Digital transition in rural emergency medicine: Impact of job satisfaction and workload on communication and technology acceptance
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Abstract
Background: Tele-emergency physicians (TEPs) take an increasingly important role in the need-oriented provision of emergency patient care. To improve emergency medicine in rural areas, we set up the project ‘Rural|Rescue’, which uses TEPs to restructure professional rescue services using information and communication technologies (ICTs) in order to reduce the therapy-free interval. Successful implementation of ICTs relies on user acceptance and knowledge sharing behavior. Method: We conducted a factorial design with active knowledge transfer and technology acceptance as a function of work satisfaction (high vs. low), workload (high vs. low) and point in time (prior to vs. after digitalization). Data were collected via machine readable questionnaires issued to 755 persons (411 pre, 344 post), of which 304 or 40.3% of these persons responded (194 pre, 115 post). Results: Technology acceptance was higher after the implementation of TEP for nurses but not for other professions, and it was higher when the workload was high. Regarding active communication and knowledge sharing, employees with low work satisfaction are more likely to share their digital knowledge as compared to employees with high work satisfaction. This is an effect of previous knowledge concerning digitalization: After implementing the new technology, work satisfaction increased for the more experienced employees, but not for the less experienced ones. Conclusion: Our research illustrates that employees’ workload has an impact on the intention of using digital applications. The higher the workload, the more people are willing to use TEPs. Regarding active knowledge sharing, we see that employees with low work satisfaction are more likely to share their digital knowledge compared to employees with high work satisfaction. This might be attributed to the Dunning-Kruger effect. Highly knowledgeable employees initially feel uncertain about the change, which translates into temporarily lower work satisfaction. They feel the urge to fill even small knowledge gaps, which in return leads to higher work satisfaction. Those responsible need to acknowledge that digital change affects their employees’ workflow and work satisfaction. During such times, employees need time and support to gather information and knowledge in order to cope with digitally changed tasks.
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Individuals are more likely to accept and adopt technology when their workload is high.
“Hasebrook et al. (2023) found that individuals were more likely to accept and adopt technology when their workload was high.”
From Is it harmful or helpful? Examining the causes and consequences of generative AI usage among university students (2024) · cites this paper as Hasebrook et al. (2023)
The Results (Technology acceptance) report higher technology acceptance among employees with high workload, and the Conclusion says they were more willing to use TEPs. The paper does not establish that they actually adopted the technology, and its finding concerns employees and TEPs in a rural emergency-medicine setting rather than individuals and technology generally. (LLM, conf=0.87)
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Abbas, M., Jam, F. A., & Khan, T. I. (2024) · International Journal of Educational Technology in Higher Education · doi:10.1186/s41239-024-00444-7 · Cited by 531 · see citing works
“In another study, Hasebrook et al. (2023) found that individuals were more likely to accept and adopt technology when their workload was high.”
BackgroundOptimization of Rural Demand-Responsive Transportation through Transfer Point Allocation
Martí, P., Jordán, J., la Prieta, F. D., & Julián, V. (2023) · Electronics · doi:10.3390/electronics12224684 · Cited by 7 · see citing works
Hasebrook, J. P., Hecke, J., Volkert, T., Singer, M., Hinkelmann, J., Michalak, L., & Hahnenkamp, K. (2023) · Frontiers in Psychology · doi:10.3389/fpsyg.2023.1106501 · Cited by 6 · see citing works
Self-citationKlager, E., Teufel, A., Eitenberger, M., Bukowski, N., Lintschinger, J. M., Manschein, V., Metelka, P., Willschke, H., Schaden, E., Frimmel, C., et al. (2024) · PLoS ONE · doi:10.1371/journal.pone.0310895 · Cited by 5 · see citing works
Adoption of ChatGPT in Higher Education: A UTAUT Based Comparative Study of Students and Lecturers
Ayalon, A., & Ido, O. (2026) · Journal of Educational Technology Systems · doi:10.1177/00472395261439145 · Cited by 3 · see citing works
Kausar, F., Sabha, N. U., Sanam, T., Bibi, N., & Hussain, S. (2025) · medtigo Journal of Medicine · doi:10.63096/medtigo30623222 · Cited by 3 · see citing works
Hahnenkamp, K., Fleßa, S., Laslo, T., & Hasebrook, J. P. (2025) · Journal of Personalized Medicine · doi:10.3390/jpm15070314 · Cited by 3 · see citing works
Self-citationSrisuksa, N., Wiriyapinit, M., Bhattarakosol, P., & Phuthong, T. (2025) · TEM Journal · doi:10.18421/tem142-48 · Cited by 2 · see citing works
Ugon, J., Pierce, C., Cain, A., & Laird, B. (2026) · Australasian Computing Education Conference · doi:10.1145/3786228.3786244 · Cited by 1 · see citing works
Population Dynamics in Digital Communication Transformation: Kajang Community in Bulukumba Regency
Zelfia, Z., Cangara, H., Pulubuhu, D. A. T., & Unde, A. A. (2024) · International Journal of Religion · doi:10.61707/5dr9mp74 · Cited by 1 · see citing works
Davis, D., Wray, J., Oldham, G., Elkeles, D., Borham, T., Gough, P., Tomlinson, M., James, N., Hill, A., Sullivan, E., et al. (2025) · medRxiv · doi:10.64898/2025.11.27.25340564 · Cited by 1 · see citing works
Lambelanova, R., & Toyib, A. (2024) · Journal of Ethnic and Cultural Studies · doi:10.29333/ejecs/2000
Innovation – Anzeichen eines strukturellen Kraftmangels?
