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Advances in digital health and digital learning are transforming the lives of patients, health care providers, and health professional students. In the interdisciplinary field of communication sciences and disorders (CSD), digital uptake and incorporation of digital topics and technologies into clinical training programs has lagged behind other medical fields. There is a need to understand professional and student experiences, opinions, and needs regarding digital health and learning topics so that effective strategies for implementation can be optimized.
This cross-sectional survey study aims to interdisciplinarily investigate professional and student knowledge, use, attitudes, and preferences toward digital health and learning in the German-speaking population.
An open-ended, web-based survey was developed and conducted with professionals and students in CSD including phoniatricians and otolaryngologists, speech-language pathologists (
A total of 170 participants completed the survey. Respondents demonstrated greater familiarity with digital learning as opposed to eHealth concepts. Significant differences were noted across profession (
This comprehensive investigation into the current state of CSD student and professional opinions and experiences has shown that incorporation of digital topics and skills into academic and professional development curricula will be crucial for ensuring that the field is prepared for the ever-digitalizing health care environment. Deeper empirical investigation into efficacy and acceptance of digital learning and practice strategies and systematic training and practical organizational supports must be planned to ensure adaptive education and practice.
Rapid technological progress is transforming health care and clinical teaching and learning. Telepractice wearable medical devices, medically certified apps through mobile health (mHealth), health portals, and personalized medicine are among just a few of the many technologies that are increasingly affecting the health care sector. In this context, the multifaceted terms
However, research has demonstrated that digital skills and the use of digital tools are still not an integral component of professional health care education [
In the field of communication sciences and disorders (CSD), investigation into such topics appears to fall behind other medical fields [
Importantly, CSD is an interdisciplinary field that includes speech-language pathologists (SLPs;
The following cross-sectional survey study was conducted in accordance with the guidelines of the Checklist for Reporting Results of Internet E-Surveys (CHERRIES) [
The study was approved by the Ethics Committee of the Medical Faculty, RWTH Aachen University, and participation was voluntary, anonymous, and could be ended at any time. A convenience sample was collected through sharing an invitational letter and flyer containing a link to the open survey with professional regulating bodies and university clinical programs in speech-language pathology, phoniatrics, and otolaryngology, as well as open student and professional groups on Facebook. To partake in the survey, participants had to be one of the following: (1) physician in phoniatrics or otolaryngology, (2) SLP, (3) medical student, (4) speech-language pathology student (SLP student). Before beginning the survey, participants were prompted to read through the detailed study background, aims, procedures, anonymous data to be collected, and data protection policies; were given the information of relevant contact persons for the study such as the study organizer and data privacy office; and were required to give informed consent before proceeding. No personal information was collected other than demographic information including profession, years of experience, generation, and gender. No incentives were offered.
The web-based survey was hosted on university licensed LimeSurvey version 4.3.14+200826, a web-based statistical survey web application that conforms with the required data security legislation as dictated by the German Federal Data Protection Act, the European Data Protection Directive 95/46/EC, and the European General Data Protection Regulation (GDPR) [
A semistructured anonymous questionnaire was designed, pretested, and cross-checked by an interdisciplinary team consisting of an SLP, a phoniatrician, and an instructional designer to ensure that questions were clearly formulated and targeted desired data. The survey contained 24 questions pertaining to knowledge, use, attitudes, and preferences regarding digital learning and health as well as sociodemographic information. In total, 1 to 4 questions were displayed per page depending on the question type. There were 12 screens, including the initial page with participant information on which the participant had to give consent before proceeding. The following question types were included in the survey: multiple choice with single fixed choice, multiple answers (with a free-text response option), arrays with Likert scale ratings, yes or no questions, and free-text entries. Directions were provided for each question to avoid confusion (eg,
Data from the anonymous surveys were analyzed using the IBM SPSS version 27 [
This study analyzed student and clinician knowledge, use, attitudes, and preferences regarding digital health and learning in CSD in German-speaking countries. Of the 213 unique survey visitors, 13 visited the start page (page containing study information and informed consent) but never began the survey and 29 began the survey though did not complete it. Thus, the participation rate was 93.9% (200/213) and the completion rate was 80.3% (171/213). Only completed questionnaires (optional responses not required) were analyzed. One survey from a student in dentistry could not be used, and thus 170 total surveys were analyzed for the study. Participant characteristics are summarized in
Participant characteristics.
