HPEJ 2022 VOL 5, ISSUE. 1
Open Access
Original Article
“Exploring The Preferred Learning Styles Among First And Final Year Mbbs
Students Using Vark Inventory At Fauji Foundation Hospital Rawalpindi”
Dr. Shazia Inam1, Amna Haq2
1 Department of Medical Education, Foundation University Medical College, Islamabad.
2 Final Year MBBS Student Foundation University Medical College, Islamabad.
ABSTRACT
Introduction: 'Learning style' is defined as an individual's preference in obtaining and understanding information. Students use
different learning styles in acquisition of knowledge, skills and attitude.
Objective: To determine the learning styles of preclinical and clinical students belonging to 1st and final year MBBS using the VARK
questionnaire; to compare learning styles of 1st and final year medical students.
Methods: A cross-sectional study was conducted to collect data about the learning style preferences of 1st and final year MBBS
students of Foundation University Medical College. The VARK questionnaire was used to categorize the learning styles as Visual (V),
Auditory (A), Read and Write (R) and Kinesthetic (K). This study was conducted from 15 July to 15 August 2021. A convenience
sampling technique was used for data collection. A total of 249 students responded to the questionnaire.
Results: Among 249 students, 141 were 1st-year students and 108 were final-year students. The most common learning style reported
was Kinesthetic (34%), then Auditory (29%), then Visual (20%), and finally, Read/Write (17%). The majority of students (95.6%)
preferred quad modal sensory modality for learning followed by trimodal (4%), unimodal (0.4%), and bimodal (0%) preferences.
There was a significant difference in the mean scores of visual and auditory learning styles (overall mean of visual scores was 5.42 ±
2.9 and mean of auditory scores was 6.58 ± 2.9 ) between the students of 1st and final year.
Conclusion: Majority of the students enlisted in this study had a quad modal learning preference. The most common reported
learning style of all the students was Kinesthetic (K), followed by Auditory (A), then Visual (V), and then, Read/Write (R).
KEYWORDS:
Learning styles, VARK, Visual, Aural, Read/Write, Kinesthetic, Modal, Medical Students.
doi: https://doi.org/10.53708/hpej.v5i1.1257
This is an Open Access article and is licensed under a creative commons attribution (4.0 international License).
INTRODUCTION
'Learning style' of an individual is his/her preferred method
of attaining refining, clarifying, categorizing and investigating
information (Karim et al., 2019). The term “learning style” was
first used by Herbert Thelen in 1954 (Reza et al., 2013). Genetics,
past life experiences and social events influence the learning
styles of students(Khan, Khan, Bashir, & Hanif, 2015).
A few of the models available for the assessment of learning
styles are VARK by Fleming, Honey and Mumford, and
Kolb's learning model. These learning styles models are based
on different psychological beliefs and various theories and
principles of learning (Coffield, Moseley, Hall, & Ecclestone,
2004). The reason for using VARK model of Fleming and Mills
in this study is that it is quite reliable and relevant (Shah, Joshi,
Mehta, & Gokhle, 2011). VARK stands for the Visual (V),
Auditory (A), Read/Write (R), and the Kinesthetic (K) sensory
modalities. It informs the learners about their preferred learning
styles while they are acquiring new knowledge (Mukherjee, Das,
De, & Mukhopadhyay, 2013).
Correspondence:
Dr. Shazia Inam
Email address: shaziainam26@gmail.com, Cell: +92 321 7319445
Received: March 21, 2021 Accepted: November 3, 2021
_______________________________________________________________
Funding Source: Nil
Visual (V) learners depend on visual stimuli such as graphs, flow
charts, and images to learn better. Aural (A) learners prefer to
hear information being given through tutorials or lectures. They
may also record lectures and listen to them at a later time. The
“R” (read/write) learners learn best by reading the written text
and taking notes. Lastly, kinesthetic (K) learners try to find a
connection to reality and prefer to apply their knowledge for the
sake of learning.
If the students prefer a single sensory modality for learning
they are called unimodal learners and if they prefer more than
one sensory modality, they are called multimodal learners.
Regarding multimodality, if students prefer two, three or four
sensory modalities they are called bi-modal, tri-modal and
quad-modal learners respectively (Marcy, 2001).
