Co
m
pu
t
er
Science
a
nd
I
nfo
r
m
a
t
io
n T
ec
hn
o
lo
g
ies
Vo
l.
6
,
No
.
1
, M
ar
c
h
20
25
,
p
p
.
48
~
57
I
SS
N:
2722
-
3
2
2
1
,
DOI
:
1
0
.
1
1
5
9
1
/csi
t
.
v6
i
1
.
pp
48
-
57
48
J
o
ur
na
l ho
m
ep
a
g
e
:
h
ttp
:
//ia
e
s
p
r
ime.
co
m/in
d
ex
.
p
h
p
/csi
t
Ana
ly
sis
of t
eleh
e
a
lth
a
cceptanc
e f
o
r bas
ic lif
e
suppo
rt
t
ra
ining
in sudden
cardia
c
arrest in
P
o
ntian
a
k
Ruhi
l I
s
wa
ra
,
Sri K
us
um
a
de
wi
,
Ra
ha
dia
n K
urnia
wa
n
D
e
p
a
r
t
me
n
t
o
f
I
n
f
o
r
m
a
t
i
c
s,
F
a
c
u
l
t
y
o
f
I
n
d
u
s
t
r
i
a
l
T
e
c
h
n
o
l
o
g
y
,
U
n
i
v
e
r
s
i
t
a
s I
sl
a
m
I
n
d
o
n
e
s
i
a
,
Y
o
g
y
a
k
a
r
ta
,
I
n
d
o
n
e
s
i
a
Art
icle
I
nfo
AB
S
T
RAC
T
A
r
ticle
his
to
r
y:
R
ec
eiv
ed
Oct
29
,
2
0
2
4
R
ev
is
ed
Feb
10
,
2
0
2
5
Acc
ep
ted
Feb
18
,
2
0
2
5
S
u
d
d
e
n
c
a
rd
iac
a
rre
st
(S
C
A),
w
h
ich
is
o
n
e
o
f
th
e
m
o
st
p
re
v
a
len
t
c
a
u
se
s
o
f
m
o
rtalit
y
,
c
a
n
b
e
p
re
v
e
n
te
d
b
y
q
u
ick
l
y
c
o
n
d
u
c
ti
n
g
b
a
sic
li
fe
su
p
p
o
rt
(BL
S
).
In
P
o
n
ti
a
n
a
k
C
it
y
,
th
e
c
h
a
ll
e
n
g
e
s
a
ss
o
c
iate
d
with
o
b
tai
n
in
g
e
m
e
rg
e
n
c
y
h
e
a
lt
h
trai
n
in
g
,
su
c
h
a
s
BLS
,
re
m
a
in
h
i
g
h
.
T
h
is
stu
d
y
a
ims
to
e
v
a
lu
a
te
u
se
r
a
c
c
e
p
tan
c
e
o
f
Tele
h
e
a
lt
h
a
s
we
ll
a
s
it
s
e
ffe
c
ti
v
e
n
e
ss
in
BLS
trai
n
in
g
.
We
will
a
lso
d
isc
u
ss
it
s
imp
a
c
t
o
n
c
o
m
m
u
n
it
y
k
n
o
wle
d
g
e
a
n
d
sk
il
ls
i
n
m
a
n
a
g
in
g
c
a
rd
iac
a
rre
st.
We
u
se
d
th
e
h
u
m
a
n
,
o
r
g
a
n
iza
ti
o
n
,
a
n
d
tec
h
n
o
lo
g
y
F
it
(
HOT
-
F
it
)
m
e
th
o
d
t
o
a
n
a
ly
z
e
th
e
lev
e
l
o
f
a
c
c
e
p
tan
c
e
o
f
Tele
h
e
a
lt
h
in
BLS
train
in
g
.
We
c
o
ll
e
c
ted
d
a
ta
fro
m
6
0
re
sp
o
n
d
e
n
ts
wh
o
u
n
d
e
rwe
n
t
T
e
leh
e
a
lt
h
-
b
a
se
d
BLS
train
in
g
.
T
h
e
re
su
lt
s
s
h
o
we
d
t
h
a
t
p
a
rti
c
i
p
a
n
ts'
u
n
d
e
rsta
n
d
i
n
g
a
n
d
re
a
d
in
e
ss
in
d
e
a
li
n
g
wit
h
h
e
a
rt
a
tt
a
c
k
e
m
e
r
g
e
n
c
ies
h
a
d
in
c
re
a
se
d
sig
n
ifi
c
a
n
t
ly
,
b
y
9
0
%
a
n
d
9
2
%
,
re
sp
e
c
ti
v
e
ly
.
An
a
ly
sis
o
f
th
e
lev
e
l
o
f
a
c
c
e
p
tan
c
e
with
HO
T
-
F
it
sh
o
we
d
th
a
t
sy
ste
m
q
u
a
li
t
y
h
a
d
t
h
e
g
re
a
tes
t
in
flu
e
n
c
e
o
n
sy
ste
m
u
se
(
0
.
6
1
1
)
.
S
e
rv
ice
q
u
a
li
t
y
e
x
e
rted
th
e
m
o
st
sig
n
ifi
c
a
n
t
imp
a
c
t
o
n
u
se
r
sa
t
isfa
c
ti
o
n
(0
.
5
6
8
).
T
h
e
n
e
t
b
e
n
e
fit
wa
s
in
fl
u
e
n
c
e
d
b
y
sy
ste
m
u
se
,
u
se
r
sa
ti
sfa
c
ti
o
n
,
a
n
d
o
rg
a
n
iza
ti
o
n
a
l
su
p
p
o
rt
,
with
u
se
r
sa
ti
sfa
c
ti
o
n
h
a
v
i
n
g
t
h
e
g
re
a
tes
t
in
flu
e
n
c
e
(0
.
6
0
0
).
F
u
rth
e
r
re
se
a
rc
h
will
b
e
c
o
n
d
u
c
ted
o
n
th
e
u
ti
li
z
a
ti
o
n
o
f
a
u
g
m
e
n
ted
re
a
li
ty
(AR)
o
r
v
irt
u
a
l
re
a
li
ty
(VR) t
e
c
h
n
o
l
o
g
y
t
o
imp
lem
e
n
t
Tele
h
e
a
lt
h
fo
r
BLS
t
ra
in
i
n
g
.
K
ey
w
o
r
d
s
:
B
asic lif
e
s
u
p
p
o
r
t
Hea
lth
tr
ain
in
g
HOT
-
Fit
Su
d
d
en
ca
r
d
iac
ar
r
est
T
eleh
ea
lth
T
h
is i
s
a
n
o
p
e
n
a
c
c
e
ss
a
rticle
u
n
d
e
r th
e
CC B
Y
-
SA
li
c
e
n
se
.
C
o
r
r
e
s
p
o
nd
ing
A
uth
o
r
:
Sri
Ku
s
u
m
ad
ewi
Dep
ar
tm
en
t o
f
I
n
f
o
r
m
atics,
Facu
lty
o
f
I
n
d
u
s
tr
ial
T
ec
h
n
o
lo
g
y
,
Un
iv
er
s
itas
I
s
lam
I
n
d
o
n
esia
Kaliu
r
an
g
s
tr
ee
t,
k
m
1
4
.
5
,
Yo
g
y
ak
ar
ta,
I
n
d
o
n
esia
E
m
ail: sr
i.k
u
s
u
m
ad
ewi@
u
ii.a
c.
1.
I
NT
RO
D
UCT
I
O
N
I
n
th
e
2
0
2
3
,
th
e
h
ea
lth
ce
n
ter
i
n
Po
n
tian
ak
r
ep
o
r
ted
a
to
tal
o
f
1
,
9
5
9
in
cid
e
n
ce
s
o
f
ca
r
d
iac
ar
r
est.
T
h
is
m
ak
es
th
e
h
ea
r
t
o
n
e
o
f
th
e
m
ain
ca
u
s
es
o
f
d
ea
th
.
Su
d
d
e
n
ca
r
d
iac
ar
r
est
(
SC
A)
is
a
c
o
n
d
itio
n
t
h
at
o
cc
u
r
s
s
u
d
d
en
ly
d
u
e
to
elec
tr
ical
d
i
s
tu
r
b
an
ce
s
in
th
e
h
ea
r
t
th
at
in
ter
f
er
e
with
t
h
e
h
ea
r
t'
s
ab
ilit
y
to
p
u
m
p
b
lo
o
d
.
W
ith
o
u
t im
m
ed
iate
tr
ea
tm
en
t,
ca
r
d
iac
ar
r
est ca
n
ca
u
s
e
p
er
m
an
en
t b
r
ain
d
am
a
g
e
an
d
d
ea
th
with
in
m
in
u
te
s
[
1
]
.
Peo
p
le
ar
o
u
n
d
th
e
v
i
ctim
m
u
s
t
im
m
ed
iately
ad
m
in
is
ter
b
asic
life
s
u
p
p
o
r
t
(
B
L
S)
in
th
is
s
itu
atio
n
b
ef
o
r
e
m
ed
ical
p
er
s
o
n
n
el
ar
r
iv
e.
