Real Rape Stereotype: Between Knowledge and Beliefs

: The paper presents the results of a research related to the existence of stereotypes in connection with sexual violence among the general population of Serbia, as well as among the students of the University of Criminal Investigation and Police Studies in Belgrade (UCIPS). Bearing in mind that comparative studies testify to a high level the presence of stereotypes related to sexual violence, the researchers have attempted to establish whether there are any differences in under-standing this issue among the above-mentioned categories of respondents, as some of them are prospective police officers, who will likely be in contact with the victims of sexual violence given the nature of their job. The focus was also on the differences in the manner of obtaining information about this phenomenon. The study encompassed a total of 310 respondents, out of whom 62 were the students of the UCIPS and 61 the students of other universities, whereas all others were above the student age. The data were collected by filling in a questionnaire and analysing responses by the use of descriptive statistics and correlation. The results suggest that the information from the Internet is a principal source of obtaining information about sexual violence except among the UCIPS students, who primarily learn about such phenomena from professional literature. The initial thesis on the absence of significant differences related to rape stereotypes among the UCIPS students and the students of other universities, irrespective of their previous professional education, has been confirmed, which indicates the need for narrowly targeted expert education of prospective police officers in respect of issues of sexual violence.

Satisfying one's sex drive has not been instinctive for centuries now but rather based on the patterns of learning and accepting established and socially acceptable models (Marinković & Lajić, 2016). Sexual delinquency is a complex phenomenon which within a sexual relationship transcends the frames of what is natural and the consent of a partner, and whose essence derives from a specific conduct of the perpetrators of sex crimes and their relation towards the victim (Bošković, 2007). Although its share in the overall number of criminal offences is comparatively small, sexual violence has always drawn special attention of the public. Namely, according to the data of the Statistical Office, the number of adults reported for the criminal offence of rape in the Republic of Serbia has been stable for a decade at 0.1% out of the total number of reported offenders in one year. The use of aggression and violence related to violation of sexual intimacy give rise to a lot of attention both in the ranks of general and expert public (Feješ & Lajić, 2014).
Despite the nominally small number of criminal offences in this area, sexual violence is widespread, and sexual violence among acquaintances is prevalent as compared to the so-called 'rape by a stranger' . Rape among familiar persons (partners, household members, partners in a relationship or lovers) constitutes 66-76% out of the total number of sex offences, which leads to a conclusion that the closer relationship between the victim and the perpetrator, the more rarely crime gets reported (Marinković, 2012), and the literature offers data which suggest an even smaller percentage of rape by a complete stranger, at the level of only 9-11% (Anderson, 2007), or 14% (Temkin et al., 2018). Sexual violence in the family is a frequent phenomenon, but also a difficult topic for discussion (Đunđek, 2011). The data from a study dating from late 20 th century about sexual experiences of student population testify to a high incidence of unwarranted sexual contact among acquaintances, whereby 34% of girls reported some kind of unsolicited sexual contact, 20% an attempted sexual intercourse and 10% an unwanted sexual intercourse (Ward et al., 1991). According to other studies, sexual violence is also frequent in the general population, where as many as 20% of adult women from six European states reported having experienced some form of sexual violence at some point in life, with a low level of reported cases (Olszewski, 2009). The data on the high incidence of sexual violence also applies to Serbia, given that in the National Study on the General Features of Sex Behaviour among Adolescents 5% of respondents reported having been raped or coerced into a sexual intercourse with a steady partner (Stanković et al., 2009). Sexual violence is accompanied by myths that are based on stereotypes. The scientific community became more interested in the stereotypes related to sexual violence in the 1980's and the American author Martha Burt can be regarded to be the pioneer in popularizing this topic. A stereotype is considered to be a simplified and hard-to-change attitude towards someone or something, based on a misconceived or unjustifiably widespread generalization. There is no doubt that the myths on rape are widely spread, based on misconceptions, the nature of rape itself, as well as circumstances that accompany it (Burt, 1980;Temkin et al., 2018).

O N L I N E F I R S T
Among the most frequent stereotypes related to rape are such that it always takes place at night, out in the open, dark space, that it is perpetrated by a stranger, with the use of physical force, whereas the other myth is related to the alleged frequency of false rape reports (Martinjak, 2003;Anderson, 2007;McGee et al., 2011, Temkin et al., 2018. In addition to these, there are other frequent myths, such as the one that a woman can always physically resist a rapist, that elderly men cannot perpetrate rape due to less intense libido (Cusack & Timmer, 2011), that real rape victims immediately report to the police (Temkin et al., 2018) etc. Cook and Cusack (2010) list a large number of stereotypes related to sexual violence, while McGee and associates (2011) produce a list of 20 stereotypes whose incidence they tested on a sample of 3,120 respondents. The perception of rape is significantly shaped by stereotypes about the traditional sex roles of a man and a woman, which leads to blaming the victim rather than the offender and playing down the significance of the crime (Willis, 1992), thus leading to justifying sexual violence (Spencer, 2016). The conducted research clearly indicates that the stereotypes about rape are deeply rooted and that a larger portion of the population believes in numerous myths about rape, which are at that significantly related to lack of confidence in the opposite sex and acceptance of interpersonal violence (Burt, 1980). In this respect, the judiciary, police and prosecution are no exception although they are in charge of conducting preliminary inquiry and investigation. As a part of society, they are not immune to the influence of the environment and they may also be susceptible to the above-mentioned stereotypes. From the perspective of the police and prosecution, in cases of reported rape, there are two most prominent problems that can be identified as arising from the rape-related myths: their existence may lead to justification of violence and they may result in the lack of confidence in the victim's statement that does not fit in the expected version of the event. Temkin and associates (2018) quoted the study of Angiolini from 2015 as stating that prosecutors constantly failed to recognize the myths related to rape and concluded that managing investigation of rape remained questionable. Anderson also points out to widespread stereotypes among investigative authorities, judiciary and medical professionals, along with frequent division into 'strong' and 'weak' cases, where it is desirable for the former, as the cases with the highest probability of convicting the suspect, to include as many stereotypes as possible (Anderson, 2007). Following the same lead, Fávero and associates (2020), researching the same phenomenon among police members, indicated that police officers who showed the highest levels of tolerance or acceptance of violence in their attitudes were at the same time the ones who thought there was no need for special training for work with the victims of sexual violence, which illustrates what difficulties anyone who tries to change the established customs and informal concepts that shape or characterize police actions will be faced with.