Characteristics | Values, n (%) | ||
|
|||
|
Female | 150 (88.2) | |
|
Male | 20 (11.8) | |
|
|||
|
Physician (phoniatrician, ENTa) | 34 (20) | |
|
Speech-language pathologist | 72 (42.4) | |
|
Medical student (German: |
21 (12.4) | |
|
Speech-language pathology student | 43 (25.3) | |
|
|||
|
Generation Z (1996+) | 57 (33.5) | |
|
Generation Y, millennial (1980-1995) | 64 (37.6) | |
|
Generation X (1965-1979) | 35 (20.6) | |
|
Baby boomer (1946-1964) | 14 (8.2) | |
|
|||
|
0b | 61 (35.9) | |
|
1-5 | 40 (23.5) | |
|
6-10 | 15 (8.8) | |
|
11-15 | 11 (6.5) | |
|
16-20 | 19 (11.2) | |
|
>20 | 24 (14.1) |
aENT: ear, nose, and throat.
bStill studying.
Regarding knowledge of the terms
In contrast, when respondents were asked about their familiarity with the terms
To similarly establish common understanding, the term
A total of 50% (85/170) participants responded to the optional follow-up question “What digital therapy tools are you already familiar with? What did you think of these tools?” Free-text responses consisted of references to general digital therapy tools (19/85, 22.4%; eg,
To ensure common understanding, the term
Digital tool use was primarily descriptively analyzed across devices, software or digital system, formats, and frequency of use. Whereas
Word processing software (n=169), presentation software (n=141), videoconferencing software (n=141), research databases (n=115), and spreadsheet software (n=114) were the most frequently reported software or digital systems used among respondents. Respondents also reported using online appointment systems (n=70), electronic health records (n=60), statistics software (n=52), hospital information systems (n=38), e-billing ((n=28), hospital communication systems (n=18), e-prescriptions (n=15), and telemedicine (n=13). In the optional free response
Device use across profession, generation, and years of experience.
|
Computer | Smartphone | Tablet | e-Reader | MP3 | Virtual reality equipment | Game console | Other | ||||||||||
|
|
|||||||||||||||||
|
Physicians | 34 (100) | 20 (59) | 16 (47) | 2 (6) | 2 (6) | 0 (0) | 0 (0) | 0 (0) | |||||||||
|
SLPsa | 71 (99) | 58 (81) | 40 (56) | 3 (42) | 4 (5) | 1 (1) | 0 (0) | 2 (3) | |||||||||
|
SLP students | 43 (100) | 38 (88) | 17 (40) | 1 (2) | 0 (0) | 0 (0) | 0 (0) | 3 (7) | |||||||||
|
Medical students | 20 (95) | 21 (100) | 17 (81) | 1 (5) | 0 (0) | 0 (0) | 0 (0) | 0 (0) | |||||||||
|
|
|||||||||||||||||
|
Generation Z | 56 (98) | 53 (93) | 31 (54) | 3 (5) | 0 (0) | 0 (0) | 0 (0) | 0 (0) | |||||||||
|
Generation Y | 64 (100) | 55 (86) | 30 (47) | 0 (0) | 3 (5) | 0 (0) | 0 (0) | 4 (6) | |||||||||
|
Generation X | 34 (97) | 23 (66) | 23 (66) | 3 (9) | 3 (9) | 0 (0) | 0 (0) | 1 (3) | |||||||||
|
Baby boomer | 14 (100) | 6 (43) | 6 (43) | 1 (7) | 0 (0) | 1 (7) | 0 (0) | 0 (0) | |||||||||
|
|
|||||||||||||||||
|
0b | 60 (98) | 55 (90) | 32 (52) | 2 (3) | 0 (0) | 0 (0) | 0 (0) | 2 (3) | |||||||||
|
1-5 | 40 (100) | 37 (93) | 19 (48) | 2 (5) | 2 (5) | 0 (0) | 0 (0) | 1 (3) | |||||||||
|
6-10 | 15 (100) | 12 (80) | 9 (60) | 0 (0) | 2 (13) | 0 (0) | 0 (0) | 1 (7) | |||||||||
|
11-15 | 11 (100) | 10 (91) | 6 (55) | 0 (0) | 0 (0) | 0 (0) | 0 (0) | 0 (0) | |||||||||
|
16-20 | 18 (95) | 10 (53) | 13 (68) | 1 (5) | 2 (11) | 0 (0) | 0 (0) | 1 (5) | |||||||||
|
>20 | 24 (100) | 13 (54) | 11 (46) | 2 (8) | 0 (0) | 1 (4) | 0 (0) | 0 (0) |
aSLPs: speech-language pathologists.
bStill studying.
