Digital Competencies of Nursing Students - Summary of Literature review by NDUN

Literature review summary by the Nam Dinh University of Nursing Team.

Authors: Le Thanh Tung, Ngo Huy Hoang, Truong Tuan Anh, Nguyen Thi Minh Chinh, Nguyen Thi Thanh Huong, Mai Thi Thanh Thu, Hoang Thi Minh Thai, Hoang Thi Van Lan, Pham Thi Thuy Chinh


Over the last few decades, digital competence is a concept that is increasingly used in public discourse. However, the definition and meaning of this concept are unclear. In policy documents and policy-related discussions digital competence related to “what kinds of skills and knowing people should have in a knowledge society, what to teach young people and how to do so” (Ilomäki, Paavola and Lakkala, 2016, p. 655). Therefore, the scope of this paper investigated existing literature in the field of digital competence of healthcare students in Asia to identify the lack of clear definitions and theory in the current body of evidence; and clearly understand on this concept in different times and countries.  


This literature review aims to explore the knowledge on the digital competency in healthcare students in Asia. 

Review method 

A searching was conducted on Academic Search Complete, Cumulative Index of Nursing and Allied Health Literature (CINAHL), Medline with Full Text, and Medline Journals. Two hundred and eighty-nine journal articles meeting the high-level search criteria were found. Key search phrases and database results are cited in Table 1. Key terms included “nurses,” “nursing students,” “personal digital assistants,” “mobile technology,” and “handheld devices.” After eliminating studies more than five years old, duplicates, articles related to non-nursing health care professionals, opinion pieces, published studies involving only practicing nurses and not students, dissertations, and articles on social media, seventeen published studies involving the use of mobile devices in nursing educational settings met the criteria for inclusion. 

Research Question: What are the digital competencies of nursing students/health care students in Asia? 

  1. Population: nursing students/health care students 
  2. Concept: digital competencies 
  3. Context: Asia
  4. Key words: digital competencies, nursing students, health care students 
  5. Scope of review:
  • Studies need to look at: 289 
  • Studies need to use: 5 
  • The data collection was conducted in 5 years, from 2014 to 2019 
Include criteria : Exclude criteria:
  • Articles published from 2014 to 2019 
  • English language 
  • Answers the research question 
  • Full-text available 
  • Non-research article  
  • Government policy 



  1. Search Strategy:

Data sources: A comprehensive electronic database search was conducted in PubMed, Web of Science, CINAHL, Embase, PsycINFO, ISI, SCOPUS, to retrieve relevant articles published in English between January 2014 and November 2019 

Search Strategy: (“digital competenc*” OR “digital skills” OR “ICT competenc*OR “ICT skills” OR “digital abilit*” OR “ICT abilit*” OR “digital capabilit*” OR “ICT capabilit* OR “informatics competenc*” OR “informatics abilit*” OR “informatics capabilit*) AND (“nursing students” OR “health care students”) 

  1. Search outcomes:

After the removal of duplicates, the remaining records were assessed for relevance by the searcher based on abstracts. Subsequently we identified 5 records that met the criteria of this systematic review. The process used to reduce and evaluate the records is illustrated in Fig 1 Prisma diagram (2009) 

  1. Data extraction and synthesis

All 5 articles included were quantitative studies. Table 1 summarizes studies included in this review and we may later report detailed findings in terms of these subsequent themes to identify models that we could investigate as a part of the DigiCare project. 




The purpose of this paper searched the articles that related to digital competences of Asia health care students. After searching, five articles which are quantitative studies were found. The contents of those articles illustrated the digital competences of Asia health care students 

As a result of the analysis, three main digital competences of Asia students were knowledge, skill and attitude about digital were found (Table 2.). Firstly, knowledge about digital which consists of perceive smartphone useful for internet, perceive internet useful for health, perceive internet useful for leaning activities, knowledge about using software, knowledge about evaluating and using health resources located on the Internet. Secondly, skills about digital include skills to search, use and evaluate health information on the Internet; skills to learn through internet; and skills to find and use websites. Finally, attitude about digital includes attitude to use the internet and attitude to use the computer. 

