|Year : 2020 | Volume
| Issue : 2 | Page : 74-79
Prevalence and patterns of journal use among undergraduate medical students in a tertiary care teaching hospital – A cross-sectional analytical study
Siddhartha Das1, Sitanshu Sekhar Kar2, Parthibane Sivanantham2, Vaibhav Shukla1, Noopura Ramavarman1
1 Department of Forensic Medicine and Toxicology, Jawaharlal Institute of Postgraduate Medical Education and Research, Puducherry, India
2 Department of Preventive and Social Medicine, Jawaharlal Institute of Postgraduate Medical Education and Research, Puducherry, India
|Date of Submission||16-Apr-2020|
|Date of Decision||31-Jul-2020|
|Date of Acceptance||18-Oct-2020|
|Date of Web Publication||30-Dec-2020|
Dr. Siddhartha Das
Department of Forensic Medicine and Toxicology, Jawaharlal Institute of Postgraduate Medical Education and Research, Puducherry - 605 006
Source of Support: None, Conflict of Interest: None
Background: Medical students are expected to be self-directed learners and constantly update their knowledge. Apart from the books, journals also help in this knowledge gathering exercise. This study was conducted with an objective to assess the journal usage pattern among undergraduate medical students and to consider implementing a training program on journal use based on the survey findings. Materials and Methods: This was a cross-sectional study conducted among the undergraduate medical students using anonymous self-administered online questionnaire. The e-mail address and WhatsApp number of the students were initially collected with the help of student volunteers from each batch, and then, an online link to the survey was sent to all of them by these volunteers. Results: Around 37% (190/505) of the respondents reported having used journals, and nearly three-fourths of them were introduced to journals by their faculties. Research articles were the most sought after article type among the students. The Medline database was very commonly used by the students. Around 80% of the respondents opined that journal usage may be included as a training program at the undergraduate level. Conclusion: Perception regarding including journal usage as a training program at the undergraduate level was significantly associated (P < 0.05) with journal use among students.
Keywords: Cross-sectional studies, journal article, periodicals, reading, undergraduate medical education
|How to cite this article:|
Das S, Kar SS, Sivanantham P, Shukla V, Ramavarman N. Prevalence and patterns of journal use among undergraduate medical students in a tertiary care teaching hospital – A cross-sectional analytical study. Int J Adv Med Health Res 2020;7:74-9
|How to cite this URL:|
Das S, Kar SS, Sivanantham P, Shukla V, Ramavarman N. Prevalence and patterns of journal use among undergraduate medical students in a tertiary care teaching hospital – A cross-sectional analytical study. Int J Adv Med Health Res [serial online] 2020 [cited 2021 Jan 24];7:74-9. Available from: https://www.ijamhrjournal.org/text.asp?2020/7/2/74/305455
| Introduction|| |
Medical students are expected to continually update their knowledge for academic and research purposes. The students are encouraged to be life-long and self-directed learners. Although traditionally books have been used, journals also play a very important role in this knowledge building process. Studies report that medical faculty and other healthcare professionals rely on peer-reviewed journals as their preferred source for reliable information, followed by professional consultations with colleagues, association meetings, education courses, and medical representatives. However, unfortunately, the importance of reading journals is not highlighted at the undergraduate level and is not usually a part of the medical curriculum. One study has evaluated the awareness of reading journals among the undergraduate medical students. Another study reported that 5% of the undergraduate medical students went to the library to read journals. Very little literature is available on this topic. Further, the institute where the study was conducted is one of the premier medical schools in the country that places substantial emphasis on medical research. To promote the culture of research among the undergraduate medical students, the institute has a self-financed short-term research program. The students are also encouraged to apply for Indian Council of Medical Research-Short Term Student research projects. The institute also holds an annual research meet and an international medical conference exclusively for undergraduate students to present their research activities. Therefore, this study would help the academic fraternity of the institute to understand the current level of journal use among the undergraduate medical students and thereby consider implementing curriculum changes to promote journal use and the consequent application in patient care and research. With this objective in mind, we assessed the patterns of journal use among the undergraduate medical students in our institute.
| Materials and Methods|| |
Setting and design
This was a cross-sectional study conducted among undergraduate medical students of a government medical college located in Puducherry, India. Our library houses hard copies of books and journals of different specialties, some of which are six decades old. In addition, we have intranet as well as remote access to almost all the leading service providers such as BMJ Publishing Group Ltd. 2020©, Elsevier, Inc. 2020©, Wolters Kluwer Health, Inc. 2020©, Springer Nature Ltd. 2020©, Wolters Kluwer N. V. 2020©, Oxford University Press 2020©, and John Wiley & Sons, Inc. 1990–2020©. A total of 700 students from 1st to 4th-year MBBS were administered the questionnaire. The study was conducted using anonymous self-administered online questionnaire between March and April 2018.
