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

Abstract

Background

Many factors shape the quality of learning. The intrinsically motivated students adopt a deep approach to learning, while students who fear failure in assessments adopt a surface approach to learning. In the area of health science education in Nepal, there is still a lack of studies on learning approach that can be used to transform the students to become better learners and improve the effectiveness of teaching. Therefore, we aimed to explore the learning approaches among medical, dental, and nursing students of Chitwan Medical College, Nepal using Biggs’s Revised Two-Factor Study Process Questionnaire (R-SPQ-2F) after testing its reliability.

Methods

R-SPQ-2F containing 20 items represented two main scales of learning approaches, deep and surface, with four subscales: deep motive, deep strategy, surface motive, and surface strategy. Each subscale had five items and each item was rated on a 5-point Likert scale. The data were analyzed using Student’s t-test and analysis of variance. Reliability of the administered questionnaire was checked using Cronbach’s alpha.

Results

The Cronbach’s alpha value (0.6) for 20 items of R-SPQ-2F was found to be acceptable for its use. The participants predominantly had a deep approach to learning regardless of their age and sex (deep: 32.62±6.33 versus surface: 25.14±6.81, P<0.001). The level of deep approach among medical students (33.26±6.40) was significantly higher than among dental (31.71±6.51) and nursing (31.36±4.72) students. In comparison to first-year students, deep approach among second-year medical (34.63±6.51 to 31.73±5.93; P<0.001) and dental (33.47±6.73 to 29.09±5.62; P=0.002) students was found to be significantly decreased. On the other hand, surface approach significantly increased (25.55±8.19 to 29.34±6.25; P=0.023) among second-year dental students compared to first-year dental students.

Conclusion

Medical students were found to adopt a deeper approach to learning than dental and nursing students. However, irrespective of disciplines and personal characteristics of participants, the primarily deep learning approach was found to be shifting progressively toward a surface approach after completion of an academic year, which should be avoided.

Video abstract

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Keywords:

• deep
• surface
• motive
• strategy

Acknowledgments

We acknowledge the article “The Revised Two Factor Study Process Questionnaire: R-SPQ-2F” by John Biggs, David Kember, and Doris YP Leung that encourages use of the questionnaire for the evaluation of teaching and for genuine research purposes.⁴ We also accept that the copyright on the questionnaire is owned by John Biggs and David Kember. We are thankful to Mr Govinda Prasad Dungana for his support in analyzing the data. We express sincere thanks to Institutional Review Board of Chitwan Medical College and the students who voluntarily participated in this study. The authors advise that they received consent to use the images of all of the students from Chitwan Medical College who appear in the video abstract.

Author contributions

All the authors made substantial contributions to conception and design, acquisition of data, and analysis and interpretation of data. They also contributed to drafting the article and revising it critically for important intellectual content, gave final approval of the version to be published, and agree to be accountable for all aspects of the work.

Disclosure

This research work has not been funded by the Chitwan Medical College or any other private/government organization. The authors report no conflicts of interest in this work.