Social media usage and addiction among

medical students in Islamabad, Pakistan

Authors:
1. Ammar Haider Malik (Lead investigator)
Mobile No : +923215330004
E-mail address: ​ammar95malik@gmail.com
2. Raza Zubair Khan
3. Amir Khan
4. Ali Naseem
Abstract
Background:
Social media use in recent years has been gaining popularity worldwide. It has
been stipulated by research that the prevalence of social media usage is very high
and especially so in the 18-25 age group. Very few studies have been carried out
in Pakistan on social media usage and addiction especially on medical students
who compared to other students have a bigger workload.
Objective:
The main objective of the study is to determine the usage and addiction to social
media among medical students in Pakistan. The secondary objectives are to
examine the effects of social media on sleep quality and academic performance of
medical students.
Methods:
A cross sectional study will be conducted among MBBS students of Shifa College
of Medicine in Islamabad randomly selecting students from all 5 classes enrolled.
Data will be collected by a means of a questionnaire​ ​incorporating two validated
instruments and self-designed questions. ​Data will be analyzed using SPSS version
23.
Possible Constraints:
Approaching the study subjects will be challenging as most will be reluctant to
disclose any negative impact social media has had in their lives as in their mind
social media is a vital part of their lives without which they do not know how to
interact with each other.

Key Words​: Social networking, depression, Academic performance, medical

students
Introduction
The internet as we know is the foremost tool that the younger generations take to
when they come up with any sort of problem in everyday life. Especially the
current generation of children who dominate as the most active online users grew
up in what we know as the digital age. It has been highlighted that internet usage
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can enhance the social lives of its users . Social networking is one of the most
popular online activities with high user engagement rate. Social ​Networking Sites
(SNSs) that come in this category including Facebook, Snapchat, Twitter and
Instagram and their rapid integration into our lives is due to their ease of use and
their simplicity.​ ​Social network usage is ever increasing in 2017, 71% of internet
users were social network users and these figures are expected to grow, in 2019,
it is estimated that there will be around 2.77 billion social media users around the
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globe, up from 2.46 billion in 2017 .
In this age of technological development social networking sites are becoming
more and more popular among students especially in Pakistan. Around
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20,431,000 Pakistanis are using internet on a regular basis . The aim of social
websites in the beginning was for people to share ideas and innovations all over
the world without the limitations of geography and language .But that original
goal has been overtaken with a desire to share any and all details of life with the
world with the advent of the SNSs. This attitude to compulsively share private
moments with complete strangers on the internet has seen a sharp increase in
recent years. For example Facebook the dominant SNS since the past decade has
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seen year to year increase in its online presence .
A recent study conducted in Pakistan showed that 67.1% students are spending
more than four hours per day on social media as compared to the usage of the
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traditional media which is just 25.2% . Many believe that online activity is the
modern norm and should be considered a right but can be potentially addictive
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and its prolonged use can suggest an underlying narcissistic personality trait .

