In 1997, Sternberg defined ‘learning style’ as the individual preferences for learning 1. There are definite relationships between the learner’s concepts of learning, the processes by which they attempt to learn, and the outcomes of their attempts to learn 2.
Gaining knowledge and insight into the learning style preference among medical students may result in improved methods of teaching to optimize the students’ learning experiences 3. University teaching staff should be aware of their students’ learning preferences as much as their detailed knowledge on the subjects they teach. Knowledge of the learners’ characteristics will definitely improve classroom instruction 4.
To date, more than 70 different learning style models have been identified. The VARK learning style inventory, the instrument used in this study, has four elements: visual, aural, read/write, and kinesthetic. VARK is not only an inventory to identify learners’ preferences but guides learners and instructors in selecting the best fitting learning strategies for the learning process and their evaluation 5.
Sex-based differences in learning styles have been studied. A number of studies have suggested that women prefer to learn in a collaborative and supportive environment. In contrast, men tend to solve problems, give advice, and share information independently; however, females are more inclined to do so in groups 6. The manner in which men and women learn is influenced not only by their brain chemistry but also by the society 7.
Most of the undergraduate students tend to view research methodology courses with negative attitudes because of the learning difficulties they experience during the course, which hinders their future research productivity 8,9. Traditional research methodology courses are limited as they concentrate on the methods of carrying out research without explaining the realities of research. A variety of approaches for teaching research methodology courses have been reported 10–12. Lectures have traditionally been viewed as an inexpensive way of presenting new ideas and concepts to a large group of students. However, lectures rarely stimulate student thinking and processing of information beyond their short-term memory 13. Small group learning activities including tutorials, seminars, etc, provide students with opportunities to engage with course materials at levels they find suitable 14. Presently, the ‘learning by doing’ approach has emerged as the preferred methodology in higher education 15.
The first medical school in Saudi Arabia was established in 1969, and at present, there are 21 colleges of medicine. Since then, medical education has witnessed major changes. However, Al-Shehri and Al-Ghamdi 16 reported a predominance of passive teaching with little active participation of students and a lack of consensus on the core curriculum and subjects of interest for students in Saudi medical colleges.
Taibah University is a Saudi governmental University located in Almadinah Almunawwarah city and was established in 2003. The basic medical sciences, including the research methodology course, are taught over two and a half years (phase 1) in the medical college, followed by a clinical phase (phase 2). Because of the cultural and religious considerations, male and female students are separated during classes. The Department of Family and Community Medicine takes the responsibility of teaching research methodology courses to the third-year medical students. Thus, we decided to explore the preferred learning styles of the second-year male and female medical students and modify the curriculum of the research methodology course accordingly to meet their needs and characteristics. Being medical instructors, we believe that student motivation and performance will definitely improve when the teaching methods are adapted to students’ learning preferences and styles.
Participants and methods
After obtaining approval of the ethics committee, all second-year medical students at Taibah University (n=129) were invited to participate in this study. The Arabic version of the VARK questionnaire 17 was administered to the students who were in the second semester of the academic year 2011–2012; however, only 89 students, 45 female and 44 male, completed the questionnaire with a response rate of 67%. Although medical students at Taibah University receive their medical education in English, we preferred to use the Arabic version of VARK as they are more familiar with that language. The questionnaire was distributed to male and female students in two separate sessions, each of a duration of 15–20 min. Students were instructed to choose the answer that best explains their preference; they were allowed to circle more than one answer per question or exclude all answers according to their perception.
There are a variety of methods assessing the learning styles; each method offers a distinctly different view of learning style preferences. In this study, we decided to use a method that defines the preference in learning styles on the basis of the sensory modality through which a student prefers to receive the new information. The three major sensory modalities are visual (V), aural (A), and kinesthetic (K), collectively known as VAK. Recently, Fleming expanded VAK to VARK to include reading/writing (an additional mixed sensory learning modality that is not assessed under VAK).