Students learn better if the instruction methodologies are
modified to fit their learning styles. That is why medical teachers go
an extra mile to be well-informed of the preferred learning styles
of their students and thus adapt appropriate teaching techniques
that the students would be compliant with(Chaudhary et al.,
2015). Kinesthetic learners prefer to learn by practical sessions
e.g ward-based and case-based teaching methodologies. Lectures
are the best mode of teaching for visual learners. A lecture can be
made more interesting by incorporating graphics, videos, audios
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HPEJ 2022 VOL 5, ISSUE. 1
and, presentations. The preferred teaching sessions for auditory
learners can be interactive small group discussions along with
audio-visual material. Handouts and printed reading materials
can be to be provided to the read-write learners during teaching
sessions (Romanelli).
Many studies have already explored the influence of gender,
age, academic achievement, cognitive processing, cultural
background , and critical reasoning on the learning preferences
of students (Nuzhat, Salem, Quadri, & Al-Hamdan, 2011).
However, there are very few studies that have explored the
learning preferences of medical students in relation to their
academic year of study (Eid et al., 2021). According to a study
by Aldosari et al, second-year students’ preferred uni-modal
learning and this preference grew as students got promoted
from third to the fourth year in dental school(Aldosari, Aljabaa,
Al-Sehaibany, & Albarakati, 2018). According to Samarakoon
et al., first-year medical students prefer auditory and read/write
learning styles while final year students preferred multimodal
learning styles (Samarakoon, Fernando, Rodrigo, & Rajapakse,
2013). There are no sufficient studies to support this research
(Eid et al., 2021) and my study would be helpful to address this
gap and explore the difference in learning style preferences of
preclinical students belonging to 1st year MBBS and clinical
students belonging to final year MBBS.
My study has assessed the preferred sensory modalities and
the learning styles preferences in pre-clinical and clinical
students by utilizing the VARK questionnaire. This would help
these students be aware of their preferred learning styles and
understand how they should use the information for being more
effective learners. It would assist the teachers in evaluating and
working on their teaching methodologies (Mohamed, Fiala, &
Ghaly, 2015).
METHODS
This is a descriptive cross-sectional study. The study was
conducted from July 2021 to August 2021. It was carried out on
1st and final-year students of the MBBS course of Foundation
University Medical College. High quality medical education is
a continuous struggle and an ever-evolving process, rather than
a destination. Foundation University Medical College provides
quality medical education to national and international students.
Modern teaching-learning methodologies are being practiced
here and stepwise shift from passive to active learning is also
being stressed upon in preclinical and clinical classes. The study
protocol and instruments were approved by the ethical review
committee of the Foundation University Medical College.
VARK (visual, auditory, read/write, and kinesthetic) version
7.8 was incorporated into a self-administered questionnaire,
then used. The questionnaire consisted of two sections. The first
section concerned age, gender, and educational level of students
and the second section contained the VARK questionnaire
consisting of 16 questions with 4 options each.
A convenience sampling technique was adopted for data
collection. The class teachers of 1st and final year were asked
for a time slot for the collection of data from the students. The
students were allowed to opt out of the study if they so desired.
10
Students had the choice to select more than one option to
questions regarding their preferred learning styles.
The aim of the study was explained, and then questionnaires
were distributed amongst the students to give their answers. Each
student had 15 minutes to fill the questionnaire. The anonymity
of the students was kept by asking them not to mention their
names. Participants were asked to write their scores for each
VARK Category. Completed questionnaires were collected.
Duplicated and incomplete questionnaires were excluded.
The students were categorized as auditory, kinesthetic, visual,
or read/write learners depending on the predominant option
they had chosen. If a respondent had opted for a single sensory
preference he was considered as unimodal and if he had opted
for two or more than two sensory preferences he was considered
as bi-, tri-, or quad-modal.
SPSS version 23 was used for data analysis. Descriptive and
inferential statistics were employed. Categorical variables
were analyzed in the form of frequencies. Sensory modality
preferences were represented as the percentages of students of
each respective category. Individual VARK components were
scored and expressed as Mean +/- SD. A Chi-square test was
applied to detect an association between gender and year of
study. VARK scores were compared based on year of study using
an independent samples t-test. Statistical significance was set at
P =0.05. P-value ≤ 0.05 was considered significant.