Software or digital system use across profession, generation, and years of experience.
|
Word processing | Videoconferencing | Presentation software | Research databases | Spreadsheet software | Web Appt. systema | Electronic health record | Statistics software | Hospital information system | e-Billing | Hospital communication system | e-Prescriptions | Tele- |
Other |
|
|
|
||||||||||||||||
|
Physicians | 33 |
27 |
27 |
27 |
28 |
19 |
24 |
15 |
19 |
14 |
13 |
8 |
7 |
2 |
|
|
SLPsb | 72 |
55 |
59 |
49 |
56 |
34 |
30 |
26 |
15 |
13 |
4 |
4 |
6 |
3 |
|
|
SLP |
43 |
42 |
42 |
30 |
22 |
10 |
3 |
8 |
0 |
1 |
1 |
3 |
0 |
0 |
|
|
Medical students | 21 |
17 |
13 |
9 |
8 |
7 |
3 |
3 |
4 |
0 |
0 |
0 |
0 |
1 |
|
|
||||||||||||||||
|
Generation Z | 57 |
53 |
49 |
38 |
30 |
14 |
10 |
12 |
4 |
4 |
0 |
1 |
4 |
1 |
|
|
Generation Y | 64 |
48 |
52 |
44 |
45 |
29 |
25 |
25 |
16 |
6 |
8 |
7 |
2 |
3 |
|
|
Generation X | 35 |
28 |
29 |
22 |
29 |
22 |
18 |
9 |
12 |
16 |
6 |
6 |
7 |
1 |
|
|
Baby boomer | 13 |
12 |
11 |
11 |
10 |
5 |
7 |
6 |
6 |
2 |
4 |
1 |
0 |
1 |
|
|
||||||||||||||||
|
0c | 61 |
56 |
53 |
38 |
29 |
17 |
7 |
10 |
4 |
2 |
0 |
3 |
0 |
1 |
|
|
1-5 | 40 |
29 |
31 |
29 |
28 |
13 |
13 |
17 |
5 |
7 |
3 |
3 |
5 |
3 |
|
|
6-10 | 15 |
12 |
12 |
9 |
12 |
9 |
10 |
6 |
8 |
2 |
3 |
2 |
1 |
0 |
|
|
11-15 | 11 |
9 |
10 |
9 |
11 |
8 |
8 |
6 |
5 |
1 |
3 |
0 |
3 |
1 |
|
|
16-20 | 18 |
15 |
13 |
12 |
15 |
8 |
9 |
6 |
5 |
8 |
4 |
3 |
4 |
1 |
|
|
>20 | 24 |
20 |
22 |
18 |
19 |
15 |
13 |
7 |
11 |
8 |
5 |
4 |
0 |
0 |
|
aWeb Appt. system: Web Appointment system.
bSLPs: speech-language pathologists.
cStill studying.
In terms of digital formats, respondents most frequently used videos (n=155), websites (n=150), web-based seminars or courses (n=130), and apps (n=100). When compared with digital formats that respondents could imagine themselves using in the future, many respondents reported also being open to other currently less frequently available digital formats including podcasts (n=112), 3D models (n=108), simulations (n=106), e-books (n=105), VR (n=72), serious games (n=66), and social networking (n=59). In the
Current and future use of digital format among study participants.