Subjects and methods
The study was started after obtaining the approval of the institute ethics committee. Desired information was assessed using an online questionnaire developed in English. The questionnaire had three parts. The first part sought information about the personal and demographic characteristics such as gender, year of study, and medium of education in school. The second and third parts sought information about the use of journals by the students such as frequency, purpose, preferred mode and type of journals, and journal databases. The third part sought information on the college infrastructure-related characteristics including student's level of satisfaction over journal resources available in the institute's library. The questionnaire was pretested by administering it to random group of students, and depending on their responses, a few questions were rephrased for the final survey. For data collection in the study, a cover letter was attached to the questionnaire's online link, explaining the objectives of the study, and that the participation was voluntary and responses would be kept confidential. Two student representatives from each batch were asked to facilitate the data collection procedure. An initial announcement was made by them in their respective classrooms following which they collected the e-mail address and WhatsApp number of their batch mates. The link to the survey was sent to their e-mail address and to the respective batch WhatsApp groups. Two reminders were given to the nonrespondents, and the survey was finally closed on April 2018. To ensure anonymity of responses collected, the whole data collection process was carried out only by the student volunteers. The final dataset collected after the participants responded was shared with the investigators which had no student identifiers.
Sample size calculation
The sample size was calculated using OpenEpi (version 3.01) at 95% confidence interval, 80% power, and 5% absolute precision. Assuming the prevalence of journal use among the study population as 50%, the required sample size was 384. To account for nonresponse of 25%, the required sample size was raised to 512.
Assessment and analysis
The use of journals by the students was assessed using a screening question “If you use journals, kindly specify who introduced you to journals?” Those who responded as “Do not use journal” to this question were considered as nonusers of journals and were asked not to respond to the remaining questions, except the one where they were asked whether journal usage should be included as a training program at undergraduate level. The rest moved on to questions related to patterns of use and other parts of the questionnaire. At the end of the survey, data were downloaded to one database and were analyzed using Statistical Package for the Social Sciences version 20 (IBM Corp., Armonk, NY, USA). Continuous and categorical variables were summarized using mean (standard deviation) and proportions, respectively. The tests of association between categorical variables and outcome variable were assessed using Chi-square test. P < 0.05 was considered statistically significant.
| Results|| |
The response rate of the survey was 72.1% (505/700) with almost equal percentage of participation from the four batches. More than half, i.e., 55.8% (282), of the participants were male. Almost all the participants had studied in English-medium schools, and about four-fifths of the participants were staying in the institute's hostel [Table 1].
Thirty-seven percent (190) of the students reported using journals. Journal use among the 1st–4th-year students were 29.6% (49/166), 41.2% (54/131), 45% (50/111), and 38.1% (37/97), respectively. Among the students who used journals, 76.8% of them were introduced to journals by the faculty and the rest by their classmates and seniors. More than three-fourths (78.4%) used journals only when required. Majority of the students used journals for any project/assignment (58.4%), followed by updating of knowledge (47.9%), research (33.7%), and literature retrieval (26.8%) in that order. The five important reasons cited for underutilizing journals as a study resource material were time constraints (30.7%), unnecessary at undergraduate level (27.7%), lack of training (16%), lack of interest (11.3%), and lack of access to full-length articles (10.1%) [Figure 1].
|Figure 1: Reasons for underutilizing journals as a resource material by the study participants (n = 505)|
Click here to view
When it comes to their preferred mode of using journals, 63.7% preferred the online version as compared to 12.1% who preferred the print version. About 64.7% of the students showed no preference when it comes to using international-, national-, or regional-level journals although 25.3% reported preferring international journals.
The most sought after type of journal articles were the research articles followed by the review articles. The Medline/PubMed medical database was most commonly used for retrieving the journal articles. About 42.6% of the students mentioned that they were satisfied with only the abstract information, whereas 31.6% used only free full-text information [Table 2]. Nearly two-thirds (65.2%) of the students were either satisfied or partially satisfied with the journal resources available in the institute library. 80% of the total respondents were in favor of starting a journal usage training program at the undergraduate level.
