Learning approach among health sciences students in a medical college in Nepal: a cross-sectional study

Modelling the associations between academic engagement, study process and grit on academic achievement of physical education and sport university students

OBJECTIVE

The present study examined the impact of academic engagement, study processes, and grit on the academic achievement of physical education and sport university students.

METHODS

An internet-based survey recruited 459 university students aged 19-25 years (M = 21 ± 1.3) in physical education and sports (PES) to fill out questionnaires on Physical Education-Study Process Questionnaire (PE-SPQ), Physical Education-Grit (PE-Grit), academic engagement (A-USEI), and Grade Point Average (GPA). A path analysis was carried out to understand variable relationships.

RESULTS

Data from each variable exhibited symmetrical and normal distribution, as indicated by the skewness and kurtosis values. The model's fit indices showed sufficient Comparative Fit Index (CFI = 0.92), Tucker-Lewis Index (TLI = 0.90), Goodness of Fit Index (GFI = 0.99) and Normed Fit Index (NFI = 0.90) and showed acceptable levels. The results indicated a statistically significant positive impact of engagement (β = 0.299, p < 0.001) and study processes (β = 0.397, p < 0.001) on academic achievement. However, the effect of grit on achievement was non-significant.

CONCLUSIONS

Academic engagement as well as study processes are two important factors predicting academic achievement while grit seems to be not a major predictor. Hence, physical education and sport faculty and university administrators should prioritize student engagement as a determinant of academic outcomes by reforming or redesigning physical education and sport curriculum modules that can facilitate engagement.

Relationship between learning approach, Bloom's taxonomy, and student performance in an undergraduate Human Anatomy course

Researchers have long been interested in understanding how different learning approaches impact learning outcomes. Learning approaches are often conceptualized as a dichotomy of superficial and deep, and learning outcomes are typically viewed on a cognitive scale that ranges from lower- to higher-order. While there appears to be an inherent relationship between learning approach and outcomes where superficial approaches lead to lower-order learning and deep approaches result in higher-order learning, this concept is not well documented. The purpose of this study is to better understand this relationship by evaluating whether student performance on higher- and lower-order examination questions is influenced by the approach a student takes when studying. To investigate this, survey and examination data were collected from an upper-level undergraduate Human Anatomy course at the University of Cincinnati. Results indicate that, on average, students in the course favored a deep approach to learning. The impact that learning approach had on examination performance was investigated using a series of analytical approaches, which revealed that students who took a deep approach to learning performed marginally better on both higher- and lower-order examination questions in lecture and practical examination settings. These results are contextualized within the literature, which highlights the need for more research surrounding the interrelatedness and dependency of categories within both learning approaches and cognitive levels.

Students' approaches to learning (SALs): Validation and psychometric properties of a tool measurement

BACKGROUND

Deep learning is an important outcome of the higher education and is mostly determined by students' approaches to learning (SALs). The latest version of the Study Process Questionnaire (SPQ) is one of the most used instruments assessing SALs. Many studies from various contexts have either validated or used this famous tool. But none of them-to the best of our knowledge-stem from the Moroccan tertiary context. The current study fills this gap by first: Getting a local translation of the questionnaire following the standardized methodological process and secondly to update the validity and psychometric properties of the construct.

MATERIALS AND METHODS

Arabic back translation was performed. Data were collected among tertiary scientific students. Descriptive statistics, Cronbach's coefficient alpha, and confirmatory factor analysis were carried out under SPSS version 22.

RESULTS

A strong fit of the dichotomic construct (deep and surface) was found, whereas the hierarchical models were disappointing.

CONCLUSIONS

Following the standards of the psychometrics' validation, this Arabic version could be used only in first-order factor model to evaluate the deep and surface approach within tertiary education in Moroccan context.

Development and implementation of a self-directed learning readiness scale for undergraduate health professional students

BACKGROUND

To motivate students toward the path of lifelong learning, it is important to train them for a self-directed learning (SDL) approach, where they identify the need of learning the content as well as look forward to attaining the learning outcome, independently. The level of readiness for SDL will allow the learner to be self-disciplined, self-organized, an effective team builder and communicator, a self-assessor, and a self-reflector, thus being a self-learner with the ability to accept and give constructive feedback. The aim of the study was to develop, validate, and implement the SDL readiness scale for health professional students.