RESULTS
Out of the total of 249 medical students who were included in
this study, 141 (56.6%) were from the first year and 108 (43.4%)
were from the final year.
Table I. Demographic variables of First and Final year classes
Demographic
Variables
First Year
Final Year
(n = 141)
(n= 108)
p value
Age (Years)
19.20 ± 0.88
23.24 ± 0.841
0.001
Gender
Male
Female
1.00
45 (31.9%)
96 (68.1%)
35 (32.4%)
73 (67.6%)
According to my research, multimodal learning preferences
(99.6%) were the most common among undergraduate medical
students. The majority of students (95.6%) preferred quad
modal sensory modality for learning followed by trimodal (4%),
unimodal (0.4%), and bimodal (0%) preferences (Table II).
Table II: VARK sensory modality distribution among 1st and final year
students
Year of Study
1st and Final Year
students
Quadmodal
95.6 %
Trimodal
Bimodal
4%
0%
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Unimodal
0.4%
HPEJ 2022 VOL 5, ISSUE. 1
Table III: Percentages of students using Trimodal blends of learning styles
Trimodal Blends
Percentage of Students
VAR
0%
VAK
2.4%
VRK
0%
ARK
1.6%
The unimodal preference used by only one student was aural
(0.4%) while the most used trimodal blend was VAK (2.4%)
followed by ARK (1.6%) (Table III) and the most used quad
modal blend was KVAR (15.03%) followed by KAVR (12.15%),
KARV (9.24%), AKRV (8.43%) and so on (Table IV).
Table IV: Percentages of students using quadmodal blends of learning
styles
Quadmodal Blends
Percentage of Students
RKVA
1.21%
RAVK
1.61%
RKAV
2.01%
VAKR
2.81%
VARK
3.61%
RAKV
4.04%
AVRK
4.04%
AVKR
4.82%
KVRA
4.82%
KRAV
5.62%
VKAR
6.02%
AKRV
8.43%
KARV
9.24%
AKVR
10%
KAVR
12.15%
Mean VARK scores for different sensory modalities are
represented in Table V. They were highest for Kinesthetic
learning (6.99 ± 2.8) and lowest for Read/Write learning (4.46
± 2.7).
Table V: Mean VARK scores for different sensory modalities
Minimum
Maximum
Mean ± SD
Visual scores
0
15
5.42 ± 2.9
Auditory scores
0
16
6.58 ± 2.9
Read/Write scores
0
14
4.46 ± 2.7
Kinesthetic scores
0
14
6.99 ± 2.8
Table VI: Comparison of the Mean VARK scores among 1st and final
year students.
Profile
First Year
(n=141)
Final Year
(n=108)
t value
p value
Mean ± SD
Visual scores
5.44 ± 2.88
5.38 ± 3.00
0.155
0.877
Auditory scores
7.00 ± 2.92
6.03 ± 2.70
2.661
0.008
Read/Write scores
4.65 ± 2.97
4.21 ± 2.45
1.255
0.211
Kinesthetic scores
7.58 ± 2.91
6.22 ± 2.43
3.917
0.001
DISCUSSION
It is very important for the medical educators to understand
that students have different learning styles. This knowledge will
help them learn about the learning preferences of their students,
review the effectiveness of their teaching techniques and develop
appropriate curricular approaches (Teja, Patil, Shete, Patel, &
Bansal, 2016).The main aim of this study was to identify learning
styles preferences in 1st and final year students of FUMC and
then compare if there are any differences between students of
these two years in this respect.