Current (C) and future (F) digital format use across profession, generation, and years of experience.
|
Videos | Websites | Web |
Apps | e-Books | Podcasts | Social |
3D |
Simula- |
Serious |
Virtual |
Other | |
|
|||||||||||||
|
Physicians |
31 (91) | 29 (85) | 28 (82) | 11 (32) | 13 (38) | 13 (38) | 5 (15) | 8 (24) | 6 (18) | 1 (3) | 3 (9) | 0 (0) |
|
Physicians |
30 (88) | 27 (79) | 28 (82) | 24 (71) | 18 (53) | 22 (65) | 6 (18) | 21 (62) | 19 (56) | 4 (12) | 14 (41) | 0 (0) |
|
SLPsa |
64 (89) | 65 (90) | 57 (79) | 44 (61) | 33 (46) | 28 (39) | 33 (46) | 16 (22) | 3 (4) | 2 (3) | 1 (1) | 1 (1) |
|
SLPs |
66 (92) | 56 (78) | 65 (90) | 63 (88) | 46 (64) | 46 (64) | 30 (42) | 48 (67) | 47 (65) | 35 (49) | 34 (47) | 1 (1) |
|
SLP |
41 (95) | 37 (86) | 33 (77) | 27 (63) | 22 (51) | 10 (23) | 9 (21) | 14 (33) | 5 (11) | 1 (2) | 0 (0) | 0 (0) |
|
SLP |
37 (86) | 29 (67) | 37 (86) | 33 (77) | 26 (60) | 28 (65) | 13 (30) | 24 (56) | 23 (53) | 19 (44) | 12 (28) | 0 (0) |
|
Medical students (C) | 19 (90) | 19 (90) | 12 (57) | 18 (86) | 13 (62) | 13 (62) | 11 (52) | 7 (33) | 4 (19) | 3 (14) | 1 (5) | 0 (0) |
|
Medical students (F) | 19 (90) | 16 (76) | 16 (76) | 20 (95) | 15 (71) | 16 (76) | 10 (48) | 15 (71) | 17 (81) | 8 (38) | 12 (57) | 0 (0) |
|
|||||||||||||
|
Generation Z (C) | 53 (93) | 50 (88) | 39 (68) | 40 (70) | 32 (56) | 22 (39) | 23 (40) | 18 (32) | 7 (12) | 4 (7) | 1 (2) | 0 (0) |
|
Generation Z (F) | 52 (91) | 44 (77) | 48 (84) | 50 (88) | 37 (65) | 42 (74) | 24 (42) | 36 (63) | 40 (70) | 29 (51) | 21 (37) | 0 (0) |
|
Generation Y (C) | 58 (90) | 55 (86) | 50 (78) | 41 (64) | 26 (41) | 18 (28) | 26 (41) | 15 (23) | 4 (6) | 2 (3) | 0 (0) | 1 (2) |
|
Generation Y (F) | 56 (88) | 45 (70) | 53 (83) | 53 (83) | 39 (61) | 39 (61) | 23 (36) | 42 (66) | 37 (58) | 23 (36) | 26 (41) | 1 (2) |
|
Generation X (C) | 31 (89) | 32 (91) | 29 (83) | 13 (37) | 18 (51) | 19 (54) | 8 (23) | 9 (26) | 5 (14) | 1 (3) | 3 (9) | 0 (0) |
|
Generation X (F) | 31 (89) | 27 (77) | 32 (91) | 27 (77) | 22 (63) | 23 (66) | 9 (26) | 20 (57) | 21 (60) | 11 (31) | 17 (49) | 0 (0) |
|
Baby boomer (C) | 13 (93) | 13 (93) | 12 (86) | 6 (43) | 5 (36) | 5 (36) | 1 (7) | 3 (21) | 2 (14) | 0 (0) | 1 (7) | 0 (0) |
|
Baby boomer (F) | 13 (93) | 12 (86) | 13 (93) | 10 (71) | 7 (50) | 8 (57) | 3 (21) | 10 (71) | 8 (57) | 3 (21) | 8 (57) | 0 (0) |
|
|||||||||||||
|
0b (C) | 58 (95) | 53 (87) | 42 (69) | 44 (72) | 34 (56) | 22 (36) | 19 (31) | 19 (31) | 9 (15) | 4 (7) | 1 (2) | 1 (2) |
|
0 (F) | 54 (89) | 43 (70) | 51 (84) | 51 (84) | 39 (64) | 42 (69) | 22 (36) | 38 (62) | 39 (64) | 28 (46) | 23 (38) | 0 (0) |
|
1-5 (C) | 35 (88) | 35 (88) | 31 (78) | 25 (63) | 21 (53) | 11 (28) | 22 (55) | 10 (25) | 1 (3) | 1 (3) | 0 (0) | 0 (0) |
|
1-5 (F) | 35 (88) | 30 (75) | 33 (83) | 33 (83) | 26 (65) | 23 (58) | 15 (38) | 27 (68) | 26 (65) | 16 (40) | 15 (38) | 0 (0) |
|
6-10 (C) | 13 (87) | 14 (93) | 12 (80) | 9 (60) | 4 (27) | 6 (40) | 6 (40) | 4 (27) | 0 (0) | 0 (0) | 0 (0) | 0 (0) |
|
6-10 (F) | 15 (100) | 12 (80) | 14 (93) | 14 (93) | 8 (53) | 10 (67) | 7 (47) | 9 (60) | 6 (40) | 6 (40) | 4 (27) | 0 (0) |
|
11-15 (C) | 11 (100) | 8 (73) | 10 (91) | 5 (45) | 3 (27) | 6 (55) | 4 (36) | 2 (18) | 1 (9) | 1 (9) | 1 (9) | 0 (0) |
