Medical Students’ Perceptions of Small Group Teaching versus Lecture-based Teaching in a Resource-limited Setting: A Pilot Study from India

Abstract

Background:

Medical education is evolving toward interactive teaching methods, and small group teaching (SGT) is increasingly being adopted. While lecture-based teaching using PowerPoint (LBTP) remains common, its effectiveness in fostering student engagement, retention, and critical thinking is being questioned.

Objective:

To compare students’ perceptions of SGT versus LBTP among Indian medical undergraduates.

Methods:

A cross-sectional, within-subject, comparative pilot study was conducted among 100 undergraduate medical students at Sheikh Bhikhari Medical College, Hazaribagh, India. The same topic was taught using two approaches: SGT (15–17 students per group, divided into six groups) and LBTP (a whole-class PowerPoint lecture). Feedback was collected via a semistructured questionnaire using Google Forms. Responses were analyzed using descriptive statistics and Chi-square tests (P < 0.05 was considered statistically significant).

Results:

Of the 100 students, 98 completed the questionnaire. Most students (85%) rated SGT as more effective, particularly for understanding and engagement. Knowledge retention was higher with SGT (62.2%) compared to LBTP (11.2%). Strengths of SGT included better interaction, clarity, peer learning, and personalized feedback.

Conclusion:

SGT was perceived as more effective than LBTP. These findings support the integration of interactive, learner-centered methods in resource-limited medical education contexts, such as those found in many parts of Sub-Saharan Africa and South Asia.

INTRODUCTION

Medical education is undergoing a significant transformation, shifting from traditional teacher-centered approaches to more interactive, student-centered methods that foster deeper learning and critical thinking.[1] The classroom environment profoundly impacts student behavior, academic achievement, and well-being. Historically, lectures delivered via PowerPoint (LBTP) have been the cornerstone of medical curricula, offering efficient delivery of foundational knowledge to large groups. However, this didactic approach often results in passive learning, limited student engagement, and low retention of complex concepts, with students finding it difficult to express their opinions.[2]

In contrast, small group teaching (SGT) has emerged as a favored interactive learning strategy in contemporary medical education, emphasizing active participation, peer collaboration, and the development of essential competencies such as problem-solving skills and communication. Nearly all of the teaching strategies used in problem-based learning are done in small groups. SGT enhances both comprehension and student satisfaction by providing opportunities to clarify doubts, receive personalized feedback, and engage more deeply with the teaching material.[2,3] Effective SGT creates an environment for students to discuss their ideas in a nonthreatening group setting, without domination by the tutor, and promotes autonomous thought and problem-solving skills, which are all vital for future healthcare professionals.[4]

Despite these advantages, the effectiveness of teaching methods can vary depending on institutional resources, faculty expertise, and student preferences. LBTP offers visual appeal and standardized content delivery, but they lack in promoting meaningful interaction and individualized feedback. Even highly qualified tutors may not always be good at delivering the best lectures. In LBTP, teaching can be difficult for some students to follow due to individual differences in how quickly they retain information and comprehend the material. As a result, the tutor may end up functioning primarily as a source of information.[5]

Given the ongoing debate regarding the optimal teaching strategy in medical education, it is essential to assess and compare the impact of large-group and small-group methods from the learners’ perspective. Understanding students’ perceptions and preferences can inform curriculum development and guide the adoption of approaches that maximize engagement, retention, and the acquisition of critical competencies. Comparative evidence on the effectiveness of SGT versus traditional lecture-based teaching (LBT) remains limited, particularly in low- and middle-income countries such as India and Sub-Saharan Africa. This study aims to evaluate and compare the effectiveness of LBTP and SGT among Indian medical undergraduates, focusing on student engagement, retention of knowledge, and the development of critical thinking skills.

METHODS

A cross-sectional, within-subject, comparative pilot study using a structured questionnaire was conducted from August to December 2024 at Sheikh Bhikhari Medical College and Hospital, Hazaribagh, Jharkhand, India. The study population consisted of 100 undergraduate medical students (1^st year = 75; 2^nd year = 18; and 4^th year = 5) [Table 1 and Supplementary File 1]. No formal sample size calculation was performed, as this was designed as a pilot exploratory study aimed to assess trends in student preferences and perceptions. Only 1^st year MBBS students participated in both teaching styles, serving as their own controls. Two teaching interventions were conducted:

Table 1.

Demographic frequencies of participants

Year of study	Number of participants	Percentage of total (%)
1st	n=75, male:female=39:36	~77
2nd	n=18, male:female=6:12	~18
4th	n=5, male:female=5:0	~5

• (a) LBT using PowerPoint (LBTP): Delivered to the whole class by a tutor with over 15 years of experience

• (b) SGT: Conducted in batches of 15–17 students, split into 5–7 groups each facilitated by two tutors with over 10 years of teaching experience, conducted in two demonstration rooms in three rotational shifts using an interactive, discussion-based approach due to infrastructural and logistical constraints.

Teaching content was predefined with a uniform PowerPoint presentation for LBTP, and a standardized teaching script and discussion prompts for SGT. Tutors were briefed in advance and used the same materials to ensure consistency in content delivery across all small group sessions. Following the sessions, students completed a validated semistructured questionnaire via Google Forms. The questionnaire included demographic details of the students and items assessing the advantages and disadvantages of each teaching method. Students were asked to rate their responses for both teaching formats using a 5-item Likert scale (effective, very effective, neutral, ineffective, and very ineffective). The questionnaire was pretested and reviewed for validity and reliability before administration. The complete survey instrument is included in Supplementary File 2.

