ABSTRACT
Under the impact of COVID-19, medical telelearning education is increasingly becoming urgent to resolve the contradiction between the physical isolation of medical students and the need for on-site clinical teaching. In this study, the push-pull-mooring (PPM) theory is integrated into a comprehensive model as a conceptual PPM framework: push factors (information system quality and perceived risk), pull factors [telepresence (TP), trust, etc.], mooring factors (switching costs), and switching intention. The results show that most hypotheses were positive, but perceived risk did not influence user satisfaction significantly, and switching costs did not provide the impact on switching intention. This study provides a comprehensive empirical analysis of key factors influencing the choice of distance education by medical students through the integrated multi-model framework.