On
e
k
in
d
o
f
B
L
S
is
ca
r
d
io
p
u
lm
o
n
ar
y
r
esu
s
citatio
n
(
C
PR
)
.
C
P
R
is
a
s
er
ie
s
o
f
em
er
g
en
cy
ac
tio
n
s
tak
en
to
h
elp
s
o
m
eo
n
e
wh
o
is
ex
p
er
ien
cin
g
ca
r
d
iac
ar
r
e
s
t
m
ain
tain
b
lo
o
d
f
lo
w
an
d
o
x
y
g
en
to
th
e
b
r
ain
an
d
o
th
er
v
ital
o
r
g
an
s
[
2
]
.
Stu
d
ie
s
h
av
e
d
em
o
n
s
tr
ated
th
at
B
L
S
tr
ain
in
g
en
h
an
ce
s
an
in
d
iv
i
d
u
al'
s
lik
elih
o
o
d
o
f
s
u
r
v
iv
in
g
ca
r
d
iac
ar
r
est.
B
ased
o
n
in
f
o
r
m
atio
n
f
r
o
m
th
e
A
m
er
ican
Hea
r
t
Ass
o
ciatio
n
,
c
ar
d
iac
ar
r
est
v
ictim
s
wh
o
r
ec
eiv
e
C
PR
h
av
e
a
two
to
th
r
ee
tim
es
g
r
ea
ter
ch
a
n
ce
o
f
s
u
r
v
iv
al
c
o
m
p
ar
e
d
to
th
o
s
e
wh
o
d
o
n
o
t
r
ec
eiv
e
ass
is
tan
ce
[
3
]
.
T
r
ai
n
in
g
is
o
n
e
s
tr
ateg
y
f
o
r
i
n
cr
ea
s
in
g
co
m
m
u
n
ity
k
n
o
wled
g
e
a
n
d
s
k
ills
in
p
r
o
v
id
i
n
g
B
L
S
[
4
]
.
An
y
o
n
e,
in
clu
d
i
n
g
th
e
g
en
e
r
al
p
u
b
lic,
ca
n
p
e
r
f
o
r
m
B
L
S
d
u
e
to
th
e
ea
s
e
o
f
teac
h
in
g
an
d
lear
n
i
n
g
b
asic
tech
n
iq
u
es lik
e
C
PR
[
5
]
.
Evaluation Warning : The document was created with Spire.PDF for Python.
C
o
m
p
u
t Sci
I
n
f
T
ec
h
n
o
l
I
SS
N:
2722
-
3
2
2
1
A
n
a
lysi
s
o
f
T
eleh
ea
lth
a
cc
ep
ta
n
ce
fo
r
b
a
s
ic
life su
p
p
o
r
t tra
in
in
g
in
s
u
d
d
en
ca
r
d
ia
c
a
r
r
est …
(
R
u
h
il I
s
w
a
r
a
)
49
A
s
tu
d
y
ap
p
lied
th
e
"SE
L
AM
AT
"
m
o
d
el
to
en
h
a
n
ce
p
u
b
lic
r
ec
all
an
d
a
p
p
licatio
n
o
f
th
e
B
L
S
s
tep
s
.
T
h
e
g
en
er
al
p
u
b
lic
ca
n
ea
s
ily
r
em
em
b
e
r
an
d
im
p
lem
en
t
t
h
is
m
o
d
el'
s
s
tag
es
in
em
er
g
en
cy
s
itu
atio
n
s
.
T
h
e
s
tep
s
in
th
e
"SE
L
AM
AT
"
m
o
d
el
in
clu
d
e:
im
m
e
d
iately
c
h
ec
k
in
g
r
esp
o
n
s
e
an
d
b
r
ea
th
in
g
;
ev
alu
atin
g
th
e
s
u
r
r
o
u
n
d
in
g
co
n
d
itio
n
s
;
m
ak
i
n
g
an
em
er
g
en
cy
ca
ll;
s
tar
tin
g
C
PR
if
th
er
e
is
n
o
b
r
ea
th
i
n
g
;
m
o
n
ito
r
in
g
th
e
v
ictim
'
s
co
n
d
itio
n
;
o
b
s
er
v
in
g
an
d
p
r
o
v
id
in
g
s
u
p
p
o
r
t
u
n
til
h
elp
ar
r
iv
es;
a
n
d
c
o
n
tin
u
i
n
g
ac
tio
n
s
ac
co
r
d
in
g
to
m
ed
ical
p
r
o
f
ess
io
n
als'
in
s
tr
u
ctio
n
s
.
Acc
o
r
d
in
g
to
r
esear
ch
,
tr
ain
in
g
with
th
e
"SE
L
AM
AT
"
m
o
d
el
is
e
f
f
ec
tiv
e
in
im
p
r
o
v
in
g
th
e
s
k
ills
an
d
k
n
o
wled
g
e
o
f
th
e
p
u
b
lic
in
p
r
o
v
i
d
in
g
B
L
S
ass
is
tan
ce
.
Ho
wev
e
r
,
p
u
b
lic
awa
r
en
ess
an
d
B
L
S
tr
ain
in
g
lev
els
in
I
n
d
o
n
esia
ar
e
s
till
lo
w
Ma
n
y
p
eo
p
le
h
av
e
n
ev
er
r
e
ce
iv
ed
B
L
S
tr
ain
in
g
,
an
d
ac
ce
s
s
to
th
is
tr
ain
in
g
is
o
f
te
n
lim
ited
to
ce
r
tain
g
r
o
u
p
s
.
On
t
h
e
o
th
er
h
an
d
,
alth
o
u
g
h
Po
n
tian
ak
C
ity
is
o
n
e
o
f
I
n
d
o
n
esia'
s
lar
g
est
citie
s
,
ch
al
len
g
es
r
elate
d
t
o
lim
ited
r
eso
u
r
ce
s
to
p
r
o
v
id
e
B
L
S
tr
ain
in
g
r
em
ain
wid
esp
r
ea
d
.
T
h
is
in
clu
d
es
a
lim
ited
am
o
u
n
t
o
f
tim
e
f
o
r
m
ed
ical
p
e
r
s
o
n
n
el
to
p
r
o
v
id
e
tr
ain
in
g
,
as
well
as
a
lack
o
f
o
p
p
o
r
tu
n
ities
f
o
r
t
h
e
g
en
e
r
al
p
u
b
lic
to
atten
d
f
ac
e
-
to
-
f
ac
e
in
s
tr
u
ctio
n
o
n
a
r
e
g
u
lar
b
asis
.
T
eleh
ea
lth
tech
n
o
lo
g
y
is
ex
p
ec
ted
to
b
e
an
ef
f
ec
tiv
e
s
o
lu
tio
n
to
im
p
r
o
v
e
ac
ce
s
s
,
ef
f
icien
cy
,
an
d
q
u
ality
o
f
h
ea
lth
s
er
v
ices,
esp
ec
ially
in
em
er
g
en
c
y
s
itu
atio
n
s
o
r
wh
en
p
atien
t
m
o
b
ilit
y
is
lim
ited
[
6
]
–
[
9
]
.
T
eleh
ea
lth
h
as
b
ee
n
s
h
o
wn
to
p
r
o
v
id
e
s
ig
n
i
f
ican
t
h
ea
lth
o
u
tco
m
es,
s
u
ch
as
r
ed
u
ce
d
p
er
i
n
atal
m
o
r
tality
,
an
d
its
ef
f
ec
tiv
en
ess
i
s
co
m
p
ar
ab
le
to
f
ac
e
-
to
-
f
ac
e
tr
ain
in
g
,
wh
ile
r
ed
u
cin
g
co
s
ts
an
d
tim
e
r
eq
u
ir
ed
[
1
0
]
–
[
1
3
]
.
Hea
lth
tr
ain
in
g
th
r
o
u
g
h
T
eleh
ea
lth
h
as
s
ev
er
al
ad
v
an
tag
es.
First,
th
e
f
l
ex
ib
ilit
y
o
f
tim
e
an
d
p
lace
o
f
f
er
ed
b
y
T
eleh
ea
lth
p
latf
o
r
m
s
allo
ws
p
ar
ticip
an
ts
to
s
ch
ed
u
le
tr
ain
in
g
ac
co
r
d
in
g
to
th
eir
av
aila
b
ilit
y
[
1
4
]
.
Seco
n
d
,
T
eleh
ea
lth
ca
n
r
ea
ch
p
ar
ticip
a
n
ts
in
v
ar
io
u
s
lo
ca
tio
n
s
,
ev
e
n
th
o
s
e
f
ar
f
r
o
m
h
ea
lth
f
ac
ilit
ies
[
1
4
]
,
[
1
5
]
.