Experimental Approach to the Problem
While conducting this research, the authors -motivated by the data from the aforementioned studies -sought to establish in which way the respondents acquired information about the issue of sexual violence, as well as to find out whether any of the real rape stereotypes

O N L I N E F I R S T
were present among the UCIPS students, as prospective police officers who would encounter the victims of sexual violence in the course of their work in Serbia, or to compare and find out whether their attitudes in this respect differ from the attitudes of the students from other universities or the attitudes of the general population. In this way the researchers wanted to check their initial hypothesis, according to which there was no significant difference in the attitudes of the UCIPS students on the one hand -despite acquired skills and knowledge related to criminal law, criminal investigation and practical police procedures -and the general public, on the other hand, as well as that sensitivity to delicate issues of sexual violence and the exclusion of stereotypes in professional practice can be achieved only by narrowly targeted professional training. In doing so, the authors were aware of the limitations arising from the snow ball sampling technique, as well as the fact that respondents may strive to give the expected answers.

Participants
The sample comprised a total of 310 respondents from the territory of the Republic of Serbia. The core of the sample consisted of 62 third-year UCIPS students of vocational studies of criminalistics. The rest of the sample was provided by the snowball method, with each of the students providing four more respondents from their place of residence, thus ensuring better territorial coverage. The sample was semi-structured, with each student surveying one student from another university, one respondent up to the age of 30, and two respondents aged over 30. The last two categories made "general population" part of the sample. In this way, in addition to the territorial balance, a balance was established in respect of the respondents' age. The research was conducted in early 2020.

Measurements and Procedures
A survey questionnaire covering a total of 19 questions was used during the survey. The first five questions were of socio-demographic nature and related to gender, age, level of education, occupation, place of residence and its type (village, city, suburbs). The respondents then answered the questions concerning the dominant way of obtaining information about the phenomenon of rape, possible personal acquaintance with a person who was a rape victim and gave their opinion on the frequency of the commission of the act by a complete stranger. The respondents chose among the offered answers, with the possibility of writing an answer that was not offered on the list. The rest of the questionnaire consisted mainly of a set of statements reflecting the aforementioned stereotypes related to rape, to which the respondents expressed a degree of (dis)agreement via the Likert scale. The survey was conducted anonymously.

Statistical analyses
The statistical analyses were conducted using Social Package for Social Sciences (IBM, SPSS statistics, version 18). The descriptive statistics for each age category were calculated including mean, standard deviation (SD), minimum (Min) and maximum (Max). The significance level was set to p < 0.05.

RESULTS
For easier analysis and comparison, the sample in the research was divided into three groups. The first group consisted of the sample of the UCIPS students, including a total of 62 respondents, 36 men (58.1%) and 26 women (41.9%), average age of 22.55 (SD 1.888, Min 20, Max 32). Most students were from Belgrade, 13 (20.8%), followed by Gornji Milanovac 5 (8.1%), Zemun 4 (6.5%) and Vlasotince 3 (4.8%), whereas other places were represented with less than 5%. The second group was made up of the students from other universities and colleges from the territory of Serbia, a total of 61, out of whom 25 were men (41%) and 36 women (59%) The first question related to the dominant source of knowledge related to rape generally, its manifestations and frequency with which specific criminal offences were committed. The respondents could circle one (prevalent) of the offered answers or opt for writing an answer that was not on the list. Following this, the respondents declared whether they personally knew anyone who had had non-consensual sexual intercourse at least once in their life, and the answers received from the three groups were presented in the table below. This was followed by a set of questions about attitudes regarding the aforementioned stereotypes about rape -the stereotype of a complete stranger, the commission of the act in the open and remote place, and the mandatory use of force in the course of committing the crime, i.e. about the inevitable physical harm to the rape victim. Regarding the views on previous acquaintance between the perpetrator and the victim, the respondents were offered to choose among answers that implied: a) that the victim and the perpetrator had known each other before, at least superficially (familiar); b) that they did not know each other at all (unfamiliar); or c) that there was no significant difference in the incidence of the two options. The final response was offered to allow the respondents to remain undecided. The next question concerned the victim's clothing and the respondents were asked if a female person who dresses more liberally and moves in the locations and at the time when there are no other people around thereby contributes significantly to becoming a victim of rape. T-Test for independent samples was applied to test the assumption of age differences (older and younger age group of participants) in the context of accepting the mentioned stereotypes. The result showed that there was not statistical significant difference between two groups (t(121) = 1.13, p > .05). The same kind of the result, from the same statistical analysis, was obtained in the context of type of faculty (UCIPS or non-UCIPS students) for accepting the mentioned stereotypes (t(186) = 1.64, p > .05). Also, there was no statistically significant difference between the UCIPS students and the second group of participants, which consisted of the students from other faculties and the general population (t(308) = 1.44, p > .05). The question that followed concerned physical violence against the victim as an indispensable part of the act of rape. The question was formulated as a claim according to which rape is always and inevitably accompanied by physical harm to the victim, with which the respondents expressed a degree of (dis)agreement on the Likert scale.