VARK questionnaire is a simple questionnaire (consists of 16 questions) that was developed by Fleming 18 and has been validated for measuring learning preferences 19. It classifies learners by their preferred mode of interaction with others based on input stimuli and output performances. Learners with a V preference learn best by seeing or observing (drawings, pictures, diagrams, demonstrations, etc), learners who prefer A are best suited to learning by listening to or recording lectures, discussing material, and talking through material with themselves or others. R-type learners learn through interactions with textual materials, whereas K-type learners perform best using physical experiences: touching, performing an activity, moving, lessons that emphasize doing, and manipulation of objects. Participants with a single learning style preference were referred to as unimodal, whereas those preferring a variety of learning styles were described as multimodal. Multimodal participants have been subclassified as bimodal, trimodal, and quadmodal according to the number of styles they preferred to use, namely two, three, or four styles, respectively. The VARK questionnaire was analyzed using the validated scoring instructions explained on the VARK website 20.
Data was entered into the computer using statistical package for social science program for statistical analysis (SPSS) (Version 19; SPSS Inc., Chicago, Illinois, USA). Two types of statistical analyses were carried out: (a) descriptive statistics: in which quantitative variables were summarized as mean, SD, and range and qualitative variables were expressed as frequency and percent, (b) analytical statistics: where the χ2-test was used to measure the association between the qualitative variables. A P-value less than 0.05 was considered statistically significant. Pie and grouped bar charts were plotted.
The age of the participants ranged from 19 to 23 years, with a mean±SD of 20.79±0.69 years; nearly half of the participants were female students (50.6%). Among the 89 students who completed and returned the VARK questionnaire, 59 (66.3%) preferred the multiple modes of information presentation (Table 1). A significant difference has been found between male and female students, where more than three-quarters of female students (77.8%) compared with about half the male students (54.5%) showed a preference to the multiple modes of information presentation (P=0.02, Table 1). One-third of the students (33.7%) preferred the single mode of information presentation, with male students representing double the number of female students who preferred the unimodal learning style (45.5% of male students vs. 22.2% of female students), with a statistically significant difference (Table 1).
Figure 1 shows that a combination of two modes of information presentation was the preferred style among male multimodal learners (45.8%), whereas Fig. 2 shows that a combination of three modes was preferred among female multimodal learners (51.4%).
Among the 45 female students who participated in the study, the auditory mode was the most preferred (11.1%), followed by the visual and reading/writing modes (4.4% each), and the least preferred mode was the kinesthetic mode (2.2%). None of the male students showed a preference to the single visual or the reading/writing modes. Interestingly, the largest percentage of male students (41%) preferred the single auditory mode, whereas 4.5% preferred the single kinesthetic mode (Fig. 3).
Among the male and female students who showed a preference for two modes of information presentation, more female students compared with male students preferred the A and K modes (8.9 vs. 6.8%) and the V and A modes (6.7 vs. 4.5%). In contrast, more male students compared with female students preferred the A and R modes (4.5 vs. 2.2%). The V and R modes and the A and K modes were preferred by nearly equal percentages of male and female students.
Among the male and female students who preferred three modes of information presentation, more female students compared with male students preferred the combination of V, A, and K modes (22.2 vs. 9.1%), V, A, and R modes (6.7 vs. 2.3%), and V, R, and K modes (4.4 vs. 2.3%). However, more male students compared with female students preferred the combination of A, R, and K modes (9.1 vs. 6.7%). The quadmodal learning preference of VARK was higher among female students compared with the male students (15.6 vs. 6.8%) (Fig. 3).
Many studies have been carried out to examine the usefulness of learning style inventories in providing information to enable improvement of the curriculum design and teaching–learning practices 21–23. This study was carried out on second-year medical students at Taibah University in Saudi Arabia, being the prospective students for the research methodology course, to explore their learning style preferences and assess the possible sex-based differences. The results would help to determine whether the current teaching strategies of the research methodology course are consistent with the learning preferences of these prospective students.
The study revealed that 33.7% of students preferred the single mode of information presentation, which could be visual, auditory, reading/writing, or kinesthetic. The highest percentage of male students (45.5%) preferred a single mode of information presentation; interestingly, 41% preferred the single auditory mode and the remaining 4.5% preferred the single kinesthetic mode. Unlike male students, only 22.2% of female students showed a preference to the unimodal learning style, and half of them (11.1%) preferred the single auditory mode. The auditory learners best learn through discussions, chats, explanations in words, and answering questions 24.