T
h
ir
d
,
in
co
r
p
o
r
atin
g
d
ig
ital
tech
n
o
l
o
g
y
in
to
tr
ain
in
g
ca
n
h
elp
in
c
r
ea
s
e
co
m
m
u
n
ity
p
ar
ticip
atio
n
in
h
ea
lth
ed
u
ca
tio
n
p
r
o
g
r
a
m
s
[
1
6
]
,
[
1
7
]
.
T
h
er
ef
o
r
e,
th
is
in
v
esti
g
atio
n
will
ad
d
r
ess
n
u
m
er
o
u
s
is
s
u
es
th
at
co
n
s
titu
te
th
e
p
r
im
ar
y
co
n
ce
r
n
s
.
At
f
ir
s
t,
th
e
ch
allen
g
es
e
n
co
m
p
a
s
s
th
e
lim
itatio
n
s
o
f
tech
n
o
l
o
g
ical
in
f
r
astru
ctu
r
e
,
s
u
ch
as
th
e
u
n
e
q
u
al
in
ter
n
et
ac
ce
s
s
in
Po
n
tian
ak
,
a
n
d
th
e
v
ar
iatio
n
s
in
d
i
g
ital
liter
ac
y
o
f
tr
ain
in
g
p
ar
ticip
an
ts
.
Seco
n
d
,
th
e
ch
allen
g
es
th
a
t
B
L
S
tr
ain
in
g
th
r
o
u
g
h
T
ele
h
e
alth
m
ay
en
c
o
u
n
ter
in
ter
m
s
o
f
th
e
d
eliv
er
y
o
f
p
r
ac
tical
s
k
ills
,
th
e
lim
ited
in
ter
ac
tio
n
,
a
n
d
th
e
ch
allen
g
es
ass
o
ciate
d
with
ev
alu
atin
g
p
ar
ticip
a
n
t
co
m
p
eten
cy
.
T
h
ir
d
,
th
e
im
p
ac
t
o
n
co
m
m
u
n
ity
k
n
o
wled
g
e
a
n
d
s
k
ills
ca
n
also
b
e
in
f
lu
en
ce
d
b
y
l
o
w
in
f
o
r
m
atio
n
r
eten
tio
n
o
r
in
ap
p
r
o
p
r
iate
tr
ain
in
g
m
eth
o
d
s
.
Fo
u
r
th
,
th
e
p
au
city
o
f
r
ep
r
esen
tativ
e
d
ata
an
d
th
e
v
ar
y
i
n
g
m
o
tiv
atio
n
o
f
p
ar
ticip
an
ts
p
r
esen
t
ad
d
itio
n
al
o
b
s
tacle
s
to
th
e
d
ev
elo
p
m
en
t
o
f
p
e
r
tin
en
t
r
ec
o
m
m
en
d
atio
n
s
.
Fifth
,
th
e
m
an
n
e
r
in
wh
ich
m
itig
atio
n
s
tr
ateg
ies ar
e
im
p
lem
en
ted
to
en
s
u
r
e
th
at
th
e
r
esear
c
h
r
esu
lts
p
r
o
v
i
d
e
th
e
g
r
ea
test
p
o
s
s
ib
le
b
en
ef
it.
Sy
s
tem
q
u
ality
a
n
d
in
f
o
r
m
ati
o
n
q
u
ality
i
n
telem
e
d
icin
e
a
p
p
licatio
n
s
h
a
v
e
a
p
o
s
itiv
e
a
n
d
s
ig
n
if
ican
t
ef
f
ec
t
o
n
u
s
er
s
atis
f
ac
tio
n
.
I
m
p
r
o
v
in
g
s
y
s
tem
an
d
in
f
o
r
m
ati
o
n
q
u
ality
s
ig
n
if
ican
tly
in
cr
ea
s
es
u
s
er
s
atis
f
ac
tio
n
.
Patien
ts
ar
e
m
o
r
e
s
atis
f
ied
with
telem
ed
icin
e
s
er
v
ices
th
at
a
r
e
o
f
h
ig
h
q
u
ality
,
wh
ic
h
ca
n
lead
to
a
n
in
c
r
ea
s
e
in
th
eir
u
tili
za
tio
n
[
1
8
]
.
T
h
er
e
f
o
r
e,
in
th
e
f
ield
o
f
T
ele
h
ea
lth
,
s
u
b
s
tan
tial
n
et
b
en
ef
its
ca
n
b
e
ac
h
iev
ed
t
h
r
o
u
g
h
h
ig
h
u
s
er
s
atis
f
ac
tio
n
an
d
s
y
s
tem
u
s
ag
e.
T
h
er
ef
o
r
e,
th
e
p
u
r
p
o
s
e
o
f
t
h
is
s
tu
d
y
is
t
o
e
v
alu
ate
u
s
er
ac
ce
p
tan
ce
o
f
T
ele
h
ea
lth
,
an
d
its
ef
f
ec
tiv
en
ess
in
B
L
S
tr
ain
in
g
in
B
L
S
tr
ain
in
g
in
Po
n
tian
ak
C
ity
.
W
e
will
also
d
is
c
u
s
s
i
ts
im
p
ac
t
o
n
co
m
m
u
n
ity
k
n
o
wled
g
e
an
d
s
k
ills
in
m
an
ag
in
g
ca
r
d
iac
ar
r
est.
T
h
e
id
en
tific
atio
n
o
f
ch
allen
g
es
in
its
im
p
lem
en
tatio
n
,
s
u
ch
as
p
a
r
ticip
an
ts
'
d
ig
ital
liter
ac
y
an
d
te
ch
n
o
lo
g
ical
in
f
r
astru
ctu
r
e
s
u
p
p
o
r
t,
c
o
m
p
lem
e
n
ts
th
is
an
aly
s
is
.
W
e
h
o
p
e
th
at
b
y
an
al
y
zin
g
t
h
e
r
esu
lts
o
f
t
h
is
T
eleh
ea
lth
tr
ain
in
g
,
we
c
an
f
in
d
s
o
lu
tio
n
s
to
en
h
an
ce
f
u
tu
r
e
tr
ai
n
in
g
a
n
d
b
r
o
ad
en
p
u
b
lic
ac
ce
s
s
to
ess
en
tial h
ea
lth
ed
u
ca
tio
n
lik
e
B
L
S.
2.
M
E
T
H
O
D
2
.
1
.
Da
t
a
c
o
llect
io
n
Po
n
tian
ak
C
ity
h
as
c
u
r
r
e
n
tly
im
p
lem
en
ted
a
T
eleh
ea
lth
s
y
s
tem
f
o
r
B
L
S
tr
ain
in
g
in
t
h
e
c
o
n
tex
t
o
f
ca
r
d
iac
ar
r
est
m
an
ag
em
e
n
t.
T
h
e
"SE
L
AM
AT
"
m
o
d
el
was
im
p
lem
en
ted
to
d
e
v
elo
p
th
is
T
eleh
ea
lth
s
y
s
tem
.
Fig
u
r
e
1
(
a)
illu
s
tr
ates
a
p
ar
ti
al
v
iew
o
f
a
T
eleh
ea
lth
ap
p
l
icatio
n
,
s
p
ec
if
ically
a
g
a
m
e,
wh
ile
Fig
u
r
e
1
(
b
)
illu
s
tr
ates
a
p
ar
t
ial
v
iew
o
f
a
T
eleh
ea
lth
a
p
p
licatio
n
,
p
ar
ti
cu
lar
ly
a
v
id
eo
.
Desp
ite
th
e
d
ev
elo
p
m
e
n
t
o
f
th
is
s
y
s
tem
,
we
h
av
e
n
ev
e
r
ev
alu
at
ed
its
ef
f
ec
tiv
en
ess
an
d
lev
el
o
f
u
s
er
ac
ce
p
tan
ce
.
T
h
is
s
tu
d
y
u
s
ed
a
q
u
a
n
titativ
e
m
eth
o
d
with
a
s
u
r
v
ey
a
p
p
r
o
ac
h
.
R
esp
o
n
d
en
ts
co
n
s
is
ted
o
f
6
0
p
ar
ticip
an
ts
r
eg
is
ter
ed
in
th
e
T
eleh
ea
lth
-
b
ased
B
L
S
tr
ain
in
g
p
r
o
g
r
am
in
Po
n
tian
ak
C
ity
.
T
h
is
s
tu
d
y
u
s
ed
a
q
u
esti
o
n
n
air
e
th
at
in
q
u
ir
ed
a
b
o
u
t
th
e
p
ar
ticip
a
n
ts
'
tr
ain
in
g
ex
p
er
ien
ce
s
,
th
e
q
u
ality
o
f
th
e
d
eliv
er
ed
m
ater
ial,
an
d
th
e
tr
ain
i
n
g
'
s
im
p
ac
t o
n
th
eir
p
r
ep
ar
e
d
n
ess
to
h
an
d
le
ca
r
d
iac
ar
r
est em
er
g
e
n
cies.
