Learning preferences of undergraduate medical students in a tertiary care teaching institution: A cross-sectional study

Abstract

BACKGROUND:

Learning preferences influence how students acquire and engage with knowledge. Understanding these preferences is important for aligning instructional strategies with learner needs in medical education. This study assessed the learning preferences of undergraduate medical students and evaluated their perceptions of existing teaching modalities.

MATERIALS AND METHODS:

A cross-sectional study was conducted on 395 undergraduate medical students from June 2025 to February 2026 (9 months) at a tertiary teaching institution. Learning preferences were assessed using the validated version 9.2 of visual, auditory, read/write, and kinesthetic (VARK) questionnaire, which categorizes learners as unimodal (single learning modality), bimodal (two modalities), trimodal (three modalities), or quadmodal (all four modalities) based on their VARK scores. Perceptions on lectures, practical, and clinical teaching modalities were also assessed. Data analysis included descriptive statistics; test for statistical significance performed using Chi-square or Fisher’s exact tests, as appropriate, at 5% significance level.

RESULTS:

Unimodal learning preferences were observed in 50.1% of students, with kinesthetic learning being the most common (37.2%). For 49.9%, multimodal preferences were identified, with auditory-kinesthetic as the predominant combination (16.7%). Clinical teaching received the highest mean satisfaction score (6.99 ± 1.90), followed by practical sessions (6.77 ± 1.71), while lecture-based teaching received the lowest score (6.14 ± 1.75). No statistically significant association was observed between learning preferences and gender (P = 0.970), age (P = 0.426), or year of study (P = 0.068).

CONCLUSION:

The predominance of kinesthetic and multimodal learning highlights the need for active, experiential, and blended teaching strategies in undergraduate medical education.

Introduction

Educational research recognizes that learners differ in how they perceive, process, and engage with information. Learning style is described as a composite of cognitive, affective, and physiological characteristics that influence an individual’s interaction with the learning environment.[1,2] In medical education, where students are expected to acquire not only theoretical knowledge but also clinical skills and professional competencies, understanding learning preferences has become increasingly important for designing effective, inclusive, and learner-centered educational strategies.[3]

Over the past few decades, medical education has shifted from predominantly teacher-centered approaches to student-centered and active learning models. The rapid expansion of online and blended learning, particularly following the coronavirus disease 2019 pandemic, has further emphasized the need for educators to adapt instructional strategies to meet the evolving needs of learners. These transitions have underscored the importance of aligning teaching methods with learner preferences while preserving the experiential, reflective, and humanistic components fundamental to clinical training and medical professionalism.[4]

Among the various frameworks used to assess learning preferences, the Visual, Auditory, Read/Write, and Kinesthetic (VARK) model categorizes learners based on the sensory modalities they preferentially use to acquire information.[5] The model acknowledges that learners may rely on a single dominant modality or adopt multimodal approaches, particularly in professional education settings. Awareness of learning preferences has been shown to assist students in adopting effective learning strategies. It helps to guide educators in selecting teaching methods that enhance engagement and learning.[2,6]

The experiential and skills-based nature of medical training makes the assessment of learning preferences particularly relevant. Previous studies among medical and dental students have reported a predominance of kinesthetic and multimodal learning styles.[3,7] Studies conducted among Indian medical students have also reported similar preferences, emphasizing the importance of active and learner-centered teaching approaches in medical education.[7,8]

However, learning preferences may vary across institutions and educational settings. Although several studies have assessed VARK learning preferences among medical students in different regions of India, limited evidence is available from Central India, particularly regarding students’ perceptions of existing teaching modalities and their relationship with learning preferences.[9,10]

Therefore, the present study was undertaken to assess the learning preferences of undergraduate medical students at a tertiary teaching institution in Central India using the VARK model, to determine the distribution of learning preferences among students, and to evaluate their perceptions of lecture, practical, and clinical teaching modalities.

Materials and Methods

A cross-sectional study was carried out among undergraduate medical students from first, second, third, and final professional MBBS years at a tertiary teaching institution from June 2025 to February 2026. Ethical approval was obtained from the Institutional Review Board of All India Institute of Medical Sciences, Raipur (Chhattisgarh) vide Letter No. 5208/IEC-AIIMSRPR/2025 dated 19/05/2025, and written informed consent was taken from all participants in the study before data collection.