MATERIALS AND METHOD

The readiness scale of 43 items was used in four sub-titles (awareness, learning strategies, and style, motivation, team building) was developed using the Delphi method with 12 experts and was implemented for the medical students at Karamsad, Gujarat as a cross-sectional survey after a pilot trial scale from May 2021 to September 2021, using mean, the standard deviation for each item, and arrived sub-titles. The ANOVA test was used to find differences in readiness scores as per different years of the medical program.

RESULT

The result demonstrates that the maximum score was obtained for the first-year medical student (149.89 ± 24.72), which dropped in year 2 (136.35 ± 32.26) but increased by the final year (147.67 ± 56.66), although not as high as the initial joining year. However, a statistically significant difference per gender was identified for a few items of the scale [(items 24 (P < 0.034), 26 (P < 0.0005), 37 (P < 0.035), and 40 (P < 0.013)]. The logistic regression analysis showed no statistical significance for the DSVS-self-directed learning readiness scale (SDLRS) score and demographic variables.

CONCLUSION

The outcome of the study strongly suggests training/sensitization sessions for students to highlight the importance of a SDL approach in a digital millennium. Moreover, a longitudinal follow-up needs to be conducted for the readiness score of the students based on the developed scale and subsequent training sessions need to be organized for students as well as faculty for better outcomes for the students toward SDL sessions.

Development and Preliminary Validation of the Physical Education-Study Process Questionnaire : Insights for Physical Education University Students

Background

The Revised Two Factor Study Process Questionnaire (R-SPQ-2F) is used to examine students' study approaches in higher education. The questionnaire is designed to measure two factors: deep and surface approaches. In order to measure these approaches for students in physical education and sport, a new measurement instrument should take into consideration the practical context of this field of education that makes it specific to other fields.

Objective

The present study aims (a) to develop and empirical test of a new instrument for measuring the study process in physical education and sports students, and (b) to test psychometric properties of the tool.

Methods

Two exploratory and confirmatory samples of physical education students enrolled in a bachelor's degree program in physical education at the High Institute of Physical Education and Sports of Kef-Tunisia, aged 19-26 years, were recruited online among female students (n = 414) and male students (n = 393). The participants filled in Google Form survey including Physical Education-Study Process Questionnaire (PE-SPQ) and the Arabic version of the Revised Study Process Questionnaire-2 Factors (R-SPQ-2F).

Results

Exploratory factor analysis showed a suitable four factors solution, which is approved by confirmatory factor analysis indices [χ2 = 466.47, TLI = 0.94, CFI = 0.95; RMSEA = 0.56 IC 90% (0.050-0.062)]. Internal consistency of the PE-SPQ simultaneously checked by McDonald's ω, Cronbach's α and Gutmann's λ6 showed good reliability of the PE-SPQ. Convergent validity examined by Average variance extracted (AVE) was good. The comparison between the AVE root mean square and Pearson correlation coefficients of each factor with his indicators reveals the discriminant validity of the PE-SPQ. Furthermore, Pearson's correlation between the PE-SPQ factors and the R-SPQ-2F establishes the concurrent validity of the new scale.

Conclusion

The PE-SPQ scale is valid and reliable and can be used to assess study process factors in physical education students.

Comparing the Learning Approaches of Transfer Students and Direct Entrants in an Asian Higher Education Context

Transfer students (TSs) transitioning from community college (CC) to university have been found to experience adjustment challenges different from those experienced by direct entrants (DEs) admitted straight from high school, which in turn influences their approaches to learning. Learning can enhance the transition towards sustainability, and it is influenced by various factors. However, there have been limited studies examining the factors associated with TSs’ and DEs’ learning approaches. To fill this research gap, this current study used a cross-sectional survey with both TSs (n = 841) and DEs (n = 978) to identify the factors. Our results indicated that the TSs had a higher rate of adoption of surface approaches (SA) to learning than DEs, while TSs and DEs shared some similar predictors of their learning approaches. The results suggest that the commitment of education stakeholders is essential for sustainable learning. They should improve the transfer system by providing adequate support and reduce disparities in the allocation of resources to TSs and DEs, as these affect learning approaches.