Par
ticip
an
ts
m
u
s
t
cr
ea
te
an
ac
co
u
n
t
o
n
th
e
p
r
o
v
i
d
ed
T
el
eh
ea
lth
p
latf
o
r
m
.
T
h
is
s
tep
g
u
ar
an
tees
p
ar
ticip
an
ts
'
ac
ce
s
s
to
th
e
d
esig
n
ated
tr
ain
in
g
p
latf
o
r
m
.
Af
ter
s
u
cc
ess
f
u
lly
r
eg
is
ter
in
g
,
p
ar
ticip
an
ts
ar
e
r
eq
u
ir
ed
t
o
watc
h
an
ed
u
ca
ti
o
n
al
v
id
eo
co
n
tain
in
g
m
ater
i
al
ab
o
u
t
B
L
S.
Par
ticip
an
ts
will
tak
e
p
ar
t
in
an
in
ter
ac
tiv
e
g
am
e
th
at
in
clu
d
e
s
ev
alu
atio
n
q
u
esti
o
n
s
th
at
a
r
e
p
er
ti
n
en
t
t
o
th
e
v
i
d
eo
'
s
co
n
ten
t
f
o
llo
win
g
its
v
iewin
g
.
T
h
e
d
esig
n
o
f
th
is
g
am
e
is
to
g
au
g
e
th
e
p
ar
ticip
an
ts
'
co
m
p
r
eh
en
s
io
n
o
f
th
e
B
L
S
m
ater
ial
th
ey
h
a
v
e
Evaluation Warning : The document was created with Spire.PDF for Python.
I
SS
N
:
2
7
2
2
-
3
2
2
1
C
o
m
p
u
t Sci
I
n
f
T
ec
h
n
o
l
,
Vo
l.
6
,
No
.
1
,
M
ar
ch
20
25
:
48
-
57
50
ac
q
u
ir
ed
.
T
h
e
q
u
esti
o
n
s
in
th
e
g
am
e
in
clu
d
e
b
asic
B
L
S
co
n
ce
p
ts
,
C
PR
s
tep
s
,
an
d
id
en
tific
atio
n
o
f
ca
r
d
iac
ar
r
est s
itu
atio
n
s
.
Par
ticip
an
ts
will
f
ill
o
u
t
a
q
u
esti
o
n
n
air
e
af
ter
f
in
is
h
in
g
th
e
g
am
e
.
T
h
is
q
u
esti
o
n
n
air
e
will
m
ea
s
u
r
e
s
ev
er
al
k
ey
asp
ec
ts
,
s
u
ch
as
p
ar
ticip
an
ts
'
ex
p
er
ien
ce
u
s
in
g
T
eleh
ea
lth
,
s
atis
f
ac
tio
n
with
th
e
T
eleh
ea
lth
s
y
s
tem
,
th
e
ef
f
ec
tiv
en
ess
o
f
e
d
u
ca
tio
n
al
v
id
eo
s
in
im
p
r
o
v
in
g
p
ar
ticip
an
ts
'
u
n
d
er
s
tan
d
in
g
o
f
B
L
S,
p
er
ce
iv
ed
s
u
p
p
o
r
t
f
r
o
m
th
e
Po
n
tian
a
k
H
ea
lth
Of
f
ice
i
n
im
p
lem
en
tin
g
t
h
e
T
eleh
ea
lth
p
r
o
g
r
a
m
,
a
n
d
c
o
m
p
letio
n
an
d
d
ata
co
llectio
n
.
On
ce
th
e
p
ar
ticip
a
n
ts
co
m
p
lete
th
e
q
u
esti
o
n
n
air
e
,
we
will
co
llect
an
d
s
tati
s
tical
ly
an
aly
ze
th
e
d
ata
to
ass
ess
th
e
ef
f
ec
tiv
en
ess
o
f
T
eleh
ea
lth
in
en
h
an
cin
g
th
eir
k
n
o
wled
g
e
an
d
s
k
ills
.
(
a)
(
b
)
Fig
u
r
e
1
.
T
ele
h
ea
lth
f
o
r
B
L
S tr
ain
in
g
: (
a)
v
id
eo
an
d
(
b
)
g
am
e
2
.
2
.
H
O
T
-
F
it
mo
del dev
elo
pm
ent
T
h
e
h
u
m
a
n
,
o
r
g
an
izatio
n
,
a
n
d
tech
n
o
lo
g
y
Fit
(
HOT
-
Fit
)
m
o
d
el
was
u
s
ed
to
e
v
a
lu
ate
th
e
im
p
lem
en
tatio
n
o
f
T
eleh
ea
lth
in
th
is
tr
ain
in
g
.
T
h
e
HOT
-
Fi
t
m
o
d
el
em
p
h
asizes
th
r
ee
m
ain
asp
ec
ts
:
h
u
m
an
,
o
r
g
an
izatio
n
,
an
d
tech
n
o
l
o
g
y
[
1
9
]
.
T
h
is
m
o
d
el
is
u
s
ed
t
o
u
n
d
er
s
tan
d
cr
itical
co
m
p
o
n
e
n
ts
o
f
ap
p
licatio
n
im
p
lem
en
tatio
n
a
n
d
t
h
e
ev
al
u
atio
n
o
f
r
ea
d
in
ess
.
W
e
co
m
p
iled
th
e
q
u
esti
o
n
n
ai
r
e
b
as
ed
o
n
th
e
HOT
-
Fit
m
o
d
el,
in
co
r
p
o
r
atin
g
th
e
v
ar
i
ab
les
o
f
s
y
s
tem
q
u
ality
,
in
f
o
r
m
atio
n
q
u
ality
,
s
er
v
ice
q
u
ality
,
s
y
s
tem
u
s
e,
u
s
er
s
atis
f
ac
tio
n
,
o
r
g
an
izatio
n
,
a
n
d
n
et
b
en
ef
its
.
T
h
e
q
u
esti
o
n
n
air
e
u
s
es
a
L
ik
er
t
s
ca
le
o
f
1
–
5
to
m
ea
s
u
r
e
r
esp
o
n
d
en
ts
'
p
er
ce
p
tio
n
s
o
f
ea
ch
v
ar
iab
le.
User
s
ca
n
f
ill o
u
t
th
is
q
u
esti
o
n
n
air
e
af
ter
co
m
p
l
etin
g
th
e
T
eleh
ea
lth
tr
ain
in
g
p
r
o
ce
s
s
.
W
e
p
er
f
o
r
m
ed
d
ata
an
al
y
s
is
u
s
in
g
p
ar
tial
least
s
q
u
ar
es
(
PLS)
,
a
s
tatis
tica
l
m
eth
o
d
s
u
itab
le
f
o
r
ev
alu
atin
g
m
o
d
els
with
m
a
n
y
v
ar
iab
les.
Fig
u
r
e
2
s
h
o
ws
th
e
h
y
p
o
th
esis
m
o
d
el
b
y
a
d
o
p
t
in
g
r
esear
ch
f
r
o
m
Har
d
iy
an
ti
et
al
.
[
1
9
]
.
T
en
h
y
p
o
th
eses
ca
n
b
e
d
er
i
v
ed
f
r
o
m
F
ig
u
r
e
2
,
as illu
s
tr
ated
in
T
ab
le
1
.
Var
ian
t
-
b
ased
PLS
-
SEM
is
i
m
p
lem
en
ted
to
ev
alu
ate
r
elia
b
ilit
y
an
d
v
alid
ity
.
T
h
is
m
eth
o
d
is
also
u
s
ed
to
ev
alu
ate
th
e
s
tr
u
ctu
r
a
l
m
o
d
el
in
t
h
e
ca
u
s
ality
test
,
wh
ic
h
is
a
h
y
p
o
th
esis
test
th
at
u
s
es
a
p
r
ed
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e
m
o
d
el.
Mo
d
el
test
in
g
is
co
n
d
u
cted
in
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s
tag
es: o
u
ter
m
o
d
e
l a
n
d
in
n
e
r
m
o
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el
test
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g
.
I
n
th
is
o
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ter
m
o
d
el,
t
h
e
ca
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s
al
r
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n
s
h
ip
is
ex
p
lain
ed
.
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n
o
th
er
wo
r
d
s
,
th
e
o
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ter
m
o
d
el
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p
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th
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r
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h
ip
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r
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b
o
th
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s
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ex
o
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o
u
s
,
a
n
d
in
d
icato
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s
in
ex
is
tin
g
v
ar
iab
les.
T
h
e
v
ar
iab
ilit
y
o
f
ex
o
g
en
o
u
s
v
ar
iab
les
is
in
f
lu
en
ce
d
b
y
ass
u
m
p
tio
n
s
ab
o
u
t
ca
u
s
es
th
at
ar
e
eith
er
ex
ter
n
al
to
th
e
m
o
d
el
o
r
ca
n
b
e
r
ef
er
r
e
d
to
as
in
d
ep
en
d
e
n
t
v
ar
iab
les.
