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Perceptions, barriers, and practices of medical

research among students at Taibah College
of Medicine, Madinah, Saudi Arabia
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Advances in Medical Education and Practice
6 July 2015
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Muatasim M Noorelahi 1 Background: Research is an extremely crucial element in the advancement and improvement
Abdulrahman A of health care services provided to the public.
Soubhanneyaz 1 Aim: To assess perceptions, barriers, and practices of medical research among students at Taibah
Khaled A Kasim 2 College of Medicine, Madinah, Saudi Arabia.
For personal use only.

Methods: A cross-sectional, self-administered, validated, pretested, and structured questionnaire

1
College of Medicine, 2Department
of Family and Community Medicine, was completed by 233 medical students (third, fourth, and fifth study year). The questionnaire
College of Medicine, Taibah University, consisted of demographic data, students’ attitude, practices, and barriers. The collected data
Madinah, Saudi Arabia
were analyzed using appropriate statistical methods including predictive logistic regression
models. The level of statistical significance was defined as P#0.05.
Results: The overall response rate was 64.7% (233/360). The mean age of the studied students
was 22.6±1.1 years, of them 50.1% were males and 48.9% were females. The average attitude
score was significantly higher among fourth- and fifth-year medical students compared with
that of the third-year students. There has been a statistically significant difference between male
and female students regarding their practice of medical research where the higher percent of
students reported participation in previous medical research was among female students (79%).
The most important obstacle predictors implicated in not conducting research among all the
studied students were inadequate facility for research, lack of interest by faculty or guide, and
unavailability of the samples or patients.
Conclusion: The students in the study showed a moderately high positive attitude toward
medical research. Addressing and solving perceived students’ barriers by faculty staff and
administrators are essential in order to ensure an improvement in research activities among
medical students.
Keywords: attitude, knowledge, obstacles, medical research, students, undergraduate

Introduction
Research is an extremely crucial element in the advancement and improvement of
health care services provided to the public.1 Exposure to health research training
has been documented as an important activity in modern undergraduate medical
education.2 Previous studies in various countries have attempted to gage students’
attitudes, understand students’ practices, and determine students’ barriers and
motivation toward medical research in undergraduates.3,4 It has been reported that
Correspondence: Muatasim M Noorelahi
medical students’ involvement in research activity would allow them to gain research
Al-Hijra Road, Scheme Prince Naif, skills, thus improving patient’s care.5 Hence, adequate levels of knowledge and
Madinah, Saudi Arabia
Tel +966 540 940 210
reasoning skills and development of a positive attitude are crucial to carrying out
Email motasimelahi@aol.com the research.6

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Unfortunately, the number of worldwide physician scien- and they are expected to complete a research project and to write
tists’ has been noticed to decline recently. This has generated a report at the end of the block. Accordingly, third-, fourth-, and
much interest in developing programs for early exposure to fifth-year students of the college were considered.
research in medical schools in order to encourage students’
research activity and fill up the void of physician scientists’.7–9 Data collection
Studies have shown that the uptake of research experience The questionnaire consisted of several parts. The first part
during medical school and subsequent publications increase documented the demographic data of the participants: age,
the chance of acceptance in highly competitive residency pro- sex, academic year, and marital status. Questions in the
grams and improve postgraduate research productivity.10,11 second part pertained to assessing students’ attitude toward
However, previous reports of survey data showed that stu- research. The third part addressed questions related to stu-
dents were still facing many barriers to successfully engaging dents’ practices, ie, attempts to write, conduct projects, pub-
in scientific research activity.12,13 lish in journals, and oral and poster presentations. The final
A review of literature showed that there were no data part questions included the barrier items that might prevent
related to attitude, practice, and barriers of Taibah University medical students to conduct or participate in the research.
(TU) medical students toward medical research. Other Saudi
Arabian universities had produced data of such purpose; Study variables
therefore, this study aimed to assess further characteristics Attitudes toward conducting medical research were assessed
of this issue at Taibah University. using Likert response scale from 1 to 5 (1= totally disagree;
2= disagree; 3= neutral; 4= agree; 5= totally agree). The
Objectives attitude section included 14 statements representing all
The objectives of this study were to assess attitude and aspects concerning medical research. Item and scale score
practice of medical research among medical students at the were reported in the range +1 to −1. The midpoint zero corre-
College of Medicine, TU, Madinah, Saudi Arabia. Also, the sponds to the neutral Likert scale rating of 0, +1 corresponds
study investigated barriers of conducting and publishing to totally agree and agree, and −1 corresponds to totally dis-
medical research by medical students that made them unable agree and disagree. Accordingly, the used 14 attitude items
to participate in, complete and publish research papers. in the study questionnaire have a maximum score of +14 and
a minimal score of −14. A mean score for all studied attitude
Subjects and methods items was then calculated from the individual scores.
The present study was based on a cross-sectional survey The study questionnaire also included questions about the
among medical students. The study was conducted at the obstacles and barriers preventing students from conducting or
College of Medicine, TU, from November to December participating in medical research. Barrier items included in
2014. The study employed a predesigned validated struc- the questionnaire (n=22 items) were formulated according to
tured questionnaire to collect the data. The questionnaire the data available in the previous qualitative studies,2,5,9,10,14,15
was distributed to 360 registered students at the college, out and then categorized to include personal (n=6 items) and
of whom 233 students (64.7%) have participated, filled, and institutional aspects (n=16 items). Each studied barrier item
returned the study questionnaire. Participation in this study was scored as follows: 1= totally disagree; 2= disagree;
survey was completely voluntary, and full confidentiality and 3= neutral; 4= agree; 5= totally agree. To examine the most
anonymity were maintained at all times, with no identifying important barriers (predictors) preventing students from
information being recorded in the survey results. A consent contributing in research, each of the studied barrier item was
form was added at the beginning of the questionnaire explain- scored as follows: totally agree and agree =1, whereas totally
ing the purpose of the study and requesting their participa- disagree, disagree, and neutral =0.
tion. Permission was obtained from the Dean of the College
of Medicine. In addition, approval of the study by the Ethics Statistical analysis
Committee of the College Of Medicine, Taibah University, The collected data were entered and analyzed using statistical
Madinah, Saudi Arabia, was obtained. package for social science, version 16 (SPSS Inc., Chicago,
The medical program at TU is a 5-year undergraduate pro- IL, USA). Data were presented using frequencies, mean,
gram with ∼120 students (male and female) per year. Students and standard deviation as appropriate. The students’ attitude
attend the Medical Research block (MRES301) in the third year, and practice were assessed, analyzed, and compared by the

