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Knowledge, attitude and practice of reading habit among female medical students, Taibah University
Journal of Taibah University Medical Sciences (2013) 8(3), 192–198
Taibah University
Journal of Taibah University Medical Sciences www.sciencedirect.com
Student Section
Knowledge, attitude and practice of reading habit among female medical students, Taibah University Zainab Abdullah Emran Al Husaini * Medical Students, College of Medicine, Taibah University, Almadinah Almunawwarah, Kingdom of Saudi Arabia Received 26 December 2012; revised 11 April 2013; accepted 26 April 2013
ﺍﻟﻤﻠﺨﺺ . ﺇﻥ ﺍﻛﺘﺴﺎﺏ ﺍﻟﻤﻌﺮﻓﺔ ﻣﻦ ﺧﻼﻝ ﺍﻟﻘﺮﺍﺀﺓ ﺃﻣﺮ ﺿﺮﻭﺭﻱ ﻟﻠﻌﻤﻠﻴﺔ ﺍﻟﺘﻌﻠﻴﻤﻴﺔ ﻟﻄﻼﺏ ﺍﻟﻄﺐ ﻛﻤﺎ ﺃﻥ ﺍﻟﻘﺮﺍﺀﺓ ﻓﻲ ﺍﻟﻤﻤﺎﺭﺳﺔ ﺍﻟﺴﺮﻳﺮﻳﺔ ﺃﻣﺮ ﻣﻬﻢ ﻟﻌﻼﻗﺘﻬﺎ ﺑﺎﻟﻜﻔﺎﺀﺓ ﺍﻟﺴﺮﻳﺮﻳﺔ:ﺃﻫﺪﺍﻑ ﺍﻟﺒﺤﺚ .ﻭﻗﺪ ﺃﺟﺮﻳﺖ ﻫﺬﻩ ﺍﻟﺪﺭﺍﺳﺔ ﻟﺘﻘﻮﻳﻢ ﺍﻟﻤﻌﺮﻓﺔ ﻭﺍﻟﺴﻠﻮﻙ ﻭﺍﻟﻤﻤﺎﺭﺳﺔ ﻟﻌﺎﺩﺓ ﺍﻟﻘﺮﺍﺀﺓ ﺑﻴﻦ ﻃﺎﻟﺒﺎﺕ ﻛﻠﻴﺔ ﺍﻟﻄﺐ ﺑﺠﺎﻣﻌﺔ ﻃﻴﺒﺔ ﺗﻢ ﺍﺳﺘﺨﺪﺍﻡ ﺍﺳﺘﺒﺎﻧﻪ ﻣﻨﻈﻤﺔ ﻟﻘﻴﺎﺱ ﺍﻟﻤﻌﺮﻓﺔ.( ﻃﺎﻟﺒﺔ ﺳﺮﻳﺮﻳﺎ ﺑﺎﻟﺴﻨﻮﺍﺕ ﺍﻟﺴﺮﻳﺮﻳﺔ ﺍﻟﺮﺍﺑﻌﺔ ﻭﺍﻟﺨﺎﻣﺴﺔ130 )ﻣﻦ ﺃﺻﻞ105 ﻭﺷﻤﻞ. ﺍﻋﺘﻤﺪ ﻧﻬﺞ ﻣﻘﻄﻌﻲ ﻭﺻﻔﻲ ﻟﻠﺪﺭﺍﺳﺔ:ﻃﺮﻕ ﺍﻟﺒﺤﺚ . ﻭﻗﺪ ﺗﻢ ﺍﺳﺘﺨﺪﺍﻡ ﺍﻟﻄﺮﻕ ﺍﻟﺘﺤﻠﻴﻠﻴﺔ ﺍﻹﺣﺼﺎﺋﻴﺔ ﺍﻟﻤﺨﺘﻠﻔﺔ ﻟﺘﺤﻠﻴﻞ ﺍﻟﻨﺘﺎﺋﺞ.ﻭﺍﻟﺴﻠﻮﻙ ﻭﺍﻟﻤﻤﺎﺭﺳﺔ ﻟﻌﺎﺩﺓ ﺍﻟﻘﺮﺍﺀﺓ 60.0 ﻭﺑﺎﻟﻨﺴﺒﺔ ﻟﻤﻤﺎﺭﺳﺔ ﻋﺎﺩﺓ ﺍﻟﻘﺮﺍﺀﺓ،19.9 ± 70.2 ﻭﻟﻠﺴﻠﻮﻙ،14.4 ± 87.5 ﻭﻛﺎﻧﺖ ﻣﺘﻮﺳﻂ ﺍﻟﻨﺴﺒﺔ ﺍﻟﻤﺌﻮﻳﺔ ﻟﻠﻤﻌﺮﻓﺔ. ﺳﻨﺔ0.9 ± 22.9 ﻛﺎﻥ ﻣﺘﻮﺳﻂ ﻋﻤﺮ ﺍﻟﻄﺎﻟﺒﺎﺕ:ﺍﻟﻨﺘﺎﺋﺞ ﻭﻛﺎﻥ.(P = 0.010 ،R = 0.251) ﻣﻊ ﻭﺟﻮﺩ ﻋﻼﻗﺔ ﺇﻳﺠﺎﺑﻴﺔ ﺫﺍﺕ ﺩﻻﻟﺔ ﺇﺣﺼﺎﺋﻴﺔ ﺑﻴﻦ ﺍﻟﻤﻌﺮﻓﺔ ﻭﺍﻟﻤﻤﺎﺭﺳﺔ ﺍﻟﺴﺮﻳﺮﻳﺔ،11.1 ± 72.6 ﻭﻛﺎﻥ ﻣﺠﻤﻮﻉ ﻧﻘﺎﻁ ﻣﻤﺎﺭﺳﺔ ﻋﺎﺩﺓ ﺍﻟﻘﺮﺍﺀﺓ.17.8 ± ﻣﻦ ﺍﻟﻄﺎﻟﺒﺎﺕ ﻭﻛﺎﻥ ﺍﻟﻤﺼﺪﺭ٪ 92.4 ﻭﻛﺎﻥ ﺍﺳﺘﺨﺪﺍﻡ ﻛﺘﺐ ﺍﻟﺠﻴﺐ ﻛﻤﺮﺟﻊ ﻃﺒﻲ ﻣﻦ ﻗﺒﻞ. ﻋﻠﻰ ﺍﻟﺘﻮﺍﻟﻲ٪ 79.0 ﻭ٪ 84.8 ﺳﺒﺐ ﻋﻮﺍﺋﻖ ﺍﻟﻘﺮﺍﺀﺓ ﺑﺮﻧﺎﻣﺞ ﺍﻟﻜﻠﻴﺔ ﻭﺍﺣﺘﻘﺎﻥ ﺟﺪﻭﻝ ﺍﻟﻄﺎﻟﺒﺎﺕ ﺑﻨﺴﺒﺔ . ﻣﻦ ﺟﻬﺔ ﺃﺧﺮﻯ ﻛﺎﻥ ﺍﻟﻮﻗﺖ ﺍﻟﻤﺒﺬﻭﻝ ﻟﻠﺤﺼﻮﻝ ﻋﻠﻰ ﺍﻟﻤﻌﻠﻮﻣﺔ ﻣﻦ ﺷﺒﻜﺔ ﺍﻻﻧﺘﺮﻧﺖ ﺃﻗﻞ ﺑﻜﺜﻴﺮ ﻣﻘﺎﺭﻧﺔ ﺑﻜﺘﺐ ﺍﻟﺠﻴﺐ ﺃﻭ ﻣﻠﺨﺼﺎﺕ ﺍﻟﻤﺤﺎﺿﺮﺍﺕ. ﻣﻨﻬﻦ٪ 33.3 ﺍﻟﻤﻌﻠﻮﻣﺎﺗﻲ ﺍﻷﻫﻢ ﻟﺪﻯ ﻭﻗﺪ. ﺇﻥ ﻃﺎﻟﺒﺎﺕ ﻛﻠﻴﺔ ﺍﻟﻄﺐ ﺑﺎﻟﺴﻨﻮﺍﺕ ﺍﻟﻨﻬﺎﺋﻴﺔ ﻳﻘﻀﻴﻦ ﻭﻗﺘﺎ ﺃﻗﻞ ﻓﻲ ﺍﻟﻘﺮﺍﺀﺓ ﻭﻳﻌﺘﻤﺪﻥ ﺃﺳﺎﺳﺎ ﻋﻠﻰ ﻛﺘﺐ ﺍﻟﺠﻴﺐ ﺍﻟﺘﻲ ﺗﻌﻄﻲ ﺍﻟﻤﻌﺮﻓﺔ ﺍﻟﻤﻄﻠﻮﺑﺔ ﻓﻲ ﻭﻗﺖ ﻗﺼﻴﺮ ﻭﺑﺸﻜﻞ ﻣﻮﺟﺰ:ﺍﻻﺳﺘﻨﺘﺎﺟﺎﺕ . ﻭﻗﺪ ﻛﺎﻥ ﻫﻨﺎﻙ ﺗﻨﺎﻗﺾ ﺑﻴﻦ ﻣﻌﺮﻓﺔ ﺍﻟﻄﺎﻟﺒﺎﺕ ﻷﻫﻤﻴﺔ ﺍﻟﻘﺮﺍﺀﺓ ﻭﺍﻟﻤﻤﺎﺭﺳﺔ ﺍﻟﻔﻌﻠﻴﺔ ﺍﻟﺴﺮﻳﺮﻳﺔ. ﺿﻴﻖ ﺍﻟﻮﻗﺖ ﻭﻧﻘﺺ ﺍﻟﻤﺼﺎﺩﺭ ﺍﻟﻤﻌﺮﻓﻴﺔ،ﺷﻤﻠﺖ ﺣﻮﺍﺟﺰ ﺍﻟﻘﺮﺍﺀﺓ ﺑﺮﻧﺎﻣﺞ ﺍﻟﻜﻠﻴﺔ ﻗﺮﺍﺀﺓ; ﻃﺒﻲ; ﻃﻼﺏ:ﺍﻟﻜﻠﻤﺎﺕ ﺍﻟﻤﻔﺘﺎﺣﻴﺔ Abstract Objective: Acquiring knowledge through reading is crucial for learning process of a medical student. Reading in clinical practice is important as it relates to clinical competencies. This study was carried out to assess knowledge, attitude and practice of reading habit among female medical students at Taibah University. Methods: A descriptive cross sectional approach was adopted. It involved 105 (out of 130) female medical students from 4th and 5th years in their clinical rounds. A structured questionnaire for measuring knowledge, attitude and practice of reading habit was used. Statistical analysis was done using percent, mean, standard deviation, chi-square, Student’s t-tests, and Pearson’s correlation. Results: The mean age of the studied students was 22.9 ± 0.9 years. The mean percent score for knowledge was 87.5 ± 14.4, for attitude was 70.2 ± 19.9, and for practice 60.0 ± 17.8. The total reading habit score was 72.6 ± 11.1, with a significant positive
* Corresponding author. Medical Students, College of Medicine, Taibah University, Almadinah Almunawwarah, Kingdom of Saudi Arabia. E-mail: [email protected] Peer review under responsibility of Taibah University.
Production and hosting by Elsevier 1658-3612 Ó 2013 Taibah University. Production and hosting by Elsevier Ltd. All rights reserved. http://dx.doi.org/10.1016/j.jtumed.2013.09.004
Z.A.E. Al Husaini
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correlation between knowledge and practice (r = 0.251, p = 0.010). College related barriers and overcrowded students’ timetable were the main perceived barriers for reading (84.8% and 79.0% respectively). Pocket books were used by 92.4% of students as medical reference, and were the most useful source as stated by 33.3% of them. The mean time spent on online sources of reading is less than that spent on other sources as pocket books and lecture handouts. Conclusion: Medical students spent less time on reading and depended mainly on pocket books as they gave the desired knowledge in short time and concise form. The stated reading barriers included college barrier, insufficient time and source barrier. There was contradiction between students’ knowledge of the importance of reading and its actual practice. Keywords: : Medical; Reading; Students Ó 2013 Taibah University. Production and hosting by Elsevier Ltd. All rights reserved.