T
h
e
an
aly
s
is
o
f
v
alid
ity
an
d
r
el
iab
ilit
y
is
en
h
an
ce
d
b
y
th
e
test
in
g
o
f
th
e
o
u
ter
m
o
d
el.
W
e
co
n
d
u
ct
v
alid
ity
test
in
g
to
ev
alu
ate
th
e
r
esear
ch
in
s
tr
u
m
en
t'
s
ca
p
ab
ilit
ie
s
.
T
h
e
o
u
ter
m
o
d
el'
s
m
ea
s
u
r
e
is
ev
alu
ated
u
s
in
g
th
r
ee
cr
iter
ia:
co
n
v
er
g
en
t
v
alid
ate,
d
is
cr
im
in
an
t
v
alid
a
te,
an
d
co
m
p
o
s
ite
s
tab
ilit
y
[
2
0
]
.
C
o
n
v
er
g
e
n
t
v
alid
atio
n
is
s
h
o
wn
in
th
e
lo
ad
in
g
f
ac
to
r
v
alu
e
(
c
o
r
r
elatio
n
o
f
item
s
co
r
es
wi
th
co
n
s
tr
u
ct
s
co
r
es)
o
f
ea
ch
co
n
s
tr
u
ct.
T
h
e
o
p
tim
al
lo
a
d
in
g
f
ac
to
r
v
alu
e
is
g
r
ea
ter
th
a
n
0
.
7
.
Me
an
wh
ile,
d
is
cr
im
in
an
t
v
alid
ate
test
in
g
i
s
ev
alu
ated
b
y
c
o
m
p
ar
i
n
g
t
h
e
av
er
ag
e
v
ar
ia
n
ce
ex
t
r
ac
ted
(
AVE
)
r
o
o
t
v
alu
e
o
f
ea
ch
co
n
s
tr
u
ct
with
th
e
co
r
r
elatio
n
b
etwe
en
o
n
e
co
n
s
tr
u
ct
a
n
d
an
o
th
er
c
o
n
s
tr
u
ct
in
th
e
m
o
d
el.
T
h
e
m
in
im
u
m
AVE
v
alu
e
th
at
is
ac
ce
p
ted
is
0
.
5
0
[
2
1
]
,
en
s
u
r
in
g
th
at
m
o
r
e
th
an
5
0
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o
f
th
e
laten
t
v
ar
iab
les
ca
n
ex
p
lain
th
e
in
d
icato
r
.
Evaluation Warning : The document was created with Spire.PDF for Python.
C
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p
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I
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T
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l
I
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N:
2722
-
3
2
2
1
A
n
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cc
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fo
r
b
a
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p
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in
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c
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(
R
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h
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51
Fig
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r
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2
.
Hy
p
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th
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1
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F
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tr
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n
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tr
u
ct
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d
an
o
th
er
in
th
e
m
o
d
el
[
2
2
]
,
[
2
3
]
.
T
h
e
m
o
d
el
h
a
s
ac
ce
p
tab
le
d
is
cr
im
in
a
n
t
v
alid
i
ty
if
th
e
AVE
r
o
o
t
v
alu
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x
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s
th
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s
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tr
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x
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b
s
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tial
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if
f
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ce
s
f
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o
m
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e
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e
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ely
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o
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d
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o
wn
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to
r
s
th
an
with
o
th
e
r
co
n
s
tr
u
cts in
th
e
m
o
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el.
I
n
o
r
d
er
to
v
er
i
f
y
th
e
ac
c
u
r
a
cy
an
d
c
o
n
s
is
ten
cy
o
f
t
h
e
in
s
tr
u
m
en
t
in
co
n
d
u
ctin
g
m
ea
s
u
r
em
en
ts
,
r
eliab
ilit
y
test
in
g
o
r
co
m
p
o
s
it
e
r
eliab
ilit
y
is
im
p
lem
en
ted
.
C
r
o
n
b
ac
h
'
s
alp
h
a
an
d
co
m
p
o
s
ite
r
eliab
ilit
y
ar
e
th
e
two
m
eth
o
d
o
l
o
g
ies
em
p
lo
y
ed
in
r
eliab
ilit
y
test
in
g
with
PLS.
T
h
e
lo
wer
lim
it
o
f
a
c
o
n
s
tr
u
ct'
s
r
eliab
ilit
y
is
d
eter
m
in
ed
u
s
in
g
C
r
o
n
b
ac
h
'
s
alp
h
a,
wh
ile
th
e
ac
tu
al
r
eliab
il
ity
o
f
th
e
co
n
s
tr
u
ct
is
m
ea
s
u
r
ed
u
s
in
g
co
m
p
o
s
ite
r
eliab
ilit
y
.
A
r
eliab
ilit
y
esti
m
ate
is
p
r
o
v
id
ed
b
y
C
r
o
n
b
ac
h
'
s
alp
h
a,
wh
ic
h
is
d
ete
r
m
in
ed
b
y
t
h
e
in
ter
c
o
r
r
elatio
n
o
f
in
d
icato
r
s
.
B
ased
o
n
th
e
c
r
iter
ia
estab
lis
h
ed
b
y
Hae
n
lein
an
d
Kap
lan
,
a
C
r
o
n
b
ac
h
'
s
alp
h
a
v
alu
e
ex
ce
e
d
in
g
0
.
7
is
co
n
s
id
er
e
d
ac
ce
p
tab
le
[
2
4
]
.
I
n
n
er
test
in
g
is
d
o
n
e
af
ter
o
u
ter
tes
tin
g
.
T
esti
n
g
o
f
th
e
in
n
er
m
o
d
el
o
r
s
tr
u
ctu
r
al
m
o
d
el
ar
e
co
n
d
u
cte
d
b
y
ex
am
i
n
in
g
th
e
R
-
s
q
u
a
r
e
v
alu
e
o
f
th
e
d
ep
en
d
en
t
v
a
r
iab
l
e.
T
h
e
in
d
icato
r
'
s
r
eliab
ilit
y
with
r
esp
ec
t
to
th
e
d
ep
en
d
e
n
t
v
a
r
iab
le
is
in
d
icat
ed
b
y
th
e
R
-
s
q
u
a
r
e
v
alu
e
.
T
h
e
p
r
e
d
ictio
n
m
o
d
el
g
en
er
a
te
d
b
y
th
e
p
r
o
p
o
s
ed
r
esear
ch
m
o
d
el
is
m
o
r
e
ac
c
u
r
a
te
wh
en
th
e
R
-
s
q
u
ar
e
v
alu
e
is
h
ig
h
er
.
A
v
alu
e
o
f
0
.
7
5
i
n
d
ica
tes
a
s
tr
o
n
g
m
o
d
el,
0
.
5
0
in
d
icate
s
a
m
o
d
e
r
ate
m
o
d
el,
an
d
0
.
2
5
i
n
d
icate
s
a
f
ee
b
le
m
o
d
el
[
1
9
]
.
T
h
e
n
ex
t
s
tep
is
h
y
p
o
th
esis
test
in
g
.
T
h
e
o
b
jectiv
e
o
f
h
y
p
o
t
h
esis
test
in
g
is
to
ascer
tain
wh
eth
er
th
e
an
aly
ze
d
d
ata
s
u
p
p
o
r
t
th
e
h
y
p
o
th
esized
r
elatio
n
s
h
ip
b
etwe
e
n
co
n
s
tr
u
cts
in
th
e
r
esear
ch
m
o
d
el.
I
n
th
e
c
o
n
tex
t
o
f
p
ar
tial
least
s
q
u
ar
es
s
tr
u
ctu
r
al
eq
u
atio
n
m
o
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elin
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(
PLS
-
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E
M)
an
aly
s
is
,
h
y
p
o
th
esis
test
i
n
g
is
p
er
f
o
r
m
e
d
b
y
ass
es
s
in
g
th
e
t
-
s
tatis
tic
v
alu
es
an
d
p
ath
co
e
f
f
icien
ts
th
at
ar
e
ac
q
u
ir
ed
th
r
o
u
g
h
th
e
b
o
o
ts
tr
a
p
p
in
g
p
r
o
ce
s
s
.
T
h
e
d
ir
ec
tio
n
an
d
in
ten
s
ity
o
f
th
e
r
elatio
n
s
h
ip
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etwe
en
co
n
s
tr
u
cts
ar
e
in
d
icate
d
b
y
p
at
h
co
e
f
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icien
ts
,
wh
ile
th
e
s
tatis
t
ical
s
ig
n
if
ican
ce
o
f
th
e
r
elatio
n
s
h
ip
is
ev
al
u
ated
u
s
in
g
t
-
s
tatis
t
ic
v
alu
es.
I
f
th
e
t
-
s
tatis
tic
v
alu
e
s
u
r
p
ass
es
a
p
r
ed
eter
m
i
n
ed
th
r
esh
o
ld
,
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e
h
y
p
o
t
h
esis
h
as b
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eter
m
i
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ed
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ir
m
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B
ased
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o
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esis
test
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g
,
d
ata
an
aly
s
is
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ca
r
r
ied
o
u
t.