For knowledge about digital, nurse students perceived smartphone useful for internet as most of them (78.3%) reported smartphones as their initial vehicle for using the internet (1). The second point, nurse student perceived internet useful for health because the internet helps them to make decision, to find helpful health resources, to access health-related resources, and to find the knowledge related to ehealth. The evidence showed that there were 65.1% of students who reported internet was useful for making health decisions (1) and 16, 9% of students responded that internet was very useful tool in helping them make decisions about their health (4). Furthermore, only 25.6% (n = 45) of students felt confident using the information from the Internet to make health decisions (4). There were 40% of students either agreed or strongly agreed with where to find helpful health resources on the Internet (4). In Sharma et al (2019) showed that 61.8% of participants felt that it was important to be able to access health-related resources (1). In Park at el (2015) illustrated that participants with a high level of e-health understanding found that the Internet was more useful and important than participants with a low medical level (4). The third point, nurse student perceived internet useful for learning activities. In the study of Yan Li et al (2015) showed that the Internet DLOs (Digital Learning Objects) was accuracy, usefulness, and importance was rated as 6.85 (SD 1.48), 7.27 (SD 1.53), and 7.13 (SD 1.72), respectively, out of a high score of 10 (3). The next point, for knowledge about using software, the evidence showed that less than 25% of the students reported having little or no knowledge in Excel and other software (5). Lastly, for knowledge about evaluating and using health resources located on the Internet, Park and Lee (2015) indicated that in terms of perceived ability to differentiate between a high quality and a low quality of a health-related web site, only 27.8% (n= 49) agreed or strongly agreed (4). 

Skills about digital consists of, nurse students’ skills to search, use and evaluate health information on the Internet. Sharma et al (2019) showed that 44.7% of the sample perceived that they had an average level of Internet skills (1). Dashti et al ( 2016) study on E-Health literacy of medical and health sciences university students in Mashhad, Iran showed that almost half of the students had moderate level of internet skill based on eHealth literacy questionnaire (2). Moreover, an other study showed that 50% of the participants either agreed or strongly agreed that they felt comfortable using the Internet to find information (4). Nurse students had skills to learn through internet. The evidence showed that 97.5% (428/439) learned a variety of clinical procedures through Internet DLOs (3). Nurse students also had skills to find and use websites which were skills to using YouTube, websites and blogs (3). Three-quarters (341/439, 77.7%) of students used public search engines, 93.2% (409/439) of them used YouTube, almost half of them used universities’ websites, 12.5% of them used blogs, 29.8% of them used  manufacturers’ guidelines, and 26.9% of them used other websites  to accessed DLOs (3). 

For attitude about digital, nurse students had attitude to use the internet and attitude to use computer. Nurse students frequently used the internet but not for health purposes (1). One study showed that only 19.7% reported that they used the internet for health purposes (1). However, the internet using time was reported as 120.00, IQR=180.0 minutes (minimum was 10.0 minutes and maximum were 900.0 minutes) (2). Besides that, rarely student used internet for study on health subject (3) and attitudes towards internet depends on students’ perception of their skills, usefulness of and frequency of using internet (1). Moreover, nurse students’ attitude to computer use depends on students’ perception of their competence (5). 

For the relationship among knowledge, skill and attitude about digital was found in the literature, the information technology knowledge and experience can contribute to students’ positive attitudes toward working with computers, expose them to the world of technology and improve their computer competencies (5). 


Our findings suggest that important digital competences of healthcare student consisted of knowledge about digital, skill about digital and attitude about digital. The health care students’ ability to use internet vary depending on in what purpose internet is needed. The results can be used to develop the digital competences of nursing or health care students. The curriculum or course syllabus related to digital will be based on the current digital competences. Besides that, these results could be benefited in DigiCare Asia-project and development of our health care education.  



  1. Ayala G., Dganit S. and Lilac L. (2016). Integrating Information Technology’s competencies into academic nursing education–An action study. Information & communications technology in education, 3.
  2. Dashti S, Peyman N, Tajfard M, Esmaeeli H. E-Health literacy of medical and health sciences university students in Mashhad, Iran in 2016: a pilot study. Electron Physician. 9 (3):3966–3973
  3. Ilomäki, L., Paavola, S., Lakkala, M., & Kantosalo, A. (2016). Digital competence–An emergent boundary concept for policy and educational research. Education and Information Technologies, 21(3), 655– 679. doi:10.1007/s10639-014-9346-4
  4. Park H, Lee E. Self-reported eHealth literacy among undergraduate nursing students in South Korea: a pilot study. Nurse Educ Today. 2015; 35(2):408–413. 
  5. 5. S. Sharma, N. Oli, B. Thapa (2019). Electronic health–literacy skills among nursing students. Advances in Medical Education and Practice,10, 527–532.
  6. 6. Tse Yan Li, Xiaoli Gao, Kin Wong, Christine Shuk Kwan Tse,  Ying Yee (2015). Learning Clinical Procedures Through Internet Digital Objects: Experience of Undergraduate Students Across Clinical Faculties. JMIR Medical Education, 1(1)




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