Introduction Reading habit is an essential life skill. It not only increases our knowledge, but it also builds maturity and character, sharpens our thinking, and widens our awareness in social, economic, political, and environmental issues.1 Acquiring knowledge through reading is crucial for learning process of a medical student. In clinical practice, it is important as it relates to clinical competencies.2,3 Medical students encounter a huge volume of different subjects; with which they are not familiar and on the other hand remembering the various facts and new diagnostic and therapeutic methods seems difficult. Thus, learning all the facts needs enough time and regular curriculum planning.4 Frequently much time is devoted to developing the content of the curriculum and the type of assessments that will be completed with little attention given to how the students best learn or if they will be enhancing their lifelong learning habits.5 A student’s approach to learning, which includes study habits, has been shown to predict the student’s success.6 The most marked problems facing medical students are the time management, concentration, reading speed, notes taking, study habits and comprehension.7 Understanding the reading habit of medical students provides an insight into their information backgrounds and helps develop educational plans that meet their learning needs. Materials and Methods A cross sectional study was conducted during November 2010. The study population included fourth and fifth year female medical students (130). The response rate was 80.4% (105 females were involved). An anonymous self-administered questionnaire was distributed to all students after their mid term exam of psychiatry (4th year) and internal medicine (5th year). The questionnaire was prepared in English language. The purpose, of the study was explained to the respondents and a verbal informed consent was obtained (completing the questionnaire was considered as a written consent from the student to participate in the study). Ethics Review Committee reviewed and approved the proposal. The survey tool was pre-tested on a random sample of 20 participants to ensure practicability, validity and interpretation of responses; prior to distribution of it. The reliability of the questionnaire was assessed (for the whole questionnaire) using Cronbach’s alpha (0.86). The questionnaire included information on knowledge, attitude, and practice
of reading habit, barriers that students face during reading, time spent on reading every one of medical references. Using Likert scale the answers were designed as multiple choice questions; to answer questions about the degree of benefit gained from medical references; (with 5 answers) as not useful at all, partially not useful, neutral, somewhat useful and extremely useful. Scores for knowledge, attitude and practice were calculated using the following formula: “Total score/Maximum possible score 100”. Statistical analysis Data entered and analyzed using SPSS version 13.0. Means (± SD) were computed for continuous and proportions for categorical variables. Pearsons’ correlation was used to find out the relation between knowledge, attitude and practice and students’ characters and depression. Student’s t-test and chi square test were used, and 95% significance was chosen. Results The mean age of the studied students was 22.9 ± 0.9 years. About 96.2% of the students stated that reading is important, 96.2% knew that it has an impact on personality and 92.4% knew that it affects quality of medical student. There was an insignificant difference between the two studied years (Table 1). Nearly half of the students (51.4%) were not convinced with their reading habit and 67.6% of them tried to change it; with a significant difference between the two years (p = 0.015 and 0.044 respectively). Three fourths of students (75.2%) suspect that their score will improve on changing their reading habit especially when known that 89.5% have the ability to develop a better one (Table 2). The majority of students stated that they had barriers and difficulties in their college that prevent them from reading (including unavailability of suitable prepared place for reading, difficulty to reach the desired material within the library, unavailability of booking list for each subject and busy schedule), insufficient time and source barriers (including difficulty to obtain and language barrier); with a significant difference between 4th and 5th years (p = 0.04, 0.03, 0.002 respectively) (Figure 1). The most commonly used medical reference was pocket books (92.4%), followed by lecture hand outs (88.6%) and the least one was journal article (26.4%) (Table 3).