|
11-15 (F) | 10 (91) | 9 (82) | 8 (73) | 9 (82) | 6 (55) | 9 (82) | 6 (55) | 8 (73) | 9 (82) | 5 (45) | 8 (73) | 1 (9) |
|
16-20 (C) | 16 (84) | 17 (89) | 16 (84) | 7 (37) | 7 (37) | 9 (47) | 2 (11) | 5 (26) | 2 (11) | 1 (5) | 0 (0) | 0 (0) |
|
16-20 (F) | 15 (79) | 14 (74) | 16 (84) | 17 (89) | 10 (53) | 14 (74) | 2 (11) | 12 (63) | 11 (58) | 6 (32) | 8 (42) | 0 (0) |
|
>20 (C) | 22 (92) | 23 (96) | 19 (79) | 10 (42) | 12 (50) | 10 (42) | 5 (21) | 5 (21) | 5 (21) | 0 (0) | 3 (13) | 0 (0) |
|
>20 (F) | 23 (96) | 20 (83) | 24 (100) | 16 (67) | 16 (67) | 14 (58) | 7 (29) | 14 (58) | 15 (63) | 5 (21) | 14 (58) | 0 (0) |
aSLPs: speech-language pathologists.
bStill studying.
When asked about frequency of digital therapy tool use, of the total 170, 47 (27.6%) respondents indicated that they were still studying, 60 (35.3%) respondents indicated never using digital therapy tools, 27 (15.9%) indicated monthly, 26 (15.3%) indicated weekly, and 10 (5.9%) indicated daily. Significant effects for profession (
Regarding digital learning tools, 18.8% (32/170) respondents never used such tools, 31.2% (53/170) used these monthly, 32.9% (56/170) used these weekly, and 17.1% (29/170) used digital learning tools daily. Significant differences were found across generation (
Most of the respondents held positive views regarding digitalization in medicine. When asked whether they viewed digitalization positively, of the total 170, 68 (40%) respondents agreed, 90 (52.9%) somewhat agreed, 11 (6.5%) somewhat disagreed, and 1 (0.6%) disagreed. Significant generational differences were found (
Regarding digital therapy tool attitudes, of the 170, 91 (53.5%) respondents agreed, 74 (43.5%) somewhat agreed, and 5 (2.9%) somewhat disagreed to being open to the use of digital therapy tools. In total, 28.2% (48/170) respondents agreed and 41.2% (70/120) somewhat agreed that digital therapy tools offered more advantages than disadvantages with the potential to individualize therapy, whereas 28.8% (49/170) somewhat disagreed and 1.8% (3/170) disagreed. A total of 2.9% (5/170) respondents agreed and 32.4% (55/170) somewhat agreed that they doubted the quality or validity of digital therapy tools, whereas 53.5% (91/170) somewhat disagreed and 11.2% (19/170) fully disagreed. When asked whether they would be more likely to use a digital therapy tool if it were medically certified, of the 170 respondents, 87 (51.2%) respondents agreed, 63 (37.1%) somewhat agreed, 16 (9.4%) somewhat disagreed, and 4 (2.4%) disagreed. Significant differences were demonstrated across profession (
When asked about concerns regarding digital therapy tools, 8.8% (15/170) respondents indicated no concerns, 55.9% (95/170) indicated technical difficulties, 49.4% (84/170) indicated limited validity of digital therapy tools, and 72.9% (124/170) indicated insufficient diagnostic and therapeutic quality of tools. A total of 12.9% (22/170) participants indicated