DISCUSSION
When discussing the general knowledge about rape, its manifestations and frequency of occurrence of specific criminal offences, it is evident that, in accordance with the time we live in, the Internet is the dominant form of obtaining information among all categories of respondents. Still, there are noticeable differences stemming from the difference in age and age-related habits, as well as education, so that students are informed in the aforementioned manner in over two thirds (68.9%) of cases, and the rest in just over a half of the cases (51.3%). Newspapers and other printed media, together with radio and television, account for only 18% among the students whose average age was 23, whereas in the general population sample (average age around 37) they made up 43.4%. Quite expectedly, the UCIPS students significantly differed from the other two categories of respondents as the Internet as a source of information in this category was half the level of the students from other universities (35.5%), while expert literature and previous education together accounted for more than 40%, whereas for the other two categories this value was below 5%. The question about personal acquaintance with a victim of sexual violence was aimed at establishing whether there were significant differences regarding the perception of the prevalence of this phenomenon in the society, regardless of official statistics, which indicates a relatively small share of sexual violence in the overall number of perpetrated criminal offences. The respondents' answers suggest a relative uniformity of experience across all three categories, where the number of those who knew the victims of sexual violence ranged between 14.5% and 17.1%, which is a value that significantly exceeds official statistics on the incidence of sexual violence and calls for additional research. Again, as expected, this number is the highest in the group of respondents who do not belong to the student population, given their more advanced age and hence their richer life experience and a wider circle of persons they got to know in various aspects of life. Yet, as previously mentioned, a difference of only 1.6% suggests that these differences are insignificant. The views regarding the stereotype of rape by a complete stranger show that police education does yield results in terms of better knowledge of the facts from criminal investigation practice and better awareness of stereotypes, although their knowledge of the facts was nevertheless of limited range, which is illustrated by the example that follows and also by some other examples yet to be discussed. Namely, just under a half (46.8%) of the UCIPS students thought that in most cases there was previous acquaintanceship between the perpetrator and the victim, which is the case in practice (Anderson, 2007;Marinković, 2012;Temkin et al., 2018), but 17.7% respondents from this group still think the opposite, along with almost a third who thought that there were no significant differences between these two forms. By comparison, a national study on rape-related stereotypes conducted in Ireland found that this percentage was over 80% (McGee et al., 2011) and in this context the value obtained in our research can be regarded as rather low. Burt (1980) also found that more than half of respondents agreed with the stereotypes about sexual violence. In this relation it should be noted that the respondents were the third-year UCIPS students who had previously obtained the information about this criminal offence through four academic courses. These included criminal law, criminology, criminalistic psychology, and criminalistic methodology. Reasons for the poor state of information could be in part attributed to the fact that in the course of the reform of higher education at the O N L I N E F I R S T beginning of the 21 st century, known as the Bologna process, all of the mentioned subjects were reduced to one-term courses with a very limited number of lessons (2-3 lectures and -on average -2 practical lessons per week), which is a rather modest scope that may have easily resulted in a complete failure to adopt vital information related to this aspect of sexual violence. Hence the situation in which familiarity of the students with such details depends exclusively on the lecturers' sensibility and sense of what is important, and does not derive from the systemic approach to sexual violence as something that should be in the focus of practical police activities.
The number of respondents in the remaining two categories who found that both forms were equally present exceeded 40%, where 31.1% of younger respondents (students) believed that there was previous acquaintanceship between the perpetrator and the victim and among the older ones the percentage was 27.3%. The last thing mentioned testifies to the known thesis that younger and better educated respondents are less likely to accept stereotypes related to rape (Burt, 1980) and that, conversely, older ones are more likely to accept them (McGee et al., 2011). The stereotype about the victim's liberal dressing and presence in locations and at times with lower frequency of people as a typical pattern for rape was present among over 50% of respondents in all categories. It is interesting that this stereotype was most prevalent among the prospective police officers -the UCIPS students (64.5%), while it was significantly lower among the two remaining categories of respondents -50.8% among students and 54.6% among the older population. By comparison, this stereotype was present among approximately 30% of respondents in Ireland (McGee et al., 2011). Although a lot of the UCIPS students know that rape most often occurs among familiar persons, and therefore in locations where they usually live and work, it appears that the stereotype about rape in dark distant spots is exceptionally appealing and seems so convincing that the respondents simply forgot the previously acquired knowledge. The data speak in favour of the two previously mentioned assumptions -fragmentation of the educational process of police officers-to-be regarding the facts related to sexual violence, as well as a lower tendency towards stereotypes among the younger and better educated. This should be seen in the context of data showed by Ljubin (2004), who researched the attitudes of students of Police College in Zagreb (Croatia) and found that there were no statistically significant differences between men and women in their belief in the testimonies of rape victims. In relation to the attitudes of the UCIPS students, there is a need for more detailed research on the psychological profile of future police officers and possible links between machismo and conservativism as prominent features of law enforcement profession (Milosavljević, 1997) and the attitudes regarding the subject under survey.
The stereotype on physical harm to the rape victim as a constituent part of the act of rape belongs to the group of the most prevalent stereotypes, with an extremely high incidence among all groups of respondents. Namely, the percentage of respondents agreeing with the claim that rape is always and inevitably accompanied by inflicting physical injury to the victim ranged between 85.5% and 90.1%. Interestingly, the older respondents showed a slightly weaker belief in this stereotype (85.5%) as compared to students (90.1%) or the UCIPS students (88.7%), which was the only situation that departed from the thesis about the younger population being better informed. The result can in part be explained by a O N L I N E F I R S T slightly larger number of undecideds in this category (9.1% as compared to 3.3% among students or 3.2% among the UCIPS students), probably as a result of a more pronounced critical attitude deriving from life experience. However, it is still an extremely high level of acceptance for this misconception about rape, especially if one bears in mind that the reality is diametrically opposed. This is best illustrated by the example given by Anderson (2007), who quoted research by other authors as saying that in 84% of analysed rape cases minimal aggression was applied, the use of weapons was absent, and the injury to the victims of sexual violence was minimal.

CONCLUSIONS
The results obtained in the research speak in favour of the dominant impact of information adopted through the Internet on the formation of awareness of rape as a form of crime, as well as the wide acceptance of stereotypes related to rape as a manifestation of crime, both in the general population and among the UCIPS students. It is also evident that there are no significant differences in the level of adopting stereotypes related to rape among the UCIPS students and the students of other universities. However, when we move beyond that, the students' answers to other questions that correlate with the mentioned one, for instance the question regarding the inevitable occurrence of physical injuries, rape in dark and distant places, etc., a fragmentation is evident in the adopted knowledge because the initial information loses its significance, and the students approach the mainstream in terms of their views and opinions, noticeably moving towards accepting what they think is right -the stereotype of real rape. It can be said that the initial hypothesis has been confirmed as there is no significant difference between the attitudes of the UCIPS students and the rest of the population, despite the skills and knowledge they acquired in the course of education.
We can therefore conclude that sensitivity to delicate issues of sexual violence and exclusion of stereotypes in professional practice can be achieved only through narrowly targeted professional training.
The studies referred to in the opening section of the paper indicate that stereotypes about rape are present among other professionals, not only police officers, but also doctors, prosecutors and judges. It appears that at the professional level there is frequently harsh realism, which does not respect actual needs of the victims, the violation of their integrity and dignity, nor the interests of criminal justice that should be achieved through criminal proceedings and the cases are seen through the prism of the expected outcome of the ensuing court proceedings. The broad acceptance of rape stereotypes and the relevant acts of professionals result in repercussions on a personal level to the victims of sexual violence, such as secondary victimization of the victims, withdrawal, non-reporting and waiving further criminal prosecution of the perpetrator, and -seen in a wider social context -all of the above gives an unintentional incentive to sexual violence and its persistence in the given community.
The intangible damage inflicted in this way is immeasurable and it seems that the O N L I N E F I R S T least one can do is to initiate the implementation of specialist training among all relevant subjects that come into contact with victims of sexual violence.


