Abstract
Background
Scientific research is an approach to acquiring information to enhance the quality of the world. The aim of this study was to identify the obstacles among undergraduate medical students to publish their study papers.
Materials and methods
This was a web-based descriptive cross-sectional study that used an online survey to collect data from medical students of Umm Al-Qura University in Makkah, Saudi Arabia. The minimum sample size required for the study calculated by the Raosoft website was 323. Statistical analysis was conducted with IBM SPSS Statistics for Windows, Version 25 (Released 2017; IBM Corp., Armonk, New York, United States).
Results
A total of 337 medical students were included in the study. The frequencies of male and female students were relatively comparable, with a marginally greater proportion of male students (177, 52.5%). The majority of students (294, 87.2%) had participated in at least one research project. Notably, 159 (47.2%) students had engaged in more than three research projects, whereas 42 (12.4%) had experience with only one previous research project. A notable peak in publication rate was observed for the year 2023, indicating the highest rate within the study period. The most frequently encountered obstacle in research publication was poor academic teaching, as reported by 133 (39.5%) students, followed by lack of active research groups (130, 38.6%), lack of time (122, 36.2%), and lack of supervisors in their preferred specialty (91, 27%). Associations were found between students’ participation in research projects and various demographic characteristics. Among medical students who had previously participated in a research group, 174 (51.7%) were female, and 163 (48.3%) were male (p=0.001). In terms of academic year, most students who participated in a research project were in their sixth year (143, 42.5%), followed by medical interns (81, 24.1%) and fourth-year medical students (54, 16%), with these differences being statistically significant (p=0.001). Finally, the medical students’ grade point average showed no statistically significant association with participation in a research project.
Conclusion
To boost publication rates and research experience of graduating medical students, it is important to articulate the barriers that prevent them from publishing their research. Educators and supervisors of medical research should strongly consider developing a framework that addresses current and future obstacles.
Keywords: academic teaching, article, barriers, cross-sectional, medical research, publication, research curriculum, saudi arabia, students, undergraduate
Introduction
Scientific research is a methodical approach to acquiring information and utilizing curiosity to enhance the quality of the world. For example, research is crucial for the development of medicine, as it is required in shaping evidence-based medical practice [1-5]. A 2010 Peruvian study on medical students at Cayetano Heredia University revealed that, out of 482 students' scientific papers, only 85 (17.6%) research papers were accepted to be published; however, other papers were rejected [6]. A 2011 British study on medical students at Manchester University revealed that, out of 515 students, only 72 (14%) submitted their scientific papers for publication due to a lack of time and opportunity [2]. In 2012, a local study of 249 medical interns from King Abdulaziz University showed that only eight (3.2%) submitted and published their research due to a lack of training in the field of research [7]. In 2023, a local study of 162 undergraduate medical students in Riyadh, Saudi Arabia, revealed numerous obstacles faced when publishing scientific papers, including unsupportive supervisor (63, 38.9%), lack of time (50, 30.9%), insufficient sample size (41, 25.3%), inability to reconcile research and studying (37, 22.8%), poor methodology (31, 19.1%), advanced topic/field of research (29, 17.9%), limited access to databases (16, 9.9%), lack of funding (15, 9.3%), and language barriers (7, 4.3%) [8]. According to the scientific research unit of the Faculty of Medicine at Umm Al-Qura University (UQU), out of 235 medical students, only 48 (20.43%) published a scientific paper by their fifth or sixth years. From all the data that were obtained, no clear determinant was found to determine the cause of the low publication rate among students in Saudi Arabia.
The medicine program at UQU provides courses throughout the academic years for students to learn and publish papers with the help and supervision of university doctors. Our primary objectives in this study were to assess and determine the obstacles and barriers faced by undergraduate medical students in UQU when publishing scientific papers, identify any determinants, and present solutions. Our secondary objectives were to determine the challenges and opportunities faced by undergraduate medical students in UQU when conducting research projects.