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There are multiple studies that imply there is a negative relationship between
Facebook and its impact on academic performance including one which suggests
how children with lower attention span focused more on Facebook as its diversity
of topics and interactive interface makes it more appealing as opposed to
studying. However students with longer attention spans do not need as much
change of pace to keep up their interest so generally they are the ones who use
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Facebook less .
A study conducted in Peshawar, Pakistan concluded that students in age group of
15-25 mostly used social media for entertainment purposes. 60% of male
students commonly used social networking websites for knowledge. Graduation
students generally prefer social networking websites for entertainment. From this
research study it was also found that people can use social networking websites
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due to social influence . Social media use in medical education is an emerging
field of scholarship that merits further investigation. Educators face challenges in
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adapting new technologies, but they also have opportunities for innovation .
Socializing in this digital age is a very easy yet difficult task. The easy part being,
simply go online on the many ​Social Networking Sites and connecting with people
from around the world with a few clicks. Difficult at the same time because we
are no longer acquainted to going out of the comfort of our homes and meeting
new people and connecting with them using the old fashioned way ​of talking. Not
only does this apply to us meeting new people but we have difficulty talking to
the people we have known before. This era of social media has made us distant to
the people physically around us and at the same time closer to an audience of
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people on our social media that we call ‘friends’ or ‘followers’ .
Medical students, have used these SNSs platforms as means of communication
not just with their peers but with health care professionals and their respective
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alumni and seniors to gain a better understanding of their field of study . It
should be noted that this does not come without adverse effects. Generally social
media has a negative impact on academic performance especially for new
student’s just entering higher education, as students eager to please in their new
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environment tend to read online guidance with negative outcomes . People
active on SNSs have also been linked with depression and anxiety such not having
enough likes on their posts or photographs and this may correlate to drop in
medical students academics. Since more time on Facebook is correlated
negatively with GPA it is likely that this student will have a lower than average
GPA. A good amount of sleep is paramount to a good academic performance for
medical students as it dictates how active their mind is during classes. In our study
we would want to correlate the amount of sleep lost to social media and how it
impacts academic performance.
A study conducted in Bangladesh concluded that the more addicted the students
are to the Internet the more they develop psychological distress and depression
and this study further emphasizes that internet usage increases proportionally
with increased workload as “From 1st to 4th year students severe Internet
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addiction was reported among 4th year students” as stated in this study .
A study conducted in the Oklahoma State of America revealed through a survey
that previous studies conducted in the region have found that more than 90% of
college students use social networks and that has bad effects on their learning
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performance .
According to a study conducted among first year undergraduates in a United
Kingdom university, it was concluded that the majority of the students thought of
Facebook as an important social tool used to aid their settling in process at
University, as a means of communication within the student community and
primarily as a tool for social purposes rather than educational. The study also
concluded that Facebook was but one tool that students use to socialize, and that
'face-to-face and "real" friendships remain significant as well'. The study advised
that “higher education institutions could sensibly and gently act as a catalyst for
this process for pre-registration students by promoting the existence of Facebook
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groups”
One study conducted in India revealed that social network websites grab
attention of the students and then diverts it towards non-educational actions

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including useless chatting online and random browsing of whatever may catch
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their eye while online 15​.
According to studies done previously social networking websites best serve
educational goal and objectives by connecting students through such informal
methods as it allows student through the process of collaborative sense making.
Some social networking websites are specifically specified for educational
environment including linkedin.com which is fully featured for education purpose
and lets users update their educational credential and make professional
connections but social networking websites which entertain user with special and
detailed information profile are more liked by people instead of other social
networking websites which provide fewer features. Education is very essential
part of an individual’s life and according to a study conducted in India that the
youth of today shows a lot of interest in using social networks but unfortunately
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the study concluded that Social Networks affect education adversely. 16
In a study conducted in America it was concluded that the “prevalence of
depression or depressive symptoms among medical students was 27.2% and that
of suicidal ideation was 11.1%. Further research is needed to identify strategies
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for preventing and treating these disorders in this population” 17

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Research Question:
What is the usage and addiction to social networking sites among medical
students in Islamabad, Pakistan?

Objectives
Primary Objective:
● To determine the usage and addiction to different social networking sites
among medical students in Islamabad, Pakistan

Secondary Objectives:
● To investigate the effect of social media on sleep quality in medical
students in Islamabad, Pakistan

● To examine the effect of social media on academic performance of medical

students in Islamabad, Pakistan

Methodology
Using a questionnaire first year medical students were inquired about the current
status of their SNS using habits to determine their sleep quality and academic
performance. To this end we used Bergen scale to assess the severity of SNS
addiction and the Pittsburgh Sleep Quality Index (PSQI) to measure the quality of
sleep in the medical students. Due to time constraints only first year medical
students of Shifa medical college (SCM) were assessed. For an extensive review of
SNS’s impact self-generated questions were used to inquire about the different
aspects of SNS’s and the opinions generated from their usage by medical
students.
Results
Out of 95 valid samples there was 1:1 gender presence. Collectively the single
most used SNS’s was Whatsapp and second most used was Facebook while least
used were Snapchat and Twitter in that order. Most used way to access social
media accounts were smartphones (58.9) and laptops (32%) respectively. More
than 50% were using social media for more than 5 years while new users who
started in last 6 months accounted for only 4%. Mean time spend on social media
was about 2.84Hrs. 72.6% restricted usage of social media when attending
college. 55.8% agreed that social media helped in studies and 52.6% agreed that
SNS’s were used by them for examination preparation while 33.7% agreed that
social media has a negative impact on academics. Only 26 maintained that that
social media be integrated in academic learning. Pqsi results showed 40% had
sleep deprivation or were having irregular sleep patterns.
Do you think SSNS distract you during study time or exams