s2fieldsofstudy: Education Medicine

text:
Utilization of information and communication technology (ICT) among undergraduate health science students: a cross-sectional study

Background We already know that incorporating information and Communication technology (ICT) into every aspect of human activity result in significant change and makes tasks easier to complete. It can help in areas of healthcare systems and medical education. Therefore, this study aimed to assess utilization ICT and its associated factors among Arba Minch University College Medicine and Health Science students. Methods A cross sectional study design was conducted in June through August 2021 among under graduate students in college of medicine and health science at Arba Minch University, Ethiopia. A self-administered questionnaire was used to collect information on the students’ socio-demographic factors as well as the utilization ICT. The data entry form was prepared with Epi-data 3.1 versions software and STATA version 14 software was used to analyze the data. Results A total of 355 participants enrolled in the study, with a response rate of 98.34%. The percentage of students who used ICT was 55.77% [95% CI, 0.50, 0.60]. Regarding of field of study, health informatics students (84%) used the most ICT, while midwifery students (52%) used the least. Urban resident [AOR = 1.85, 95% CI = 1.08, 3.16], ICT knowledge [AOR = 3.8, 95% CI = 2.25, 6.40], having formal training of ICT [AOR = 1.9, 95% CI = 1.06,3.48], having IT in current course study [AOR = 2.2, 95% CI = 1.23, 3.84], and had good IT skill [AOR = 2.4, 95% CI = 1.34, 4.23] revealed a significant and positive correlation with the use of ICT. Conclusion In the current study previous residence, ICT knowledge, having formal training, having IT in current courses, and IT skill were significantly associated with student ICT utilization. Therefore, the university should continue to invest in professional development in order to improve teaching and student performance, as well as provide the college with student-centered ICT computer labs to encourage students to use technology.

Introduction
In today's society, information and communication technologies (ICT) play an important part in almost every area [1,2]. ICTs have the potential to promote patient-centered healthcare at a reduced cost, increase quality care and information sharing, educate health professionals and patients, stimulate a different sort of interaction with patients and health providers, and minimize travel time [3,4]. The healthcare system is growing increasingly dependent upon technology, so, health science students are expected to improve their skills of ICT [5,6]. Also, ICT enables the use of novel educational materials and the renewal of learning methods, allowing students to collaborate more actively and simultaneously acquire technological expertise [7]. In spite of the fact that there's no single, widespread definition of ICT, the term is for the most part acknowledged to cruel all devices, organizing components, applications and frameworks that combined permit individuals and organizations associated within the computerized world [8].
While we understand that the use of educational technologies in higher education teaching and learning activities is still in its infancy in Ethiopia, ICT instructional use is critical to both faculty and student success and development [9]. In education, the use of ICT to improve or support learning and teaching has grown increasingly significant [10,11]. For several decades, many authors have argued that ICT as educational devices facilitate the adaptation of teaching to each student [9,12]. Although it is widely assumed that ICT can empower teachers and students, encourage change, and nurture the development of 'twenty-first century skills, data to back up these claims is still scarce ( [9], Https:// www. infod ev. org/ innov ation andEn trepr eneur ship). ICT in health care, and both educational opportunities and assistance for students and health care professionals have expanded [13,14]. The COVID-19 epidemic has had a significant impact on all aspects of schooling, particularly in light of existing social distancing norms. Medical educators are employing a variety of information and communication technology (ICT) methods to maintain medical education in the face of the pandemic. The majority of medical educators use university websites and online collaboration technologies to disseminate study materials [15,16].
Computer technology and digital world have revolutionized the way people live, work, development and distribution of knowledge and power around the world (Https:// learn ingpo rtal. iiep. unesco. org/ en. learn ing porta l,2021). Because the integration of informatics into health science education is becoming necessary in many universities across the world, it is critical to assess health science students' factors to use computers and ICT technologies [17][18][19]. Expanded usage of eHealth is projected in Ethiopia in the future years, appreciations to new efforts, but these systems must be used properly to accomplish objectives; this is entirely dependent on health science student since they will be professional in few years later [20]. Therefore, the objective this study was to assess utilization of information and Communication technology and its associated factors among undergraduate health science student.

Study design, setting, and period
A cross sectional study design was conducted in June through August 2021 among under graduate students in college of medicine and health science at Arba Minch University, Ethiopia. Arba Minch University College of Medicine and Health Sciences, was founded in 2008. It is located in Ethiopia, SNNP regional State, Gamo Gofa zone, Arba Minch town is located around 434.3 kms from Addis Ababa, the capital city of Ethiopia. It has been focusing on its fundamental mission of operating programs that earnestly complement and augment the nation's healthcare needs since its foundation. Under college of medicine and health science there are 10 departments running undergraduate study programs.

Study population
This study included all regular undergraduate students from Arba Minch University College of Medicine and Health Sciences who were available during the data collection period and were in their second year or above were included in this study.

Sample size determination and sampling procedure
The sample size was calculated using single population proportion formula with the following assumptions: 95% confidence level (CI), Z (1-α/2) =1.96), based on previous studies proportion of ICT utilization (p = 30.9%) [21], and 5% margin of error by considering a 10% non-response rate. Finally, 361 full-time undergraduate students were enrolled in this study. In Arba Minch University, college of medicine and health science, there are 10 departments (i.e. medicine, public health officer, medical laboratory sciences, midwifery, health informatics, anesthesia, radiology, pharmacy, environmental health and nursing). Later on, the proportional allocation was used for each department and academic year. Finally, using a student attendance list, a simple random sampling technique was used to withdraw study participants.

