This paper, titled “Teaching research methodology in medical schools: students’ attitudes towards and knowledge about science,” by Hren, Lukić, Marušić, Vodopivec, Vujaklija, Hrabak, and Marušić (2004), delves into the complex relationship between the teaching of scientific methodology and medical students’ attitudes towards and knowledge about science and scientific methodology. The study was conducted at the Zagreb University School of Medicine in Croatia, employing an anonymous questionnaire survey specifically developed for this research.
The research aimed to explore this relationship, particularly focusing on the impact of a mandatory Year 2 course on scientific methodology. A total of 932 students from all six years of the medical curriculum were invited to participate in September 2001, when they were enrolling for the next academic year. The study achieved a 58% response rate, which, while not exceptionally high, was considered acceptable for this type of questionnaire study. Crucially, the sample was found to be representative of the overall student population in terms of average academic grades (3.6 for both respondents and the whole population), the percentage of students with low academic success (38% for both), and the female/male ratio (1.7 for respondents versus 1.6 for the whole population).
The study utilized a comprehensive survey questionnaire divided into three domains: demographics, attitudes towards scientific research, and knowledge of scientific methodology. The main outcome measures were scores on an attitude scale and a knowledge test.
- Attitude Scale: This was a 45-statement Likert-type scale, with a maximum possible score of 225. Its development involved an extensive process:
- It began with a brainstorming session with 50 psychology students, who generated 199 initial positive and negative Likert-type statements on science and scientific method in medicine.
- Eight independent raters then selected 60 (30 positive and 30 negative) of the most relevant statements for initial inclusion.
- After administration, content examination and discriminant validation led to the exclusion of 15 items, resulting in a final scale of 45 items.
- The 45 items were grouped into three distinct subscales: “value of science to medicine” (21 items), “value of science to humanity” (20 items), and “value of scientific methodology” (16 items).
- The scale demonstrated good internal consistency, with a Cronbach’s alpha of 0.910 for the whole scale. The scoring points ranged from 1 (strongly disagree) to 5 (strongly agree), a system familiar to Croatian students.
- Knowledge Test: This consisted of 8 multiple-choice questions, with a maximum score of 8. These questions were chosen from a database of items used in the mandatory Year 2 course, “The Principles of Scientific Research in Medicine.” The questions were composed by course teachers based on a mandatory textbook and reviewed for validity. The reliability of this 8-item test, measured by the Kuder-Richardson 20 formula, was 0.48, which the authors noted was sufficient for assessing basic knowledge without excessively lengthening the survey.
Key findings of the study illuminated several important aspects:
- Overall Positive Attitudes: Medical students generally exhibited positive attitudes towards science and scientific research. The average attitude score for all students was 166 ± 22 out of a maximum of 225, which was significantly higher than the neutral score of 135 (mean difference 31; P < 0.001).
- Subscale Contributions: Among the attitude subscales, the “value of science to medicine” showed the highest positive mean difference from its neutral score (mean difference 15; P < 0.001), followed by “value of science to humanity” and “value of scientific methodology”.
- Impact of Year 2 Course: Students who had recently completed Year 2, specifically those in Year 3, displayed the highest mean attitude score (173 ± 24) and the highest mean knowledge score (4.7 ± 1.7) compared to all other year groups (P < 0.001). This observation is particularly relevant as Year 3 students had just finished their mandatory 20-hour course on the principles of scientific research in medicine.
- Course Attendance and Attitude: When comparing students who had attended the course (Years 3 to 6) with those who had not (Years 1 and 2), attitude scores were significantly higher among course attendees (167 ± 23 versus 164 ± 19; P = 0.045).
- Predictors of Attitude: Multiple linear regression analysis for students who had attended the course revealed that knowledge test score (B = 3.4; P < 0.001) and average grades (B = 7.6; P < 0.001) were significant predictors of a positive attitude towards science. Neither sex nor failure to pass a year significantly predicted attitude. These predictors collectively explained 11.3% of the total attitude score variance.
- Observations on Other Years: Newly enrolled Year 1 students also demonstrated positive attitudes, expected due to their high school backgrounds, exhibiting the second most positive attitudes among all groups. Conversely, students in Year 2 showed the least positive attitudes, which could be linked to lower knowledge of science or the stress of their first year in medical school.
The study concludes that medical students generally hold positive attitudes towards science and scientific research in medicine, and importantly, attendance of a course on research methodology is related to a positive attitude towards science. The authors acknowledge that while they cannot definitively establish a causal relationship due to the cross-sectional study design, the observed higher scores in Year 3 students suggest a potential enhancement of attitudes by the course, which primarily targets the cognitive component of attitude.
The researchers emphasize the significance of these findings, suggesting that fostering positive attitudes towards scientific research among medical students can contribute to:
- The development of critical thinking abilities and critical appraisal skills for evidence-based medicine.
- Assisting in counselling students for research careers.
- Promoting the responsible conduct of research in the academic environment.
Furthermore, the study’s development and successful application of a sensitive and reliable instrument for assessing medical students’ attitudes towards science is highlighted as a strength, providing valuable baseline data for future longitudinal or intervention studies.
Reference: Hren, D., Lukić, I. K., Marušić, A., Vodopivec, I., Vujaklija, A., Hrabak, M., & Marušić, M. (2004). Teaching research methodology in medical schools: students’ attitudes towards and knowledge about science. Medical Education, 38(1), 81–86. https://doi.org/10.1046/j.1365-2923.2004.01735.x