showed that 85 % of students have computers at home, 70 % of all students get online at least once a day and 66 % use social media at least once a day, spending 72 min on average. This shows that most of the time spent on internet is dedicated to social media. The same study shows that 99 % of the children who have a social media account use Facebook. 60 % of the children reported that they don’t study enough because of spending too much time on Facebook, 25 % of them said that they spend less time with their parents and friends (TIB 2011 ).

The most common online social activities for young people in the EU-28 in 2014 included sending and receiving e-mails (86 %) and participating on social networking sites (82 %)—for example, Facebook or Twitter, by creating a user profile, posting messages or making other contributions—while close to half (47 %) of all young people in the EU-28 uploaded self-created content, such as photos, videos or text to the internet (Eurostat 2014 ).

Summarizing the literature, the high importance of students’ use of ICT for social communication in their daily life is evident. But does this type of ICT use enhance students’ CIL skills? Or, does it even rather have a negative effect, because less time remains for “worthwhile” computer usage, such as learning activities? This study examines the relationship between students’ use of ICT for social communication and their computer and information literacy and attempts to contribute to a deeper understanding of this relationship.

Methods and data sources

Students’ data of ICILS was used to explore the hypotheses. ICILS gathered data from almost 60,000 Grade 8 (or equivalent) students and 35,000 teachers in more than 3300 schools from 21 countries or education systems within countries. These data were augmented by contextual data collected from school ICT-coordinators, school principals, and the ICILS national research centres.

Students completed a computer-based test of CIL that consisted of questions and tasks presented in four 30-min modules. Each student completed two modules randomly allocated from the set of four so that the total assessment time for each student was 1 h.

After completing the two test modules, students answered (again on computer) a 30-min questionnaire. It included questions relating to students’ background characteristics, their experience and use of computers and ICT to complete a range of different tasks in school and out of school, and their attitudes toward using computers and ICT (Fraillon et al. 2014 ).

IEA’s IDB Analyzer was utilized for all statistical analyses, including the estimation of percentages, means and regression models. The IDB analyzer takes the complex data structure of ICILS data into account by applying sampling weights and employing jackknife repeated replication for variance estimation. Comparisons between dependent samples were conducted using regression models in order to account for the covariance between the comparative groups.

Analysis results

We first analysed the relationship between students’ CIL score and their use of ICT for social communication. In the ICILS study, the student questionnaire included three questions that require students to rate the frequencies of their use of ICT applications. From these questions four scales were derived. One of them was “Students’ use of ICT for Social Communication” (S_USECOM). The students were asked to identify the frequency with which they were using the internet for various communication and information exchange activities outside of school. The response categories were “never”, “less than once a month”, “at least once a week but not every day” and “every day”. S_USECOM had an average reliability of 0.74 (Fraillon et al. 2015 ).

The index variable (“S_USECOM”) consists of the following items:

How often do you use the Internet outside of school for each of the following activities?

Posting comments to online profiles or blogs.

Uploading images or videos to an [online profile] or [online community] (for example. Facebook or YouTube).

Using voice chat (for example Skype) to chat with friends or family online.

Communicating with others using messaging or social networks [for example instant messaging or (status updates)].

We could identify indeed a relationship between students’ CIL score and their use of ICT for social communication: in all educational systems participating in ICILS (further for simplicity referred to as “countries”), the CIL score increased along with an increase of students’ scale score in “Use of ICT for social communication”. This relationship was statistically significant in 16 out of 21 countries. However, the relation was weak; the explained variance of the CIL score was less than 10 % in most countries. We continued the analysis by investigating further the relationship between CIL and each of the four variables constructing the scale score for “Use of ICT for social communication”.

Posting comments to online profiles or blogs

There were no consistent patterns for relations between the reported frequencies for this variable in most countries except for Chile, Thailand and Turkey—the countries with relatively low CIL average scores. In these three countries, the CIL score increased along with an increasing frequency of postings.

Uploading images or videos to an [online profile] or [online community] (for example. facebook or youtube)

Interestingly, students with a medium frequency of ICT use for uploading images or videos had an average CIL score of 20 more points than those who reported to either never do that or do it every day. This pattern could be observed in all countries and was statistically significant in all countries but three (Republic of Korea, Turkey, Canada—Newfoundland and Labrador).

Using voice chat (for example Skype) to chat with friends or family online

No clear patterns could be identified for relationships between the CIL scores and frequencies of ICT usage for voice chats.

Communicating with others using messaging or social networks [for example instant messaging or (status updates)]

Apparently this variable had the closest relationship with CIL among the variables constructing the index variable (“S_USECOM”): as shown in Fig. 5 , the more frequent students use ICT for communication using messaging or social networks the higher was their CIL score, a finding that generally holds in all countries. Looking at the cross-country average, mean CIL scores of students who never use the internet for communication are as low as 463 points while are as high as 522 points for students who do that on a daily basis (see Table 1 ).

