Honey-Mumford's Learning Styles of Medical Laboratory Students: An Observational Study with Implications for Laboratory Efficiency : Archives of Medicine and Health Sciences

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Medical Education

Honey-Mumford's Learning Styles of Medical Laboratory Students

An Observational Study with Implications for Laboratory Efficiency

Yadav, Shakti Kumar; Kalra, Rupinder; Naeem, Roshina; Verma, Alekh; Gupta, Ruchika1; Sarin, Namrata; Singh, Sompal

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Archives of Medicine and Health Sciences 8(1):p 107-111, Jan–Jun 2020. | DOI: 10.4103/amhs.amhs_43_20
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Background and Aim: 

Learning styles are subconscious stable traits influencing the perception and response of learners to their learning environment. Honey–Mumford classification of learning styles has been utilized and evaluated in a number of studies among students across different professional courses. Though learning style preferences of medical students have been assessed, we did not come across any study evaluating the paramedical students of Medical Laboratory Technology (MLT). Because laboratory technicians form the backbone of clinical laboratories in today's evidence-based medicine, it seems imperative to understand the basic learning styles of these students. Thus, this study aimed to identify the learning styles among students pursuing the bachelor degree of medical laboratory technology at a tertiary-level hospital.

Materials and Methods: 

A cross-sectional observational study was undertaken among 98 students pursuing Bachelor of MLT at a tertiary-level hospital and medical college. The Honey–Mumford's learning style questionnaire was administered to each student after taking informed consent. Individual students' preference for learning style was categorized as per Mumford classification, and students were categorized according to their preferred learning style.


Majority of the students (60%) showed very strong preference for the activist learning style followed by reflector style. Prevalence of activist and reflector styles was found to be equal among our students followed by the theorist style. No difference was noted between male and female students.


We demonstrated, for the first time, the learning styles of medical laboratory technology students or the future laboratory technicians. Activist and reflector styles were the most frequent among our study group. Future studies at other institutions providing similar training shall help in refining these results. Such studies are likely to help in adopting appropriate teaching methods and assessment strategies leading to better learning and consequent improvement in laboratory efficiency.


Learning is said to have occurred when the learner acquires knowledge of new facts or can effectively use a new skill. An individual's reaction to a learning experience in identical circumstances may differ from another due to the divergence in their learning styles. Learning style, a stable trait, has been defined as “a person's characteristic but potentially malleable way of interacting with a learning environment.”[1] Learning styles are subconscious and innate features of a person's personality and should be differentiated from the consciously made learning strategies.[2] Various researchers have classified learning styles in different manner, though majority of the classifications encompass the learning styles defined in the neuro-linguistic programming theory, namely, visual, auditory, and kinaesthetic.[2] The theories on learning styles have been classified as: (i) modality style such as Fleming's visual, aural, read/write, kinesthetic theory – based on the assumption that learners have fixed traits tied to their sensory modalities; (ii) flexible style such as Kolb's and Honey–Mumford's learning styles – using theory of flexible learning style depending on the personal characteristics and experience with the assumption that learning style can be acquired; and (iii) instructional style – whereby learners adapt their learning style to suit the current context.[3] The modality learning styles suffer from the disadvantage that less than half of the learners would fit into one category. It was found to be more common for people to have characteristics of more than one category. The instructional model, though found to be useful for evaluation during higher education, is too complex leading to a danger of inappropriate evaluation if the teacher is not able to understand the underlying theory and implications clearly.[3]

Among the flexible style theories, David Kolb defined four main styles of learning – concrete experience, reflective observation, abstract conceptualization, and active experimentation and suggested that learning process was a circle for a learner to pass through to complete the learning.[4] The advantage of the Kolb's learning cycle was that the learner could enter the cycle at their preferred location followed by completion of the cycle. Kolb's work was further refined by Honey and Mumford into a method that has been widely used in the evaluation of learning styles. Honey and Mumford categorized the learners as activist (relying on concrete experience), reflector (using reflective observation), theorist (utilizes abstract conceptualization), and pragmatist (learns best through active experimentation). These categories incorporated the individual's general behavioral tendencies in addition to the learning preferences with strengths and weaknesses described for each of them.[5] Honey and Mumford also devised a 80-point questionnaire, the “learning style questionnaire (LSQ)” to help the learners discover their preferred learning style. LSQ has been shown to have a higher validity and reliability than the “learning style inventory.”[67] Kappe et al. have also shown that LSQ data can be utilized to tailor-make the learning activities and instructional methods to suit the preferred learning styles of learners.[7]

In medical education, learning styles of medical students, both the undergraduates and postgraduates, as well as nursing students have been evaluated in various studies.[28910] However, an extensive literature search failed to reveal any such study assessing the learning styles of laboratory technology students. In view of the laboratories acquiring a center-place in today's evidence-based medicine, technologists' training assumes great importance. With this background, the present study aimed to evaluate the learning styles of students pursuing bachelor degree program in medical laboratory technology course using the Honey–Mumford's LSQ.