Data collection
Structured self-administered questionnaires were adapted after reviewing relevant literature [21][22][23]. Pretest for the questionnaire was made on about 5% of the total studied population at Wolaita Sodo University which is outside of the study area and used to collect data from the study participants. The questionnaire comprised of socio demographic and basic IT skills and knowledge of computer hardware, software, computer input devices, computer output devices, basic computer words and definitions, and a general concept of how a computer works were assessed by a questionnaire. A total of 16 questions on ICT knowledge were asked, with each statement having a yes or no question to assess the level of ICT knowledge. In this study, participants were also asked about ICT Utilization questions to determine their level of ICT usage. In this study, respondents who scored mean value and above for utilization related questions were rated as good utilization rate; those who scored below mean value for a set utilization related questions were rated poor utilization rate.

Study variables
The dependent variable for this study was utilization of ICT.
Independent variables sex, age, year of study, previous residence, field of study, parental educational status, family monthly income, previous IT training status, personal computer ownership, current information technology course taken, IT knowledge, availability of computer lab session, IT skill.

Statistical analysis
Epi-data 3.1 versions used for data entry and STATA version 14software was used to analyze the data. Descriptive statistics was computed to describe socio demographic characteristics. Bivariate and multivariable logistic regression analysis was done to identify factors associated with ICT utilization. To control the possible effect of confounders, variables from the bivariate logistic regression with a p-value less than 0.25 were fitted into the multivariable logistic regression. Model fitness was checked by the Hosmer-Lemeshow goodness of-fit test. Finally, the results were interpreted using an adjusted odds ratio (AOR) with a 95% confidence interval (CI).

Ethical issues and approval
Ethical clearance obtained from Arba Minch University, College of Medicine and Health Sciences, Institutional Research Ethics Review Board (IRB). Written and signed voluntary informed consent obtained from all study participants. All methods were performed in accordance with the relevant guidelines and regulations.

Socio-demographic characteristics of study population
A total of 355 participants enrolled in this study, with a response rate of 98.34%. Majority 239 (67.3%) of respondents were from urban residents. More than half of the respondents (54.08%) were men. The majority of the participants (75.8%) were between ages group of 21-24. Majority of the participant were from medicine (35.2%) department followed by nursing (10.4%) and public health (10.4%). Regarding to family educational status 61.4% fathers and 50.7% mothers had secondary and above educational levels (Table 1).

Access to computer and internet
In this study finding (23%) student had formal IT training access. From the total of study participant 63.9% stated that they have access to a computer, of this 50.7% had laptop, 9.6% palmtop, and 3.7% PAD respectively. From the total of study participant 87.6% had internet access, of this 31.3% the participant was access from computer laboratory and 10.7% from internet cafe. It was observed from the study that only 36.3% of the participant had laboratory session during their ICT course ( Table 2).

Student ICT utilization
In this study percentage of students who used ICT was 55.77% [95% CI, 0.50, 0.60]. In terms of field of study, health informatics students used the most, while midwifery students used the least (Fig. 1).

Factors associated with ICT utilization
In the multivariable logistic regression model five variables; previous residence, ICT knowledge, having training, current IT courses taking, and IT skill were significantly associated with ICT utilization.
The odds of utilizing ICT among student who come from urban resident were 1.85 times [AOR = 1.85, 95% CI = 1.08, 3.16] higher than that of those come from rural resident. Students who had ICT knowledge were 3.8 times [AOR = 3.8, 95% CI = 2.25, 6.40] more likely to utilize ICT compared to their counterpart. Students who had formal training of IT were 1.9 times [AOR = 1.9, 95% CI = 1.06, 3.48] more likely to utilize ICT compared to those who had not formal IT training. Students who taking IT course in their present study were 2.2 times more likely to use ICT than students who did not take an IT course in their current study [AOR = 2.2, 95% CI = 1.23, 3.84]. Students who had good IT skill were 2.4 times more likely utilize ICT than those with poor IT skill [AOR = 2.4, 95% CI = 1.34, 4.23] (Table 3).

Discussion
The objective of this study was to examine utilization of information communication technology and its associated factors among Arba Minch University College of medicine and health science students. This study revealed that ICT utilization among student was 55.77% [95% CI, 0.50, 0.60], and 44.23% [95% CI: 0.39, 0.49] students didn't utilize the ICT. This finding was greater than study from Gondar [22]. The temporal gap between globalization and technical improvement in recent years could be the reason. This finding was lower than study  done in Jordan [24], Egypt [25] and Ghana [26]. This could be owing to limited access to IT resources in college, or because students were dissatisfied with computer laboratory sessions in terms of the number of computers accessible, the amount of time allowed for exercise and assistance from the laboratory assistant. Besides, the inadequacy of computer laboratories and computers in the college, where there are only two computer labs, each with about 40 computers, as well as the majority of computers in the university were not working for all of the students, could explain the poor use of ICT.
In multivariable logistic regression analysis; previous residence, ICT knowledge, having formal training, taking IT in current courses, and IT skill were all found to be significantly associated with ICT utilization. When compared to students from rural areas, students from urban areas were more likely to utilize ICT. This finding was similar with previous study [27]. This might be due to that those students who come from rural resident don't have access to electronic materials, because luck of infrastructure like electricity and computers. Students who had good ICT knowledge were more likely to utilize ICT as compared to poor ICT knowledge. This finding supported study done in Ghana [26]. The possible explanation could be it is therefore essential that students acquire ICT knowledge in order to ensure that ICT tools are used and adopted in order to facilitate efficient learning and teaching.
Regarding to students who had IT skills were more likely to utilize ICT than who had not skill. The finding was supported by similar study [11,12]. This could be attributed to the fact that knowing how to use a range of computer programs, software, and other applications is   [7]. This might be due to that taking IT related course may help to increase the use of computer and electronics materials. Also, formal information technology training was found to be significantly associated with ICT utilization [22,28]. Furthermore, his finding revealed that student utilization of ICT was inadequate. Emphasis should be placed on helpful training in ICT as well as ICT-enabled teaching and learning. ICT should be skilled as a subject, and combined as a pedagogical tool for teaching and learning in other theme areas. Arba Minch University's College of Medicine and Health Sciences might accordingly take advantage of respondents' interest to learn more about ICT applications and create electronics health related courses for each of the schools.