Materials and methods
Study design, setting, and population
This was a web-based descriptive cross-sectional study. An online survey was used to collect data from undergraduate medical students attending UQU in Makkah, Saudi Arabia.
Sample size and study population
According to the scientific research unit of the Faculty of Medicine at UQU, there were approximately 2000 students studying at UQU at the time of this study. Therefore, based on the Raosoft sample size calculator (Raosoft Inc., Seattle, USA) while assuming a 95% confidence level and 5% margin of error, the minimum recommended sample size was calculated to be 323 individuals.
Study period and duration
The study lasted approximately four months, from March 2024 to July 2024, including the entire process of writing the proposal to submit the article to the journal including data collection process that was held in the period from April 2024 to May 2024.
Survey design and pilot study
The questionnaire used in this study was validated by expert opinions and piloting study. The questionnaire’s test-retest reliability was evaluated by administering it multiple times during the pilot phase and observing consistent responses. The sample size is large, which contributes to the reliability of Cronbach's Alpha. Through this iterative process, we arrived at an optimized form of the questionnaire.
Data collection
An online survey was developed using Google Forms so that respondents could conveniently complete the questionnaire. The survey comprised two sections. In section 1, the respondents provided consent to participate in the study and sociodemographic characteristics. Section 2 comprised questions about students’ published or unpublished studies, study type, topic area, and barriers to publication. The questionnaire can be found in the appendix of this paper.
Statistical analysis
Statistical analysis of the current study was conducted using IBM SPSS Statistics for Windows, Version 25 (Released 2017; IBM Corp., Armonk, New York, United States). Frequencies and percentages were used to express categorical variables. Items with multiple responses were analyzed using the multiple-response analysis technique. Factors associated with students’ participation in research projects were assessed using Pearson’s chi-squared test or Fisher’s exact test whenever applicable. A p-value of <0.05 indicated statistical significance, and the confidence interval (CI) was set at 95% for all analyses used in the study. We controlled for potential confounding variables such as individual motivation, prior research experience, and access to resources by ensuring homogeneity in these factors across our study groups. Moreover, we checked all the p-values for these variables, and none were found to be significant, indicating that these factors did not influence our results.
Ethical approval and ethical considerations
The study received ethical approval from the Research Ethical Committee of UQU on April 29, 2024 (approval no. HAPO-02-K-012-2024-04-2119). No study activities began until approval was obtained. Survey responses were collected in an anonymous fashion.
Results
Demographic characteristics
A total of 337 medical students were included in the study. Table 1 presents the demographic characteristics of the participants. Regarding gender distribution, the frequencies of male and female students were relatively comparable, with a marginally greater proportion of male students (52.5% (177 students)). Most of the participants were in their sixth academic year (131, 38.9%), followed by medical interns (71, 21.1%), and fourth-year students (65, 19.3%). More than half of students recorded a grade point average (GPA) between 3.50 and 4.0 with 73.3% (247 students).
Table 1. Demographic data of medical students at Umm Al-Qura University during the academic year 2023-2024.
GPA: grade point average
Characteristic | Frequency | Percentage | |
Gender | Male | 177 | 52.5% |
Female | 160 | 47.5% | |
Academic year | 2nd year in medical school | 6 | 1.8% |
3rd year in medical school | 2 | 0.6% | |
4th year in medical school | 65 | 19.3% | |
5th year in medical school | 62 | 18.4% | |
6th year in medical school | 131 | 38.9% | |
Medical intern | 71 | 21.1% | |
Current GPA (out of 4) | 3.50-4 | 247 | 73.3% |
3.00-3.49 | 66 | 19.6% | |
2.50-2.99 | 23 | 6.8% | |
<2.50 | 1 | 0.3% |
Previous research experiences of medical students
Table 2 outlines the previous research experiences of medical students at UQU. The majority of students had participated in at least one research project, with 294 students (87.2%) indicating participation. A notable portion of students had engaged in more than three research projects (159, 47.2%), whereas 42 students (12.4%) described experience in only one previous research project. Regarding research publication frequency, nearly half of the participants had not yet published any research project (164, 48.7%). Meanwhile, 59 students (17.5%) contributed to the publication of one research project. Fewer students had higher publication frequencies, with 37 students (11.0%) having two research projects published, and even fewer, 25 students (7.4%), with three research publications.