Validation of Internal structure of Self-Directed Learning Readiness Scale among Indian Medical Students using factor analysis and the Structural equation Modelling Approach

BACKGROUND

The Self-Directed Learning Readiness Scale (SDLRS) is a tool that helps in the assessment of the readiness of the students to pursue Self-Directed Learning (SDL). There are no documented studies on the validation of internal structure of the SDLRS among Indian medical students. Hence, the objective of this study is to validate the internal structure of SDLRS among Indian medical students using factor analysis and the Structural Equation Modelling (SEM) approach.

METHODS

We administered Fisher's 40-item SDLRS to 750 students after receiving the ethics clearance and the author's permission and taking written informed consent from all the study participants (response rate: 92%). The exploratory factor analysis (EFA), confirmatory factor analysis (CFA), and Cronbach's alpha were performed using SPSS version 25 and the Lavaan package of R version 3.1.2.

RESULTS

The values of the comparative fit index (CFI), standardised root-mean-square residual (SRMR), and root mean square error of approximation (RMSEA) were ≥ 0.9, ≤ 0.08, and ≤ 0.08, respectively, for a model fit to be acceptable. EFA showed that except for Q2 (loading score: 0.210), Q12 (loading score: 0.384), Q13 (loading score: 0.362), and Q25 (loading score: -0.219), all the items loaded well. After the exclusion of the aforementioned items, the factor loading scores for the items in the self-management, desire for learning, and self-control factors ranged from 0.405 to 0.753 (Cronbach α: 0.775), 0.396 to 0.616 (Cronbach α: 0.730), and 0.427 to 0.556 (Cronbach α: 0.799), respectively. The updated model was used for CFA, which displayed a good model fit.

CONCLUSIONS

The resultant model consisting of 36 items is shown to have internal structure validity for Indian version of SDLRS, which can be used to assess medical students.

Association Between Learning Approaches and Medical Student Academic Progression During Preclinical Training

PURPOSE

Students have diverse learning preferences that can impact the achievement of learning outcomes. However, there is a lack of unequivocal evidence for an association between the learning preferences and academic success. The purpose of the study was to examine the association between learning approaches and academic success of medical students during the basic science curriculum.

METHODS

In this cross-sectional comparative study, low-achieving (n=80) and high-achieving students (n=50) from semesters 1 through 3 of the Ross University School of Medicine's basic science curriculum completed the Approaches and Study Skills Inventory for Students (ASSIST) short-form to provide data on their learning approaches. Student's-t test was applied to find statistical differences in learning approaches of low and high achievers, and point-biserial was used to analyze the correlation between academic performance and learning approaches. Mean sum scores with standard deviation on ASSIST short-form scales (deep, surface, and strategic approaches) as well as subscales are reported.

RESULTS

High-achieving students reported a preference for using deep and strategic learning approaches compared to low-achieving students (p < 0.05). Low achievers indicated that they predominantly used the surface approach to learning (p<0.05). Yet, "fear of failure," a subscale of the surface approach, was greater among high achievers. Additionally, significant gender differences were found on subscales of "lack of purpose," "syllabus bound," "unrelated memorization" (surface approach), and "time management" and "organized studying" (strategic approach).

CONCLUSION

Our results suggest that low-achieving medical students' predominant reliance on the surface approach to learning may affect their academic success and that it may be worthwhile to help medical students become aware of the effectiveness of their individual preferred learning approaches early on in their training. Identification and adoption of optimal learning approaches should increase the achievement of successful learning outcomes.

Assessing the educational impact of cognitive level of MCQ and SEQ on learning approaches of dental students

Objectives:

MCQ’s and SEQ’s are the most widely used assessment tool in dental colleges across Pakistan. This study explores the impact of assessment tool: MCQ’s and SEQ’s on learning approach of dental students and also identifies correlation between these assessment tools and deep & surface learning approaches in integrated and discipline based curriculum.

Methods:

A quantitative co-relational study was conducted in 2018 on 2nd and 4th year dental students. A pre-validated “Revised Study Process Questionnaire” was used. Spearman’s rho correlation coefficient and Wilcoxon signed ranks test were applied to determine the relationship between learning approaches and assessment tools. Internal consistency was calculated by Cronbach’s alpha.