The sample size was calculated using Cochran’s formula, considering a prevalence of unimodal learning preference as 41.6% with a 95% confidence level and a 5% margin of error, yielding a minimum required sample size of 389 students.[11] Students with self-reported visual, auditory, or physical disabilities that could substantially influence learning modality assessment and those who submitted incomplete questionnaires were excluded from the study.

The informed consent form and the questionnaire were provided on separate, independent pages to ensure voluntary participation. Demographic details, including age, gender, and year of study, were collected. Participant anonymity and confidentiality were strictly maintained throughout the study. The questionnaire was administered in hard copy to ensure a high response rate, standardized administration conditions, and participation from all eligible students irrespective of Internet accessibility or digital device availability and completed within 10–15 min. Participants were instructed not to interact with each other while responding, and no clarifications were provided during administration. Data collection was conducted beyond routine teaching hours and did not interfere with regular academic activities.

Data were collected using a self-administered questionnaire consisting of three components. The first component comprised the validated version 9.2 VARK questionnaire originally developed by Neil D. Fleming and administered to the students in the current study with permission from VARK Learn Limited.[5] As the VARK questionnaire is a standardized and validated instrument, no additional validation was undertaken by the investigators. The participants responses for the VARK questionnaire (first component) were collated and submitted to VARK Learn Limited for analysis, and participants were categorized into unimodal, bimodal, trimodal, and quadmodal learning preference groups according to the standard VARK scoring algorithm by the VARK Learn Limited.

The second component included investigator-developed items assessing students’ perceptions regarding lecture-based teaching, practical sessions, and clinical teaching modalities using a 10-point scale, where 1 indicated the lowest level of satisfaction and 10 indicated the highest level of satisfaction. The third component consisted of open-ended questions seeking students’ feedback and suggestions regarding these teaching modalities. The investigator-developed components were pilot tested among undergraduate medical students, the data collected in pilot were not included in the final study, and necessary modifications were made before administration.

Data were entered into Microsoft Excel and analyzed using the Statistical Package for the Social Sciences (SPSS) software version 21.0 (IBM Corporation, Armonk, NY, USA). Continuous variables were summarized using mean and standard deviation, whereas categorical variables were expressed as frequencies and percentages. Responses to the open-ended questions were reviewed and grouped into recurring themes using a simple thematic content analysis approach. Associations between learning preferences and demographic variables were assessed using the Chi-square test or Fisher’s exact test, as appropriate. Since the primary outcome variables were categorical, formal testing for normal distribution was not required. P < 0.05 was considered statistically significant.

Results

A total of 395 undergraduate medical students participated in the study. The mean age of the participants was 20.4 ± 1.4 years (range: 18–25 years) and 64.3% were male. Students from all undergraduate MBBS years were represented, including 15.4% first-year, 28.1% second-year, 33.9% third-year, and 22.5% final-year students.

As shown in Figure 1, unimodal learning preferences were identified in 50.1% of participants. Among these, kinesthetic learning was the most prevalent (37.2%), followed by auditory (8.6%), visual (3.5%), and read/write (0.8%) preferences. Multimodal learning preferences were observed in 49.9% of participants. Among bimodal learners, the most common combination was auditory–kinesthetic (16.7%). The visual–auditory–kinesthetic combination was the most frequent trimodal preference (9.9%). Quadmodal learners constituted 15.2% of participants, including both integrative and selective types.

Figure 1.

Distribution of visual, auditory, read/write, and kinesthetic Learning Preferences among Undergraduate Medical students at All India Institute of Medical Sciences, Raipur, India. ^†Visual Auditory, Visual Read, Auditory Read, Read Kinesthetic, ^‡Visual Auditory Read Kinesthetic standard, ^§Auditory Read Kinesthetic, Visual Read Kinesthetic

No statistically significant association was observed between learning preference category (unimodal vs. multimodal) and gender (P = 0.970), age (P = 0.426), or year of study (P = 0.068) [Table 1].

Table 1.