The primary outcome was to assess the effectiveness of both teaching methods for understanding, engagement, and retention. The secondary outcome was students’ perceptions of critical thinking, communication, and application to real-world scenarios through both teaching styles. The data were analyzed using JAMOVI software version 2.3.28 (JAMOVI Project, Sydney, Australia). Descriptive statistics summarized demographic data and student preferences. Frequencies and percentages were calculated for categorical variables. Chi-square tests assessed associations between student preferences and variables such as age, gender, and academic year. P < 0.05 was considered statistically significant.

Written informed consent was obtained from all participants. Ethical clearance was granted by the university ethics committee.

RESULTS

Of the 100 students invited, 98 completed the questionnaire (females = 48 and males = 50). Most respondents were 1^st year MBBS students (77%). Detailed frequency distributions of responses by gender and year of study are available in Supplementary Table 1. Feedback was also obtained from 2^nd and 4^th year students to assess evolving perceptions across academic years.

The gender connection analysis was nonsignificant (P = 0.435), supporting the idea that there was no significant difference in the preferences for better teaching strategies. Additional age did not significantly affect the improvements in teaching strategies (P = 0.165). The recommendations for raising the standard of instruction differ considerably (P < 0.005) from year to year, indicating that students’ perceptions and educational requirements change as they progress through the medical course in their academic journey. First-year students favored more interactive sessions and technological improvements, reflecting a need for engaging and modern teaching methods. Conversely, suggestions from 4^th year students, though fewer, included unique needs such as making classes voluntary and reducing reliance on traditional PowerPoint methods. This finding suggests that students’ educational needs and perceptions evolve throughout their academic journey.

For overall improvement in medical education, 57.1% of students expressed a preference for both the methods, 26.5% of students preferred SGT, while LBTP was preferred by 14.3% of students only. Students perceived SGT as considerably more effective than LBTP for understanding course material more effectively. SGT was rated as effective or very effective by a significantly higher proportion of students (85.7%) compared to LBTP (56.1%). Neutral, ineffective, or very ineffective ratings were also much lower for SGT (14.3%) than for LBTP (43.8%) [Tables 2 and 3].

Table 2.

Comparison of student perceptions and preferences for small group teaching versus large group teaching using PowerPoint and lecture-based teaching using PowerPoint

Outcome/preference	SGT (%)	LGTP (%)	Both methods equally (%)	Neither/no preference (%)
Effectiveness for understanding and engagement	85.7	56.1	-	-
Knowledge retention	62.2	11.2	24.5	2.0
Promotes critical thinking skills	63.3	12.2	24.5	-
Enhances communication and presenting skills	52.0	18.4	28.6	1.0
Understanding complex concepts	42.9	15.3	38.8	-
Student engagement	64.3	13.2	21.4	-
Applies theory to real-world scenarios	49.0	19.4	31.6	-
Overall preference for medical education	26.5	14.3	57.1	2.0

SGT=Small group teaching, LGTP=Large group teaching using PowerPoint

Table 3.

Strengths, weaknesses, and suggested improvements for small group teaching and large group teaching using PowerPoint and lecture-based teaching using PowerPoint

Teaching style	Main strength	Main weaknesses	Suggested improvement
SGT	Interactive nature, peer collaboration, better understanding, personalized feedback, enhances student engagement, promotes critical thinking, improves knowledge retention, fosters communication skills	Dependent on group dynamics, less structured, resource-intensive, potential for tutor variability, can be slower	Increase interactive sessions, better use of visual aids, slower pace, clearer handwriting, more focus on group dynamics, improved structure, more technology-enhanced tools
LBTP	Multimedia inclusion (videos, images), organized structure, visual appeal, easy to follow, efficient delivery of foundational knowledge, standardized content delivery	Monotonous delivery, lack of interaction, passive learning, low retention, rigid organization, less personalized feedback, can be challenging for students with different learning paces	Add interactive elements (quizzes, Q and A), simplify slides, increase visual content, better organization of content, reduce monotonous delivery, encourage participation

SGT=Small group teaching, LBTP=Lecture-based teaching using PowerPoint

The vast majority of students (63.3%) identified SGT as the method that helps them retain information best, while only a small proportion (10.2%) favored LBTP for retention. About 24.5% of students believed both methods were equally effective, and only 2% felt that neither method was helpful. Survey results show that students identified multimedia inclusion, organized structure, and visual appeal as the primary strengths of LBTP. In contrast, they most valued the interactive nature, peer collaboration, enhanced understanding, and personalized feedback offered by SGT [Tables 2 and 3].

When it comes to understanding complex medical concepts, SGT is the most preferred method (42.9%), followed by both methods (38.8%), and least by LBTP (15.3%). SGT is also most effective for retaining information by 62.2% of students, whereas LBTP was only preferred by (11.2%), although both methods were seen as equally effective by (24.5%) [Tables 2 and 3].

For the teaching method that keeps students most engaged and interested during class sessions, SGT was the most engaging method preferred by 64.3% of students, followed by both equally (21.4%), and then by LBTP (13.2%). SGT is consistently preferred by a majority of students for promoting critical thinking (63.3%), retaining information (62.2%), and enhancing communication and presenting skills (52%). A notable minority of students see both methods as equally effective, while LBTP is less often chosen as the preferred method for promoting critical thinking (12.2%), retaining information (11.2%), and enhancing communication and presenting skills (18.4%) [Tables 2 and 3].