Results:

Ninety six students out of one hundred and fifty completed the questionnaire. Correlation test showed that surface approach correlates significantly with MCQ’s (0.73) while no co-relation exists with SEQ’s (-0.14) in our study. Deep approach has a strong and significant correlation with SEQ’s (0.80) as compared to MCQ’s (0.056).

Conclusion:

Assessment tool has an impact on learning approaches used by the students. It was concluded that students used to prefer deep learning approach while preparing for SEQ’s as they were designed at higher cognitive level, whereas, they preferred surface approach while preparing for MCQ’s as they were developed at low cognitive order.

Student characteristics associated with dominant approaches to studying: Comparing a national and an international sample

BACKGROUND

Productive approaches to studying (deep and strategic learning) are associated with a variety of favourable academic outcomes, and may be of particular importance for students in multifaceted and complex disciplines such as occupational therapy.

AIM

To explore associations between student characteristics and their dominant approaches to studying in two samples of occupational therapy students: a national sample of Norwegian first-year students, and an international sample of students in different year cohorts (Australia, Hong Kong, Singapore and Norway).

MATERIALS AND METHODS

A total of 180 (national sample) and 665 (international sample) students were included in the study. Approaches to studying were measured with the Approaches to Study Skills Inventory for Students (ASSIST). Data were analyzed with adjusted multinomial regression analyses.

RESULTS

Age, gender and prior higher education were not associated with the dominant study approach. More time spent on independent study (international sample: OR = 1.07/1.08, p < 0.01/<0.001) and having current study program as the top priority line of education at enrolment (national sample: OR = 2.89, p < 0.05) predicted productive study approaches.

CONCLUSIONS AND SIGNIFICANCE

Factors such as age, gender and prior higher education seem to be of limited importance for understanding students' dominant approaches to studying.

Students' perceptions towards self-directed learning in Ethiopian medical schools with new innovative curriculum: a mixed-method study

BACKGROUND

Self-directed learning (SDL) is an appropriate and preferred learning process to prepare students for lifelong learning in their professions and make them stay up-to-date. The purpose of this study was to explore preclinical students following a hybrid curriculum in Ethiopia experiences to SDL and the support of several learning activities from the curriculum on their SDL. A mixed-method research design was employed.

METHODS

Quantitative data were collected by using a self-administered questionnaire of 80 items measuring students' perceptions on their SDL capability as well as to explore students' views about the influence of components of the curriculum on their SDL. Additional two focus group discussions, each containing eight participants from year-1 and year^- 2 students, were conducted. The quantitative data were analyzed using SPSS. The focus group discussions were reviewed, coded, and then thematically analyzed.

RESULTS

Our study showed a significant increase in SDL score on comparing students at year-1 with students at year-2 (p = 0.002). Both year-1 and 2 students rated PBL tutorial discussion and tutors had high influence on their individual learning; whereas, other curricular components such as lectures and testes had low influence on their SDL ability. PBL tutorial discussion and module objectives showed strong correlation with students' SDL scores, r = 0.718 & r = 0.648 (p < 0.01), respectively. Besides, PBL tutorial discussion was found strongly correlated with tutors (r = 0.599 (p < 0.01)) and module objectives (r = 0.574 (p < 0.01)). Assessment was highly correlated with lectures (r = 0.595 (p < 0.01)). Findings from qualitative data showed that certain curricular components played role in promoting students' SDL. Tutorials analyzing problems played a major role on students' self-directed learning abilities.

CONCLUSIONS

Although the study implied that components of the hybrid curriculum, mainly PBL, could encourage preclinical students' self-directed learning, the curriculum is still not free from teacher-centred culture as the majority of teachers still have high power in deciding the learning process. A further longitudinal study is needed to verify the actual level and ability of medical students' SDL.

Testing anxiety in undergraduate medical students and its correlation with different learning approaches

Objectives

Undergraduate medical students experience a considerable amount of stress and anxiety due to frequent exams. The goal of the present study was to examine the development of exam related anxiety and to test for a correlation between anxiety and learning approaches.