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Knowledge, attitude and practice of reading habit
Table 1: Knowledge of students about reading habit. 4th Year
Reading No Yes Reading No Yes Reading No Yes Reading No Yes Reading No Yes Reading No Yes Reading No Yes *
5th Year
p-Value*
Total
N
%
N
%
N
%
3 50
5.7 94.3
1 51
1.9 98.1
4 101
3.8 96.2
0.317
5 48
9.4 90.6
2 50
3.8 96.2
7 98
6.7 93.3
0.251
3 50
5.7 94.3
1 51
1.9 98.1
4 101
3.8 96.2
0.317
4 49
7.5 92.5
7 45
13.5 86.5
11 94
10.5 89.5
0.322
5 48
9.4 90.6
3 49
5.8 94.2
8 97
7.6 92.4
0.479
12 41
22.6 77.4
18 34
34.6 65.4
60 75
28.6 71.4
0.174
13 40
24.5 75.5
15 37
28.8 71.2
28 77
26.7 73.3
0.617
is an important issue
is important for medical students
has an impact on personality
has an impact on student score
affects quality of medical students
is an enjoyable habit
from many sources are beneficial
p-Value is significant at level <0.05.
Table 2: Attitude of students toward reading habit. 4th Year
Are you convinced with your reading habit? No Yes Are you attempting to change it? No Yes If you attempting to change it, you suspect to get higher score No Yes Do you have the ability to develop better reading habit? No Yes *
5th Year
p-Value*
Total
N
%
N
%
N
%
21 32
39.6 60.4
33 19
63.5 36.5
54 51
51.4 48.6
0.015*
22 31
41.5 58.5
12 40
23.1 76.9
34 71
32.4 67.6
0.044*
12 41
22.6 77.4
14 38
26.9 73.1
26 79
24.8 75.2
0.611
6 47
11.3 88.7
5 47
9.6 90.4
11 94
10.5 89.5
0.775
p-Value is significant at level <0.05.
Figure 1: Perceived barriers for reading.
195
Z.A.E. Al Husaini Table 3: Practice of reading habit by students. 4th Year
Medical text book No Yes Essential version of a basic medical text book No Yes Online version of text book No Yes Online journal article No Yes Medical websites No Yes Pocket books No Yes Journal articles (Print version) No Yes Lecture hand outs No Yes Test preparation textbooks No Yes *
5th Year
p-Value*
Total
N
%
N
%
N
%
23 30
43.4 56.6
32 20
61.5 38.5
55 50
52.4 47.6
0.043*
18 35
34.0 66.0
17 35
32.7 67.3
35 70
33.3 66.7
0.890
28 25
52.8 47.2
36 16
69.2 30.8
64 41
61.0 39.0
0.085
38 15
71.7 28.3
38 14
73.1 26.9
76 29
72.4 27.6
0.874
10 43
18.9 81.1
11 41
21.2 78.8
21 84
20.0 80.0
0.770
5 48
9.4 90.6
3 49
5.8 94.2
8 97
7.6 92.4
0.479
41 12
77.4 22.6
36 16
69.2 30.8
77 28
73.3 26.4
0.346
7 46
13.2 86.8
5 47
9.6 90.4
12 93
11.4 88.6
0.563
10 43
18.9 81.1
20 32
38.5 61.5
30 75
28.6 71.4
0.026
p-Value is significant at level <0.05.
Regarding the time spent on reading habit, the maximum was for essential version of a basic medical text book (median = 5 h per week), followed by medical text book and lecture handouts (median = 5 h per week for each) and the least for online sources (median = 2 h per week for each) and journal article (median = 1 h per week) with a statistically significant difference (p = 0.035) (Table 4). The maximum degree of benefit was gained from pocket books where the mean score was 80.4 ± 25.11, followed by lecture hand outs; where the mean score was 77.3 ± 22.54 and the minimum was obtained from journal articles; the mean score was 53.9 ± 25.44 (Table 5). The most useful source as stated by students was again pocket books (33.3%), followed by essential version of a basic medical text book (21.9%) and the least was for journal article (1.0%) (Figure 2). The mean percent score for knowledge was 87.5 ± 14.38, for attitude was 70.2 ± 19.94 and for practice was 60.0 ± 17.81 with an insignificant difference between the two years. The total score for reading habit was 72.6 ± 11.06; again with an insignificant difference between the two years (Table 6). There was a significant correlation between knowledge score and reading practice score (r = 0.251, p = 0.010). Discussion Reading habit is an essential life skill. It not only increases knowledge, but it also builds maturity and identity, sharpens our thinking, and increases awareness in all daily life issues 1.
Acquiring knowledge through reading is crucial for learning process of a medical student. In clinical practice, it is important as it relates to clinical competencies.1 Medical students spent on average 5.7 h per week (median 3 h) on reading lecture hand outs and 4.9 h per week on reading pocket books (median 4 h), which was nearly similar to the results of similar study performed at King Saud Medical college 2009.8 A study of reading habits of medical clerks at John Hopkins University School of Medicine in 2002–2003 revealed that medical clerks reported for an average of 10.8 h per week.9 Medical students were reported in another study to read for an average of 10.8 h per week and relied solely on medical textbooks.10 One study reported that internists read for an average of 4.4 h per week.11 The most useful source rated by students in the current study was pocket books followed by lecture hand outs and focused on them more than online updated sources. While online sources are easily accessible and provides up to date information, it may not be the most efficient source for students to obtain critical information. However, students need to be encouraged and motivated to use these online sources. The same result was obtained by the study performed at King Saud University.8 Meanwhile, online sources were the most useful source rated by students of John Hopkins University School of Medicine.9 Another study reported that the medical journals were the most useful source.11 All students reported problems with reading. Time was a barrier stated by majority of the students that hinders the reading process. Medical students face a huge volume of different
196
Knowledge, attitude and practice of reading habit
Table 4: Time spent on reading different medical references per week. Medical text book Mean ± SD Median Essential version of a basic medical text book Mean ± SD Median Online version of text book Mean ± SD Median Online journal article Mean ± SD Median Medical websites Mean ± SD Median Pocket books Mean ± SD Median Journal articles (Print version) Mean ± SD Median Lecture hand outs Mean ± SD Median Test preparation textbooks Mean ± SD Median *
4th Year
5th Year
Total
p-Value*
5.2 ± 6.28 3.00
8.7 ± 9.62 4.5
6.9 ± 8.27 4.00
0.026*
5.9 ± 5.32 5.00
6.1 ± 6.82 3.50
6.0 ± 6.08 5.00
0.848
2.3 ± 2.08 2.00
2.5 ± 2.34 2.00
2.4 ± 2.22 2.00
0.684
1.7 ± 1.69 1.00
2.2 ± 2.35 2.00
1.9 ± 2.05 2.00
0.185
2.7 ± 3.74 2.00
3.0 ± 2.45 2.50
2.8 ± 3.16 2.00
0.583
4.2 ± 3.54 3.00
5.8 ± 7.1 3.00
4.9 ± 5.64 3.00
0.137
0.97 ± 1.56 0.10
1.9 ± 2.66 1.00
1.4 ± 2.21 1.00
0.035*
6.2 ± 5.83 4.00
5.1 ± 5.85 3.50
5.7 ± 5.84 4.00
0.331
2.6 ± 2.45 2.00
3.1 ± 2.80 2.00
2.8 ± 2.59 2.00
0.413
p-Value is significant at level <0.05.