For applying theoretical knowledge to real-world medical scenarios, SGT was the most frequently chosen (49%), with a substantial proportion also favoring both methods (31.6%), and only a small proportion of students preferred LBTP (19.4%) [Tables 2 and 3]. Detailed item wise survey responses are presented in Supplementary File 2.

The Chi-square test showed that females tended to rate LBTP more positively than males (χ² = 11.5, P = 0.022). Males more frequently rated SGT as “Very Effective,” but the association between gender and SGT effectiveness was not statistically significant (χ² = 6.18, P = 0.186). A statistically significant association was found between year of study and perceived effectiveness of LBTP (χ² = 16.5, P = 0.036). No significant association was observed between year of study and effectiveness ratings for SGT (χ² = 5.91, P = 0.658) [Table 4].

Table 4.

Association of gender and year of study with perceived effectiveness of large group teaching using PowerPoint and small group teaching: Chi-square test (χ²)

Variable	Teaching method	χ 2	df	P	Significance
Gender (male/female)	LBTP	11.50	4	0.022	Significant
Gender (male/female)	SGT	6.18	4	0.186	Not significant
Year of study (1st, 2nd, 4th)	LBTP	16.50	8	0.036	Significant
Year of study (1st, 2nd, 4th)	SGT	5.91	8	0.658	Not significant

SGT=Small group teaching, LBTP=Lecture-based teaching using PowerPoint, DF=degree of freedom

DISCUSSION

The present study explored the perceptions and preferences of undergraduate medical students regarding two prevalent teaching methods in medical education: LGTP and SGT. Consistent with contemporary educational trends, SGT was highly valued for its ability to promote critical thinking, enhance retention, improve communication and presentation skills, and facilitate them to assess, incorporate, and apply their theoretical knowledge to real-world situations, which are important in the medical profession.[6] These findings align with established educational theories emphasizing active learning, peer interaction, and personalized feedback, having important implications for medical training in resource-constrained environments such as many African and South Asian institutions.[,8,9] Instead of considering students as passive recipients of a lecture powered by slides, SGT actively engages them and promotes high-order thinking.[10,11] This aligns with previous research suggesting that active learning environments, retention, and the application of knowledge to clinical scenarios are promoted by SGT.[,13,14]

Although the Chi-square test did not reveal a statistically significant association between gender or year of study and perceived effectiveness of SGT (P > 0.05), descriptive data showed that a majority of students across all groups rated SGT as “effective” or “very effective,” indicating a consistent preference. The lack of statistically significant associations may be influenced by small subgroup sizes, particularly in higher academic years, potentially limiting the power of the Chi-square test to detect true differences.

LGTP, the traditional tool for teaching medical students, offers benefits such as structured content delivery and multimedia integration. However, it is often criticized for its limited interactivity and lower engagement, which may reduce lectures to a monologue and create issues related to the speed of teaching or rigid organization of slides, all failing to promote deep learning.[,16,17] However, adding interactive elements in LGTP can significantly improve collaboration and satisfaction among learners.[18]

The present study has several limitations. The sample size, while adequate for preliminary analysis, is relatively small, and results may not fully generalize to other populations. The study relied on self-reported data, which may introduce response bias. Although students from multiple academic years were included, the majority were 1^st year students. The involvement of multiple tutors in SGT, despite standardization efforts, may have introduced some variation in teaching style. The study provides a general overview of students’ preferences but does not explore specific aspects of teaching that may influence perceptions.

Future research should involve larger, multicenter, more balanced cohorts and incorporate both qualitative and quantitative data to better capture factors contributing to teaching method effectiveness. Exploring the impact of faculty training and curriculum design on teaching outcomes is also recommended.

CONCLUSION

Most students prefer a blended approach, highlighting the need for developing interactive, well-balanced teaching strategies. These findings underscore the importance of contextually appropriate, interactive medical teaching strategies in low-resource settings such as those in Sub-Saharan Africa and South Asia.

Conflicts of interest

There are no conflicts of interest.

Supplementary Files

Supplementary files (descriptive and Chi.square test results)

Descriptives
	Gender	n	Mean	Median	SD	Minimum	Maximum
Year of study	Female	48
	Male	50
How effective do you find PowerPoint presentations in helping you understand the material?	Female	48
	Male	50
How effective do you find small group teachings in helping you understand the material?	Female	48
	Male	50
Which method helps you retain information better?	Female	48
	Male	50
What do you consider the main strengths of PowerPoint presentation? (select all that apply)	Female	48
	Male	50
What do you consider the main strengths of small group teaching? (select all that apply)	Female	48
	Male	50
What do you consider the main weaknesses of PowerPoint presentations? (select all that apply)	Female	48
	Male	50
What do you consider the main weakness of small group teaching? (select all that apply)	Female	48
	Male	50
Which teaching method do you find most effective for undertstanding complex medical concepts?	Female	48
	Male	50
Which teaching method keeps you most engaged and interested during class sessions?	Female	48
	Male	50
Which teaching method best promotes the development of your critical thinking skills?	Female	48
	Male	50
Which teaching method helps you retain information most effectively?	Female	48
	Male	50
Which teaching method best enhances your communication and presenting skills?	Female	48
	Male	50
Which teaching method lets you best apply theoretical knowledge to real world medical scenarios?	Female	48
	Male	50
Which teaching method do you prefer overall for your medical education?	Female	48
	Male	50
What improvements would you suggest for small group teachings? (select all that apply)	Female	48
	Male	50
What improvements would you suggest for PowerPoint presentations? (select all that apply)	Female	48
	Male	50
What changes would you suggest to improve the quality of your classes? (select all that apply)	Female	48
	Male	50