Average CIL scores by ICT use for communicating with others using messaging or social networks

For further in-depth analysis we decided to simplify the data by collapsing categories, resulting in a dichotomous variable. The split was taken between the response categories where the difference in CIL scores was the greatest. Referring to the patterns visible in Fig. 5 , CIL scores of students reporting to use ICT for communication at least once a week or even every day were rather close to each other; also, no large differences in CIL scores occurred for students using ICT for communication less than once a week (or never). Therefore we collapsed the respective categories accordingly. This procedure split the countries’ target populations into two groups of varying proportions, as can be seen in Fig. 6 . On average, three-fourth of the students use the Internet for communication more than once a week. This proportion is less in Thailand and Turkey.

Proportion of students by use of ICT for communicating with others using messaging or social networks

Comparing the resulting two groups of students, we found an average difference in CIL scores of 44 points on favor of students using ICT for social communication more frequently. The direction of the effect was the same in all countries and ranged from 19 points difference in Switzerland to as much as 75 points in the Slovak Republic (refer to Table 2 , Model 1, coefficients of E-communication). In all countries, the difference was found to be statistically significant. Since these results were rather striking, we wondered if this effect was moderated by other variables. Consequently we set up various multivariate regression models in order to control for such effects.

Gender as moderating variable

It is known from the literature that girls spend on average more time on social network sites and use them more actively than boys (Duggan and Brenner 2013 ). Lenhart ( 2012 ) reported that some 95 % of teenagers use the internet in the US. 42 % of girls who use the internet report to video-chat, while only about a third of boys engage in that activity. Girls are also more active in their texting and mobile communication behaviours (Lenhart et al. 2010 ). Our own study confirms this finding for all ICILS countries as can be seen in Fig. 7 — except for Turkey. Interestingly, in Turkey (highlighted by the black arrow in Fig. 7 ) boys report to use the Internet for social communication more often than girls. The differences of the gender group percentages are statistically significant in all countries.

Percentages of students using ICT for communicating at least once a week by gender

Although gender is a major determinant in CIL scores of ICILS, it did hardly moderate the difference in CIL scores between the two groups presented in Fig. 5 . The group differences remained significant in all countries (see Model 2 in Table 2 , coefficients of E-communication.

Socio-economic background as moderating variable

In a next step we included the national index of students’ socio-economic background (variable “S_NISB”) into the model, reasoning that the availability of internet access and communication devices may depend on the socio-economic status (SES) of the students.

The “digital divide”—referring to the gap between those who do and those who do not have access to ICT’s (Warschauer 2003 )—generally affects individuals who are unemployed or in low-skilled occupations, and who have a low income and/or a low level of education. Students from families with a lower SES tend to be less confident and capable in navigating the Web to find credible information (Adler 2014 ). Also Adegoke and Osoyoko ( 2015 ) support the theory that SES influences students’ access (exposure) to ICT and internet. The findings of Hargittai ( 2010 ) suggest that even when controlling for basic Internet access, among a group of young adults, SES is an important predictor of how people are incorporating the Web into their everyday lives. Bozionelos ( 2004 ) showed that SES had a direct positive relationship with computer experience and an indirect negative relationship with computer anxiety. The findings are supportive of the digital divide and they imply that information technology may in fact be increasing inequalities among social strata in their access to employment opportunities.

After controlling for both, gender and SES, the difference in CIL between our two groups of interest declined to 32 points on average across all countries. However, the difference remained to be statistically significant in all countries but one (Denmark).

Table 2 presents regression coefficients of all three discussed models; Fig. 8 presents the differences in CIL scores of students using ICT for social communication more vs. less than once a week for all three considered models (coefficient of “E-communication” in Table 2 ). Evidently, this difference is hardly moderated in any country by gender, while the socio-economic status plays a larger role. In twelve out of twenty countries, after controlling for gender and SES, the examined difference in the CIL score decreases by more than 10 points. Only in Switzerland neither SES nor gender seemed to be associated with the difference in CIL scores between the two groups of interest, i.e., the coefficient of E-communication remains constant across the three models.

Differences in CIL scores of students using ICT for social communication more vs. less than once a week by model

Further variables with potential moderating effects

We also investigated the effect of further variables that may have moderated the found relationship and thereby could have affected the presented relationship in significant ways. We identified such variables based on evidence from the literature, evidence from ICILS (Fraillon et al. 2014 ) or simply by applying common sense. It would exceed the purpose of this paper to present all details of these analyses; however, the following paragraphs give some major findings.

While girls use ICT more often for social communication, boys use it more often for playing games (Rideout and Foehr 2010 ). This is also evident from ICILS data and is presented as cross-country average in Fig. 9 . The patterns are similar for all participating countries. However, there was no general relation between using ICT for playing games and CIL except for Turkey and Thailand, where an increased frequency of gaming was related with increasing CIL scores.

Using a computer for playing games (outside of school) by gender (estimated percentages across all participating countries)

Further, one may argue that the overall use of computers could have a moderating effect on the studied relationship. However, including the respective variable into the regression model proofed to not change much the effect of ICT use for social communication on CIL and also did not enhance the explained variance of the CIL score significantly.