Table 5: Mean percent score of benefit obtained from various sources. Medical text book Mean ± SD Essential version of a basic medical text book Mean ± SD Online version of text book Mean ± SD Online journal article Mean ± SD Medical websites Mean ± SD Pocket books Mean ± SD Journal articles (Print version) Mean ± SD Lecture hand outs Mean ± SD Test preparation textbooks Mean ± SD From all sources Mean ± SD *
4th Year
5th Year
Total
p-Value*
67.9 ± 20.88
65.0 ± 26.83
66.5 ± 23.94
0.534
66.4 ± 22.79
73.8 ± 24.59
70.1 ± 23.88
0.111
63.4 ± 25.94
55.4 ± 24.61
59.4 ± 25.49
0.108
57.4 ± 24.51
60.8 ± 25.04
59.0 ± 24.71
0.482
75.1 ± 22.50
73.1 ± 25.01
74.1 ± 23.68
0.665
83.0 ± 26.43
77.7 ± 23.65
80.4 ± 25.11
0.279
50.6 ± 22.74
57.3 ± 27.73
53.9 ± 25.44
0.176
75.1 ± 23.17
57.3 ± 27.73
77.3 ± 22.54
0.306
80.0 ± 23.86
68.1 ± 26.35
74.1 ± 25.71
0.017*
68.8 ± 13.89
67.9 ± 14.93
68.3 ± 14.35
0.750
p-Value is significant at level <0.05.
subjects with which they are not familiar and on the other hand remembering the various facts and new diagnostic and therapeutic methods seems difficult. Thus, learning all the facts needs enough time and regular curriculum planning.2,4,9,12 Also, difficulties found at the college were another problem facing students where places and texts were insufficient to meet
their needs. Upgrading the medical college is an ongoing process trying to facilitate every difficulty stated by its students. Many students stated that there were difficulties in obtaining the source of reading; even though the source was unclear. This must be enhanced by teaching the students to be self learners and to get use of the available resources.13–15
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Z.A.E. Al Husaini 3.8% 3.8%
Test preparation textbooks
7.7%
Lecture hand outs Journal articles
17.0%
1.9% 0.0%
Pocket books Medical websites Online journal article Online version of text book
30.2% 1.9% 5.7% 3.8% 3.8%
36.5%
5th year 4th year
0.0% 1.9%
basic medical text book Medical text book
18.8% 19.3% 18.8%
25.0%
Figure 2: Most useful source as medical reference.
Table 6: Mean percent score knowledge, attitude and practice of reading habit. Mean knowledge score ± SD Mean attitude score ± SD Mean practice score ± SD Total mean score for reading habit ± SD *
4th Year
5th Year
Total
p-Value*
87.9 ± 15.95 71.2 ± 19.85 62.3 ± 18.53 73.8 ± 11.97
87.1 ± 12.73 69.2 ± 20.18 57.7 ± 16.91 71.3 ± 10.02
87.5 ± 14.38 70.2 ± 19.94 60.0 ± 17.81 72.6 ± 11.06
0.782 0.611 0.190 0.259
p-Value is significant at level <0.05.
Conclusion and recommendation
References
Medical students spent less time on reading and depended mainly on pocket books as they gave the desired knowledge in short time and concise form. The stated reading barriers included college barrier, insufficient time and source barrier. There was contradiction between students’ knowledge of the importance of reading and its actual practice. There is a great need for an intervention plan to improve attitude and practice of reading habit. Motivation (by contests for example) should be planned to induce them to change their habit. Online sources are important recent source as medical references. Students must utilize it as much as possible and they must be informed about their importance. Lecturers should give assignment that will compel students to make use of the Internet for academic reading. They should encourage students to give enough time for self study on the Internet. College should have an electronic library open to all students with all necessary accessories.
1. Pandian A. A study on readership behaviour among multi-ethnic, multi-lingual Malaysian students. A paper presented at the seventh International Literacy and Education Research Network (LERN) Conference on Learning, RMIT University, Melbourne, 5–9 July 2000. 2. Van Der Hem-Stokroos HH, Scherpbier AJ, et al. How effective is a clerkship as a learning environment? Med Teach 2001; 23: 599–604. 3. Khan KS. A hierarchy of effective teaching and learning to acquire competence in evidence-based medic. BMC Med Educ 2006; 15(6): 59. 4. Abbasali N, Seyed NM, Arezo F, Akbar M, Jamshid M. Evaluation of study skills and habits in medical students. South East Asian J Med Educ 2008; 2(1): 34. 5. Newble DI, Entwistle NJ. Learning styles and approaches: implications for medical education. Med Educ 1986; 20: 162–175. 6. Ramsden P, Entwistle NJ. Effects of academic departments on students’ approaches to studying. Br J Educ Psychol 1981; 51: 368–383. 7. Stark Mary C. (2008) Retention, bonding, and academic achievements: effectiveness of the college’s seminar in promoting college success. In: Ninth Annual National Conference on Retention, New York. 8. Mona MS, Khalid FN. The reading habits of medical students at medical college King Saud University. J Taibah Univ Med Sci 2009; 4(2): 115–122. 9. Leff B, Harper M. The reading habit of medicine clerks at one medical school: frequency, usefulness and difficulties. Acad Med 2006; 81: 489–494. 10. Schein M, Harry M, Lois S, William A. What American surgeons read: a survey of a thousand Fellows of the American College of Surgeons. Curr Surg 2000; 57(3): 252–258. 11. Saint S, Mony R, Lois H, Jone O, Perter N. Journal of reading habits on internists. J Gen Intern Med 2000; 15(12): 881–884.
Study limitation The main limitation of this study is that it was done at the end of mid year examination; when students are stressed and confused. As it was performed for one single medical college at a time its generalizability will be limited. Another point was that the data were self-reported and may be subjected to bias. Acknowledgments Thanks to all who helped us in the distribution of the questionnaire and fourth and fifth year female medical students for their co-operation.
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12. Bloomfield L, Harris P, Hughes C. What do students want? The types of learning activities preferred by final year medical students. Med Educ 2003; 37: 110–118. 13. Gallik JD. Do they read for pleasure? Recreational reading habits of college students. J Adolesc Adult Literacy 1999; 42(6): 480. 14. Kaur S, Che Lah S. The Sociocultural Development of Mature Learners at the University. Paper presented at the Malaysia International Conference on Languages, Literatures and Cultures
(MICOLLAC). The Mines Resort Hotel, Kuala Lumpur. 10–12 May 1999. 15. Kaur S, Mahadi TS. Challenges Faced By Malay Employees in Using English at the Workplace. Paper presented at the 3rd International Conference: “On the Role of Language in a Borderless World: Harkening to the Voices of Asia”. Nikko Hotel, Kuala Lumpur. 10–12 May 1998.
