Abstract

Background & objective: It’s no secret that medical students have access to a plethora of medical literature, which can    make it  challenging to   determine the   right   sources and    how    to  cover them effectively using various study habits and strategies. Our objective was to determine the association of study habits (time and location), study duration, study strategies, and study sources with academic performance.

Methods

It  was a  cross-sectional  study conducted  in  six Medical  Colleges  in Peshawar,  Pakistan  between 13th April 2023 to 13th Jun 2023. Total 138 students were selected for the study. A well-structured questionnaire was used for data collection. Participants were from both genders and in both public and private sector medical colleges. First-year students and students from medical colleges outside of Peshawar were excluded from the study. SPSS (Version 20.0) was used for data analysis.

Results:  The study  revealed  that daily  study  hours (during  normal  days), residence  status,  library study,  morning  study timings, active recall, MCQS solving, and    watching online videos made a  significant association with    academic performance (P < 0.05). Pearson’s correlation showed a positive and statistically significant association between daily study hours  (during  normal days),  study  strategies, and  academic  performance (p  <  0.05). The  multiple  regression model explained 30.5% of the variance in academic performance. 

Conclusion:

This study established a noteworthy link between academic performance and various factors, including daily    study hours, strategies, and    specific study sources. Notably, morning study sessions, active recall, MCQs-based strategies, and online video resources showed significant associations with enhanced academic performance.

Worldwide,  millions of  students  strive to  get  into medical schools, but only the best-performing students can   do  so.   Medical   schools  present   a   challenging  environment,   as   students  face   an   enormous  level   of  information and  are  inundated by  the  number of  resources available for learning. Good study habits and proper resources  are  essential to  achieving  academic excellence.1  The  clear link  between  different study  habits,  and resources  with  academic performance  is  much more complex and needs to be fully elucidated.  Many studies have     identified different factors that    can lead to higher or lower academic achievement. An Irish study  found  that prioritizing  one’s  work and  studying  in an  organized  manner are  associated  with higher  academic outcomes. In   contrast, a superficial approachto studying  was  associated with  poor  outcomes.2 A  study  by West  and  Sadoski found  that  two skills:  time  management  and   self-testing,   bore   better  academic outcomes.3 Sayer M  et   al.   report some unique findingsin   their study, stating that     domestic, financial, and emotional  problems primarily  lead  to poor  academic  outcomes.4 A     Saudi    Arabian     study     completely     contradicts the    findings of   Al  Shawwa et   al.,   claimingthat    financial and    domestic problems had    no  impact on academic achievement; they also found that the source of studying had no impact on academic achievement.5We  have conducted  this  study because  of  a lack  of  published data  locally.  Also, every  individual  study’s results are different from the other’s study results.  Our target was  to  determine the  association  between the  study habits, methods, and sources with the academic performance of the MBBS students. This study will be helpful to many students in modifying their methods, sources, and habits.

It  was a  cross-sectional  study conducted  between  13th April  2023  to 13th  Jun  2023 at  six  public and  private    medical   colleges    in    Peshawar,   Pakistan.    Informed  consent was  taken  from all  the  participants before the study. STROBE guidelines were followed in the preparation of this manuscript.Ethical approval: It  was obtained from The Institutional Research and  Ethical  Review Board  (IREB)  of Khyber  Medical College (KMC), Peshawar (Ref no. 221/DME/KMC. dated: April 13, 2023).Studyparticipants and sampling technique: A sample size of  138  was calculated  utilizing  the online  sample  size calculator  Calculator.net  (Available at: https://www.calculator.net/sample-size-calculator.html).  The confidence interval (CI)   was    kept    at 95%,     the   margin of error at  5%  and    a  population proportion of   10%   basedon  a  previous study  conducted  in Kermanshah-Iran.6Participants that  were  included in  this  research were  studying  in both  public  and private  sector  medical colleges,    were  from both  genders,  and were  enrolled  in 2nd  to  5th year  MBBS  classes. Additionally,  students  enrolled in  disciplines  other than  MBBS  or from  a  medical college  outside  Peshawar were  excluded.  A convenience sampling technique was employed for the selection of participants. Questionnaire:  A  well-structured  questionnaire was  developed through the online platform Google Forms. Participants were asked about their basic demographic characteristics,   including   their  college   name,   age,  gender,  year  of  study,  and residence.  Performance  in  the  last professional  exam  was considered  as  their academic   performance.   The  questionnaire   includes   questions about  daily  study hours  (during  normal routine as well as exam routine), study location, study strategies,   and  study   sources.   Lynn  criteria   were   utilized for  face  validation with  a  criterion threshold  of   0.80  by   six   subject  experts.   After   developing  the  questionnaire,  a pilot  study  was conducted  for  content validity  in  which responses  from  10 students  were   recorded.  Necessary   changes   were  made   to   the questionnaire  after  it. To  minimize  bias, these  10  students were later on excluded from data analysis.Data   analysis:   The  collected   data   were  analyzed   through SPSS software (IBM Corp. Released 2011. IBM SPSS Statistics  for  Windows, Version  20.0.  Armonk, NY:  IBM  Corp.) All  the  qualitative variables  were  presented in  the  form of  frequency  and percentages  while  the quantitative  variables  were presented  as  mean ±  SD.  To draw  a  comparison between  variables  chi-square test,  Pearsons’s  correlation, and  multiple  regression analysis were used. P < 0>