Table 2. Previous research experiences of medical students at Umm Al-Qura University, 2023-2024.
Characteristic | Frequency | Percentage | |
Previous participation in a research project | Participated | 294 | 87.2% |
Did not participate | 43 | 12.8% | |
Frequency of research participation | One research project | 42 | 12.4% |
Two research projects | 43 | 12.8% | |
Three research projects | 50 | 14.8% | |
More than three research projects | 159 | 47.2% | |
None | 43 | 12.8% | |
Frequency of research publication | One research project | 59 | 17.5% |
Two research projects | 37 | 11.0% | |
Three research projects | 25 | 7.4% | |
More than three research projects | 52 | 15.4% | |
None | 164 | 48.7% |
Figure 1 illustrates the annual trend in research publication rates among the students who had engaged in research. There was a notable peak observed in 2023, indicating the highest publication rate within the depicted time frame. Figure 2 summarizes the types of study designs in which the medical students engaged. Cross-sectional studies had the most substantial participation from students (272 projects), followed by case reports/case series (100 projects) and cohort studies (70 projects).
Figure 1. The rate of research publication among medical students at Umm Al-Qura University who had previously published a research project.
Figure 2. Types of study design participated in/published by medical students at Umm Al-Qura University, 2023-2024.
Medical students’ obstacles in research publication
According to the participants’ responses, the most commonly encountered obstacle in research publication was poor academic teaching (133, 39.5%), followed by a lack of active research groups (130, 38.6%), a lack of time (122, 36.2%), and a lack of supervisors in their preferred specialty (91, 27%). Figure 3 outlines the obstacles and barriers reported by the medical students.
Figure 3. Medical students’ obstacles in research publication at Umm Al-Qura University, 2023-2024.
Associations between research participation and demographic factors
Table 3 summarizes the associations between students’ participation in research projects and demographical factors. Among medical students who had previously participated in a research project, 174 participants (51.7%) were female and 163 participants (48.3%) were male, which was a statistically significant difference (p=0.001). In terms of the academic year, most students who participated in a research project were in their sixth year (143, 42.5%), followed by medical interns (81, 24.1%) and fourth-year medical students (54, 16.0%). These findings recorded a p-value of 0.001, indicating statistical significance. No statistically significant association between GPA and participation in a research project was observed.
Table 3. The association between students’ participation in research projects and demographical factors.
GPA: grade point average
* represents statistical significance (p<0.05); § Pearson Chi-square test and likelihood ratio were used to calculate the p-value depending on the number of cells expected to count less than 5.