SD=Standard deviation

Frequencies

Frequencies of year of study
Year of study	Gender	Counts	Percentage of total	Cumulative (%)
1st	Female	36	36.7	36.7
	Male	39	39.8	76.5
2nd	Female	12	12.2	88.8
	Male	6	6.1	94.9
4th	Female	0	0.0	94.9
	Male	5	5.1	100.0

Frequencies of how effective do you find PowerPoint presentations in helping you understand the material?
How effective do you find PowerPoint presentations in helping you understand the material?	Gender	Counts	Percentage of total	Cumulative (%)
Neutral	Female	14	14.3	14.3
	Male	16	16.3	30.6
Very effective	Female	4	4.1	34.7
	Male	7	7.1	41.8
Very ineffective	Female	0	0.0	41.8
	Male	6	6.1	48.0
Effective	Female	28	28.6	76.5
	Male	16	16.3	92.9
Ineffective	Female	2	2.0	94.9
	Male	5	5.1	100.0

Frequencies of how effective do you find small group teachings in helping you understand the material?
How effective do you find small group teachings in helping you understand the material?	Gender	Counts	Total (%)	Cumulative (%)
Neutral	Female	5	5.1	5.1
	Male	4	4.1	9.2
Very effective	Female	13	13.3	22.4
	Male	23	23.5	45.9
Very ineffective	Female	1	1.0	46.9
	Male	0	0.0	46.9
Effective	Female	28	28.6	75.5
	Male	20	20.4	95.9
Ineffective	Female	1	1.0	96.9
	Male	3	3.1	100.0

Frequencies of which method helps you retain information better?
Which method helps you retain information better?	Gender	Counts	Total (%)	Cumulative (%)
Both equally	Female	11	11.2	11.2
	Male	13	13.3	24.5
Neither	Female	0	0.0	24.5
	Male	2	2.0	26.5
PowerPoint	Female	6	6.1	32.7
	Male	4	4.1	36.7
Small group teaching	Female	31	31.6	68.4
	Male	31	31.6	100.0

Frequencies of what do you consider the main strengths of PowerPoint presentation? (select all that apply)
What do you consider the main strengths of PowerPoint presentation? (select all that apply)	Gender	Counts	Total (%)	Cumulative (%)
Ability to include multimedia (videos; images)	Female	16	16.3	16.3
	Male	10	10.2	26.5
Ability to include multimedia (videos; images); easy to follow	Female	0	0.0	26.5
	Male	1	1.0	27.6
Easy to follow	Female	1	1.0	28.6
	Male	1	1.0	29.6
None	Female	0	0.0	29.6
	Male	1	1.0	30.6
Nothing	Female	0	0.0	30.6
	Male	1	1.0	31.6
Organized structure	Female	1	1.0	32.7
	Male	4	4.1	36.7
Organized structure; ability to include multimedia (videos; images)	Female	5	5.1	41.8
	Male	4	4.1	45.9
Organized structure; ability to include multimedia (videos; images); easy to follow	Female	2	2.0	48.0
	Male	0	0.0	48.0
Organized structure; easy to follow	Female	0	0.0	48.0
	Male	1	1.0	49.0
Visual appeal	Female	4	4.1	53.1
	Male	8	8.2	61.2
Visual appeal; ability to include multimedia (videos; images)	Female	8	8.2	69.4
	Male	5	5.1	74.5
Visual appeal; ability to include multimedia (videos; images); easy to follow	Female	0	0.0	74.5
	Male	1	1.0	75.5
Visual appeal; organized structure	Female	1	1.0	76.5
	Male	1	1.0	77.6
Visual appeal; organized structure; ability to include multimedia (videos; images)	Female	7	7.1	84.7
	Male	7	7.1	91.8
Visual appeal; organized structure; ability to include multimedia (videos; images); easy to follow	Female	2	2.0	93.9
	Male	4	4.1	98.0
Visual appeal; organized structure; ability to include multimedia (videos; images); easy to follow; every student gets access to same source	Female	0	0.0	98.0
	Male	1	1.0	99.0
Visual appeal; organized structure; ability to include multimedia (videos; images); easy to follow; better recalling	Female	1	1.0	100.0
	Male	0	0.0	100.0

Frequencies of What do you consider the main strengths of small group teaching? (select all that apply)
What do you consider the main strengths of small group teaching? (select all that apply)	Gender	Counts	Total (%)	Cumulative (%)
Better understanding	Female	9	9.2	9.2
	Male	9	9.2	18.4
Better understanding; personalized feedback	Female	2	2.0	20.4
	Male	1	1.0	21.4
Interactive nature	Female	12	12.2	33.7
	Male	10	10.2	43.9
Interactive nature; better understanding	Female	4	4.1	48.0
	Male	2	2.0	50.0
Interactive nature; better understanding; personalized feedback	Female	3	3.1	53.1
	Male	1	1.0	54.1
Interactive nature; better understanding; personalized feedback; visual appeal; teaching from videos	Female	0	0.0	54.1
	Male	1	1.0	55.1
Interactive nature; peer collaboration	Female	0	0.0	55.1
	Male	1	1.0	56.1
Interactive nature; peer collaboration; better understanding	Female	4	4.1	60.2
	Male	2	2.0	62.2
Interactive nature; peer collaboration; better understanding; personalized feedback	Female	9	9.2	71.4
	Male	13	13.3	84.7
Interactive nature; peer collaboration; better understanding; personalized feedback; lesser hesitation to interact	Female	0	0.0	84.7
	Male	1	1.0	85.7
Interactive nature; peer collaboration; personalized feedback	Female	0	0.0	85.7
	Male	2	2.0	87.8
Interactive nature; personalized feedback	Female	1	1.0	88.8
	Male	3	3.1	91.8
Peer collaboration	Female	2	2.0	93.9
	Male	1	1.0	94.9
Peer collaboration; better understanding	Female	2	2.0	96.9
	Male	1	1.0	98.0
Personalized feedback	Female	0	0.0	98.0
	Male	2	2.0	100.0

