Digital Literacy Upskilling in Public Hospitals: A Case Study in Jamaica's Health Sector

Thesis Abstract

Digital literacy skills are increasingly essential for effective service delivery in Jamaica’s public hospitals, where rapid digitization of patient records, telemedicine, and e-health systems necessitate proficient use of information and communication technologies by healthcare workers. The study addresses the gap between available digital tools and frontline staff capabilities, which undermines patient safety, data integrity, and operational efficiency. The aim is to examine how structured digital literacy upskilling interventions influence competence, adoption, and performance among hospital staff. Specific objectives include (1) assessing baseline digital literacy levels across professional cadres in three major public hospitals, (2) evaluating the design, delivery, and content relevance of the hospital-led upskilling program, (3) measuring changes in digital competencies post-training using a validated instrument aligned with the Technological Acceptance Model (TAM) and the Digital Competence Framework for Healthcare, (4) analyzing the relationship between training exposure, perceived usefulness, and actual system usage via regression analysis, and (5) identifying contextual enablers and barriers to sustained digital practice through thematic analysis of staff interviews. A sequential mixed-methods design is employed. The population comprises all clinical and non-clinical staff employed at the University Hospital of the Jamaican Health Service, Noel Holmes Memorial Hospital, and Cornwall Regional Hospital (N=4,200). A stratified random sample of 600 staff members will be selected for quantitative data collection, complemented by purposive sampling of 40 staff for qualitative interviews and 6 focus groups with 48 participants. Data collection instruments include a digital literacy assessment tool validated for Jamaica’s health sector, an attitude-surrounding-technology survey anchored in TAM, training satisfaction questionnaires, and semi-structured interview guides. Quantitative data will be analyzed using descriptive statistics, multiple regression to test hypotheses regarding predictors of system use and performance, and repeated-measures ANOVA to detect changes in digital competencies over time. Qualitative data will be analyzed using thematic analysis guided by Braun and Clarke’s approach, with coding panels to ensure reliability. The study will triangulate findings to build a comprehensive understanding of how upskilling translates into practice. Key expected findings include (i) heterogeneity in digital literacy levels across cadres, with higher baseline competence among IT staff and nursing informatics officers and lower levels among ancillary staff; (ii) positive associations between training exposure, perceived usefulness, and actual use of digital health records and decision-support tools; (iii) significant improvements in the digital competence subscales post-intervention, evidenced by effect sizes (Cohen’s d > 0.5) in the repeated-measures analysis; (iv) identification of organizational readiness factors, such as leadership support, availability of tech-enabled devices, and dedicated training time, as critical enablers; and (v) recurrent barriers including intermittent network connectivity, user interface limitations, and workload pressures that impede routine use. The study contributes to knowledge by integrating TAM with the Digital Competence Framework within a resource-constrained public health system, providing empirical evidence on the design and effectiveness of hospital-led digital upskilling programs in a developing country context. It advances understanding of how targeted training interacts with organizational factors to influence technology adoption and performance outcomes in Jamaica’s health sector, offering a pragmatic model for scalability and sustainability. The main conclusion is that structured, context-sensitive digital literacy upskilling, reinforced by organizational readiness and ongoing support, significantly enhances staff competency and technology utilization, leading to improved data quality, patient safety, and efficiency. Recommendations include adopting a phased, modular training approach aligned with job roles, investing in reliable IT infrastructure and help-desks, integrating periodic competency reassessments into human resource development, and scaling the program to regional hospitals through a centralized e-learning platform with local trainer networks.