Characteristic | Participation in a research project | Chi-square value | p-value§ | |
Participated | Not participated | |||
Gender | ||||
Male | 142 (48.3%) | 35 (81.4%) | 16.478 | 0.001* |
Female | 152 (51.7%) | 8 (18.6%) | ||
Academic year | ||||
2nd year in medical school | 3 (1.0%) | 3 (7.0%) | 52.778 | 0.001* |
3rd year in medical school | 2 (0.7%) | 0 (0.0%) | ||
4th year in medical school | 47 (16.0%) | 18 (41.9%) | ||
5th year in medical school | 46 (15.6%) | 16 (37.2%) | ||
6th year in medical school | 125 (42.5%) | 6 (14.0%) | ||
Medical Intern | 71 (24.1%) | 0 (0.0%) | ||
Current GPA (out of 4) | ||||
3.50-4 | 222 (75.5%) | 25 (58.1%) | 6.434 | 0.069 |
3.00-3.49 | 54 (18.4%) | 12 (27.9%) | ||
2.50-2.99 | 17 (5.8%) | 6 (14.0%) | ||
<2.50 | 1 (0.3%) | 0 (0.0%) |
Discussion
Determining the barriers that keep students from publishing their work is essential to scientific progress and the primary objective of the current study. Few research studies address and acknowledge these obstacles in undergraduate medical curricula, especially in Saudi Arabian universities [7-9]. The findings of this study indicate that only half of the students at UQU published research papers, with higher publication rates compared to other similar studies that found low publication rates among undergraduate medical students [6,10,11]. However, in a German study, 28% of the participants had publications [12]. In a US study, 41% of the student participants had published research papers, similar to our study [13]. Numerous factors are responsible for the variations in publishing rates over time and between colleges. The most common barrier in our study was poor academic teaching followed by a lack of active research groups. As the majority of supervisors work as full-time teachers at universities and physicians simultaneously, research projects are an additional obligation for them. Moreover, this barrier appears to be more prevalent than predicted in previous studies. A survey conducted by Australian medical researchers revealed that research infrastructure support is critical to research productivity [14]. As expected, a major portion of the issues that our students encountered were related to time constraints and their incapacity to balance their studies and research. Furthermore, funding, lack of research opportunities, lack of research interest among colleagues, limited access to databases, and unsupportive research supervisors were also reported as obstacles.
In a study conducted at King Saudi bin Abdulaziz University for Health Sciences, poor English was reported as an obstacle to research publication, which was not measured in our study [4]. Insufficient sample size was another obstacle facing medical students at UQU due to students’ lack of interest in filling out research questionnaires. Another interesting barrier medical students faced in our study was limited access to databases, which is crucial to conducting high-quality studies. The students study the research curriculum in multiple lectures over the years. However, these lectures are limited to theoretical sessions, which leads to another of the barriers reported as an obstacle in our study, a lack of practical sessions. Furthermore, UQU has mandatory research courses for undergraduate medical students at all academic levels. Our results indicate that students carry negative attitudes toward medical research curricula due to multiple factors, such as spaced research lectures and lack of practical sessions.
In terms of demographic factors associated with research participation, our results showed a statistically significant sex-based difference with higher female participation. Furthermore, most participants were sixth-year medical students, followed by medical interns (p=0.001). There was no statistically significant association between GPA and research publication. Although the majority of students who participated in our study engaged in one research project, nearly half of the participants had not yet published any research. These findings agreed with those of previous studies on publication rates among medical students [6,11]. Students must overcome these challenges by relying on their willingness to embrace suitable solutions, such as improving time management skills, collaborating with cooperative mentors, and strengthening their essential biostatistical abilities to plan proper methodology [15-17].
This study had many strengths, as it had a large number of participants, it covered medical students throughout all academic years, and it attempted to identify possible obstacles to publication practices. The authors highly recommend giving more lectures and practical sessions to enhance students’ ability in scientific research. Moreover, holding more research medical conferences could enhance students’ ability to conduct medical research.
Although our study findings may be beneficial for undergraduate medical students from UQU, their usefulness for students of other universities may be limited. As each institution has a unique curriculum and approach to research, our findings cannot be applied to all research programs. Future studies should investigate gaps in the rate of publication and difficulties reported by students according to their academic year as well as other student demographic variables. Furthermore, due to the COVID-19 pandemic, the research course at UQU has been taught online exclusively for two years. It would be fascinating to investigate the challenges that students have and find possible solutions to improve the quality of undergraduate medical students research papers.
Conclusions
Medical students have a poor understanding of how to write papers and abstracts, as well as publication methods, despite the fact that such abilities are employed as postgraduate criteria when selecting candidates for positions. Medical students encounter several obstacles that hinder their chances of publishing papers, including working with an unsupportive supervisor, insufficient time, and sample size limitations. To overcome these barriers and improve students’ research process and quality, further studies are needed to provide a clearer image and practical ideas. This process may be enhanced by making research opportunities more available and providing encouragement and advice from mentors.