This study showed that 99.6 % of medical students at FUMC
preferred a multimodal VARK learning. Multimodal learning
preference is a characteristic of an adult learner (Teja et al.,
2016). In my study, the majority of students (95.6%) preferred
quad modal sensory modality for learning followed by trimodal
(4%), unimodal (0.4%), and bimodal (0%) preferences.Various
studies are available that report multimodality to be the most
preferred learning style. In a study conduted by Peyman,
quad modal learning was found to be most prevalent among
first-year or preclinical students (Panambur, Nambiar, &
Heming, 2014; Peyman et al., 2014) while Baykan and Nacar
(Baykan & Naçar, 2007) and Prithishkumar and Michael
(Prithishkumar & Michael, 2014) found that bimodality
was the most preferred VARK sensory modality. The results
of these studies showed that medical students expect their
teachers to use different teaching methodologies to bring about
more effective learning. (Paiboonsithiwong, Kunanitthaworn,
Songtrijuck, Wongpakaran, & Wongpakaran, 2016). A study
by Paiboonsithiwong showed that Quad-modality was the
most preferred VARK modality (43.6%) while uni-modality,
bimodality, and tri-modality was preferred by 35%, 12.9%, and
18.6% of the participants, respectively.
Kinesthetic and aural preferences were the most prevalent
learning preferences among the students participating in the
study. This may be because students at FUMC have early handson training in a safe learning environment in a clinical skills lab
that starts in first year and runs through all five years, in addition
to an early patient exposure in clinical wards. Another reason
for the dominance of kinesthetic and aural preferences may be
that present medical students are the millennial generation who
prefer to learn through new technologies and online teaching
(Kadam, Bagle, & Baviskar, 2018). Results in our study match
with a study in King Saud Bin Abdul Aziz University for Health
Sciences, King Fahad Medical College, Saudi Arabia; the Mean
VARK scores for aural (6.6) and kinesthetic learners (6.4) were
higher than those for visual (5.3) and Read /Write learners (4.7)
(Nuzhat et al., 2011). Prevalence of kinesthetic preference in
undergraduate medical students was found in a study conducted
by Baykan (Bayken & Nacar, 2007). Kinesthetic preferences were
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HPEJ 2022 VOL 5, ISSUE. 1
also reported in two other studies conducted on physiotherapy
(Brown, Manogue, & Martin, 1999) and nursing students
(Meehan-Andrews, 2009). On the contrary, a study by Murphy
et al (2004) showed that only 0.4 percent of dental students
showed kinesthetic preference while 9.2 percent of students
preferred aural modality, 20.1%of students showed read/write
preference and 14.5 % of them showed visual preferences.
The current study has certain limitations. The sampling
technique used was convenience sampling of students of different
gender distribution from a single institution. Considering this,
the sample may not a representative of the medical student
population in Pakistan. Future studies should be based on
larger samples from multiple educational institutions across
Pakistan. Adding to this endeavor, longitudinal studies are
recommended to follow and compare the learning preferences
among medical students through the entirety of medical college.
Further studies are recommended to investigate the correlation
between different learning styles and academic achievement of
the students in different formats of exams (e.g. Do Kinesthetic
learners perform better in practical exams?)
CONCLUSION
ACKNOWLEDGMENT
I acknowledge the motivation provided to me by the Department
of Medical Education and the inspiration provided by HOD
Medical Education Department, FUMC Prof Irfan Shukr to
conduct this research. I also acknowledge the students who
participated in the study. Great appreciation is extended to
Amna Haq and Abeeha Zia (4th-year MBBS, Foundation
University Medical College), Dr. Tayyiba Haq (House Officer
Fauji Foundation Hospital), and Dr. Momina Haq (House
Officer, Benazir Bhutto Hospital, Rawalpindi). Great thanks
to Mrs. Anum (Statistician, NUMS, Rawalpindi) for helping
me with the statistical analysis and helpful comments. Special
thanks and appreciation to the College Dean and Administration
of the Foundation University Medical College for every help and
allowing the use of facilities.
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This study addresses the gaps of knowledge in the preferred
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The author report no declaration of interest.
RECOMMENDATIONS
Medical educators need to improve their teaching styles to
help create a more inclusive, positive, and effective learning
environments for students. Active learning strategies and new
technologies should be introduced in medical teaching, from the
initial pre-clinical years to the clinical ones. This will make the
educational experience more productive and help students in
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AUTHOR CONTRIBUTORS
1 Dr Shazia Inam. Confirms the responsibility of methodology,
review, result and discussion.
2. Amna Haq. Data Collection & Final review.
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