T
h
e
u
s
e
r
ac
c
e
p
tan
ce
o
f
T
eleh
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lth
ap
p
licatio
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s
will
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u
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o
f
th
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al
y
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Fu
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eg
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latio
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in
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will a
ls
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d
r
ess
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p
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ten
tial
f
o
r
f
u
tu
r
e
T
eleh
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lth
d
ev
el
o
p
m
en
t.
Evaluation Warning : The document was created with Spire.PDF for Python.
I
SS
N
:
2
7
2
2
-
3
2
2
1
C
o
m
p
u
t Sci
I
n
f
T
ec
h
n
o
l
,
Vo
l.
6
,
No
.
1
,
M
ar
ch
20
25
:
48
-
57
52
3.
RE
SU
L
T
S AN
D
D
I
SCU
SS
I
O
N
3
.
1
.
I
m
pro
v
ing
o
f
k
no
wledg
e
a
nd
s
k
ills
T
h
e
r
esu
lts
s
h
o
wed
th
at
T
eleh
ea
lth
-
b
ased
B
L
S
tr
ain
in
g
s
ig
n
if
ican
tly
im
p
r
o
v
ed
p
ar
ticip
an
ts
'
k
n
o
wled
g
e
an
d
s
k
ills
.
As
m
a
n
y
as
9
0
%
o
f
r
esp
o
n
d
en
ts
r
e
p
o
r
ted
an
in
cr
ea
s
e
in
th
eir
u
n
d
er
s
tan
d
in
g
o
f
B
L
S
p
r
o
ce
d
u
r
es
as
s
h
o
wn
in
Fig
u
r
e
3
.
Mo
r
e
th
an
9
0
%
s
tated
th
at
th
ey
f
elt
m
o
r
e
p
r
ep
ar
ed
t
o
d
ea
l
with
ca
r
d
iac
ar
r
est
s
itu
atio
n
s
af
ter
p
ar
tici
p
atin
g
in
t
h
e
tr
ain
in
g
as
p
r
e
s
en
ted
in
Fig
u
r
e
4
.
T
h
is
f
in
d
in
g
is
in
lin
e
with
r
esear
ch
[
1
2
]
,
wh
ich
f
o
u
n
d
th
at
T
eleh
ea
lth
-
b
ased
tr
ain
in
g
c
an
im
p
r
o
v
e
m
ed
ical
s
k
ills
in
ar
ea
s
with
lim
ited
ac
ce
s
s
to
f
ac
e
-
to
-
f
ac
e
tr
ain
i
n
g
.
T
eleh
ea
lth
-
b
ased
B
L
S
tr
ain
in
g
n
o
t
o
n
l
y
im
p
r
o
v
es
p
ar
ticip
a
n
ts
'
k
n
o
wled
g
e,
b
u
t
also
p
r
o
v
id
es
wid
er
ac
ce
s
s
to
th
e
co
m
m
u
n
ity
to
r
ec
eiv
e
tr
ain
in
g
with
o
u
t
h
av
i
n
g
to
s
p
en
d
tim
e
an
d
m
o
n
e
y
tr
av
elin
g
to
a
tr
ain
in
g
ce
n
ter
.
T
h
is
is
esp
ec
ially
im
p
o
r
tan
t
f
o
r
p
eo
p
le
wh
o
h
av
e
lim
ited
tim
e
d
u
e
to
w
o
r
k
o
r
o
th
er
c
o
m
m
itm
en
ts
[
6
]
–
[
9
]
.
T
eleh
ea
lth
'
s
ab
ilit
y
to
p
r
o
v
id
e
f
le
x
ib
le,
ac
ce
s
s
ib
le
tr
ain
in
g
is
o
n
e
o
f
its
m
ain
ad
v
a
n
tag
es
co
m
p
ar
ed
to
tr
ad
itio
n
al
tr
ain
in
g
m
eth
o
d
s
.
Fig
u
r
e
3
.
I
m
p
r
o
v
em
en
t i
n
k
n
o
wled
g
e
o
f
B
L
S
p
r
o
ce
d
u
r
es
Fig
u
r
e
4
.
I
m
p
r
o
v
em
en
t i
n
r
ea
d
in
ess
to
h
an
d
le
SC
A
ca
s
es
3
.
2
.
H
O
T
-
F
it
mo
del
T
h
e
v
alid
ity
test
r
esu
lts
ar
e
p
r
esen
ted
in
T
ab
le
2
.
T
h
e
o
u
ter
lo
ad
in
g
v
alu
es
in
th
e
tab
le
s
u
g
g
est
th
at
all
v
ar
iab
les
an
d
in
d
icato
r
s
u
s
e
in
th
is
s
tu
d
y
h
av
e
s
tr
o
n
g
co
n
v
er
g
en
t
v
alid
ity
,
with
o
u
ter
lo
ad
in
g
v
alu
es
ex
ce
ed
in
g
0
.
7
.
T
h
is
s
u
g
g
ests
th
at
ea
ch
i
n
d
icato
r
h
as
a
s
tr
o
n
g
c
o
r
r
elatio
n
with
th
e
m
ea
s
u
r
ed
v
ar
iab
les.
T
h
e
m
ea
s
u
r
ed
co
n
s
tr
u
cts
d
em
o
n
s
tr
ate
a
v
er
y
s
tr
o
n
g
co
r
r
elatio
n
with
in
d
icato
r
s
with
in
cr
ea
s
ed
o
u
ter
lo
ad
in
g
(
ab
o
v
e
0
.
9
)
,
as o
b
s
er
v
e
d
in
th
e
in
f
o
r
m
atio
n
q
u
ality
an
d
s
er
v
ice
q
u
ality
v
ar
ia
b
les.
T
h
e
ev
alu
a
tio
n
r
esu
lts
b
ased
o
n
th
e
Fo
r
n
ell
-
L
ar
ck
er
cr
iter
i
o
n
ar
e
p
r
esen
ted
in
T
ab
le
3
.
I
t
is
s
h
o
wn
in
th
e
d
is
cr
im
in
an
t
v
alid
ity
tab
le
th
at
all
co
n
s
tr
u
cts
p
o
s
s
ess
s
tr
o
n
g
d
is
cr
im
in
an
t
v
alid
ity
,
in
d
i
ca
tin
g
th
at
th
ey
ca
n
b
e
ea
s
ily
d
is
tin
g
u
is
h
ed
f
r
o
m
o
n
e
an
o
th
er
.
A
s
tr
o
n
g
d
is
cr
i
m
in
an
t
v
alid
ity
is
in
d
icate
d
b
y
th
e
c
r
o
s
s
-
lo
ad
in
g
v
alu
e,
wh
ich
in
d
icate
s
th
at
ea
ch
in
d
icato
r
is
m
o
r
e
co
r
r
elate
d
with
its
o
wn
co
n
s
tr
u
ct
th
an
with
o
th
er
co
n
s
tr
u
cts.
T
h
e
v
ar
iab
les
in
th
is
m
o
d
el
h
a
v
e
b
ee
n
ac
cu
r
ately
m
ea
s
u
r
ed
,
an
d
th
e
in
d
icato
r
s
d
o
n
o
t
m
ea
s
u
r
e
th
e
in
co
r
r
ec
t o
r
o
v
e
r
lap
p
in
g
co
n
s
tr
u
cts,
as e
v
id
en
ce
d
b
y
th
e
h
ig
h
d
is
cr
im
in
an
t v
alid
ity
.
T
ab
le
4
s
h
o
ws
th
e
C
r
o
n
b
ac
h
'
s
alp
h
a
a
n
d
co
m
p
o
s
ite
r
eliab
i
lity
v
alu
es.
As
s
ee
n
in
th
e
r
e
s
u
lts
,
th
e
v
ar
iab
les
in
th
e
m
o
d
el
s
h
o
w
g
o
o
d
to
v
er
y
g
o
o
d
r
eliab
ilit
y
.
C
r
o
n
b
ac
h
'
s
alp
h
a
v
alu
es
f
o
r
all
co
n
s
tr
u
cts
ex
ce
ed
0
.
8
,
with
th
e
m
ajo
r
ity
ap
p
r
o
a
ch
in
g
o
r
ex
ce
ed
i
n
g
0
.
9
.
T
h
is
s
u
g
g
ests
th
at
th
e
in
d
icato
r
s
with
in
ea
ch
co
n
s
tr
u
c
t
ar
e
h
ig
h
ly
c
o
r
r
elate
d
an
d
s
tab
le.
T
h
e
co
n
s
tr
u
cts
ar
e
also
co
n
s
is
ten
tly
m
ea
s
u
r
ed
b
y
co
m
p
o
s
ite
r
eliab
ilit
y
(
r
h
o
_
a
)
a
n
d
c
o
m
p
o
s
ite
r
eliab
ilit
y
(
r
h
o
_
c)
,
with
m
ajo
r
ity
v
alu
es
ex
ce
ed
in
g
0
.
9
.