Acknowledgments
The authors acknowledge the respondents for participating in the study and would like to thank the scientific research unit of the Faculty of Medicine at Umm Al-Qura University for administrative support and secondary data collection. The authors would like to thank Dr. Arwa Flemban for her major support in the data collection process. The authors would like to thank Dr. Hatim A. Almaghrabi for his contribution to the statistical analysis of the study.
Appendices
Table 4. The questionnaire of the study.
Consent for participation | By answering this survey you are participating in research entitled "Barriers to Research Publication for Undergraduate Medical Students in Makkah, Saudi Arabia: A Cross-Sectional Study." Data will be used for medical research while protecting the privacy of participants’ personal data. | Agree to participate in the study |
Disagree | ||
Section 1: Sociodemographics | Are you studying at Umm Al-Qura University? | Yes |
No | ||
What is your gender? | Male | |
Female | ||
What is your current academic year? | 2nd year medical student | |
3rd year medical student | ||
4th year medical student | ||
5th year medical student | ||
6th year medical student | ||
Medical intern | ||
What is your current GPA? (Out of 4) | 3.5–4 | |
3–3.49 | ||
2.5–2.99 | ||
<2.5 | ||
Section 2: Main questionnaire | Have you participated in any previous research? | Yes |
No | ||
How many research projects did you participate in? | None | |
1 | ||
2 | ||
3 | ||
>3 | ||
How many research papers did you publish? | None | |
1 | ||
2 | ||
3 | ||
>3 | ||
When did you publish your research? | Not yet | |
2020 | ||
2021 | ||
2022 | ||
2023 | ||
2024 | ||
What is the research study design? | Case report/series | |
Case control | ||
Cross-sectional | ||
Cohort | ||
Randomized clinical trial | ||
Systematic review/meta-analysis | ||
What were the obstacles that you faced in publishing your research? (choose as many as applicable) | Funding | |
Lack of time | ||
Poor academic teaching | ||
Advanced topic | ||
Poor methodology | ||
Poor research opportunity | ||
Lack of supervisors in your preferred speciality | ||
Lack of active research groups | ||
Unsupportive research supervisor | ||
Poor appreciation/ No rewards | ||
Limited access to databases | ||
Insufficient sample size | ||
Inability to reconcile between research and studying | ||
Lack of research interest among your colleagues | ||
Lack of practical sessions | ||
None | ||
Others |
Disclosures
Human subjects: Consent for treatment and open access publication was obtained or waived by all participants in this study. Research Ethical Committee of Umm Al-Qura University issued approval HAPO-02-K-012-2024-04-2119.
Animal subjects: All authors have confirmed that this study did not involve animal subjects or tissue.
Conflicts of interest: In compliance with the ICMJE uniform disclosure form, all authors declare the following:
Payment/services info: All authors have declared that no financial support was received from any organization for the submitted work.
Financial relationships: All authors have declared that they have no financial relationships at present or within the previous three years with any organizations that might have an interest in the submitted work.
Other relationships: All authors have declared that there are no other relationships or activities that could appear to have influenced the submitted work.
Author Contributions
Concept and design: Sari A. Alrehaili, Abdullah H. Binmulaih, Mohammed M. Alshomrani, Abdullah S. Alnefaie, Ahmad O. Bazarra, Mohammad S. Dairi
Drafting of the manuscript: Sari A. Alrehaili, Abdullah H. Binmulaih, Mohammed M. Alshomrani, Abdullah S. Alnefaie, Ahmad O. Bazarra, Mohammad S. Dairi
Critical review of the manuscript for important intellectual content: Sari A. Alrehaili, Abdullah H. Binmulaih
Acquisition, analysis, or interpretation of data: Mohammed M. Alshomrani
Supervision: Mohammad S. Dairi
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