Taibah University
Journal of Taibah University Medical Sciences www.sciencedirect.com
Student Section
Knowledge, attitude and practice of reading habit among female medical students, Taibah University Zainab Abdullah Emran Al Husaini * Medical Students, College of Medicine, Taibah University, Almadinah Almunawwarah, Kingdom of Saudi Arabia Received 26 December 2012; revised 11 April 2013; accepted 26 April 2013
ﺍﻟﻤﻠﺨﺺ . ﺇﻥ ﺍﻛﺘﺴﺎﺏ ﺍﻟﻤﻌﺮﻓﺔ ﻣﻦ ﺧﻼﻝ ﺍﻟﻘﺮﺍﺀﺓ ﺃﻣﺮ ﺿﺮﻭﺭﻱ ﻟﻠﻌﻤﻠﻴﺔ ﺍﻟﺘﻌﻠﻴﻤﻴﺔ ﻟﻄﻼﺏ ﺍﻟﻄﺐ ﻛﻤﺎ ﺃﻥ ﺍﻟﻘﺮﺍﺀﺓ ﻓﻲ ﺍﻟﻤﻤﺎﺭﺳﺔ ﺍﻟﺴﺮﻳﺮﻳﺔ ﺃﻣﺮ ﻣﻬﻢ ﻟﻌﻼﻗﺘﻬﺎ ﺑﺎﻟﻜﻔﺎﺀﺓ ﺍﻟﺴﺮﻳﺮﻳﺔ:ﺃﻫﺪﺍﻑ ﺍﻟﺒﺤﺚ .ﻭﻗﺪ ﺃﺟﺮﻳﺖ ﻫﺬﻩ ﺍﻟﺪﺭﺍﺳﺔ ﻟﺘﻘﻮﻳﻢ ﺍﻟﻤﻌﺮﻓﺔ ﻭﺍﻟﺴﻠﻮﻙ ﻭﺍﻟﻤﻤﺎﺭﺳﺔ ﻟﻌﺎﺩﺓ ﺍﻟﻘﺮﺍﺀﺓ ﺑﻴﻦ ﻃﺎﻟﺒﺎﺕ ﻛﻠﻴﺔ ﺍﻟﻄﺐ ﺑﺠﺎﻣﻌﺔ ﻃﻴﺒﺔ ﺗﻢ ﺍﺳﺘﺨﺪﺍﻡ ﺍﺳﺘﺒﺎﻧﻪ ﻣﻨﻈﻤﺔ ﻟﻘﻴﺎﺱ ﺍﻟﻤﻌﺮﻓﺔ.( ﻃﺎﻟﺒﺔ ﺳﺮﻳﺮﻳﺎ ﺑﺎﻟﺴﻨﻮﺍﺕ ﺍﻟﺴﺮﻳﺮﻳﺔ ﺍﻟﺮﺍﺑﻌﺔ ﻭﺍﻟﺨﺎﻣﺴﺔ130 )ﻣﻦ ﺃﺻﻞ105 ﻭﺷﻤﻞ. ﺍﻋﺘﻤﺪ ﻧﻬﺞ ﻣﻘﻄﻌﻲ ﻭﺻﻔﻲ ﻟﻠﺪﺭﺍﺳﺔ:ﻃﺮﻕ ﺍﻟﺒﺤﺚ . ﻭﻗﺪ ﺗﻢ ﺍﺳﺘﺨﺪﺍﻡ ﺍﻟﻄﺮﻕ ﺍﻟﺘﺤﻠﻴﻠﻴﺔ ﺍﻹﺣﺼﺎﺋﻴﺔ ﺍﻟﻤﺨﺘﻠﻔﺔ ﻟﺘﺤﻠﻴﻞ ﺍﻟﻨﺘﺎﺋﺞ.ﻭﺍﻟﺴﻠﻮﻙ ﻭﺍﻟﻤﻤﺎﺭﺳﺔ ﻟﻌﺎﺩﺓ ﺍﻟﻘﺮﺍﺀﺓ 60.0 ﻭﺑﺎﻟﻨﺴﺒﺔ ﻟﻤﻤﺎﺭﺳﺔ ﻋﺎﺩﺓ ﺍﻟﻘﺮﺍﺀﺓ،19.9 ± 70.2 ﻭﻟﻠﺴﻠﻮﻙ،14.4 ± 87.5 ﻭﻛﺎﻧﺖ ﻣﺘﻮﺳﻂ ﺍﻟﻨﺴﺒﺔ ﺍﻟﻤﺌﻮﻳﺔ ﻟﻠﻤﻌﺮﻓﺔ. ﺳﻨﺔ0.9 ± 22.9 ﻛﺎﻥ ﻣﺘﻮﺳﻂ ﻋﻤﺮ ﺍﻟﻄﺎﻟﺒﺎﺕ:ﺍﻟﻨﺘﺎﺋﺞ ﻭﻛﺎﻥ.(P = 0.010 ،R = 0.251) ﻣﻊ ﻭﺟﻮﺩ ﻋﻼﻗﺔ ﺇﻳﺠﺎﺑﻴﺔ ﺫﺍﺕ ﺩﻻﻟﺔ ﺇﺣﺼﺎﺋﻴﺔ ﺑﻴﻦ ﺍﻟﻤﻌﺮﻓﺔ ﻭﺍﻟﻤﻤﺎﺭﺳﺔ ﺍﻟﺴﺮﻳﺮﻳﺔ،11.1 ± 72.6 ﻭﻛﺎﻥ ﻣﺠﻤﻮﻉ ﻧﻘﺎﻁ ﻣﻤﺎﺭﺳﺔ ﻋﺎﺩﺓ ﺍﻟﻘﺮﺍﺀﺓ.17.8 ± ﻣﻦ ﺍﻟﻄﺎﻟﺒﺎﺕ ﻭﻛﺎﻥ ﺍﻟﻤﺼﺪﺭ٪ 92.4 ﻭﻛﺎﻥ ﺍﺳﺘﺨﺪﺍﻡ ﻛﺘﺐ ﺍﻟﺠﻴﺐ ﻛﻤﺮﺟﻊ ﻃﺒﻲ ﻣﻦ ﻗﺒﻞ. ﻋﻠﻰ ﺍﻟﺘﻮﺍﻟﻲ٪ 79.0 ﻭ٪ 84.8 ﺳﺒﺐ ﻋﻮﺍﺋﻖ ﺍﻟﻘﺮﺍﺀﺓ ﺑﺮﻧﺎﻣﺞ ﺍﻟﻜﻠﻴﺔ ﻭﺍﺣﺘﻘﺎﻥ ﺟﺪﻭﻝ ﺍﻟﻄﺎﻟﺒﺎﺕ ﺑﻨﺴﺒﺔ . ﻣﻦ ﺟﻬﺔ ﺃﺧﺮﻯ ﻛﺎﻥ ﺍﻟﻮﻗﺖ ﺍﻟﻤﺒﺬﻭﻝ ﻟﻠﺤﺼﻮﻝ ﻋﻠﻰ ﺍﻟﻤﻌﻠﻮﻣﺔ ﻣﻦ ﺷﺒﻜﺔ ﺍﻻﻧﺘﺮﻧﺖ ﺃﻗﻞ ﺑﻜﺜﻴﺮ ﻣﻘﺎﺭﻧﺔ ﺑﻜﺘﺐ ﺍﻟﺠﻴﺐ ﺃﻭ ﻣﻠﺨﺼﺎﺕ ﺍﻟﻤﺤﺎﺿﺮﺍﺕ. ﻣﻨﻬﻦ٪ 33.3 ﺍﻟﻤﻌﻠﻮﻣﺎﺗﻲ ﺍﻷﻫﻢ ﻟﺪﻯ ﻭﻗﺪ. ﺇﻥ ﻃﺎﻟﺒﺎﺕ ﻛﻠﻴﺔ ﺍﻟﻄﺐ ﺑﺎﻟﺴﻨﻮﺍﺕ ﺍﻟﻨﻬﺎﺋﻴﺔ ﻳﻘﻀﻴﻦ ﻭﻗﺘﺎ ﺃﻗﻞ ﻓﻲ ﺍﻟﻘﺮﺍﺀﺓ ﻭﻳﻌﺘﻤﺪﻥ ﺃﺳﺎﺳﺎ ﻋﻠﻰ ﻛﺘﺐ ﺍﻟﺠﻴﺐ ﺍﻟﺘﻲ ﺗﻌﻄﻲ ﺍﻟﻤﻌﺮﻓﺔ ﺍﻟﻤﻄﻠﻮﺑﺔ ﻓﻲ ﻭﻗﺖ ﻗﺼﻴﺮ ﻭﺑﺸﻜﻞ ﻣﻮﺟﺰ:ﺍﻻﺳﺘﻨﺘﺎﺟﺎﺕ . ﻭﻗﺪ ﻛﺎﻥ ﻫﻨﺎﻙ ﺗﻨﺎﻗﺾ ﺑﻴﻦ ﻣﻌﺮﻓﺔ ﺍﻟﻄﺎﻟﺒﺎﺕ ﻷﻫﻤﻴﺔ ﺍﻟﻘﺮﺍﺀﺓ ﻭﺍﻟﻤﻤﺎﺭﺳﺔ ﺍﻟﻔﻌﻠﻴﺔ ﺍﻟﺴﺮﻳﺮﻳﺔ. ﺿﻴﻖ ﺍﻟﻮﻗﺖ ﻭﻧﻘﺺ ﺍﻟﻤﺼﺎﺩﺭ ﺍﻟﻤﻌﺮﻓﻴﺔ،ﺷﻤﻠﺖ ﺣﻮﺍﺟﺰ ﺍﻟﻘﺮﺍﺀﺓ ﺑﺮﻧﺎﻣﺞ ﺍﻟﻜﻠﻴﺔ ﻗﺮﺍﺀﺓ; ﻃﺒﻲ; ﻃﻼﺏ:ﺍﻟﻜﻠﻤﺎﺕ ﺍﻟﻤﻔﺘﺎﺣﻴﺔ Abstract Objective: Acquiring knowledge through reading is crucial for learning process of a medical student. Reading in clinical practice is important as it relates to clinical competencies. This study was carried out to assess knowledge, attitude and practice of reading habit among female medical students at Taibah University. Methods: A descriptive cross sectional approach was adopted. It involved 105 (out of 130) female medical students from 4th and 5th years in their clinical rounds. A structured questionnaire for measuring knowledge, attitude and practice of reading habit was used. Statistical analysis was done using percent, mean, standard deviation, chi-square, Student’s t-tests, and Pearson’s correlation. Results: The mean age of the studied students was 22.9 ± 0.9 years. The mean percent score for knowledge was 87.5 ± 14.4, for attitude was 70.2 ± 19.9, and for practice 60.0 ± 17.8. The total reading habit score was 72.6 ± 11.1, with a significant positive
* Corresponding author. Medical Students, College of Medicine, Taibah University, Almadinah Almunawwarah, Kingdom of Saudi Arabia. E-mail: [email protected] Peer review under responsibility of Taibah University.
Production and hosting by Elsevier 1658-3612 Ó 2013 Taibah University. Production and hosting by Elsevier Ltd. All rights reserved. http://dx.doi.org/10.1016/j.jtumed.2013.09.004
Z.A.E. Al Husaini
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correlation between knowledge and practice (r = 0.251, p = 0.010). College related barriers and overcrowded students’ timetable were the main perceived barriers for reading (84.8% and 79.0% respectively). Pocket books were used by 92.4% of students as medical reference, and were the most useful source as stated by 33.3% of them. The mean time spent on online sources of reading is less than that spent on other sources as pocket books and lecture handouts. Conclusion: Medical students spent less time on reading and depended mainly on pocket books as they gave the desired knowledge in short time and concise form. The stated reading barriers included college barrier, insufficient time and source barrier. There was contradiction between students’ knowledge of the importance of reading and its actual practice. Keywords: : Medical; Reading; Students Ó 2013 Taibah University. Production and hosting by Elsevier Ltd. All rights reserved.