Limitations of the study
This study did not address the attitude of student towards ICT, which can influence their computer knowledge and utilization. Moreover, the information collected was self-perceived, which might have reported bias. The cross-sectional nature of study design may affect causality being inferred between independent and dependent variables.

Conclusion
In the current study previous residence, ICT knowledge, having formal training, taking IT in current courses and IT skill were significant predictors of ICT utilization. The findings suggest that positive actions should be done to raise the level of ICT utilization among undergraduate students, such as the formal inclusion of ICT training in undergraduate student education. This will improve health science students' ability to obtain, analyze, and use information in order to solve clinical and other problems promptly and efficiently throughout their studies and, more crucially, after graduation.


The Role of Illustrations in Following Along with the Events in Fiction

The study explores the effect of using illustrations with written narratives in short stories on the readers who are following along with the events and linking these events together. The study also explores the impact of applying critical thinking skills in using illustrations with the written narrative on readers who are following along with the events of the short story and linking them together. A mixed method was used to answer the questions and obtain the results. The quantitative method was used, where a study sample consisting of 35 students who were asked to submit an exam twice. The first time the exam contained only the written text. However, the second exam contained both the written text and the illustrations from a book. The qualitative method was applied on the same sample of students, where they were interviewed and asked whether the illustrations helped them in answering the questions on the written narrative. Next, they were asked specifically about the six questions which were based on the students’ use of their critical thinking skills in linking the provided illustrations with the written narrative. The study concluded by presenting how illustrations have a great effect on the students’ following along with the events and understating the main ideas in the narrative story. The results also show that the written text cannot always stand alone, and especially when it comes to young readers because they still lack the experience and the ability to be able to understand things on their own.

Introduction
Fiction -whether a novel, a short story or novella -varies in its length, and the number of events and characters that occur within it. Sometimes it may get too difficult for the reader to follow along with the events and chatters that are presented in type of fiction. This is why fiction is sometimes illustrated with pictures. Illustrations are added to these short stories, novels and novellas to help the reader link between the events and follow along with the narrative, which will help in its way to understand the plot of the story. Illustrations have been continuously defined by different scholars depending on their aim and purpose, but usually the purpose of illustrations that are added to stories, whatever the length is, is to give clarity, and more understanding to the written text. So, the aim is to interpret and deliver the written text. Lots of readers, and especially young ones, find it difficult to both understand all of the events and follow along with all the characters in the story; as a result, they may find some strategies that they can use to help them follow along with the narrative. For instance, they use strategies like writing down notes, summarizing incidents or perhaps they even start making mind maps for the characters or for the events. This is where the role of illustrations comes into play; they are used in a written narrative to explain what is going on, to follow along, and to enhance the written narrative.

Problem of the Study
Stories are sometimes hard to follow, especially when the story contains a plethora of characters and events. In this case, the reader may be forced to find other strategies to make it easier for him/her to follow along with who is doing what in the story. These tactics might include writing notes, filling in certain tables, or even creating mind maps. To avoid all this extra-added work in order to follow along with the events and link them together when reading a story, the authors of these stories will often add detailed illustrations to these written narratives in order to help the reader.

Research Questions
With the use of illustrations in short stories, the sequencing and linking of events become easier and more interesting, especially for children. Without using them, the reader may need to take notes and focus more to understand the story. Hence, the main research questions were formulated as follows: • What is the effect of using illustrations with the written narrative in short stories on the readers who are following along with the events in short stories and linking the events together? • What is the effect of applying critical thinking in using illustrations with the written narrative on the readers who are following along with the events in short stories and linking the events together?

Definition of Illustrations
According to Ibrahim (2013), illustrations can be defined as tools that are represented in the form of pictures and depictions, which have the aim of clarifying the information represented in and associated with any text, whether, informational, literary or others. These illustrations help to deliver the ideas that are written in the text (145-155). Olshansky (2008) adds that illustrations are important to stories and are a vital element in each story. To Olshansky (2008), illustrations are considered to be a visual language that helps the viewer understand and comprehend the written text. This has been common knowledge about illustrations ever since they first started being used in fiction. Ughton & Willows (1987) add that illustrations help in imagining the events which may add more comprehension about the narrative. This means that illustrations are part of the written language that may work together to contribute more by adding to both comprehension and interpretation. Chu (2018) states that illustrations have developed alongside the written text because they complement one another. Thus, they give better interpretation and understanding, in which illustrations are related to certain graphic techniques, which are directly linked to the text. These graphic techniques enable the reader to read through visual signs instead of just reading written words. Adding to what Chu (2018) states, by adding illustrations in written stories or narratives in general, the reader has the choice to either follow the images or to follow the written words, or even both. Likewise, Yan (2019) adds that illustrations that are added to fiction could be considered "an artistic language" that delivers information through visual means that provide the reader with detailed interpretation and explanation since it gives visual descriptions of all of these details.