Methods

A whole class of 212 medical students was invited to participate in the study. During their first term, trait anxiety and learning approaches were assessed by use of the state-trait-anxiety inventory (STAI-T) and the approaches-and-study-skills-inventory-for-students (ASSIST), respectively. Acute state anxiety was assessed twice in the course of the second term. To that extent, the STAI-S in combination with measuring salivary cortisol were employed immediately before two oral anatomy exams.

Results

Our most important results were that a surface learning approach correlated significantly with anxiety as a trait and that students with a predominantly strategic approach to learning were the least anxious yet academically most successful.

Conclusion

As surface learners are at risk of being academically less successful and because anxiety is a prerequisite for burn-out, we suggest that medical faculties place particular emphasis on conveying strategies for both, coping with stress and successful learning.

Evaluation of learning approaches in physiotherapy students: A valuable insight

INTRODUCTION

Every individual has different learning approaches in acquisition and processing of knowledge. Physiotherapy, an evolving allied health science profession, is developing rapidly. Exploration of learning approaches among physiotherapy students will help the academicians to enrich the quality of learning. This study aimed to analyze the learning approaches among physiotherapy students.

MATERIALS AND METHODS

A cross-sectional study was carried out among 435 physiotherapy students. The Approaches and Study Skills Inventory for Students questionnaire was used to evaluate learning approaches in both preclinical and clinical students. Data were analyzed using the Statistical Package for the Social Sciences software version 21. Statistical significance was set at P < 0.05.

RESULTS

A total of 435 participants, 233 (53.56%) in preclinical phase and 202 (46.44%) in clinical phase with a mean age of 19.01 ± 1.01 and 22.03 ± 1.43 years, respectively, participated in the study. Among the 435 students, 411 (94.49%) adopted the deep approach, while only 21 (4.83%) and 3 (0.69%) adopted strategic approach and surface approach, respectively. Preclinical students had significantly higher mean scores for strategic and surface approaches than clinical (P = 0.000) and (P = 0.000) using independent t-test, respectively. Out of the 435 students, 50 (11.45%) were male and 385 (88.51%) were female. Male students appeared less likely to adopt the deep learning approach than female students (P = 0.013).

CONCLUSIONS

Assessment of learning approaches will assist the academicians to develop teaching and learning strategies and effective curriculum depending on the perspectives of students. Multiple methodologies focused on interactive student-centric approach should be utilized to enhance positive learning outcomes.

Self-directed learning readiness of Indian medical students: a mixed method study

BACKGROUND

Self-directed learning (SDL) is defined as learning on one's own initiative, with the learner having primary responsibility for planning, implementing, and evaluating the effort. Medical education institutions promote SDL, since physicians need to be self-directed learners to maintain lifelong learning in the ever-changing world of medicine and to obtain essential knowledge for professional growth. The purpose of the study was to measure the self-directed learning readiness of medical students across the training years, to determine the perceptions of students and faculty on factors that promote and deter SDL and to identify the role of culture and curriculum on SDL at the Christian Medical College, Vellore, India.

METHODS

Guglielmino's SDL Readiness Scale (SDLRS) was administered in 2015 to six student cohorts (452 students) at admission, end of 1st, 2nd, 3rd and 4th year of training, and at the beginning of internship in the undergraduate medicine (MBBS) program. Analysis of variance (ANOVA) was used to compare SDL scores between years of training. 5 student focus groups and 7 interviews with instructors captured perceptions of self-direction. Transcripts were coded and analyzed thematically.

RESULTS

The overall mean SDLRS score was 212.91. There was no significant effect of gender and age on SDLR scores. There was a significant drop in SDLRS scores on comparing students at admission with students at subsequent years of training. Qualitative analysis showed the prominent role of culture and curriculum on SDL readiness.

CONCLUSIONS

Given the importance of SDL in medicine, the current curriculum may require an increase in learning activities that promote SDL. Strategies to change the learning environment that facilitates SDL have to be considered.

Distribution and academic significance of learning approaches among pre-clinical medical students at Trinity School of Medicine, St Vincent and the Grenadines

PURPOSE

Different students may adopt different learning approaches: namely, deep and surface. This study aimed to characterize the learning strategies of medical students at Trinity School of Medicine and to explore potential correlations between deep learning approach and the students' academic scores.