Discussion and conclusions

The arrival and rapid dissemination of digital technology in the last decade of the twentieth century raises the question how so called digital natives use technology in daily life and what relevant skills they need to develop in order to participate effectively in the digital age. From the literature, the high importance of students’ use of ICT for social communication in their daily life is evident. In this paper we tried to answer the question if this type of ICT use enhances students’ CIL skills or if it—on the opposite—perhaps even rather has a negative effect, because less time remains for “worthwhile” computer usage, such as learning activities.

We first analyzed the relationship between students’ CIL score and their use of ICT for social communication. The CIL score increased along with an increase of students’ scale score in “Use of ICT for social communication” in all educational systems participating in ICILS. This relationship was statistically significant in 16 out of 21 countries. However, the relation was weak. We continued the analysis by investigating further the relationship between CIL and each of the four variables constructing the index “Use of ICT for social communication”. We found out that the variable which has the closest relationship with CIL was “Communicating with others using messaging or social networks [for example instant messaging or (status updates)]”, while other variables comprising the index showed different or no patterns related with CIL.

For accommodating further analysis on this variable, we decided to split students’ data into two groups. We collapsed the five original categories of the variable into two categories, reflecting the use of messaging or social networks “at least once a week or even every day” versus “less than once a week (or never)”.

Comparing the resulting two groups of students, we found a large average difference in CIL scores (44 points) favoring students using ICT for social communication more frequently. The direction of the effect was the same in all countries; the difference ranged from 19 points in Switzerland to as much as 75 points in the Slovak Republic. Since these results were rather striking, we examined whether this effect was moderated by other variables such as SES and Gender. We found however that the moderating effect of these variables on the observed relationship was weak or even negligible in all participating countries. In other words, the relation between the use of ICT for communicating with others using messaging or social networks and CIL scores was still high and consistent across countries when controlling for SES and Gender.

This positive and cross-nationally observed relationship was rather unexpected, especially because the relationship between the communication index created by ICILS and the CIL scores was weak. Trying to understand this phenomenon, we considered the nature of messaging and participation in social networks. We see that it actually includes posting comments, uploading and downloading images and videos—hence, these features are no different than the separate items creating the social communication index. In fact the single item basically contains the other index items. Possibly the written communication portion included makes the difference, or the actual widespread of activities involved in messaging/electronic social networking explains the indistinct positive relationship with CIL. In future cycles of ICILS it may be worthwhile to review the index items accordingly.

To explore this phenomenon further, we also should focus on the CIL construct. As Fraillon et al. ( 2014 ) pointed out in the ICILS international report, the CIL construct was conceptualized in terms of two strands:

Strand 1; collecting and managing information , focuses on the receptive and organizational elements of information processing and management,

Strand 2; producing and exchanging information , focuses on using computers as productive tools for thinking, creating, and communicating.

When we consider the interactive nature of social media, it can be assumed that they provide students with a medium for collecting and managing information as anticipated in Strand 1 and also for producing and exchanging information as conceptualized in Strand 2. Hence, this item seems truly be related with both strands of the CIL construct, which may be one reason for the close relationship. Lacking of an experimental design, this study cannot make causal inferences on the relation between CIL and e-communication. Therefore we cannot conclude if frequent use of ICT for communication enhances CIL skills, or if in turn students with high CIL use more frequently ICT for social communication.

Future studies should also monitor the use of social networks in education further. Students should not be expected to accomplish high skills in using information and computer technology and at the same time expect them to keep this aspect of their personality outside of their social life. Rather, it is worth to explore the additional learning opportunities arising from electronic tools and media out- but also and especially inside schools. According to findings from Fraillon et al. ( 2014 ), there is a need in many countries to equip teachers with the respective knowledge to use ICT (including social communication tools) in their teaching. Utilizing social media for teaching may hold the potential to increase CIL for all students independently from their gender and SES backgrounds; and thereby avoid that students with low CIL or limited access to ICT may increasingly lack opportunities to actively participate in the modern society.

As a matter of fact, nowadays messaging and Facebook or other social networks became a part of students’ daily life. As parents, teachers and educators, our responsibility is to help our children to benefit from social networks educationally.

See Fraillon et al. 2014 for detailed explanations of the determined CIL levels.

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Authors’ contributions

MA developed the research questions, conducted the literature research and drafted significant parts of the manuscript. SM developed the research design, conducted data compilation, the statistical analysis and interpretation of results and drafted significant parts of the manuscript. Both authors have given final approval of the manuscript version to be published and agree to be accountable for all aspects of the work in ensuring that questions related to the accuracy or integrity of any part of the work are appropriately investigated and resolved. All authors read and approved the final manuscript.

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The authors are thankful to Diego Cortes for his very useful comments while reviewing this paper.

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Alkan, M., Meinck, S. The relationship between students’ use of ICT for social communication and their computer and information literacy. Large-scale Assess Educ 4 , 15 (2016). https://doi.org/10.1186/s40536-016-0029-z

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