Association between learning preference category (unimodal vs. multimodal) and demographic characteristics of undergraduate medical students at All India Institute of Medical Sciences, Raipur, India (n=395)

Variable		Unimodal N (%)		Multimodal N (%)		χ 2		P-value
Gender
Male (n=254)		128 (50.4)		126 (49.6)		0.001		0.970
Female (n=141)		70 (49.6)		71 (50.4)
Age group (years)
≤19 (n=105)		47 (44.8)		58 (55.2)		6.992		0.426
20–21 (n=213)		113 (53.1)		100 (46.9)
≥22 (n=77)		38 (49.4)		39 (50.6)
Year of study
First year (n=61)		37 (60.7)		24 (39.3)		7.150		0.068
Second year (n=111)		60 (54.1)		51 (45.9)
Third year (n=134)		56 (41.8)		78 (58.2)
Final year (n=89)		45 (50.6)		44 (49.4)

Student satisfaction was assessed across lecture, practical, and clinical teaching modalities. Clinical teaching received the highest mean satisfaction score (6.99 ± 1.90), followed by practical sessions (6.77 ± 1.71), while lecture-based teaching had the lowest score (6.14 ± 1.75), as shown in Figure 2.

Figure 2.

Students’ evaluation of teaching modalities (Lecture, Practical, and Clinical Posting. Satisfaction scores were assessed using a 10-point scale, where 1 indicated the lowest level of satisfaction and 10 indicated the highest level of satisfaction. Box plots represent the median, interquartile range, and range of scores

Qualitative analysis of student feedback provided insights into factors influencing perceptions of different teaching modalities. Student responses were analyzed inductively and grouped into recurring themes related to lecture sessions, practical sessions, and clinical teaching, as shown in Figures 3-5.

Figure 3.

Students’ Feedback and Suggestions Regarding Lecture Sessions. Data were derived from open-ended responses provided by students regarding potential improvements in teaching modalities. Responses were grouped into recurring themes through thematic content analysis. Multiple responses were permitted from each participant; therefore, frequencies may exceed the total number of participants

Figure 5.

Students’ Feedback and Suggestions on Clinical Postings. Data were derived from open-ended responses provided by students regarding potential improvements in teaching modalities. Responses were grouped into recurring themes through thematic content analysis. Multiple responses were permitted from each participant; therefore, frequencies may exceed the total number of participants

Figure 4.

Students’ Feedback and Suggestions on Practical Sessions. Data were derived from open-ended responses provided by students regarding potential improvements in teaching modalities. Responses were grouped into recurring themes through thematic content analysis. Multiple responses were permitted from each participant; therefore, frequencies may exceed the total number of participants

Feedback on lecture sessions predominantly highlighted concerns regarding teaching methods and delivery. The extensive use of slide-based presentations emerged as the most frequently reported issue, with students expressing a preference for more interactive, discussion-based, and clinically oriented approaches. Additional themes included limited interactivity, suboptimal time utilization, and inadequate integration of clinical relevance.

In practical sessions, feedback largely emphasized experiential learning. Students valued hands-on components but reported the need for increased opportunities for active participation. Concerns related to large group sizes, insufficient practice time, and variable instructor engagement were also identified.

Clinical teaching was perceived as the most effective modality, with feedback strongly emphasizing real-world applicability. Students highlighted the importance of patient-centered learning, history taking, and clinical reasoning during bedside teaching. The duration and quality of clinical exposure, along with opportunities for supervised hands-on involvement, were also important recurring themes.

Discussion

The present study explored learning preferences among undergraduate medical students using the VARK model and examined their perceptions of prevailing teaching modalities. The findings demonstrate a predominance of kinesthetic and multimodal learning preferences, reflecting the experiential nature of medical education and underscoring the importance of learner-centered, activity-based instructional strategies.[3,7]

In this study, kinesthetic learning emerged as the most common unimodal preference, while nearly half of the students exhibited multimodal learning styles. This pattern aligns with the intrinsic demands of medical training, where competency acquisition relies heavily on observation, hands-on practice, and real-life clinical exposure. Kinesthetic learners benefit most from demonstrations, simulations, bedside teaching, and procedural training, which constitute the core of undergraduate medical education. These findings are consistent with previous studies. Shah et al., reported kinesthetic learning as the dominant preference among Indian medical and dental students, with a substantial proportion demonstrating multimodal learning styles. Similarly, Fahim et al., in a multicentric study, found that over half of the participants preferred multimodal learning, with kinesthetic learning being the most common unimodal style. Collectively, these findings suggest that learning preferences among medical students remain broadly consistent across diverse educational contexts.[3,7]