Association of demographic and contextual variables with journal use among the students is presented in [Table 3]. The odds of using journals was significantly higher among 2nd-year and 3rd-year students by 1.7 (1.03–2.7) and 1.9 (1.2–3.2) times, respectively, when compared to 1st-year students. The odds of journal use by day scholars was also significantly higher when compared to hostelites by 1.9 (1.3–3) times. Student's preference to different sources of information had statistically significant association with the usage of journals. Satisfaction levels of the students toward journal resources available in the institute's library and their perception on including journal usage as a training program at the undergraduate level were also significantly associated (P < 0.05) with journal use among students.
|Table 3: Association of demographic and contextual variables with journal use among study participants|
Click here to view
| Discussion|| |
Various studies done on this topic had reported a response rate varying from as low as 37% to as high as 94%. [4,6-8] The response rate from the students observed in our study was 72.1%. Further, our study shows that 37.6% of the respondents read journals, but the usage frequency was low. One study reports 40.4% of the fifth-semester and 36.2% of the eight-semester students have read at least one journal, but they read only once or twice a year. In two studies, majority of the medical students used the journal databases on a once weekly or twice monthly basis., A study from Pakistan observed once monthly usage in 23%, once in 3 months in 17%, and even less frequently in 50% of the respondents. Another study reported journal reading habit in 41.8% of the students, but with a poor reading frequency. From the above studies, it is clear that the frequency of journal usage is on the lower side. Our study revealed time constraint as the single most important reason for underutilizing journals. Although we have started a journal orientation program for the students, it is only two batches old and we are yet to see its positive results. We are also not sure whether the students are properly aware of the resources available in the library or how best to use them. The library staff may help in this regard by updating the online and print journal catalog regularly in the library website. Posters may also be pasted in prominent places in the library, student hostels, and departmental notice boards to increase the student awareness. Adam and Bonks noticed that lack of proper training and lack of information about the different databases as the two top reasons for not utilizing the available resources. According to Basu et al., teachers have an important role as they ought to motivate the students to not only read journals but also publish scientific material as an academic exercise. In fact, more than three-fourths of the students who use journals in our study were introduced to them by the faculty. To generate interest among the students, the faculty act as guides for the undergraduate student research projects. Two such programs are going on in our institute where the students are also given financial assistance.
According to one study, most students read journals while preparing for a seminar. Seventy-nine percent of the medical students accessed it for class assignments, 69% for patient care, and 61% for research. Study purpose and scientific work were the reasons observed in a separate study. In another study, 49% read journals as it was part of their curriculum and 33% read out of interest. Virtanen et al. observed younger dental students were, in general, more prone to utilizing information resources for educational purposes than senior dental students. Our study reveals that 58.4% of the undergraduate students use journals for some project/assignment, 47.9% for updating their knowledge, and 33.7% for research-related work. From the above observations, it is clear that journals are used by students as an alternative to text books. It also provides a quick and easy access to the latest trends in medical science.
Literature survey shows that most of the users prefer the online version in comparison to the print copy.,, A longitudinal study performed two decades back shows a gradual, but major shift from the print journals to the online journals. Our survey shows that 63.7% of the users prefer online journals, whereas only 12.1% prefer the print copy. Accessibility and functionality are the two very important reasons for the popularity of electronic journals over print journals. They offer advantages such as fast availability through electronic interaction with the authors, editors, and publishers, fast downloading, and printing. They are also more cost-effective than the print copies as there is no hassle of printing and mailing the print copy. One study involving medical students has clearly mentioned availability of full-text online articles as the single most valued resource. Nowadays, many online databases give open access to their journals. In those who do not give open access, the institutes enter into financial agreement with the publishers so as to get free online access to the full-text articles. In our institution, there is free in campus as well as remote access to a good number of diverse databases. This has shifted the user preference from print to the online journals. On the contrary, the major impediments for using the electronic resources were the usernames and passwords for different sites and the problem of expired passwords and payment sites. Ease of use, originality of information, and authenticity of the articles are the features which also appeals to the users of print journals. According to one study, 40% of the respondents also use the print journals because they are easy to browse.