Ov
er
all,
t
h
e
in
d
icato
r
s
i
n
th
is
s
tu
d
y
ar
e
r
eg
ar
d
ed
as
r
eliab
le
,
in
d
icatin
g
th
at
th
e
r
esu
lts
ar
e
co
n
s
is
ten
t
an
d
s
tab
le
in
th
e
ir
m
ea
s
u
r
em
en
t
o
f
ea
ch
co
n
s
tr
u
ct.
T
ab
le
5
s
h
o
ws
th
e
R
-
s
q
u
ar
e
v
alu
e
o
f
t
h
e
d
ep
e
n
d
en
t
v
ar
iab
le
s
in
th
is
s
tu
d
y
.
T
h
e
r
esu
lts
o
f
th
is
s
tu
d
y
in
d
icate
d
th
at
u
s
er
s
atis
f
ac
tio
n
h
as
a
v
er
y
s
tr
o
n
g
R
-
s
q
u
ar
e
(
0
.
8
6
4
)
,
s
u
g
g
esti
n
g
th
at
th
e
in
d
ep
en
d
e
n
t
v
ar
iab
les
in
th
e
m
o
d
el
p
r
o
p
er
ly
r
ep
r
esen
t th
e
m
ajo
r
ity
o
f
th
e
v
ar
ian
ce
in
US.
T
h
e
m
o
d
el
co
u
ld
b
e
r
e
s
p
o
n
s
ib
le
f
o
r
n
ea
r
ly
all
o
f
th
e
v
ar
ian
ce
in
n
et
b
e
n
ef
it
,
as
in
d
icate
d
b
y
its
o
u
ts
tan
d
in
g
R
-
s
q
u
a
r
e
(
0
.
9
8
9
)
.
T
h
is
s
u
g
g
ests
th
at
th
is
m
o
d
el
is
n
ea
r
ly
p
er
f
ec
t
in
its
ab
ilit
y
to
p
r
ed
ict
th
e
n
et
b
en
ef
its
o
f
th
e
T
eleh
ea
lth
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C
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I
SS
N
:
2
7
2
2
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3
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2
1
C
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m
p
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I
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f
T
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n
o
l
,
Vo
l.
6
,
No
.
1
,
M
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20
25
:
48
-
57
54
I
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6
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test
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Acc
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,
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s
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s
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h
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t
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f
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s
e
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h
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ea
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th
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t
s
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tr
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p
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itiv
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d
s
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if
ican
tly
to
in
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g
u
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f
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h
as
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f
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s
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ca
n
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ter
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m
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Po
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Of
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f
r
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m
lo
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en
tial to
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e
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et
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p
r
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r
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s
[
1
8
]
.
T
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Of
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et
b
en
ef
its
o
f
T
eleh
ea
lth
in
Po
n
tian
ak
C
ity
.
T
h
e
r
esu
lts
o
f
th
is
te
s
t
em
p
h
asize
th
e
im
p
o
r
tan
ce
o
f
m
ain
tain
in
g
th
e
tec
h
n
ical
q
u
al
ity
o
f
th
e
T
ele
h
ea
lth
s
y
s
tem
an
d
th
e
in
f
o
r
m
atio
n
p
r
o
v
id
e
d
s
o
th
at
tr
ain
i
n
g
ca
n
r
u
n
well
an
d
p
r
o
v
id
e
o
p
ti
m
al
b
en
ef
its
f
o
r
u
s
er
s
.
Ad
d
i
tio
n
ally
,
we
n
ee
d
g
o
v
er
n
m
en
t su
p
p
o
r
t in
ter
m
s
o
f
p
o
licy
a
n
d
in
f
r
astru
ctu
r
e.
3
.
3
.
Dig
it
a
l lit
er
a
cy
a
nd
re
g
ula
t
o
ry
cha
lleng
es
Desp
ite
th
e
p
o
s
itiv
e
im
p
ac
t o
f
T
eleh
ea
lth
-
b
ased
B
L
S tr
ain
in
g
,
th
e
s
tu
d
y
id
en
tifie
d
s
ev
er
al
ch
allen
g
es
th
at
r
eq
u
i
r
e
atten
tio
n
to
en
h
a
n
ce
th
e
p
r
o
g
r
am
'
s
ef
f
ec
tiv
en
ess
in
th
e
f
u
tu
r
e.
On
e
o
f
th
e
m
ai
n
ch
allen
g
es
is
th
e
lo
w
d
ig
ital
liter
ac
y
am
o
n
g
th
e
co
m
m
u
n
ity
.
So
m
e
p
ar
tici
p
an
ts
ex
p
e
r
ien
ce
d
d
if
f
icu
ltie
s
in
o
p
er
atin
g
th
e
T
eleh
ea
lth
p
latf
o
r
m
,
esp
ec
iall
y
th
o
s
e
wh
o
wer
e
less
f
am
ilia
r
with
th
e
u
s
e
o
f
d
ig
ital
tech
n
o
lo
g
y
.
T
h
is
cr
ea
tes
o
b
s
tacle
s
to
o
p
tim
al
ac
ce
s
s
to
tr
ain
in
g
m
ater
ials
.
R
eg
u
lato
r
y
s
u
p
p
o
r
t
f
o
r
T
eleh
ea
lth
at
th
e
lo
ca
l
lev
el
is
also
s
till
lim
ited
.
Desp
ite
th
e
r
ec
o
g
n
itio
n
o
f
T
eleh
ea
lth
as
a
c
r
u
cial
to
o
l
in
h
ea
lth
s
er
v
ices
d
u
r
in
g
th
e
C
OVI
D
-
1
9
p
an
d
em
ic,
th
e
r
e
r
em
ain
s
a
l
ac
k
o
f
well
-
s
tr
u
ctu
r
e
d
r
eg
u
latio
n
s
f
o
r
its
im
p
lem
en
tatio
n
in
h
ea
lth
tr
ain
in
g
,
p
ar
ticu
lar
ly
in
n
o
n
-
clin
ical
tr
ain
in
g
lik
e
B
L
S
[
1
2
]
.
3
.
4
.
T
elehea
lt
h
dev
elo
pm
ent
in t
he
f
uture
T
eleh
ea
lth
n
o
t
o
n
ly
o
f
f
er
s
a
s
o
lu
tio
n
f
o
r
B
L
S
tr
ain
in
g
,
b
u
t
also
h
o
ld
s
s
ig
n
if
ican
t
p
o
ten
tial
f
o
r
ap
p
licatio
n
i
n
v
ar
io
u
s
o
th
er
h
e
alth
f
ield
s
.
Fo
r
in
s
tan
ce
,
a
T
el
eh
ea
lth
p
latf
o
r
m
en
ab
les v
ir
tu
al
tr
ain
in
g
f
o
r
o
th
er
f
ir
s
t
aid
,
in
clu
d
in
g
m
an
a
g
in
g
b
u
r
n
s
,
h
ea
d
in
ju
r
ies,
an
d
tr
au
m
a.
T
h
is
ca
n
e
x
p
an
d
p
u
b
l
ic
ac
ce
s
s
to
b
asic
m
ed
ical
k
n
o
wled
g
e
th
at
is
cr
u
cial
in
an
em
er
g
en
cy
.
Fu
tu
r
e
d
ev
elo
p
m
en
ts
in
m
u
ltime
d
ia
tech
n
o
lo
g
y
an
d
v
is
io
n
s
y
s
tem
s
will
en
ab
le
th
e
in
te
g
r
atio
n
o
f
T
eleh
ea
lth
with
v
ir
tu
al
r
ea
lity
(
VR
)
o
r
au
g
m
e
n
ted
r
ea
lity
(
AR
)
tech
n
o
lo
g
y
,
r
esu
ltin
g
in
a
m
o
r
e
im
m
er
s
iv
e
a
n
d
r
ea
lis
tic
tr
ain
in
g
ex
p
er
ien
ce
.
Par
ticip
an
ts
ca
n
d
o
liv
e
s
im
u
latio
n
s
u
s
in
g
VR
d
e
v
ices,
allo
win
g
th
em
to
p
r
ac
tic
e
in
em
er
g
e
n
cy
s
itu
atio
n
s
th
at
a
r
e
cl
o
s
er
to
r
ea
l
co
n
d
itio
n
s
.
T
r
ain
ee
s
ca
n
u
s
e
VR
to
r
ec
o
n
s
tr
u
ct
r
ea
l
ca
s
es
f
r
o
m
p
atien
t
d
ata
f
o
r
f
u
r
t
h
er
s
tu
d
y
.
T
h
u
s
,
tr
ain
ee
s
ca
n
lear
n
f
r
o
m
m
is
tak
es
o
r
u
n
d
er
s
tan
d
clin
ic
al
s
itu
atio
n
s
b
etter
.
Evaluation Warning : The document was created with Spire.PDF for Python.