Introduction Reading habit is an essential life skill. It not only increases our knowledge, but it also builds maturity and character, sharpens our thinking, and widens our awareness in social, economic, political, and environmental issues.1 Acquiring knowledge through reading is crucial for learning process of a medical student. In clinical practice, it is important as it relates to clinical competencies.2,3 Medical students encounter a huge volume of different subjects; with which they are not familiar and on the other hand remembering the various facts and new diagnostic and therapeutic methods seems difficult. Thus, learning all the facts needs enough time and regular curriculum planning.4 Frequently much time is devoted to developing the content of the curriculum and the type of assessments that will be completed with little attention given to how the students best learn or if they will be enhancing their lifelong learning habits.5 A student’s approach to learning, which includes study habits, has been shown to predict the student’s success.6 The most marked problems facing medical students are the time management, concentration, reading speed, notes taking, study habits and comprehension.7 Understanding the reading habit of medical students provides an insight into their information backgrounds and helps develop educational plans that meet their learning needs. Materials and Methods A cross sectional study was conducted during November 2010. The study population included fourth and fifth year female medical students (130). The response rate was 80.4% (105 females were involved). An anonymous self-administered questionnaire was distributed to all students after their mid term exam of psychiatry (4th year) and internal medicine (5th year). The questionnaire was prepared in English language. The purpose, of the study was explained to the respondents and a verbal informed consent was obtained (completing the questionnaire was considered as a written consent from the student to participate in the study). Ethics Review Committee reviewed and approved the proposal. The survey tool was pre-tested on a random sample of 20 participants to ensure practicability, validity and interpretation of responses; prior to distribution of it. The reliability of the questionnaire was assessed (for the whole questionnaire) using Cronbach’s alpha (0.86). The questionnaire included information on knowledge, attitude, and practice
of reading habit, barriers that students face during reading, time spent on reading every one of medical references. Using Likert scale the answers were designed as multiple choice questions; to answer questions about the degree of benefit gained from medical references; (with 5 answers) as not useful at all, partially not useful, neutral, somewhat useful and extremely useful. Scores for knowledge, attitude and practice were calculated using the following formula: “Total score/Maximum possible score 100”. Statistical analysis Data entered and analyzed using SPSS version 13.0. Means (± SD) were computed for continuous and proportions for categorical variables. Pearsons’ correlation was used to find out the relation between knowledge, attitude and practice and students’ characters and depression. Student’s t-test and chi square test were used, and 95% significance was chosen. Results The mean age of the studied students was 22.9 ± 0.9 years. About 96.2% of the students stated that reading is important, 96.2% knew that it has an impact on personality and 92.4% knew that it affects quality of medical student. There was an insignificant difference between the two studied years (Table 1). Nearly half of the students (51.4%) were not convinced with their reading habit and 67.6% of them tried to change it; with a significant difference between the two years (p = 0.015 and 0.044 respectively). Three fourths of students (75.2%) suspect that their score will improve on changing their reading habit especially when known that 89.5% have the ability to develop a better one (Table 2). The majority of students stated that they had barriers and difficulties in their college that prevent them from reading (including unavailability of suitable prepared place for reading, difficulty to reach the desired material within the library, unavailability of booking list for each subject and busy schedule), insufficient time and source barriers (including difficulty to obtain and language barrier); with a significant difference between 4th and 5th years (p = 0.04, 0.03, 0.002 respectively) (Figure 1). The most commonly used medical reference was pocket books (92.4%), followed by lecture hand outs (88.6%) and the least one was journal article (26.4%) (Table 3).