The study was conducted in a tertiary-level hospital imparting graduate degree training to medical laboratory technology (MLT) students. The study was approved by the Institutional Ethics Committee. In this cross-sectional observational study, 98 students enrolled in Bachelor of Science in Medical Laboratory Technology (BScMLT) course in the 1st, 2nd, or 3rd year participated in the study. After taking informed consent, each student was required to complete a structured questionnaire. The questionnaire used in this study, LSQ, was developed and validated by Honey and Mumford.[5]

The LSQ includes eighty questions – twenty each for the four learning styles namely activist, reflector, theorist, and pragmatist. Every positive response was given 1 point, while no point was considered for unattempted questions and negative points were not awarded. Each learning style carried a maximum of 20 points. The questionnaire took approximately 20 min to complete for a student.

For every student, the score for each learning style was recorded, and individual preferences for the learning styles were categorized in accordance with the Honey–Mumford classification [Table 1] into very strong, strong, moderate, low, and very low.

Table 1:
Honey-Mumford scale of preference for each learning style (1992)[23]

The students were categorized according to their preferred learning styles, and the number of students with preference for a particular learning style was noted. Chi-square test was applied to compare learning styles of male and female students. P < 0.05 was considered to be statistically significant.


Of the 98 students, majority (67, 68.3%) were females. The mean age of these students was 20 years (18–23 years). Upon grouping as per the preferred learning style, very strong preference was seen for activist style in 60% students followed by 32% each for reflector and theorist styles and lowest for pragmatist (12%). It is to note that the total proportion of students in each of the styles as well as each category of strength of preference add to more than 100%, indicating that the group included students having equally strong preference for more than one learning style [Table 2]. The sum of very strong and strong preference was equal (72%) for both activist and reflector learning styles followed by the theorist style (52%). This suggests that the activist and reflector styles are the most prevalent in our MLT students. Table 2 and Figure 1 depict the various preferences for each of the learning styles.

Table 2:
Distribution of the percentage of scale of intensity of preferences among medical laboratory technologist students for the four learning styles as per Honey-Mumford
Figure 1:
Graph depicting the percentage of medical laboratory technology students having different level of preferences for the Honey-Mumford learning styles

About a third (36%) of students was found to have equal preference for more than one learning style. Of these, half (16%) demonstrated very strong to strong preference for activist style in combination with either reflector or theorist learning styles. Reflector-theorist styles combination was noted as a strong preference in 8% of the students. In addition, 12% students showed preference for three or more learning styles and were characterized to have no preferred style. No appreciable difference was noted in learning style preference between male and female students.

Descriptive statistics of scores for each learning styles, as shown in Table 3, shows highest mean (15.96) and median (16) values for the reflector style. A kite diagram representing the preferred learning of the whole batch was plotted [Figure 2]. The mean and median values for activist style are the lowest among the learning styles, in spite of this being the most frequent style with very strong preference. Upon referring to Table 1, it becomes clear that this may be attributed to the lower values in the range used for categorizing the preference for activist style.

Table 3:
Descriptive statistics for the learning style scores of medical laboratory technology students in the present study
Figure 2:
Kite diagram showing mean of learning styles among students of bachelor degree of medical laboratory technology


The present study evaluated the learning style preferences of MLT students for the first time. Because laboratories are an integral part of health-care system today and laboratory technicians are one of the important components ensuring quality reporting, adequate training of this personnel force is imperative for optimum laboratory functioning. Learning styles have been evaluated in several other professions at student level with varying results.[1112] The common finding of the previous studies has been the importance laid on the elucidation of learning styles of students.

Learning styles, in themselves, do not provide the complete picture of the learning capabilities of a student; rather these help in giving an outline with main points to consider while designing the teaching program.[13] Another interesting observation in the previous as well as the current study is the fact that these learning styles are not mutually exclusive but are rather preferences with varying levels of strengths. Majority of the students in any field and at any level would have a combination of different strengths of these preferences, leading to variations among students within the same learning style with very strong preference.[13]

In the present study, we found an equal strong/very strong preference for the activist and reflector learning styles. The prevalence of pragmatist learning style was found to be the least, with majority (60%) of students having low-to-moderate preference for this style. Students with preference for activist learning style have flexibility, readiness for action, and optimism for new things and changes and like to learn through concrete experience. On the other hand, reflectors are careful, thorough, and methodical with good listening capabilities before making their conclusions through reflective observations. People with preference for theorist style are logical, rational, and objective thinkers with disciplined approach and are good at asking questions and developing abstract conceptualization. Pragmatists are eager to test principles into practice and so, are technique oriented and learn through active experimentation.[3]

Our results indicate that for our cohort of MLT students, action learning, self-study, observation, as well as listening to lectures seem to be the preferred learning activities. However, at the same time, the learning style preferences of the remaining about one-third of students also need to be taken into account while designing their coursework and teaching activities. Because ours is the first such study in laboratory technology students, we could not find similar studies to compare our results with.