Frequencies of what do you consider the main weaknesses of PowerPoint presentations? (select all that apply)
What do you consider the main weaknesses of PowerPoint presentations? (select all that apply)	Gender	Counts	Total (%)	Cumulative (%)
Can be monotonous	Female	1	1.0	1.0
	Male	4	4.1	5.1
Can be monotonous; information overload	Female	1	1.0	6.1
	Male	0	0.0	6.1
Can be monotonous; limited interaction	Female	1	1.0	7.1
	Male	0	0.0	7.1
Can be monotonous; limited interaction; information overload	Female	0	0.0	7.1
	Male	1	1.0	8.2
Can be monotonous; over-reliance on slides	Female	1	1.0	9.2
	Male	2	2.0	11.2
Can be monotonous; over-reliance on slides; information overload	Female	3	3.1	14.3
	Male	2	2.0	16.3
Can be monotonous; over-reliance on slides; information overload; hard to follow	Female	0	0.0	16.3
	Male	1	1.0	17.3
Can be monotonous; over-reliance on slides; limited interaction	Female	2	2.0	19.4
	Male	0	0.0	19.4
Can be monotonous; over-reliance on slides; limited interaction; information overload	Female	6	6.1	25.5
	Male	7	7.1	32.7
Can be monotonous; over-reliance on slides; limited interaction; information overload; having to sit in a class full of humans	Female	0	0.0	32.7
	Male	1	1.0	33.7
Information overload	Female	2	2.0	35.7
	Male	8	8.2	43.9
Information overload	Female	0	0.0	43.9
	Male	1	1.0	44.9
Limited interaction	Female	14	14.3	59.2
	Male	9	9.2	68.4
Limited interaction; information overload	Female	2	2.0	70.4
	Male	0	0.0	70.4
Over-reliance on slides	Female	5	5.1	75.5
	Male	7	7.1	82.7
Over-reliance on slides; information overload	Female	3	3.1	85.7
	Male	3	3.1	88.8
Over-reliance on slides; limited interaction	Female	6	6.1	94.9
	Male	3	3.1	98.0
Over-reliance on slides; limited interaction; information overload	Female	1	1.0	99.0
	Male	1	1.0	100.0

Frequencies of What do you consider the main weakness of small group teaching? (select all that apply)
What do you consider the main weakness of small group teaching? (select all that apply)	Gender	Counts	Total (%)	Cumulative (%)
Dependant on group dynamics	Female	10	10.2	10.2
	Male	4	4.1	14.3
Less structured	Female	4	4.1	18.4
	Male	5	5.1	23.5
Less structured; dependant on group dynamics	Female	0	0.0	23.5
	Male	5	5.1	28.6
Requires more resources	Female	6	6.1	34.7
	Male	3	3.1	37.8
Requires more resources; dependant on group dynamics	Female	2	2.0	39.8
	Male	2	2.0	41.8
Requires more resources; less structured	Female	1	1.0	42.9
	Male	1	1.0	43.9
Requires more resources; time-consuming	Female	0	0.0	43.9
	Male	7	7.1	51.0
Requires more resources; time-consuming; dependant on group dynamics	Female	0	0.0	51.0
	Male	1	1.0	52.0
Requires more resources; time-consuming; less structured	Female	1	1.0	53.1
	Male	0	0.0	53.1
Requires more resources; time-consuming; less structured; dependant on group dynamics	Female	2	2.0	55.1
	Male	0	0.0	55.1
Time- consuming	Female	10	10.2	65.3
	Male	17	17.3	82.7
Time- consuming; dependant on group dynamics	Female	5	5.1	87.8
	Male	2	2.0	89.8
Time- consuming; less structured	Female	4	4.1	93.9
	Male	2	2.0	95.9
Time- consuming; less structured; dependant on group dynamics	Female	3	3.1	99.0
	Male	1	1.0	100.0

Frequencies of which teaching method do you find most effective for undertstanding complex medical concepts?
Which Teaching method do you find most effective for undertstanding complex medical concepts?	Gender	Counts	Total (%)	Cumulative (%)
Both	Female	22	22.4	22.4
	Male	16	16.3	38.8
No preference	Female	1	1.0	39.8
	Male	2	2.0	41.8
PowerPoint	Female	6	6.1	48.0
	Male	9	9.2	57.1
Small group teaching	Female	19	19.4	76.5
	Male	23	23.5	100.0

Frequencies of which teaching method keeps you most engaged and interested during class sessions?
Which Teaching method keeps you most engaged and interested during class sessions?	Gender	Counts	Total (%)	Cumulative (%)
Both equally	Female	9	9.2	9.2
	Male	12	12.2	21.4
No preference	Female	0	0.0	21.4
	Male	1	1.0	22.4
PowerPoint	Female	7	7.1	29.6
	Male	6	6.1	35.7
Small group teaching	Female	32	32.7	68.4
	Male	31	31.6	100.0