194
Knowledge, attitude and practice of reading habit
Table 1: Knowledge of students about reading habit. 4th Year
Reading No Yes Reading No Yes Reading No Yes Reading No Yes Reading No Yes Reading No Yes Reading No Yes *
5th Year
p-Value*
Total
N
%
N
%
N
%
3 50
5.7 94.3
1 51
1.9 98.1
4 101
3.8 96.2
0.317
5 48
9.4 90.6
2 50
3.8 96.2
7 98
6.7 93.3
0.251
3 50
5.7 94.3
1 51
1.9 98.1
4 101
3.8 96.2
0.317
4 49
7.5 92.5
7 45
13.5 86.5
11 94
10.5 89.5
0.322
5 48
9.4 90.6
3 49
5.8 94.2
8 97
7.6 92.4
0.479
12 41
22.6 77.4
18 34
34.6 65.4
60 75
28.6 71.4
0.174
13 40
24.5 75.5
15 37
28.8 71.2
28 77
26.7 73.3
0.617
is an important issue
is important for medical students
has an impact on personality
has an impact on student score
affects quality of medical students
is an enjoyable habit
from many sources are beneficial
p-Value is significant at level <0.05.
Table 2: Attitude of students toward reading habit. 4th Year
Are you convinced with your reading habit? No Yes Are you attempting to change it? No Yes If you attempting to change it, you suspect to get higher score No Yes Do you have the ability to develop better reading habit? No Yes *
5th Year
p-Value*
Total
N
%
N
%
N
%
21 32
39.6 60.4
33 19
63.5 36.5
54 51
51.4 48.6
0.015*
22 31
41.5 58.5
12 40
23.1 76.9
34 71
32.4 67.6
0.044*
12 41
22.6 77.4
14 38
26.9 73.1
26 79
24.8 75.2
0.611
6 47
11.3 88.7
5 47
9.6 90.4
11 94
10.5 89.5
0.775
p-Value is significant at level <0.05.
Figure 1: Perceived barriers for reading.
195
Z.A.E. Al Husaini Table 3: Practice of reading habit by students. 4th Year
Medical text book No Yes Essential version of a basic medical text book No Yes Online version of text book No Yes Online journal article No Yes Medical websites No Yes Pocket books No Yes Journal articles (Print version) No Yes Lecture hand outs No Yes Test preparation textbooks No Yes *
5th Year
p-Value*
Total
N
%
N
%
N
%
23 30
43.4 56.6
32 20
61.5 38.5
55 50
52.4 47.6
0.043*
18 35
34.0 66.0
17 35
32.7 67.3
35 70
33.3 66.7
0.890
28 25
52.8 47.2
36 16
69.2 30.8
64 41
61.0 39.0
0.085
38 15
71.7 28.3
38 14
73.1 26.9
76 29
72.4 27.6
0.874
10 43
18.9 81.1
11 41
21.2 78.8
21 84
20.0 80.0
0.770
5 48
9.4 90.6
3 49
5.8 94.2
8 97
7.6 92.4
0.479
41 12
77.4 22.6
36 16
69.2 30.8
77 28
73.3 26.4
0.346
7 46
13.2 86.8
5 47
9.6 90.4
12 93
11.4 88.6
0.563
10 43
18.9 81.1
20 32
38.5 61.5
30 75
28.6 71.4
0.026
p-Value is significant at level <0.05.
Regarding the time spent on reading habit, the maximum was for essential version of a basic medical text book (median = 5 h per week), followed by medical text book and lecture handouts (median = 5 h per week for each) and the least for online sources (median = 2 h per week for each) and journal article (median = 1 h per week) with a statistically significant difference (p = 0.035) (Table 4). The maximum degree of benefit was gained from pocket books where the mean score was 80.4 ± 25.11, followed by lecture hand outs; where the mean score was 77.3 ± 22.54 and the minimum was obtained from journal articles; the mean score was 53.9 ± 25.44 (Table 5). The most useful source as stated by students was again pocket books (33.3%), followed by essential version of a basic medical text book (21.9%) and the least was for journal article (1.0%) (Figure 2). The mean percent score for knowledge was 87.5 ± 14.38, for attitude was 70.2 ± 19.94 and for practice was 60.0 ± 17.81 with an insignificant difference between the two years. The total score for reading habit was 72.6 ± 11.06; again with an insignificant difference between the two years (Table 6). There was a significant correlation between knowledge score and reading practice score (r = 0.251, p = 0.010). Discussion Reading habit is an essential life skill. It not only increases knowledge, but it also builds maturity and identity, sharpens our thinking, and increases awareness in all daily life issues 1.
Acquiring knowledge through reading is crucial for learning process of a medical student. In clinical practice, it is important as it relates to clinical competencies.1 Medical students spent on average 5.7 h per week (median 3 h) on reading lecture hand outs and 4.9 h per week on reading pocket books (median 4 h), which was nearly similar to the results of similar study performed at King Saud Medical college 2009.8 A study of reading habits of medical clerks at John Hopkins University School of Medicine in 2002–2003 revealed that medical clerks reported for an average of 10.8 h per week.9 Medical students were reported in another study to read for an average of 10.8 h per week and relied solely on medical textbooks.10 One study reported that internists read for an average of 4.4 h per week.11 The most useful source rated by students in the current study was pocket books followed by lecture hand outs and focused on them more than online updated sources. While online sources are easily accessible and provides up to date information, it may not be the most efficient source for students to obtain critical information. However, students need to be encouraged and motivated to use these online sources. The same result was obtained by the study performed at King Saud University.8 Meanwhile, online sources were the most useful source rated by students of John Hopkins University School of Medicine.9 Another study reported that the medical journals were the most useful source.11 All students reported problems with reading. Time was a barrier stated by majority of the students that hinders the reading process. Medical students face a huge volume of different
196
Knowledge, attitude and practice of reading habit
Table 4: Time spent on reading different medical references per week. Medical text book Mean ± SD Median Essential version of a basic medical text book Mean ± SD Median Online version of text book Mean ± SD Median Online journal article Mean ± SD Median Medical websites Mean ± SD Median Pocket books Mean ± SD Median Journal articles (Print version) Mean ± SD Median Lecture hand outs Mean ± SD Median Test preparation textbooks Mean ± SD Median *
4th Year
5th Year
Total
p-Value*
5.2 ± 6.28 3.00
8.7 ± 9.62 4.5
6.9 ± 8.27 4.00
0.026*
5.9 ± 5.32 5.00
6.1 ± 6.82 3.50
6.0 ± 6.08 5.00
0.848
2.3 ± 2.08 2.00
2.5 ± 2.34 2.00
2.4 ± 2.22 2.00
0.684
1.7 ± 1.69 1.00
2.2 ± 2.35 2.00
1.9 ± 2.05 2.00
0.185
2.7 ± 3.74 2.00
3.0 ± 2.45 2.50
2.8 ± 3.16 2.00
0.583
4.2 ± 3.54 3.00
5.8 ± 7.1 3.00
4.9 ± 5.64 3.00
0.137
0.97 ± 1.56 0.10
1.9 ± 2.66 1.00
1.4 ± 2.21 1.00
0.035*
6.2 ± 5.83 4.00
5.1 ± 5.85 3.50
5.7 ± 5.84 4.00
0.331
2.6 ± 2.45 2.00
3.1 ± 2.80 2.00
2.8 ± 2.59 2.00
0.413
p-Value is significant at level <0.05.