Regarding digital learning tool attitudes, of the 170, 125 (73.5%) respondents agreed, 42 (24.7%) somewhat agreed, and 3 (1.8%) somewhat disagreed to being open to the use of digital learning tools. In total, 41.8% (71/170) respondents agreed, 44.7% (76/170) somewhat agreed, 12.4% (21/170) somewhat disagreed, and 1.2% (2/170) disagreed that digital learning offered more advantages than disadvantages. Furthermore, 0.6% (1/170) respondent agreed, 7.1% (12/170) somewhat agreed, 62.9% (107/170) somewhat disagreed, and 29.4% (50/170) disagreed that they doubted the quality and validity of digital learning tools. Many respondents agreed (97/170, 57.1%) and somewhat agreed (57/170, 33.5%) that they would be more likely to use a digital learning tool if it were to be developed by an academic institution or professional regulating body, whereas 5.9% (10/170) somewhat disagreed and 3.5% (6/170) fully disagreed. In total, 21.8% (37/170) respondents agreed, 44.7% (76/170) somewhat agreed, 26.5% (45/170) somewhat disagreed, and 7.1% (12/170) disagreed that they felt confident in their knowledge of digital learning tools.
When asked about their concerns regarding digital learning tools, 11.8% (20/170) respondents reported no concerns, 52.4% (89/170) reported technical difficulties, 45.3% (77/170) reported questionable quality of learning material, 40% (68/170) reported difficulties with self-discipline and sufficient learning competence, and 52.4% (89/170) had concerns regarding reduced social interaction. A total of 10.6% (18/170) participants indicated
Respondents were asked to indicate their preferred level of virtuality, interactivity, and flexibility in terms of time and space. Out of the 170 total respondents, 4 (2.4%) indicated that they preferred in-person learning, 39 (22.9%) preferred in-person learning with additional e-material, 105 (61.8%) respondents preferred blended learning, and 22 (12.9%) preferred the inverted classroom approach. In terms of interactivity, 21 (12.4%) respondents preferred a passive level, 69 (40.6%) preferred a limited level, 63 (37.1%) preferred a moderate or complex level, and 17 (10.0%) preferred an advanced or active level. No significant differences across profession, generation, or years of experience were found regarding the preferred level of virtuality and interactivity. In terms of time and space flexibility, 28.8% (49/170) respondents preferred traditional time and space–dependent learning environments, 3.5% (6/170) preferred time flexibility only, 30.6% (52/170) preferred space flexibility only, and 37.1% (63/170) respondents preferred time and space–flexible learning environments. As data did not meet chi-square test assumptions for the minimal number of observations per cell, significant findings across profession and years of experience are not reported.
This cross-sectional survey study is, to the best of our knowledge, one of the first to investigate knowledge, use, attitudes, and preferences regarding digital health and learning topics interdisciplinarily across the fields of speech-language pathology, phoniatrics, and otolaryngology, which work collaboratively together to treat communication disorders. Although some previous studies have investigated some of these aspects within each respective field, it is useful to analyze across disciplines to identify knowledge gaps, areas for improvement, and collaborative problem-solving opportunities.
