Are surface and deep learning approaches associated with study patterns and choices among medical students? A cross-sectional study

ABSTRACT BACKGROUND: Different approaches to learning can exert considerable influence on the teaching-learning process in medical education. This study aimed to investigate the association of surface and deep learning with study patterns, preferred type of assessment, practices of cheating and quality of sleep among medical students. DESIGN AND SETTING: Cross-sectional study on medical students enrolled in all six years of a medical school in Juiz de Fora, Brazil. METHODS: Questionnaires were applied to evaluate learning approaches (R-SPQ-2F), study patterns, sources and choices, and quality of sleep. Students’ learning approaches (deep or surface) were assessed in relation to their study patterns, study resources, quality of sleep and whether they cheated in tests. RESULTS: Among the 710 students included, 43% frequently studied on the night before an exam, 65% had used psychostimulants to study and more than 46% had cheated in an exam. Regarding quality of sleep, most students (53.4%) reported that their quality of sleep was poor, such that 45.3% slept for fewer than five hours before an exam. Those who studied just prior to an exam, used class summaries, preferred multiple-choice questions and cheated during the test had a more surface-learning approach. On the other hand, those who read books, preferred practical exams and slept better had a deeper approach. CONCLUSION: The type of learning approach was associated with study patterns and choices among medical students. Educators need to be attentive to the type of learning their students use and think of measures that impact teaching and assessment methods.

**摘要**
**研究背景**：不同的学习方式会对医学教育中的教与学过程产生显著影响。本研究旨在探讨表层学习（surface learning）与深层学习（deep learning）与医学生的学习模式、偏好的考核类型、作弊行为以及睡眠质量之间的关联。

**研究设计与实施场景**：针对巴西茹伊斯迪福拉一所医学院全部六个年级的在读医学生开展横断面研究。

**研究方法**：通过发放问卷评估学习方式（采用R-SPQ-2F量表）、学习模式、学习资源与选择，以及睡眠质量。将学生的学习方式（表层或深层）与其学习模式、学习资源、睡眠质量以及是否在考试中作弊进行关联分析。

**研究结果**：本次纳入的710名学生中，43%的学生常在考试前一晚突击学习，65%的学生曾使用精神兴奋剂辅助学习，超过46%的学生曾在考试中作弊。在睡眠质量方面，多数学生（53.4%）自述睡眠质量较差，其中45.3%的学生在考试前的睡眠时间不足5小时。仅在考试前临时抱佛脚、使用课堂总结资料、偏好选择题型考核且考试中作弊的学生，更倾向于采用表层学习方式。反之，阅读专业书籍、偏好实操类考核且睡眠质量较好的学生，则更倾向于采用深层学习方式。

**研究结论**：医学生的学习方式类型与其学习模式及学习选择存在关联。教育工作者需关注学生所采用的学习方式，并思考能够影响教学与考核方法的相关改进措施。