Hackl, B., Hasebrook, J. P., Baumann, D., & Zünkeler, B. (2024) · Springer eBooks · doi:10.1007/978-3-658-45697-9_1
Self-citationZekioğlu, A., Uluçam, E., Taş, A., Baltacıoğulları, H., & Özkeçeci, E. (2025) · Work · doi:10.1177/10519815251346452
Shishakly, R., Abukhait, R., & Khattak, M. N. (2025) · Lecture notes in networks and systems · doi:10.1007/978-3-032-00450-5_53
Ruminggo, R. K. S., & Hutabarat, Z. (2025) · Al-Kharaj Jurnal Ekonomi Keuangan & Bisnis Syariah · doi:10.47467/alkharaj.v7i8.7998
Akzeptanz des TNA-Systems und Zufriedenheit mit diesem
Metelmann, C., & Metelmann, B. (2026) · Springer eBooks · doi:10.1007/978-3-662-72121-6_24
Self-citationHumaira, H., Adam, M., & Kesuma, T. M. (2026) · International Journal of Social Science Humanity & Management Research · doi:10.58806/ijsshmr.2026.v5i6n26
Summermatter, D., Melin, J., Blomberg, H., Äng, B. O., & Strömsöe, A. (2026) · JMIR Formative Research · doi:10.2196/96083
Elmahgoub, S., Debes, W. A., Al-rawajfeh, R., Daradkeh, F. A. K., Sheeha, B. H. B., & Aburub, A. (2026) · Healthcare · doi:10.3390/healthcare14172685
Toll, K., Haywood, Z., Yeung, J., Jurat, D. R., Andrew, S., Williams, A., Moullin, J. C., & Robinson, S. (2026) · Journal of Telemedicine and Telecare · doi:10.1177/1357633x261480531
- Authors
- Hasebrook, J. P., Michalak, L., Kohnen, D., Metelmann, B., Metelmann, C., Brinkrolf, P., Flessa, S., & Hahnenkamp, K.
- Affiliations
- Steinbeis University Berlin (DE)
- KU Leuven (BE)
- Universitätsmedizin Greifswald (DE)
- Universität Greifswald (DE)
- Corresponding author
- Hasebrook, Joachim P.
- Michalak, Leonie
- Kohnen, Dorothea
- Metelmann, Bibiana
- Metelmann, Camilla
- Brinkrolf, Peter
- Flessa, Steffen
- Hahnenkamp, Klaus
- ORCID
- Venue
- PLOS ONE
- Publisher
- Public Library of Science (PLoS)
- Published
- 2023-01-24
- Volume
- 18
- Issue
- 1
- Pages
- e0280956
- ISSN
- 1932-6203 (ISSN-L)
- PMC
- PMC9873191
- OpenAlex
- W4317870133
- Cited by
- 19
- References
- 114
- Citations by year
- 2026: 6 · 2025: 5 · 2024: 5 · 2023: 3
- FWCI
- 4.89
- Type
- journal article
- Language
- en
- Open access
- gold
- doi.org
- Licence
- Locations
- PLoS ONE (publishedVersion, cc-by)
- Preprints.org (acceptedVersion, cc-by)
- PubMed Central (publishedVersion, cc-by)
- PubMed (publishedVersion)
- Lirias (submittedVersion, cc-by)
- RePEc: Research Papers in Economics (submittedVersion)
- DOAJ (DOAJ: Directory of Open Access Journals) (submittedVersion, cc-by-sa)
- Funders
- Bundesministerium für Gesundheit (01NVF16004)
- Topics
- Social Sciences › Decision Sciences › Information Systems and Management › Technology Adoption and User Behaviour
- Health Sciences › Medicine › Public Health, Environmental and Occupational Health › Telemedicine and Telehealth Implementation
- Health Sciences › Health Professions › Health Information Management › Electronic Health Records Systems
- Keywords
- rural emergency medicine, digital transition, technology acceptance, job satisfaction, workload, knowledge sharing, information and communication technologies, Dunning-Kruger effect, emergency rescue services, digitalization
- MeSH terms
- Communication, Humans, Job Satisfaction, Surveys and Questionnaires, Technology, Workload
About these checks
Registry, retraction, Cites and statistics results are computed, not judged, with one exception: a printed reference that no index lists is read once by a model before it counts as a citation error. Claims are extracted by a model and kept only when their quote appears verbatim in the text; each cited source is then checked, with a model’s help, for whether it says what the claim relies on. Those verdicts can be wrong — read the claim’s quote and the cited source before relying on one.
Statistics and arithmetic are recomputed, not judged.
Confidence bands are shown only for fields calibrated on our annotated test set. None is calibrated yet, so no band is shown.
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