C
o
m
p
u
t Sci
I
n
f
T
ec
h
n
o
l
I
SS
N:
2722
-
3
2
2
1
A
n
a
lysi
s
o
f
T
eleh
ea
lth
a
cc
ep
ta
n
ce
fo
r
b
a
s
ic
life su
p
p
o
r
t tra
in
in
g
in
s
u
d
d
en
ca
r
d
ia
c
a
r
r
est …
(
R
u
h
il I
s
w
a
r
a
)
55
AR
ca
n
al
s
o
h
elp
p
ar
ticip
an
ts
u
n
d
er
s
tan
d
h
u
m
an
an
ato
m
y
b
etter
,
m
ak
i
n
g
th
em
m
o
r
e
co
n
f
id
en
t
in
p
r
o
v
id
in
g
f
ir
s
t
aid
.
T
h
e
ap
p
licatio
n
o
f
V
R
h
as
b
ee
n
p
r
o
v
ed
to
b
e
u
s
ef
u
l
in
th
e
f
ield
o
f
n
u
r
s
in
g
ed
u
ca
tio
n
,
p
ar
ticu
lar
ly
in
th
e
ar
ea
o
f
clin
ical
k
n
o
wled
g
e
an
d
s
k
ills
ac
q
u
is
itio
n
[
2
5
]
–
[
2
7
]
.
Similar
ly
,
o
th
e
r
r
esear
c
h
h
as
d
em
o
n
s
tr
ated
th
at
AR
co
n
s
id
er
ab
ly
en
h
an
ce
s
th
e
k
n
o
wled
g
e,
m
o
tiv
at
io
n
,
an
d
s
elf
-
ef
f
icac
y
o
f
n
u
r
s
in
g
s
tu
d
en
ts
in
co
m
p
ar
is
o
n
to
t
r
ad
itio
n
al
lea
r
n
in
g
class
es
[
2
8
]
,
[
2
9
]
.
T
eleh
ea
lth
o
f
f
er
s
a
f
lex
ib
le
an
d
ea
s
ily
ac
ce
s
s
ib
le
s
o
lu
tio
n
,
esp
ec
ially
am
id
s
t
li
m
ited
r
eso
u
r
ce
s
f
o
r
f
ac
e
-
to
-
f
a
ce
tr
ain
in
g
.
W
ith
th
e
r
ig
h
t
s
u
p
p
o
r
t,
T
eleh
ea
lth
ca
n
b
e
a
v
er
y
ef
f
ec
tiv
e
to
o
l
in
ex
p
an
d
in
g
a
cc
ess
to
h
ea
lth
tr
ain
in
g
,
n
o
t
o
n
ly
in
Po
n
tian
a
k
C
ity
b
u
t
also
th
r
o
u
g
h
o
u
t
I
n
d
o
n
esia.
A
n
atio
n
al
d
ig
ital
liter
ac
y
p
r
o
g
r
am
is
r
eq
u
ir
ed
in
I
n
d
o
n
esia
to
en
h
an
ce
d
ig
ital
liter
ac
y
an
d
f
ac
ilit
ate
th
e
ad
v
an
ce
m
e
n
t
o
f
s
u
s
tain
ab
le
an
d
in
clu
s
iv
e
T
eleh
ea
lth
.
T
h
is
p
r
o
g
r
a
m
s
h
o
u
ld
en
c
o
m
p
ass
f
u
n
d
am
en
tal
tr
ain
in
g
,
i
n
s
tr
u
ctio
n
al
ca
m
p
aig
n
s
,
an
d
th
e
i
n
teg
r
atio
n
o
f
d
ig
ital
liter
ac
y
in
to
t
h
e
s
ch
o
o
l
cu
r
r
icu
l
u
m
.
Fre
e
in
ter
n
et
ac
ce
s
s
in
p
u
b
lic
f
ac
ili
ties
,
s
u
b
s
id
ies
f
o
r
tec
h
n
o
lo
g
y
d
ev
ices,
an
d
m
e
n
to
r
in
g
p
r
o
g
r
am
s
f
o
r
v
u
l
n
er
ab
le
g
r
o
u
p
s
ar
e
all
p
r
o
g
r
a
m
s
th
at
t
h
e
g
o
v
er
n
m
en
t
h
as
th
e
ab
ilit
y
to
im
p
lem
en
t.
Nu
m
e
r
o
u
s
g
o
v
e
r
n
m
en
t
p
o
licies
ar
e
r
eq
u
ir
ed
,
p
ar
ticu
la
r
ly
th
o
s
e
th
at
p
er
tain
to
n
atio
n
al
T
eleh
ea
l
th
s
tan
d
ar
d
s
,
p
latf
o
r
m
ac
cr
ed
it
atio
n
,
d
ig
ital
h
ea
lth
in
s
u
r
an
ce
,
an
d
i
n
v
estme
n
t
in
i
n
f
o
r
m
atio
n
tech
n
o
l
o
g
y
in
f
r
astru
ctu
r
e
in
r
u
r
al
ar
ea
s
.
E
s
tab
lis
h
in
g
p
u
b
lic
-
p
r
iv
ate
p
ar
tn
er
s
h
ip
s
is
o
n
e
p
r
ac
tical
ap
p
r
o
ac
h
to
ac
co
m
p
lis
h
in
g
th
is
.
T
h
e
g
o
v
e
r
n
m
en
t
s
h
o
u
l
d
p
r
o
v
id
e
f
u
n
d
in
g
f
o
r
r
esear
ch
o
n
t
h
e
s
o
cio
-
ec
o
n
o
m
ic
im
p
licatio
n
s
o
f
T
eleh
ea
lth
,
lo
ca
l
tech
n
o
lo
g
y
in
n
o
v
a
tio
n
,
an
d
ca
m
p
ai
g
n
s
f
o
r
im
p
r
o
v
in
g
p
u
b
lic
tr
u
s
t.
4.
CO
NCLU
SI
O
N
T
h
is
s
tu
d
y
s
h
o
ws th
at
T
eleh
ea
lth
h
as e
n
o
r
m
o
u
s
p
o
ten
tial in
d
eliv
er
in
g
r
em
o
te
h
ea
lth
tr
ain
in
g
s
u
ch
as
B
L
S.
Alth
o
u
g
h
th
e
r
esu
lts
s
h
o
w
a
s
ig
n
if
ican
t
in
cr
ea
s
e
in
p
ar
ticip
an
t
k
n
o
wled
g
e
an
d
s
k
ill
s
,
th
e
ch
allen
g
es
o
f
d
ig
ital
liter
ac
y
an
d
r
eg
u
latio
n
s
till
n
ee
d
f
u
r
th
er
atten
tio
n
.
W
e
n
ee
d
to
im
p
r
o
v
e
c
o
m
m
u
n
ity
d
ig
ital
liter
ac
y
an
d
d
ev
elo
p
r
eg
u
latio
n
s
th
at
s
u
p
p
o
r
t
th
e
ad
o
p
tio
n
o
f
th
is
tech
n
o
lo
g
y
in
h
ea
lth
tr
ain
in
g
in
I
n
d
o
n
esia
to
en
s
u
r
e
th
e
s
u
cc
ess
o
f
s
u
s
tain
ab
le
T
eleh
e
alth
im
p
lem
en
tatio
n
.
T
h
e
HOT
-
Fit
m
eth
o
d
was
u
s
ed
to
a
n
aly
ze
th
e
lev
el
o
f
ac
ce
p
tab
i
lity
o
f
T
eleh
ea
lth
in
B
L
S
tr
ain
in
g
,
a
n
d
th
e
r
esu
lt
s
in
d
icate
d
th
at
u
s
er
s
atis
f
ac
tio
n
is
s
ig
n
if
ican
tly
in
f
lu
en
ce
d
b
y
s
y
s
tem
an
d
s
er
v
ice
q
u
ality
.
Fu
r
th
er
m
o
r
e,
u
s
er
s
atis
f
ac
tio
n
an
d
s
y
s
tem
u
s
e
ca
u
s
e
s
ig
n
if
ican
t
n
e
t
b
en
ef
its
.
On
t
h
e
o
t
h
er
h
an
d
,
g
o
v
er
n
m
e
n
t
ass
i
s
tan
ce
is
also
a
s
ig
n
if
ican
t
f
ac
t
o
r
in
th
e
e
n
h
a
n
ce
m
en
t
o
f
th
is
n
et
b
en
ef
it.
I
n
th
e
f
u
tu
r
e,
we
a
r
e
g
o
in
g
t
o
ex
p
l
o
r
e
th
e
p
o
ten
tial
o
f
in
co
r
p
o
r
atin
g
VR
o
r
AR
t
ec
h
n
o
lo
g
y
in
to
th
e
T
eleh
ea
lth
ap
p
licatio
n
f
o
r
B
L
S
tr
ain
in
g
.
I
n
o
r
d
e
r
to
p
r
o
m
o
te
s
u
s
tain
ab
le
T
eleh
ea
l
th
d
ev
el
o
p
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.
Evaluation Warning : The document was created with Spire.PDF for Python.