It was promising to find that the majority of students in the present study (66.3%) prefer the multimodal learning style, which is consistent with the finding that ‘students remember 20% of what is read, 30% of what is heard, 40% of what is seen, 50% of what is said, and 60% of is done. This percent increases to 90% for information they read, say, hear, see, and do’ 25. The most frequent combinations were VAK (9.1% of male students vs. 22.2% of female students) and VARK (6.8% male students vs. 15.6% of female students). Preference of the multimodal learning style among undergraduate medical students has been reported by other studies 26–28.
Although both male and female students preferred multimodality in learning, they exhibited a significant difference (P=0.02). In this study, female students tended to prefer the multimodal learning style more compared with male students (77.8 vs. 54.5%, respectively). The same finding has been reported by an Indian study 4. In contrast, Jill et al.29 did not report any significant difference in learning style preferences among the female and male first-year medical students in Michigan, USA.
Knowledge of sex-based differences in learning style preferences is important when teachers are to provide tailored learning strategies to students; male students primarily prefer to use tactile resources to learn new information, whereas female students prefer to have more variety in their educational resources 30. Multimodal learners may benefit from active learning strategies over the traditional lecture format. Such learners must talk about what they learn, write about it, relate it to past experiences and knowledge, and apply it to their daily lives 31.
The Research Methodology course at Taibah University provides an introduction to the medical research methods relevant to healthcare practice. The primary learning objectives of the course curriculum are to develop students’ critical and reflective thinking on and practical skills in designing, implementing, or managing research in medicine. The teaching strategy was based mainly on traditional lectures with few practical sessions. This study proved that the majority of the prospective research methodology course students prefer the multimodal method of information presentation. Hence, active learning strategies have to be applied in our research methodology course; they promote thinking through reasoning and improve problem-solving and decision-making skills through classroom discussions and cooperative learning exercises. However, some obstacles such as large-sized classes, shortage of course time, and lack of materials and equipment that support active learning and awareness of the instructors could hinder the application of the active learning strategies 32.
Lectures could be a good educational tool if used initially to present the theoretical information in the course modules. However, lectures should be followed by tutorials, seminars, and field-based and computer-based practical sessions for searching the literature, preparing for field work, managing data, reporting the research, and critically appraising a scientific paper. This would allow active participation of the students and foster acquisition of knowledge and practicing skills.
The sex-based differences in group behavior must be taken into consideration as male students tend not to participate as effectively as female students 33. Emphasis must be given to project work in research training wherein students have the opportunity to investigate a particular topic in medicine themselves in order to develop the skills of independent inquiry.
Finally, it has to be kept in mind that it is a challenge to teach research methodology in a manner that effectively accommodates all different learning preferences of the students in a class. Much debate has arisen on how to teach research methodology to undergraduate students. Teachers tend to present the information according to their preferred learning styles; students with a VARK profile similar to that of the teachers might perform better 34.
It should be made clear that the VARK questionnaire does not assess the learner as a whole during the learning process. Preference for a certain modality indicates preference for learning in a certain way and does not necessarily show the strengths or weaknesses of a learner – rather, it is merely an indication. In addition, although the Arabic version of the VARK questionnaire has been provided by the VARK website, only the original English version of the questionnaire has been validated 19.
Conclusion and recommendations
In this study, a majority of the second-year medical students preferred multimodality in terms of learning preferences, with significant difference between male and female students; female students tended to favor the multiple modes of information presentation more compared with male students. The study recommends modification of the teaching strategies of the current research methodology course toward the use of a variety of active learning techniques that would fit the different learning styles exhibited by the studied students, rather than classic lectures.
Further research is required to examine the relationship between using teaching strategies based on students’ learning style preferences and the aggregated measures of academic achievement across the course that are best evidence for the usefulness of the information on the learning styles for educational applications.
Conflicts of interest
There are no conflicts of interest.
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Keywords:© 2013 Egyptian Public Health Association
gender differences; learning styles; medical students; research methodology course; VARK