Frequencies of which teaching method best promotes the development of your critical thinking skills?
Which teaching method best promotes the development of your critical thinking skills?	Gender	Counts	Total (%)	Cumulative (%)
Both	Female	11	11.2	11.2
	Male	13	13.3	24.5
PowerPoint presentations	Female	4	4.1	28.6
	Male	8	8.2	36.7
Small group teachings	Female	33	33.7	70.4
	Male	29	29.6	100.0

Frequencies of which teaching method helps you retain information most effectively?
Which teaching method helps you retain information most effectively?	Gender	Counts	Total (%)	Cumulative (%)
Both	Female	11	11.2	11.2
	Male	13	13.3	24.5
No preference	Female	1	1.0	25.5
	Male	1	1.0	26.5
PowerPoint presentations	Female	6	6.1	32.7
	Male	5	5.1	37.8
Small group teachings	Female	30	30.6	68.4
	Male	31	31.6	100.0

Frequencies of which teaching method best enhances your communication and presenting skills?
Which teaching method helps you retain information most effectively?	Gender	Counts	Total (%)	Cumulative (%)
Both	Female	15	15.3	15.3
	Male	13	13.3	28.6
No preference	Female	1	1.0	29.6
	Male	0	0.0	29.6
PowerPoint presentations	Female	11	11.2	40.8
	Male	7	7.1	48.0
Small group teachings	Female	21	21.4	69.4
	Male	30	30.6	100.0

Frequencies of what improvements would you suggest for small group teachings? (select all that apply)
What improvements would you suggest for small group teachings? (select all that apply)	Gender	Counts	Total (%)	Cumulative (%)
Better use of visual aids	Female	8	8.2	8.2
	Male	15	15.3	23.5
Better use of visual aids; clearer handwriting	Female	1	1.0	24.5
	Male	0	0.0	24.5
Clearer handwriting	Female	0	0.0	24.5
	Male	1	1.0	25.5
More interactive sessions	Female	10	10.2	35.7
	Male	10	10.2	45.9
More interactive sessions; better use of visual aids	Female	15	15.3	61.2
	Male	11	11.2	72.4
More interactive sessions; better use of visual aids; clearer handwriting	Female	2	2.0	74.5
	Male	1	1.0	75.5
More interactive sessions; clearer handwriting	Female	1	1.0	76.5
	Male	1	1.0	77.6
Slower pace	Female	3	3.1	80.6
	Male	3	3.1	83.7
Slower pace; better use of visual aids	Female	1	1.0	84.7
	Male	2	2.0	86.7
Slower pace; better use of visual aids; clearer handwriting	Female	1	1.0	87.8
	Male	0	0.0	87.8
Slower pace; clearer handwriting	Female	0	0.0	87.8
	Male	1	1.0	88.8
Slower pace; more interactive sessions	Female	0	0.0	88.8
	Male	5	5.1	93.9
Slower pace; more interactive sessions; better use of visual aids	Female	3	3.1	96.9
	Male	0	0.0	96.9
Slower pace; more interactive sessions; better use of visual aids; clearer handwriting	Female	3	3.1	100.0
	Male	0	0.0	100.0

Frequencies of What improvements would you suggest for PowerPoint Presentations? (select all that apply)
What improvements would you suggest for PowerPoint presentations? ( select all that apply)	Gender	Counts	Total (%)	Cumulative (%)
1 student per class	Female	0	0.0	0.0
	Male	1	1.0	1.0
Better organisation of content	Female	1	1.0	2.0
	Male	2	2.0	4.1
Interactive elements (quizzes; Q and A)	Female	12	12.2	16.3
	Male	4	4.1	20.4
Interactive elements (quizzes; Q and A); better organisation of content	Female	3	3.1	23.5
	Male	4	4.1	27.6
More visual content	Female	1	1.0	28.6
	Male	7	7.1	35.7
More visual content; better organisation of content	Female	0	0.0	35.7
	Male	1	1.0	36.7
More visual content; interactive elements (quizzes; Q and A)	Female	4	4.1	40.8
	Male	3	3.1	43.9
More visual content; interactive elements (quizzes; Q and A); better organisation of content	Female	7	7.1	51.0
	Male	1	1.0	52.0
Simplified slides	Female	3	3.1	55.1
	Male	7	7.1	62.2
Simplified slides; better organisation of content	Female	0	0.0	62.2
	Male	1	1.0	63.3
Simplified slides; interactive elements (quizzes; Q and A)	Female	3	3.1	66.3
	Male	3	3.1	69.4
Simplified slides; interactive elements (quizzes; Q and A); better organisation of content	Female	1	1.0	70.4
	Male	1	1.0	71.4
Simplified slides; more visual content	Female	1	1.0	72.4
	Male	5	5.1	77.6
Simplified slides; more visual content; better organisation of content	Female	2	2.0	79.6
	Male	2	2.0	81.6
Simplified slides; more visual content; interactive elements (quizzes; Q and A)	Female	1	1.0	82.7
	Male	1	1.0	83.7
Simplified slides; more visual content; interactive elements (quizzes; Q and A); better organisation of content	Female	9	9.2	92.9
	Male	7	7.1	100.0