METHODS

The study was a questionnaire-based, cross-sectional, observational study. A total of 169 medical students in the basic science years of training were included in the study after giving informed consent. The Biggs's Revised Two-Factor Study Process Questionnaire in paper form was distributed to subjects from January to November 2017. For statistical analyses, the Student t-test, 1-way analysis of variance followed by the post-hoc t-test, and the Pearson correlation test were used. The Cronbach alpha was used to test the internal consistency of the questionnaire.

RESULTS

Of the 169 subjects, 132 (response rate, 78.1%) completely filled out the questionnaires. The Cronbach alpha value for the items on the questionnaire was 0.8. The score for the deep learning approach was 29.4± 4.6, whereas the score for the surface approach was 24.3± 4.2, which was a significant difference (P< 0.05). A positive correlation was found between the deep learning approach and students' academic performance (r= 0.197, P< 0.05, df= 130).

CONCLUSION

Medical students in the basic science years at Trinity School of Medicine adopted the deep learning approach more than the surface approach. Likewise, students who were more inclined towards the deep learning approach scored significantly higher on academic tests.

Assessing Saudi medical students learning approach using the revised two-factor study process questionnaire

OBJECTIVES

To assess learning approaches of 1st, 2nd, and 3rd-year medical students by using revised two-factor study process questionnaire, and to assess reliability and validity of the questionnaire.

METHODS

This cross-sectional study was conducted at the College of Medicine, Riyadh, Saudi Arabia in 2014. The revised two-factor study process questionnaire (R-SPQ-2F) was completed by 610 medical students of both genders, from foundation (first year), central nervous system (second year), medicine and surgery (third year) courses. The study process was evaluated by computing mean scores of two research study approaches (deep & surface) using student's t-test and one-way analysis of variance. The internal consistency and construct validity of the questionnaire were assessed using Cronbach's α and factor analysis.

RESULTS

The mean score of deep approach was significantly higher than the surface approach among participants(t₍₇₇₀₎=7.83, p= 0.000) for the four courses. The mean scores of deep approach were significantly higher among participants with higher grade point average (F_(2,768)=13.31, p=0.001) along with more number of study hours by participants (F_(2,768)=20.08, p=0.001). The Cronbach's α-values of items at 0.70 indicate the good internal consistency of questionnaire used. Factor analysis confirms two factors (deep and surface approaches) of R-SPQ-2F.

CONCLUSIONS

The deep approach to learning was the primary approach among 1st, 2nd and 3rd-year King Saud University medical students. This study confirms reliability and validity of the revised two-factor study process questionnaire. Medical educators could use the results of such studies to make required changes in the curriculum.

The perceived stress and approach to learning effects on academic performance among Sudanese medical students

BACKGROUND

There is an increasing awareness of the perceived stress and approach to learning effects on academic achievement.

OBJECTIVE

This study aimed to assess the educational environment and approach to learning in clinical phase medical students.

METHODS

This comparative cross-sectional study was conducted among fifty-nine clinical stage medical students at Omdurman Islamic University (Khartoum, Sudan) during the period from June to August 2016. All the participants signed a written informed consent, then responded to a structured questionnaire to collect demographic data, the two process study questionnaires and the perceived stress questionnaire. The ethical committee of Omdurman Islamic University approved the research, and the Statistical Package for Social Sciences was used to compare the students based on sex, class, and their grades. Data were analyzed by SPSS version 22, using descriptive statistics and t-test.

RESULTS

There were fifty-nine medical students, of whom 41.5% were males with a mean age of 22.62±1.84 years. Stress was evident in the majority of medical students (88.1%). The students are using the deep approach to learning more than the superficial approach (The total score was 29.49±6.39 for the deep approach, while it was 20.81±6.94 for the superficial approach). In the current study, no differences were found regarding sex, class, or grades apart from the superficial approach which was used less among women.

CONCLUSION

The perceived stress was prevalent among medical students in Omdurman Islamic University, Sudan, the students used the deep approach to learning more than the superficial, no differences were evident in the perceived stress and the learning approach in relation to sex, class level or grades apart from less superficial approach among women.