However, our results are partly in consonance with those of Parejo and Von who evaluated the learning styles in the University of Chile and found a low preference for the pragmatist learning style among students of pharmacy, chemistry, and biochemistry.[14]

Studies evaluating nursing students have shown a high preference for reflector and activist learning styles with minor variations in the results.[1015] Assessment of learning styles of medical students has yielded more varied results. Bhalli et al.[16] found the reflector and pragmatist to be the most frequent styles, while Shukr et al.[2] demonstrated that undergraduate medical students had strong preference for activist learning style. This difference in learning style preferences among various professional courses as well as within a given stream may be explained on the basis of variations in the prevalent socio-cultural and educational factors. Although various authors have emphasized the role of genetic and early neurological development in learning styles, others have demonstrated the effect of curricular scheme, learning environment, and assessment methods on the favored learning style.[517] Though this aspect has not been included in the present study, we would like to suggest utilization of a mix of teaching and instructional methods as well as assessment procedures to induce a positive effect on the preferred learning style of the students.

At our hospital, similar to many other centers providing training to laboratory technologists, the same teachers who impart undergraduate teaching to the medical students are also involved in the technologists' training as well. This may assume importance in light of varied results of learning style preferences among the different professional course students. As a result, it becomes the duty of the teacher to employ varying teaching methods for students of different courses so as to fully utilize the learning styles and capabilities of maximum students. Though a study on learning style of undergraduate medical students at our center is not yet available, studies focusing on this aspect at a center providing training for more than one professional course with the same teacher workforce shall be very useful.

We observed dual preference for two learning styles in a quarter (24%) of our students. These included activist-reflector, activist-theorist, and reflector-theorist combinations. This observation is similar to the earlier studies in other professional streams.[101518] Such students have been identified by previous authors as “all-rounders” utilizing the variety of learning experiences in a teaching program compared to the students with a single very strongly preferred learning style.[18] This quality has been thought to signify greater flexibility in learning and hence is advocated.[1920] However, these “all-rounders” pose a challenge for educators to incorporate multifaceted teaching styles that support and promote the learning flexibility. Effective utilization of a balanced teaching approach helps the students with more than one preferred learning style become effective learners.[21] We did not find any significant difference in the preferred learning styles between male and female students in our study. Many earlier studies also support this observation.[21316] Wehrwein et al., however, demonstrated a significant difference between learning styles of male and female students of undergraduate physiology.[22] This aspect required further study to reach any significant conclusion.

While devising the LSQ, Honey and Mumford did caution that identification of a preferred learning style is not an indication that the same is put to best use by the learner.[23] At the same time, few studies have shown only a weak correlation between learning styles and academic performance of students.[101524] Given this limitation, understanding of strengths of various learning styles by the educator is essential for effective and efficient curriculum development. It was thought that a mismatch of the learning and teaching styles leads to frustration among learners with consequent failure of learning.[1025] However, few recent studies have demonstrated that a moderate learning–teaching style mismatch fosters student–teacher interaction with development of new learning skills.[2627] The study by Hamza et al. showed that theorists are able to cope the best with moderate mismatch of learning style and teaching modes, while pragmatists suffered due to this mismatch. However, none of the students in their study scored <60% in their performance. Hence, these authors conclude that the moderate mismatch does not seem to have a great effect on the academic performance of the students.[9]

Consequent to the results of this study, the teaching faculty involved in MLT course (all from laboratory sciences) at our center has been explained the concept of learning styles and advised to use this understanding in the improvement of learning process. For instance, for students with preference for activist or reflective styles, hands-on experience of the laboratory techniques along with their description, observation, and evaluation followed by participation in the laboratory and a problem-solving repeat activity has been suggested. Similarly, providing a global view of the laboratory followed by systematic and analytical problem-solving approach may be more effective for theorist learning style. Students with pragmatist style would likely benefit from activity or experimentation-based learning with hands-on training. Suitable modifications in the curriculum design are underway at our center for these students.


The present study, for the first time, explored and demonstrated the presence of all the four learning styles among the students of BScMLT. Activist and reflector learning styles were the most prevalent, while the pragmatist style was least frequent. These results are being utilized for tailoring the teaching methods. Such studies are imperative in current times given the vital nature of laboratories in the modern-day diagnosis. Appropriate teaching methods and assessment strategies incorporating the requirements of the different learning styles are likely to pave the way for better and effective learning with consequent improvements in laboratory output.

Financial support and sponsorship


Conflicts of interest

There are no conflicts of interest.


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Activist; Honey–Mumford; learning style; pragmatist; reflector; theorist

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