Frequencies of what changes would you suggest to improve the quality of your classes? (select all that apply)
What changes would you suggest to improve the quality of your classes? (select all that apply )	Gender	Counts	Total (%)	Cumulative (%)
-	Female	0	0.0	0.0
	Male	1	1.0	1.0
1 student per teacher; make the classes voluntary to take; everything will improve automatically	Female	0	0.0	1.0
	Male	1	1.0	2.0
Better use of technology in teaching	Female	0	0.0	2.0
	Male	5	5.1	7.1
Better use of technology in teaching; more practical/laboratory sessions	Female	1	1.0	8.2
	Male	1	1.0	9.2
Better use of technology in teaching; more practical/laboratory sessions; improved course materials	Female	2	2.0	11.2
	Male	2	2.0	13.3
Better use of technology in teaching; more practical/laboratory sessions; improved course materials; more feedback on assignments/tests	Female	1	1.0	14.3
	Male	0	0.0	14.3
Better use of technology in teaching; more practical/laboratory sessions; more feedback on assignments/tests	Female	0	0.0	14.3
	Male	1	1.0	15.3
Don’t use PPTs; writing on board is better	Female	0	0.0	15.3
	Male	1	1.0	16.3
Improved course materials	Female	1	1.0	17.3
	Male	2	2.0	19.4
More interactive sessions	Female	6	6.1	25.5
	Male	7	7.1	32.7
More interactive sessions; better use of technology in teaching	Female	3	3.1	35.7
	Male	4	4.1	39.8
More interactive sessions; better use of technology in teaching; improved course materials	Female	3	3.1	42.9
	Male	3	3.1	45.9
More interactive sessions; better use of technology in teaching; improved course materials; more feedback on assignments/tests	Female	1	1.0	46.9
	Male	0	0.0	46.9
More interactive sessions; better use of technology in teaching; more feedback on assignments/tests	Female	1	1.0	48.0
	Male	1	1.0	49.0
More interactive sessions; better use of technology in teaching; more practical/laboratory sessions	Female	3	3.1	52.0
	Male	6	6.1	58.2
More interactive sessions; better use of technology in teaching; more practical/laboratory sessions; improved course materials	Female	2	2.0	60.2
	Male	2	2.0	62.2
More interactive sessions; better use of technology in teaching; more practical/laboratory sessions; improved course materials; more feedback on assignments/tests	Female	5	5.1	67.3
	Male	7	7.1	74.5
More interactive sessions; better use of technology in teaching; more practical/laboratory sessions; more feedback on assignments/tests	Female	1	1.0	75.5
	Male	0	0.0	75.5
More interactive sessions; improved course materials; more feedback on assignments/tests; more teacher and student interaction	Female	0	0.0	75.5
	Male	1	1.0	76.5
more interactive sessions; more feedback on assignments/tests	Female	1	1.0	77.6
	Male	0	0.0	77.6
more interactive sessions; more practical/laboratory sessions	Female	5	5.1	82.7
	Male	1	1.0	83.7
More interactive sessions; more practical/laboratory sessions; improved course materials	Female	1	1.0	84.7
	Male	0	0.0	84.7
More interactive sessions; more practical/laboratory sessions; improved course materials; more feedback on assignments/tests	Female	2	2.0	86.7
	Male	1	1.0	87.8
More interactive sessions; more practical/laboratory sessions; more feedback on assignments/tests	Female	4	4.1	91.8
	Male	0	0.0	91.8
More practical/laboratory sessions	Female	4	4.1	95.9
	Male	2	2.0	98.0
More practical/laboratory sessions; improved course materials	Female	1	1.0	99.0
	Male	0	0.0	99.0
More practical/laboratory sessions; improved course materials; more feedback on assignments/tests	Female	0	0.0	99.0
	Male	1	1.0	100.0

Contingency Tables

Table 1.

What changes would you suggest to improve the quality of your classes? (select all that apply )	Gender		Total
	Female	Male
-	0	1	1
1 student per teacher; make the classes voluntary to take; everything will improve automatically	0	1	1
Better use of technology in teaching	0	5	5
Better use of technology in teaching; more practical/laboratory sessions	1	1	2
Better use of technology in teaching; more practical/laboratory sessions; improved course materials	2	2	4
Better use of technology in teaching; more practical/laboratory sessions; improved course materials; more feedback on assignments/tests	1	0	1
Better use of technology in teaching; more practical/laboratory sessions; more feedback on assignments/tests	0	1	1
Don’t use PPTs; writing on board is better	0	1	1
Improved course materials	1	2	3
More interactive sessions	6	7	13
More interactive sessions; better use of technology in teaching	3	4	7
More interactive sessions; better use of technology in teaching; improved course materials	3	3	6
More interactive sessions; better use of technology in teaching; improved course materials; more feedback on assignments/tests	1	0	1
More interactive sessions; better use of technology in teaching; more feedback on assignments/tests	1	1	2
More interactive sessions; better use of technology in teaching; more practical/laboratory sessions	3	6	9
More interactive sessions; better use of technology in teaching; more practical/laboratory sessions; improved course materials	2	2	4
More interactive sessions; better use of technology in teaching; more practical/laboratory sessions; improved course materials; more feedback on assignments/tests	5	7	12
More interactive sessions; better use of technology in teaching; more practical/laboratory sessions; more feedback on assignments/tests	1	0	1
More interactive sessions; improved course materials; more feedback on assignments/tests; more teacher and student interaction	0	1	1
More interactive sessions; more feedback on assignments/tests	1	0	1
More interactive sessions; more practical/laboratory sessions	5	1	6
More interactive sessions; more practical/laboratory sessions; improved course materials	1	0	1
More interactive sessions; more practical/laboratory sessions; improved course materials; more feedback on assignments/tests	2	1	3
More interactive sessions; more practical/laboratory sessions; more feedback on assignments/tests	4	0	4
More practical/laboratory sessions	4	2	6
More practical/laboratory sessions; improved course materials	1	0	1
More practical/laboratory sessions; improved course materials; more feedback on assignments/tests	0	1	1
Total	48	50	98

Chi-square tests
	Value	df	P
χ 2	26.5	26	0.435
n	98

Level of significance P value is <0.05

Table 2.