The relatively low proportion of read/write learners observed in the present study indicates that traditional text-heavy instructional approaches may be insufficient when used in isolation. Murphy et al., emphasized that reliance on a single teaching modality may fail to engage a significant segment of learners and advocated diversified instructional strategies to enhance learning effectiveness. Baykan and Naçar similarly reported limited preference for read/write learning among health professional students, reinforcing the need for varied and multimodal content delivery. The near-equal distribution of unimodal and multimodal learners highlights the heterogeneity of learning preferences within a single cohort. While multimodal learners demonstrate greater adaptability to different teaching methods, integrated instructional strategies combining visual, auditory, textual, and experiential components are likely to benefit the entire learner population.[1,2]

Bhagat et al., reported that students who were aware of their learning styles and exposed to mixed teaching approaches experienced higher engagement and learning satisfaction, even though academic performance was not significantly affected. These observations support the notion that learning preferences are best utilized to guide instructional design rather than to predict academic achievement.[10]

No statistically significant association was observed between learning preferences and gender, age, or year of study. These findings are consistent with those of Mozaffari et al., who reported no meaningful relationship between VARK learning styles and sociodemographic variables among dental students. Although some studies have reported gender-based differences in learning preferences, the lack of such associations in this study suggests that educational context and teaching strategies may exert a stronger influence on learning preferences than demographic characteristics.[6]

Students rated clinical teaching as the most effective teaching modality, followed by practical sessions, while lecture-based teaching received the lowest satisfaction scores. This hierarchy mirrors the predominance of kinesthetic learning identified in the study. Clinical teaching offers authentic, context-rich experiences that integrate knowledge, skills, and professional attitudes, making it particularly effective for kinesthetic and multimodal learners.[3,7]

Qualitative feedback further substantiated these findings. Students expressed dissatisfaction with slide-heavy lectures and emphasized the need for greater interactivity through case discussions, problem-solving exercises, and real-life clinical correlations. Previous studies have similarly reported that excessive reliance on didactic lectures reduces student engagement and promotes surface learning.[11,12]

Practical sessions were valued for their hands-on nature; however, students highlighted the need for improved group dynamics, adequate supervision, and increased opportunities for individual participation. These observations reinforce the importance of “learning by doing” in health professions education, particularly for skill acquisition and long-term knowledge retention.[13]

Recent reviews and multicentric studies have similarly reported substantial variability in learning preferences across institutions while emphasizing the importance of learner-centered educational approaches and context-specific teaching strategies.[14,15,16,17,18,19]

A strength of this study is the inclusion of undergraduate medical students from all years of training, providing a comprehensive assessment of learning preferences across different stages of medical education. In addition, the use of a standardized and widely validated VARK questionnaire adds methodological rigor to the study.

However, certain limitations must be acknowledged. Learning preferences were self-reported and may not always reflect actual learning behaviors. This was a single institutional study; hence, findings may not be generalizable beyond similar educational contexts. Academic performance was not assessed in relation to learning preferences, and future studies may explore this association.

Conclusion

This study demonstrated a predominance of kinesthetic and multimodal learning preferences among undergraduate medical students. Nearly half of the participants exhibited multimodal learning styles, while kinesthetic learning was the most common unimodal preference. Students reported the highest satisfaction with clinical teaching, followed by practical sessions, whereas lecture-based teaching received comparatively lower satisfaction scores. No significant association was observed between learning preference category and age, gender, or year of study. These findings highlight the importance of considering learner preferences while planning instructional activities in undergraduate medical education.

The findings suggest that incorporating active and experiential learning strategies, including clinical exposure, skills-based training, case discussions, and interactive teaching methods, may help improve student engagement and learning experiences in medical education.

Conflicts of interest

There are no conflicts of interest.

Funding Statement

Nil.