Frequency Percent Valid Percent Cumulative Percent

strongly agree 33 34.7 34.7 34.7

agree 48 50.5 50.5 85.3
not sure 5 5.3 5.3 90.5
disagree 5 5.3 5.3 95.8
strongly disagree 4 4.2 4.2 100.0
Total 95 100.0 100.0

Do you think that social networking sites should be integrated as a central part of your learning

Frequency Percent Valid Percent Cumulative Percent

strongly agree 6 6.3 6.3 6.3

agree 26 27.4 27.4 33.7
not sure 24 25.3 25.3 58.9
disagree 27 28.4 28.4 87.4
strongly disagree 12 12.6 12.6 100.0
Total 95 100.0 100.0
 PQSI Statistics
Frequency Percent Valid Percent Cumulative Percent

Valid 1 1.1 1.1 1.1

greater than 5 37 38.9 38.9 40.0
less than 5 Total 57 60.0 60.0 100.0
95 100.0 100.0

*Less than 5 is the desired score

Discussion
The findings of our study are based out of the analysis of 95 valid samples. For a
greater in depth perspective of the implications of social media addiction a larger
sample frame is required to gain a better understanding. With the current
information that we have we can, however hypothesize regarding some of the
potential hazards that may exist.
The most used SNS amongst our sample frame is Whatsapp with Facebook
coming in as a close second. Amongst these users we see a similar outcome
amongst both genders.
Whatsapp happens to be a free messenger app that can be used to send texts,
images, videos and audios to any particular individual or a group of individuals,
given that all of them happen to be active users. According to our data we see
that the majority of individuals happen to be active users for more than the past 5
years. These users either use Whatsapp as an adjunct to conventional SMS texting
or instead of it, because of its versatility and easy access of convenient features.
The other SNS most used happens to be Facebook, a website that allows users to
connect with friends, family and peers. Facebook gives its users the ability to
share updates and all sorts of content with their “audience”. Giving users a
platform of sorts, to not only express themselves but also reach out and learn
about the viewpoint of many others.
26 participants had the viewpoint that social media be integrated as part of the
mainstream academic learning method, and one can understand the ease it can
bring but it should be further investigated whether this belief of integration
benefits medical students or is it a dependency that has led to this belief,
however there is insufficient data to responsibly comment on this.
One thing made clear by our study, especially with the help of the Pqsi scale is
that out of 95 valid answers 40% showed inadequate sleep or had irregular sleep
patterns, whether these are due to SNS usage or not this can manifest
detrimental effects on physical and mental health. And according to the scoring of
the 40% it is advised that they seek counselling regarding their sleep patterns
from a certified healthcare provider especially since their field of study already
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has the highest depression rates 17​.

Conclusion
Our research was inconclusive regarding the aspect that social media use has a
directly detrimental effect upon the participants’ academics or their sleep as all
subjects used social media sites but only 40% reported of negative impacts on
sleep and only 33.7% believed that social media had a negative impact on their
academics.
For conclusive evidence that may be helpful in the betterment of medical
students there is a clear need of a much more extensive study that looks into the
fine details of the academic performance of the test subjects and correlates their
social media usage habits as well as their sleeping cycle disturbances, so that we
can clearly identify how social media negatively impacts students.
Our study identifies that there is an obvious detrimental side of excessive social
media use, however the extent needs to be evaluated so that we may look into
the apt intervention that not only helps the academics but also the digital well
being of the young generation of upcoming healthcare professionals.

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