A study involving the medical and dental students reported Medline to be the preferred database for searching journals. Fifty-three percent of the users searched Medline, whereas MD consult and CINAHL had a much lower usage. Web of science, Google, and Google Scholar are also used by researchers in addition to Medline/PubMed. Our study also reveals that nearly three-fourths of the students like to retrieve the journal articles from Medline/PubMed. Medline is widely considered the primary source for biomedical journal literature, and most researchers around the world are quite familiar with it. Lack of awareness of other databases or a lack of knowledge regarding the scope of these databases may be considered the reasons why users have not used databases other than Medline. Three-fourths of the students in our study were satisfied with either the abstract and/or free full-text information. It seems the students did not have the desire to look for alternate sources for getting full-text information, which were not freely available. Already they have mentioned time constraint as one of the main reasons for underutilizing journals. Hence, they did not want to waste time and were satisfied with the abstract information only. Nearly two-thirds of the students were partially to fully satisfied with the journal resources in the library. Although our institute has online access to wide variety of journals and publishers, but these were made available only recently. Further, our study showed that around 80% of the total respondents feel that journal usage may be included as a training program at the undergraduate level. A similar observation was noted, wherein two-thirds of the students from each semester felt that reading journals was important, whereas more than half from each semester felt reading journal should be included in the curriculum.
| Conclusion|| |
About a third of the respondents had used journals, of which nearly three-fourths were introduced to them by their faculty. Around 80% of the respondents felt the necessity of a training program on journal usage at the undergraduate level.
Financial support and sponsorship
Conflicts of interest
There are no conflicts of interest.
| References|| |
Kassirer JP. Learning medicine. Too many books, too few journals. N Engl J Med 1992;326:1427-8.
Stinson ER, Mueller DA. Survey of health professionals' information habits and needs. Conducted through personal interviews. JAMA 1980;243:140-3.
Basu S, Chakraborty A, Parmar VR, Mishra K. Journal-reading habits of undergraduate medical students. Natl Med J India 2015;28:105.
Basu M, Das P. Library use by undergraduate medical students of a tertiary care institution of West Bengal. Indian J Prev Soc Med 2012;43:315-20.
de Groote SL, Dorsch JL. Measuring use patterns of online journals and databases. J Med Libr Assoc 2003;91:231-40.
Romanov K, Aarnio M. A survey of the use of electronic scientific information resources among medical and dental students. BMC Med Educ 2006;6:28.
Ejaz K, Shamim MS, Shamim MS, Hussain SA. Involvement of medical students and fresh medical graduates of Karachi, Pakistan in research. J Pak Med Assoc 2011;61:115-20.
Mundle M, Saha S, Koley M, Arya JS, Choubey G, Saha S, et al
. A survey exploring research perception of homeopathic undergraduate students in West Bengal, India. Int J High Dilution Res 2014;13:28-44.
Adams JA, Bonk SC. Electronic information technologies and resources: Use by university faculty and faculty preference for related library services. Coll Res Libr 1995;56:119-31.
Virtanen JI, Nieminen P. Information and communication technology among undergraduate dental students in Finland. Eur J Dent Educ 2002;6:147-52.
Peterson MW, Rowat J, Kreiter C, Mandel J. Medical students' use of information resources: Is the digital age dawning? Acad Med 2004;79:89-95.
de Groote SL, Dorsch JL. Online journals: Impact on print journal usage. Bull Med Libr Assoc 2001;89:372-8.
Rogers SA. Electronic journal usage at Ohio State University. Coll Res Libr 2001;62:25-34.
Voorbij H, Ongering H. The use of electronic journals by Dutch researchers: A descriptive and exploratory study. J Acad Lib 2006;32:223-37.
Tannery NH, Foust JE, Gregg AL, Hartman LM, Kuller AB, Worona P, et al
. Use of Web-based library resources by medical students in community and ambulatory settings. J Med Libr Assoc 2002;90:305-9.
Nwokedi VC, Samuel N, Ogugua J. Online journals and databases usage patterns amongst medical doctors in Jos University Teaching Hospital (JUTH), Nigeria. Inter J Acad Lib Info Sci 2016;4:283-92.
Brennan N, Edwards S, Miller A, Kelly N, Harrower AL, Mattick K. Qualified doctor and medical students' use of information resources: What is used and why? Health Info Lib J 2014;31:204-14.
Nicholas D, Williams P, Rowlands I, Jamali HR. Researchers' e-journal use and information seeking behaviour. J Inf Sci 2010;36:494-516.
[Table 1], [Table 2], [Table 3]