The Use of Illustrations
Continued studies have been conducted on illustration efficacy in facilitating the comprehension of written texts (Haring, 1982;Donald, 1979Donald, , 1983Haring & Fry, 1979;Holliday, 1975;Koenke & Otto, 1969;Royer & Cable, 1976;Peeck, 1974;Rohwer & Harris, 1975;Rusted & Coltheart, 1979a, 1979bTennyson, 1978;and Samuels, 1970). The use of pictures and images that are added to stories could be easily "comprehended, remembered, and recalled", unlike the stories that are not presented with pictures or images. The function of illustrations has been considered vital for readers (Schallert, 1980). Illustrations have also been considered as a mnemonic strategy for story comprehension (Haring & Fry, 1979). Donald (1983) declares that illustrations in this case have the function of facilitating the intended message to be delivered. O' Keefe & Solman (1987) even believe in the superiority of pictures and images that are added to stories, saying that without these illustrations, the reader cannot reach the same interpretation or comprehension with the written narrative alone. Maria Nikolajeva and Carole Scott (2000) also argue about how the role of illustrations are important to comprehending the narrative in short stories. Kress (2003) suggests that the presence of illustrations in short stories alongside written narratives may give the reader additional information, which helps the reader in following along with the plot. Michael Benton and Geoff Fox (1985) and Donald Fry (1985) all add that illustrations help the reader build certain images in his/her mind as a part of the reading process which enables him/her to follow along with the events easier. Tessa Dekker et al. (2014) add that research has shown how the building process that the reader creates with the presence of pictures develops over time, is beneficial when reading stories, and supports the reader in the story reading process. David Perkins (1994) adds that readers engage more with illustrations than written texts which results in the integration of the pictures while reading. Berger (1972) and Berger and Mohr (1989) believe in the benefit of linking the image to the written word as well as the importance of this linking. This is the way readers approach any story. The reader gets attracted more to the illustrations rather than the written text. This is due to the fact that readers vary in the reading and comprehension skills they have. Likewise, readers also vary in their levels of knowledge and experience. On this point, Kress (2003) discusses the idea that this reading process or interpretation is guided by the relevant and related illustrations (143-144). Kress and Leeuwen (1996) claim that all modes of communication have their own limitations; however, with a combination of the written words and illustrations, most of these limitations will be fulfilled in which each mode will carry its own ''informational load'' (Kress, 2003, p. 141). Kress (2003) continues by saying that these modes of communication come together to help the reader reach a better understanding than he/she may reach with the written mode alone since they may carry added information which is not mentioned in details of the text. Peter Hunt (2009) also adds that providing illustrations adds and guides the reader's thinking to other unnoticed incidents. Hunt (2009) also adds that illustrations and wordings together give a complete meaning, while alone they give a separate meaning. Nikolajeva and Scott (2000) state that the effect of providing illustrations to the written words helps the student understand better (232). Nodelman (1988) thinks that illustrations enable the reader of the short story to think more deeply about the ideas presented in the written text (248). Domin (2007) states that pictures and illustrations were first used by people to tell a story, then written language was integrated and added to the illustrations. Carney and Levin (2002) add that illustrations helped story tellers who transfer their ideas and narratives. This has also motivated authors to provide illustrations in their books (Lai, D. T. (2021, 3) Karen M. Feathers & Poonam Arya (2015) discuss the importance of using images and illustrations along with the written text. Their study reveals images and illustrations contribute to the comprehension and understanding of the students (42 & 43). Sipe and Brightman (2005) state that young readers not only look at these images, but also unintentionally use them in integration with the written text. Arya and Feathers (2012) also came to the conclusion that young readers benefit from illustrations in such a way that they had the choice of moving between the written text and the illustrations to understand the ideas. According to Arya and Feathers (2012), this supports the reader's recognition of words and meaning construction. This means that readers, whatever their age, use illustration in many ways that help them follow along with the events in the story. Mason, Tornatora and Pluchino (2013) and Mason, Pluchino and Tornatora (2013) also state that illustrations are often used in scientific books after seeing its effect of observers or readers. They all state that the reader's integration in both the written and illustrated text has an impact on following along with the details.
Bulkani, at el. (2022) give an example of using such visual aids in presenting the concepts in Math. They justify this by saying that using aids may make the students enjoy mathematics and make it more effective. Pierce (2010) states that illustrations lead to the reader's engagement in the written text and narratives. Murguia (2013), Downing (2013) and Sloat (2013) all agree on the fact that illustrations enable readers to feel the words. This ensures that words and images are not used to replace the statement of the story, but rather add to each other (Salisbury, 2004;Paul, 2009;Dils, 2009). Hladikova (2014) states that the most important contribution of illustrations is that they complement and parallel the narrative presented in the written text. Kim at el. (2017) state that integrating visual art may enhance the readers' critical thinking.

Research Design and Flow
A mixed approach was applied to answer the questions of the study. First, the researchers used the quantitative approach, in which two exams were prepared with the same questions. The first exam that was given to the students contained a short story, but the illustrations of the story were hidden from the students. In other words, the students were only provided with the written text. The second exam given to the students consisted of both the written text and the illustrations of the story. The exam aimed to show whether the students would be able to answer questions about the story without having the illustrations in front of them. The exam also aimed at finding out whether or not the students will have the same answers whether they were provided with illustrations or not. The exam consists of 42 questions; six of the questions required the students to use their critical thinking skills in answering the questions even while they were also provided with the illustrations. All of the questions highlighted and focused on the sequence of the incidents and events. The researchers then used the qualitative method in an interview conducted with the same students where they were asked whether the illustrations helped them in answering the questions on the written narrative or not. Then, they were asked specifically about the six questions that were based on their critical thinking skills in linking the provided illustrations with the written narrative.

Population and Sample
The study was conducted on Thirty-five third-grade students, who were chosen to respond to a True/False question exam on a short story. The third-grade students were specifically chosen as they matched the level of the story chosen for the study. The sample of students was taken from one class, since the students in each grade are distributed according to their background knowledge, achievement level and needs.

Data Analysis Technique
The analysis of the study aimed at statistically defining the significant difference (α = 0.05) in-group performance in the exam, which is without illustrations, and the exam, which is with illustrations. Both exams included 42 questions. To answer the first question of the study, "What is the effect of using illustrations with the written narrative in short stories on the readers who are following along with the events in short stories and linking the events together?" A t-test known as the Paired Sample t-test was used for two correlated samples.
For the six questions that were based on the students' critical thinking, the analysis aimed at statistically defining the significant differences (α = 0.05) in-group performance in relation to the students' critical thinking skills in both exams -the first with illustrations and the second without illustrations. To answer the second question of the study, "What is the effect of applying critical thinking in using illustrations with the written narrative on the readers who are following along with the events in short stories and linking the events together?" A t-test was used for two correlated samples, known as the Paired Sample t-test.

Findings
Results of the exam with and without illustrations. Table No. 1 shows the results related to the question "What is the effect of using illustrations with the written narrative in short stories on the readers who are following along with the events in short stories and linking the events together?" Results of the questions that need critical thinking for linking the illustrations with the written narrative. Table No. 2 shows the results of the question, "What is the effect of applying critical thinking in using illustrations with the written narrative on the readers who are following along with the events in short stories and linking them together?" It is noted from the results of the analysis that there are statistically significant differences in favor of the exam with illustrations where the mean was higher compared to the exam without illustrations.  325 It is noted from the results of the analysis that there are statistically significant differences in critical thinking in favor of the exam with illustrations where the mean was higher compared to the exam without illustrations.