Participants overall reported greater surface level knowledge regarding terminology and specific therapeutic and learning tools. When presented with the terms
In contrast, respondents reported being more knowledgeable regarding the terms
Most of the respondents indicated knowing digital therapy tools, especially SLPs when compared with physicians and medical students. Although this finding could be explained by different professional scopes of practice, it could also reveal a gap that interdisciplinary collaboration could help to close. Although there is existing literature regarding digital applications in otorhinolaryngology and phoniatrics in the German-speaking population [
Most respondents (131/170, 77.1%) reported that they were familiar with digital learning tools. General and specific tools were reported with learning management systems (eg, Moodle), videoconferencing systems (eg, Zoom), and web-based courses or webinars predominating, which may reflect the surge of these platforms during the ongoing COVID-19 pandemic [
In line with commonly reported device use, professionals and students mostly used computers, smartphones, and tablets for learning, teaching, and professional purposes [
In terms of frequency of use, the largest proportion of respondents (60/170, 35.3%) surprisingly responded that they never used digital therapy tools, further pointing to the lag in digitalization implementation. Given that students are usually not working clinically, the significant differences observed between them and SLPs is unsurprising. However, the finding that professionals with 1-5 years of experience used digital therapy tools more indicates a growing acceptance of digital eHealth solutions [
Attitudes toward digitalization were primarily positive, with Generation Z demonstrating significantly more positive views than their generational counterparts, as expected per previous research trends [
Most respondents indicated being open to using digital therapy tools. Interestingly, Generation Z and respondents who were still studying reported being more likely to use digital tools with medical certification than their Generation X counterparts and those with ≥20 years of professional experience. To the best of our knowledge, this specific finding has not been previously reported in the literature. A study with French university students found that students were more comfortable with digital health interventions provided these would be promoted by institutional or official entities, though these opinions were not compared against those of seasoned professionals or older generations [
Intriguingly, a little under one-third of respondents demonstrated skepticism regarding whether such tools provided more advantages than disadvantages and indicated doubts regarding their quality and validity, and a little over half of respondents reported concerns with technical difficulties. These concerns urge for focused research on efficacy and barriers to digital technology use. Current and future physicians and clinicians should be increasingly engaged in systematically evaluating eHealth technologies through tools such as the Mobile App Rating Scale (MARS) [
In terms of digital learning, most respondents were open to its use, agreed that it offered more advantages than disadvantages, and felt mostly confident with their knowledge of digital learning tools. Interestingly, when reporting concerns, however, 45.3% (77/170) of respondents still questioned the quality of digital learning material, despite previous indications of not being doubtful of quality. This disconnect reveals hesitations in digital uptake and aligns with the reported need to find effective means of verifying the quality and validity of digital learning tools. Although technical standards exist through organizations such as the International Organization for Standardization (ISO) or the Institute of Electrical and Electronics Engineers, these are not immediately comprehensible for clinical instructors, and efforts are still being made to devise frameworks that fit within clinical professional responsibilities and standards [
In the following study, no significant differences in preferred levels of virtuality, interactivity, and flexibility in terms of time and space were observed across profession, generation, or years of experience. The absence of generational differences aligns with several previous reports [
Critically, this study must be interpreted in light of its limitations. First, this cross-sectional investigation was conducted in the German-speaking population and thus may have limited external validity to other cultural and geographical contexts. However, as digitalization is a global phenomenon, we hope that our findings shed some light on factors that could be playing into common trends, areas of opportunity, and barriers to the uptake of digital technologies. It is also important to note that the stark contrast in the number of female versus male participants can likely be attributed to the fact that the field of SLP is predominantly female (93%) and the number of female otorhinolaryngologists has been steadily rising (35.7% as of 2020) in Germany [
As a survey study, the following investigation analyzed perceptions regarding digital therapy and learning, though it would be important in future studies to also measure actual knowledge, implementation, and use. In moving forward toward an uncertain digital future in which the evidence base for new technologies has yet to be developed or may even be rendered obsolete before one can even be formed, it will be essential to engage in
Our study has demonstrated that students and professionals in CSD continue to feel uncertain regarding their knowledge of digital health and digital learning, are still using more traditional devices, software or systems, and formats, though are interested in exploring more interactive, digital means for teaching, learning, and practice. They have understandable concerns surrounding quality and validity of digital resources, data privacy, technical complexity, social engagement, and effective implementation. These concerns amidst the rapidly changing digital landscape urges for the expedited exploration of empirically substantiated, though flexible, solutions.
Survey screens (in German).
augmentative and alternative communication
communication sciences and disorders
speech-language pathologist
virtual reality
The authors would like to thank the Alexander von Humboldt Foundation for supporting the international and interdisciplinary exchange that made this collaboration possible. The first author, YL, is a former Chancellor Fellow of the Alexander von Humboldt Foundation who worked closely with and was hosted by the second and third authors, ML and CNR. The first author would also like to thank Ms Daniela Kuruczová for her tremendous guidance with the statistical analysis.
None declared.