It was observed that most of the respondents in this study were Kinesthetic learners (30.1%) regardless of their gender, age, nationality and educational backgrounds. This finding was similar to those reported by Kharb et al. for Indian medical students [1] as well as Baykan and Nacar for Turkish medical students [22].
Lujan and DiCarlo reported that the most preferred learning style of first year medical students from Indiana, USA was of Read/Write (R) modality [23]. In this study, the same was observed amongst the medical students who already possessed a primary degree prior to their entry to the medical school (postgraduate students). However, Nuzhat et al. reported that the most preferred learning style among medical students in Saudi Arabia was the auditory mode [24]. The dental students in Philadelphia were found to prefer the Visual (V) learning more than the Kinesthethic (K) learning [25]. These variance in learning styles according to countries could be due to cultural differences as well as previous exposures to different teaching styles during the years at pre-medical schools.
A majority of the participants in this study had unimodal learning style (81.9%). A study by Fleming on 31,243 students reported that the ratio of unimodal against multimodal learning style preference was 42:58 [20,25]. Other studies reported the preferences for multimodal learning styles with percentages ranging between 53% and 85%. The proportions of students preferring multimodal learning style from various studies were as follows: proportion reported by Dinakar et al. was 58% [26], Lujan et al. was 63.8% [23], Baykan and Nacar was 63.9% [22], Nuzhat et al. was 72.6% [24], Bahadori et al. was 59% [27] and Ding et al. was 85.7% [28]. However, in this study, only a small proportion of Malaysian students adopted the multimodality learning style. This could be due to their exposure to different kinds of teaching learning instructions at pre-medical schools. In Malaysia, the educational system is mostly didactic in nature, with very minimal hands-on, discussion and practical sessions. However, a majority of the respondents with multimodal learning styles belonged to the age group of (20-29) years as they were graduates before joining the medical programme. This finding was similar to a study conducted by McKean J et al. during 2009 in Hong Kong [29].
There was no significant difference in learning styles and performances at the summative examinations. This could be due to the fact that learning styles mainly focussed on strategies adopted by students in acquiring knowledge. There was no evidence in this study that any particular learning style in itself was superior as compared to others in the attainment of academic success. However, there were some reports that the knowledge and understanding of one’s own learning style could greatly enhance one’s success in the summative examinations [30,31]. The students in this study were not provided with any specific teaching and learning method which was tailored according to their preferred learning style. A blend of activities covering all the learning modalities were made available to them. The response of the participants would have been different if they were exposed to matched learning strategies according to their respective learning styles.
In this study, a majority of the students among the mid/high achievers category (79.4%) embraced the deep/strategic learning approach. Interestingly, a majority of the low achievers were also found to be deep/strategic learners. Hence, this difference was not found to be statistically significant. However, some of the previous studies reported that students with deep/strategic learning approaches performed better during their final summative examinations as compared to their superficial learning counterparts [32-34]. We concur with a study by Newble et al. which found that undergraduate medical students with deep/strategic learning approach did not perform better during summative examinations [35].
The deep/strategic learning approach was believed to be able to help students to attain more successes in summative examinations as compared to the superficial learning approach [6]. Although there was no statistically significant relationship between the learning approaches (deep/strategic) and learning outcomes in terms of summative examinations in this study, many other studies had reported a positive beneficial association [9-11].
Both the VARK and ASSIST questionnaires analysed only one aspect of the learning preferences (styles and approaches). Hence, multiple aspects of learning preferences (styles and approaches) could not be assessed in this study. The students in this study were not exposed to their preferred learning styles and approaches during their learning activities prior to the summative examinations. This prevented the investigators from studying the true effects of their learning preferences on learning outcomes.
The teaching and learning strategies should be redesigned to promote deep/strategic learning among the pre-clinical undergraduate medical students. The teaching and learning instructions should be tailored according to the learning preferences (styles and approaches) of the students. More active hands-on learning strategies like simulations, role playing, problem based discussions and debates should to be incorporated in the teaching and learning activities. This would create better learning environment for the kinesthetic learners.