Figure 2: shows the values of the means for the performance (Critical Thinking)
The Results of the interview showed that 90% of the students think that the illustrations helped them in following along with the events which made it easier for them to answer the questions. On the other hand, 5% of the students thought that most of the illustrations helped them in following along with the events. The rest are 5% of the students, who thought that some of the illustrations did not really help them in following along with the events. These percentages are illustrated in the Figure 3.

Figure 3: The Effect of Illustrations
For the six questions that are based on the students' critical thinking skills in linking the provided illustrations with the written narrative, the students who answered all of these questions were also interviewed. 98% of the students said that they had to think harder when linking the illustrations to the written narrative in answering these questions. At the same time, 2% of the students said that they were not able to answer the questions on the narrative even when providing them with the illustrations. The students' answers are illustrated in Figure (4).

Analysis and Conclusion
Going through the results that are shown in the figures, it could be generally noticed that illustrations have a great effect on the students being able to follow along with the events and understanding the main ideas in the narrative story. The results also show that the written text cannot always stand alone, especially when the readers are young, which means that they still lack the experience and the ability to understand things on their own. There were 20 illustrations in the story that were chosen for the study which are linked to the written narrative. This study shows that the provided illustrations make a vital contribution to the understanding of the students and enhanced their ability to follow up with the events presented in the short story. This is because the story was long for the students and the illustrations made it easier for the students to overcome this obstacle.
As can be noticed in Figure 1, the average number of students who answered the questions is 22. 57 out of 41. These students were not able to understand the written text and follow along with the events presented in the narrative because they were not provided with the illustrations. Some students may overcome this obstacle by writing down some notes or drawing mind maps, but if they were provided with more time. This means that the students were not able to answer the questions without linking the narrative events to the illustrations of these narratives.
On the other hand, when the students were given the same exam on the same narrative text, only this time by including the illustrations provided by the author, the average raised to 41 out of 42. This increase, presented in Figure 2, directly points out the fact that illustrations were added to the exam this time, so when the students were given and provided with the illustrations, their marks increased by a large number. This shows the effect of illustrations on their understanding. Illustrations in this way may help the students understand the story and follow up with the events without writing notes. This is important for those at the age of the students of the sample that were chosen for the study. In this case, illustrations contributed to the written text and filled in the gaps of the students' understanding of the written text. This is similar to the argument of many scholars such as Karen M. Feathers & Poonam Arya (2015). This also goes with what Sipe and Brightman (2005) argue, which is that young readers benefit a great deal from illustrating the narrative text which works in integration with the written text. Illustrations help the young readers move between the images and the written text to understand the ideas presented; this goes with what Arya andFeathers (2012), Mason, Tornatora andPluchino (2013) and Mason, Pluchino and Tornatora (2013) declare.
As mentioned before, six questions were asked on the written text; however, the first exam did not provide the students with the illustrations. They were then given the exam again, but this time with the illustrations. These questions were based on the students' critical thinking skills in linking the written text with the illustrations provided. As could be noticed from Figure 2, the average of the students' answers of these six questions without providing the students with the illustrations on the narrative text, is (2.34) out of 6. This means that even when the students are asked to apply higher levels of thinking, they need to have tools to support this thinking; in such cases, they can be provided by illustrations. This could be enhanced due to the fact that when they were given the illustrations, the students answered these questions. This appears in Figure 2, where the average increased from (2.34) to (5.6). This could be interpreted in a way that whatever the question is, the reader will unintentionally move to the illustrations if provided with the written text, looking for things to link with the narrative text. These critical thinking questions require more linking to the illustrations than the other questions. These results go with what Kress (2003) state about how the means of communication complement each other saying that sometimes the illustrations may carry more clarifications and details that are not clear in the written text and that would help the reader understand better and follow the details better. The results are also similar to what Hunt (2009) states, which is that illustrations added to written texts may add to and guide the reader's thinking to other embedded and unmentioned details and incidents.
The researchers tried to enhance the role of illustrations in asking the students and interviewing them on what really made their understanding better and whether the illustrations really helped them in answering the questions. Figure (3) shows that 90% of the students think that the illustrations helped them in following along with the events, which made it easier for them to answer the questions. On the other hand, 5% of the students thought that most of the illustrations helped them in following along with the events. The rest, which are 5% of the students, thought that some of the illustrations did not really help them in following along with the events. This shows how the readers -the students in the case of the current study -really benefit from having illustrations. This resembles what Hunt (2009) argues on, which is that illustrations and wordings together give a complete meaning, while they alone give separate meaning. This is not just shown in the exams given to the students, but also they all mentioned the role of illustrations and how it made it easier for them to answer the questions they were asked.
This could be also applied to the six questions that are based on critical thinking. The students then were specifically asked about these questions. They said that they really had to look at the illustrations when answering and trying to link what they read from the narrative text and the illustrations to be able to follow the sequence of the events and the incidents. Figure 4 shows that 98% of the students said that they had to think harder when linking the illustrations to the written narrative in answering these questions. At the same time, 2% of the students said that they were not able to answer the questions on the narrative even with providing them with the illustrations. The students show how they were pleased to have the illustrations and how they panicked and were stressed while answering the exam without illustrations. This follows what many scholars state such as Nikolajeva and Scott (2000) and Nodelman (1988), when they posit that providing illustrations with written words gives more effect on the understanding of the students and that illustrations enable the reader of the short story to think more deeply of the ideas presented in the written text. This also resembles what Kim at el. (2017) state on how using visual art may enhance the readers' critical thinking.

Limitations
The study is limited to the sample that was chosen for the study from the population of Grade 3 from a private school in Amman. The results cannot be generalized for all the students in the third grade in Jordan or in any other country for that matter. The results are also limited to the short story that was chosen for the study and to the type of exam given to the students. The results of the study are limited to the time in which the study was conducted which just happened to be at a time when people are exposed to the circumstance and conditions of COVID-19. As a result, this made it hard to enlarge the sample according to the rules of schools in Jordan because of the pandemic and subsequent quarantine.