Table-I: Demographic characteristics of students.

academic performance, F  (6,131) =9.596, (p   < 0.05).Moreover,  the  adjusted R  square  =0.300 depicts  that  the   model explains 30.5% of   the    variance in   academicperformance, (Table-IV)

Our  study revealed  that  daily study  hours  during normal   routine,   residence,  studying   at   the  library,   studying  in the  morning,  using active  recall,  MCQs-based study strategies, and watching online videos had a  significant association with academic performance.In   our    study majority of   students (53.6%), had    averagescores of  70-80%. A study conducted by   Saber et  al.  also showed that the majority of students (51%) had averageacademic  performance.7 This  showed  that the  majority  of the students of an institute have average grades. In  a  previous study  conducted  at Ayub  Medical  College Abbottabad, only 9.1% of   medical studentswere active learners with no    significant correlationwith  academic scores8,  compared  to our  study  where we    found a   significant relationship between activerecall  and  academic performance.  Studies  show that  individuals   who  study   more   hours  per   day   score  better;9  However,  there is  a  stage beyond  which  more study  hours  no longer  help.10  Poor time  management  is  the   main   reason  for   poor   performance,11   with  preclinical students and day scholars having better time management  skills compared  to  clinical students  and  hostilities respectively.12The  results of  Ahmed  et al.  are  consistent with  our  study results  in  the association  between  gender and  study  habits.13 The  presence  of an  equal  educational environment for both genders are a possible reason. We believe that every student, regardless of gender, should have  knowledge of  study  skills and  apply  them. Yet  another study conducted on university students of KP, Pakistan shows  that  the female  gender  was associated  with better academic achievements.14MCQS solving/problem solving based approach also leads  to better  academic  performance, a  similar  study was  conducted  among second-year  medical  students using  study  aids and  exam  performance compared  to  those who  don’t  use study  aids  which yielded  results  similar to our study.15 Another study in the US indicated that  the  number of  practice  test items  correlated  to higher scores in the national licensure exams.16Our   study  shows   students   who  used   the   library  were  more  likely to  succeed  academically, as  reported  by Sami  A  that factor  such  as the  library  environment, availability  of  resources, and  responsive  staff greatly  influence students’ study habits and academicoutcomes.17 Jan SU et al. state that individuals with high emotional quotient visit the library more often and have high grades.18Our study  also  pursued the  idea  that where  people  lived had a  significant impact on    the    academicperformance of the student, with day scholars achieving better  grades   on   average  compared   to   hostellers.  According   to   a  study   conducted   in  the   Northwest   School  of   Medicine,   the  most   common   motivation  amongst  the  average and  good-scoring  students was  the family pressure19, showing that the closer you are to your family the more motivated and concerned you will be about your studies. According to  various  studies, students  who  study in  the  morning tend  to  achieve better  academic  results. A  study  at Middle  Tennessee  State University  found  that male  students  who took  afternoon  classes earned  lower  grades than  those  who took  morning  classes.20  Contradictory  to  these certain  studies  reported that  early wake-up in the morning and morning classes are associated with  low  grades, one  of  the reasons  being  sleep deprivation.21Online videos are also a good source for learning and those who use them have better academic performance, one   of   the  studies   conducted   on  the   students   of Karachi University  shows  that students  prefer  to use  video sources specifically YouTube for   learning topicsthrough  animation and  simulation22,  indicating the  emergence of online video sources as an important tool for academic  achievers.  So, students  need  to consider  proper  study habits,  timings,  strategies, and  sources  to achieve better academic outcomes. This study adds significant contributions to  the    medical literaturein  terms of  providing  research-based  strategies and  methods   to  help   medical   students  improve   their   academic outcomes.Limitations: It was a cross-sectional study, so we cannot establish a causal relationship between various factors and  academic  performance. Only  MBBS  students of  Peshawar,  excluding other  programs,  were included  in  this study  which  may limit  the  generalizability  of the  results.  Our study  did  not consider  some  of the  important factors like socioeconomic status and mental health.  Longitudinal  studies, considering  all  factors will be needed to establish the causal relationship.

This   study  aimed   to   determine  the   association   between study habits, study timings, study strategies, and   study   sources  with   academic   performance  in   medical  colleges in  Peshawar, Pakistan. The  study found that daily study hours during a normal routine, day   scholars  (residence),   studying   at  the   library,   morning time  study,  using active  recall,  and MCQs-based study strategies, and watching online videos had a significant association with academic performance.Acknowledgment:The    authors   acknowledge    the    contribution  of Mr.  Muhammad  Ibrahim, Institute  of  Public Health  and  Social Sciences,  Khyber  Medical University, Peshawar, Pakistan, and Mr. Syed Hamid, Department  of Medical  Education,  Khyber Medical  College, Peshawar Pakistan, in the data analysis of this research.