In the last decade, there has been a rapid expansion of educational resources available for medical students. As well as traditional resources such as lectures, textbooks and tutorials, students are increasingly accessing mobile technology and online tools for learning [1, 2], collectively referred to as e-learning tools. The concept of blended learning, incorporating both e-learning and traditional learning tools, is well established . Currently there is little evidence available to indicate which educational resources medical students prefer to use while completing their degrees.
Reports of the proportion of students who use smartphones for learning medicine are variable. Between 64 and 98% of students have been reported to own a smartphone [1, 4,5,6,7] and the numbers are increasing. In a 2013 cross-sectional study in Birmingham, 87% of students reported using smartphones but only 70% found them useful in aiding their medical education . Another study in Leipzig found that only 32.4% of students were using medical apps on their smartphone . A systematic review of survey articles discussing smartphone apps found only 11 were aimed at medical students, possibly explaining the low uptake of apps for study purposes . Only four years later, a simple search for “medical student app” in the iPhone App store yields a staggering 726 results , including diagnostic tools, anatomy handbooks, surgical simulators, lab values, drug references and multiple choice questions covering a range of topics..
Students are also utilizing a multitude of other online resources. A recent survey in Illinois of students in their final two years of medical school found students using online tools including Google docs, Youtube, Twitter, Facebook and Wikipedia for study purposes . In a survey of Welsh medical students, 70% report using ‘Meducation’, an online learning tool consisting of videos, problem based learning cases, tutorials and quizzes .
Question banks have also emerged as a popular online learning tool. There are several commercially available question banks for medical students and doctors in training, including: ‘Passmedicine’, ‘PasTest’, ‘OnExamination’, ‘Examdoctor’ and ‘NEJM knowledge +’. Each has between 1500 and 6500 practice questions in the form of single best answer or extended matching questions, accompanied by practice exams, quizzes, images and feedback. Students are able to track their own progress over time and often compare their results with other students. They are used by students studying for the United States Medical Licensing Examination , and associated with improved rates of passing the Emergency Medicine certification examinations in the United States . In these contexts, students are using the question banks to revise and practice exam technique for specific examinations. It is also possible that students are using question banks more broadly than this, for example, to learn new information for the first time. Harris and colleagues, generated a question bank of student-written multiple choice questions and made them available online to medical students at Cardiff University . They found a significant uptake, with 600 students using the resource within a three month trial period. It is not currently known, however, what proportion of students use commercial online question banks and for what purpose: revision or learning new information.
Gender differences in the acceptance and use of e-learning have previously been explored. In comparison to females, males have been reported to be more likely to consider e-learning easy to use, useful and efficient . However, a study of first year medical students in Austria found no significant gender difference in attitudes towards e-learning . A systematic review of gender and learning in surgery found no significant difference in the uptake of e-learning resources . It is important to clarify if there is a gender difference in the uptake of new medical education resources to avoid inadvertent gender bias in medical education.
Reported in-person lecture attendance by medical students is also inconsistent. Some argue that lecture attendance is in decline [19, 20], with many students opting to watch recorded lectures online in their own time. One survey of medical students studying molecular biology found 97.9% wanted to be able to access recorded lectures . At Harvard Medical School, a survey of first and second year students reported that 57.2% of students attend lectures, whilst 29.9% watch them online . Another survey of 190 medical students from New York University reported that 80% of students attend lectures and 20% use mainly online or computer based learning . Lecture attendance may vary between institutions, depending on their importance and frequency within the curriculum, quality of lecturers and the content, whether they are available online or if attendance is compulsory. If students are no longer routinely attending lectures, medical educators may need to shift their focus to newer technologies.
Further clarity in how today’s medical students learn is necessary for three key reasons. Firstly, without knowing which of the multitude of resources are being utilised, medical schools are at risk of falling out of touch with their students’ educational needs. Secondly, to ensure consistent delivery of quality education, the most popular resources need to be identified so that their quality and relevance to university curricula can be evaluated. Finally, so that universities can more effectively allocate resources to develop education tools that students are likely to use. This study sought to assess today’s medical students’ preference for educational resources; to investigate, if this preference shifts when learning new materials, or when revising; and if students’ preference for educational resources are related to their age, previous educational exposure or future career aspirations.