Table 5: Mean percent score of benefit obtained from various sources. Medical text book Mean ± SD Essential version of a basic medical text book Mean ± SD Online version of text book Mean ± SD Online journal article Mean ± SD Medical websites Mean ± SD Pocket books Mean ± SD Journal articles (Print version) Mean ± SD Lecture hand outs Mean ± SD Test preparation textbooks Mean ± SD From all sources Mean ± SD *
4th Year
5th Year
Total
p-Value*
67.9 ± 20.88
65.0 ± 26.83
66.5 ± 23.94
0.534
66.4 ± 22.79
73.8 ± 24.59
70.1 ± 23.88
0.111
63.4 ± 25.94
55.4 ± 24.61
59.4 ± 25.49
0.108
57.4 ± 24.51
60.8 ± 25.04
59.0 ± 24.71
0.482
75.1 ± 22.50
73.1 ± 25.01
74.1 ± 23.68
0.665
83.0 ± 26.43
77.7 ± 23.65
80.4 ± 25.11
0.279
50.6 ± 22.74
57.3 ± 27.73
53.9 ± 25.44
0.176
75.1 ± 23.17
57.3 ± 27.73
77.3 ± 22.54
0.306
80.0 ± 23.86
68.1 ± 26.35
74.1 ± 25.71
0.017*
68.8 ± 13.89
67.9 ± 14.93
68.3 ± 14.35
0.750
p-Value is significant at level <0.05.
subjects with which they are not familiar and on the other hand remembering the various facts and new diagnostic and therapeutic methods seems difficult. Thus, learning all the facts needs enough time and regular curriculum planning.2,4,9,12 Also, difficulties found at the college were another problem facing students where places and texts were insufficient to meet
their needs. Upgrading the medical college is an ongoing process trying to facilitate every difficulty stated by its students. Many students stated that there were difficulties in obtaining the source of reading; even though the source was unclear. This must be enhanced by teaching the students to be self learners and to get use of the available resources.13–15
197
Z.A.E. Al Husaini 3.8% 3.8%
Test preparation textbooks
7.7%
Lecture hand outs Journal articles
17.0%
1.9% 0.0%
Pocket books Medical websites Online journal article Online version of text book
30.2% 1.9% 5.7% 3.8% 3.8%
36.5%
5th year 4th year
0.0% 1.9%
basic medical text book Medical text book
18.8% 19.3% 18.8%
25.0%
Figure 2: Most useful source as medical reference.
Table 6: Mean percent score knowledge, attitude and practice of reading habit. Mean knowledge score ± SD Mean attitude score ± SD Mean practice score ± SD Total mean score for reading habit ± SD *
4th Year
5th Year
Total
p-Value*
87.9 ± 15.95 71.2 ± 19.85 62.3 ± 18.53 73.8 ± 11.97
87.1 ± 12.73 69.2 ± 20.18 57.7 ± 16.91 71.3 ± 10.02
87.5 ± 14.38 70.2 ± 19.94 60.0 ± 17.81 72.6 ± 11.06
0.782 0.611 0.190 0.259
p-Value is significant at level <0.05.
Conclusion and recommendation
References
Medical students spent less time on reading and depended mainly on pocket books as they gave the desired knowledge in short time and concise form. The stated reading barriers included college barrier, insufficient time and source barrier. There was contradiction between students’ knowledge of the importance of reading and its actual practice. There is a great need for an intervention plan to improve attitude and practice of reading habit. Motivation (by contests for example) should be planned to induce them to change their habit. Online sources are important recent source as medical references. Students must utilize it as much as possible and they must be informed about their importance. Lecturers should give assignment that will compel students to make use of the Internet for academic reading. They should encourage students to give enough time for self study on the Internet. College should have an electronic library open to all students with all necessary accessories.
1. Pandian A. A study on readership behaviour among multi-ethnic, multi-lingual Malaysian students. A paper presented at the seventh International Literacy and Education Research Network (LERN) Conference on Learning, RMIT University, Melbourne, 5–9 July 2000. 2. Van Der Hem-Stokroos HH, Scherpbier AJ, et al. How effective is a clerkship as a learning environment? Med Teach 2001; 23: 599–604. 3. Khan KS. A hierarchy of effective teaching and learning to acquire competence in evidence-based medic. BMC Med Educ 2006; 15(6): 59. 4. Abbasali N, Seyed NM, Arezo F, Akbar M, Jamshid M. Evaluation of study skills and habits in medical students. South East Asian J Med Educ 2008; 2(1): 34. 5. Newble DI, Entwistle NJ. Learning styles and approaches: implications for medical education. Med Educ 1986; 20: 162–175. 6. Ramsden P, Entwistle NJ. Effects of academic departments on students’ approaches to studying. Br J Educ Psychol 1981; 51: 368–383. 7. Stark Mary C. (2008) Retention, bonding, and academic achievements: effectiveness of the college’s seminar in promoting college success. In: Ninth Annual National Conference on Retention, New York. 8. Mona MS, Khalid FN. The reading habits of medical students at medical college King Saud University. J Taibah Univ Med Sci 2009; 4(2): 115–122. 9. Leff B, Harper M. The reading habit of medicine clerks at one medical school: frequency, usefulness and difficulties. Acad Med 2006; 81: 489–494. 10. Schein M, Harry M, Lois S, William A. What American surgeons read: a survey of a thousand Fellows of the American College of Surgeons. Curr Surg 2000; 57(3): 252–258. 11. Saint S, Mony R, Lois H, Jone O, Perter N. Journal of reading habits on internists. J Gen Intern Med 2000; 15(12): 881–884.
Study limitation The main limitation of this study is that it was done at the end of mid year examination; when students are stressed and confused. As it was performed for one single medical college at a time its generalizability will be limited. Another point was that the data were self-reported and may be subjected to bias. Acknowledgments Thanks to all who helped us in the distribution of the questionnaire and fourth and fifth year female medical students for their co-operation.
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12. Bloomfield L, Harris P, Hughes C. What do students want? The types of learning activities preferred by final year medical students. Med Educ 2003; 37: 110–118. 13. Gallik JD. Do they read for pleasure? Recreational reading habits of college students. J Adolesc Adult Literacy 1999; 42(6): 480. 14. Kaur S, Che Lah S. The Sociocultural Development of Mature Learners at the University. Paper presented at the Malaysia International Conference on Languages, Literatures and Cultures
(MICOLLAC). The Mines Resort Hotel, Kuala Lumpur. 10–12 May 1999. 15. Kaur S, Mahadi TS. Challenges Faced By Malay Employees in Using English at the Workplace. Paper presented at the 3rd International Conference: “On the Role of Language in a Borderless World: Harkening to the Voices of Asia”. Nikko Hotel, Kuala Lumpur. 10–12 May 1998.