Factors associated with learning outcomes in first pre-clinical year medical students at the Faculty of Medicine Siriraj Hospital, Mahidol University

Objective: Electronic learning system (e-lecture) has been developed and used as a tool to assist students' learning. Usage of e-lecture and learning behaviors were evaluated for their associations with learning outcomes. Methods: This questionnaire-based, cross-sectional study enrolled 107 first pre-clinical year medical students at the Faculty of Medicine Siriraj Hospital, Mahidol University, Thailand. Information on learning outcomes of biomedical subjects and learning behavior including e-lecture use, self-study time, skipping class and inattention were collected. Mann-Whitney U test and logistic regression were used for statistical analysis. Results: Compared to students who earned average biomedical grades of > 3.0, students who earned average grades ≤3.0 significantly used more e-lecture (median, IQR 63.81, 49.17-70.03 and 31.08, 11.29-51.49, respectively, p =0.001), had more inattention time during lectures (median, IQR, 22.13, 14.94-31.19, and 13.1, 8.05-20.30, respectively, p=0.008), and spent less time for self-study and review of lessons (median, IQR 102.00, 68.00-176.50, and 147.50, 106.25-246.00, respectively, p=0.04). For each one hour increase in e-lecture usage, the chance of earning an average biomedical grade of > 3.0 was decreased by 4%. Positive correlations were found between e-lecture usage with skipping class and with inattention during lecture (coefficients = 0.31 and 0.37, with p=0.001 and p < 0.001, respectively). Time spent for self-study and review of lessons negatively correlated with inattention during lectures (coefficient =-0.28, p=0.003). Conclusion: E-lecture may be misused by students who have poor learning behaviors as a substitute for in-class lectures. Time voluntarily spent in e-lecture may be an indicator for students who need educational guidance and/ or counseling.