What changes would you suggest to improve the quality of your classes? (select all that apply)	How old are you? (years) - transform 1		Total
	1	2
-	0	1	1
1 student per teacher; make the classes voluntary to take; everything will improve automatically	1	0	1
Better use of technology in teaching	2	3	5
Better use of technology in teaching; more practical/laboratory sessions	0	2	2
Better use of technology in teaching; more practical/laboratory sessions; improved course materials	2	2	4
Better use of technology in teaching; more practical/laboratory sessions; improved course materials; more feedback on assignments/tests	1	0	1
Better use of technology in teaching; more practical/laboratory sessions; more feedback on assignments/tests	1	0	1
Don’t use PPTs; writing on board is better	1	0	1
Improved course materials	1	2	3
More interactive sessions	5	8	13
More interactive sessions; better use of technology in Teaching	5	2	7
More interactive sessions; better use of technology in teaching; improved course materials	2	4	6
More interactive sessions; better use of technology in teaching; improved course materials; more feedback on assignments/tests	1	0	1
More interactive sessions; better use of technology in teaching; more feedback on assignments/tests	2	0	2
More interactive sessions; better use of technology in teaching; more practical/laboratory sessions	3	6	9
More interactive sessions; better use of technology in teaching; more practical/laboratory sessions; improved course materials	3	1	4
More interactive sessions; better use of technology in teaching; more practical/laboratory sessions; improved course materials; more feedback on assignments/tests	8	4	12
More interactive sessions; better use of technology in teaching; more practical/laboratory sessions; more feedback on assignments/tests	1	0	1
More interactive sessions; improved course materials; more feedback on assignments/tests; more teacher and student interaction	1	0	1
More interactive sessions; more feedback on assignments/tests	1	0	1
More interactive sessions; more practical/laboratory sessions	6	0	6
More interactive sessions; more practical/laboratory sessions; improved course materials	1	0	1
More interactive sessions; more practical/laboratory sessions; improved course materials; more feedback on assignments/tests	3	0	3
More interactive sessions; more practical/laboratory sessions; more feedback on assignments/tests	4	0	4
More practical/laboratory sessions	4	2	6
More practical/laboratory sessions; improved course materials	0	1	1
More practical/laboratory sessions; improved course materials; more feedback on assignments/tests	1	0	1
Total	60	38	98

Chi-square test
	Value	df	P
χ 2	32.9	26	0.165
n	98

<22 years=1, >22 years=2

Table 3.

What changes would you suggest to improve the quality of your classes? ( select all that apply)	Year of study			Total
	1st	2nd	4th
-	0	0	1	1
1 student per teacher; make the classes voluntary to take; everything will improve automatically	0	0	1	1
Better use of technology in teaching	4	1	0	5
Better use of technology in teaching; more practical/laboratory sessions	2	0	0	2
Better use of technology in teaching; more practical/laboratory sessions; improved course materials	4	0	0	4
Better use of technology in teaching; more practical/laboratory sessions; improved course materials; more feedback on assignments/tests	0	1	0	1
Better use of technology in teaching; more practical/laboratory sessions; more feedback on assignments/tests	0	1	0	1
Don’t use PPTs; writing on board is better	0	1	0	1
Improved course materials	2	0	1	3
More interactive sessions	10	3	0	13
More interactive sessions; better use of technology in teaching	6	1	0	7
More interactive sessions; better use of technology in teaching; improved course materials	5	0	1	6
More interactive sessions; better use of technology in teaching; improved course materials; more feedback on assignments/tests	1	0	0	1
More interactive sessions; better use of technology in teaching; more feedback on assignments/tests	2	0	0	2
More interactive sessions; better use of technology in teaching; more practical/laboratory sessions	7	1	1	9
More interactive sessions; better use of technology in teaching; more practical/laboratory sessions; improved course materials	4	0	0	4
More interactive sessions; better use of technology in teaching; more practical/laboratory sessions; improved course materials; more feedback on assignments/tests	8	4	0	12
More interactive sessions; better use of technology in teaching; more practical/laboratory sessions; more feedback on assignments/tests	0	1	0	1
More interactive sessions; improved course materials; more feedback on assignments/tests; more teacher and student interaction	1	0	0	1
More interactive sessions; more feedback on assignments/tests	0	1	0	1
More interactive sessions; more practical/laboratory sessions	5	1	0	6
More interactive sessions; more practical/laboratory sessions; improved course materials	0	1	0	1
More interactive sessions; more practical/laboratory sessions; improved course materials; more feedback on assignments/tests	3	0	0	3
More interactive sessions; more practical/laboratory sessions; more feedback on assignments/tests	4	0	0	4
More practical/laboratory sessions	6	0	0	6
More practical/laboratory sessions; improved course materials	0	1	0	1
More practical/laboratory sessions; improved course materials; more feedback on assignments/tests	1	0	0	1
Total	75	18	5	98

Chi-square tests
	Value	df	P
χ²	89.9	52	<0.001
n	98

Pie Charts and Bar Graphs of Results

Funding Statement

Nil.