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 Dovepress Perceptions, barriers, and practices of medical research

students’ sex (male vs female) and the study year using Table 2 Frequency distribution of the studied students in
unpaired t-test for continuous variables, chi-squared test for research attitude scale
categorical variables, and one way analysis of variance for Attitude items 1 2 3 4 5

multiple comparisons. For all purposes, the criteria of signifi- 1. Role of research in the medical 4.2 3.9 6.0 15.5 70.4
field is important.
cance were considered at a P-value of #0.05. Furthermore,
2. Conducting a research during 5.2 8.2 16.3 28.3 42.0
the barrier items preventing students from conducting and medical school is important.
participating in research were assessed according to its used 3. Research participating should be 10.7 12.9 26.2 26.2 23.0
five scores among all studied subjects as well as by students’ made compulsory to all medical
students.
sex using predictive logistic regression models based on
4. Teaching research methodology 6.9 8.6 18.0 26.6 39.9
the stepwise regression with a P-value of 0.10 as an entry should be part of the curriculum.
criterion and a P-value of 0.15 as an exclusion criterion. 5. Research conduction during 6.4 8.2 17.6 29.6 38.2
The studied items were entered in the regression model as medical school has positive
impact on medical students.
follows: totally agree and agree =1, whereas totally disagree, 6. Your research record should 15.0 12.9 32.2 22.3 17.6
disagree, and neutral =0. be an important criterion for
acceptance in residency.
Results 7. Research conduction reinforce 3.0 9.9 23.6 35.2 28.3
teamwork spirit.
The response rate in this study was 66.1% among male stu- 8. Research will be a part of long- 3.4 6.9 21.0 33.9 34.8
dents (119 out of 180) and 63.3% among female students term career goals.
(114 out of 180), and the overall response rate was 64.7% 9. Anticipate a good understanding 3.4 9.8 39.5 30.1 17.2
of research methodology.
(233 out of 360).
10. Patient outcome improves with 3.5 2.1 18.0 33.5 42.9
Table 1 presents the identification data of the studied continued medical research.
subjects. The mean age was 22.6±1.1 years, of whom 51.1% 11. Medical student should not be 41.2 18.8 15.5 11.6 12.9
were males and 48.9% were females. About 30% of the study involved in medical research.
12. Undertaken research 7.7 11.6 37.8 28.3 14.6
subjects were from the third year, 34% and 36% were from
increases burden in already
the fourth and fifth years, respectively. The percent of married over-curriculum (heavy load –
students in the studied sample was 6.9%. educational or clinical) medical
Table 2 shows the distribution of the studied subjects student.
13. Medical student can plan and 31.8 31.3 20.6 11.6 4.7
according to the attitude scale. Students reported a high per-
conduct research project
cent of agree and totally agree toward almost all the studied without supervision.
attitude items. More than 70% of the studied subjects reported 14. You encouraged by your seniors 18.0 21.9 21.9 25.3 12.9
that they agree and totally agree for the first, second, and tenth to get involved in any research
activity.
attitude items. For other studied attitude items, however, the
Notes: Data are presented as %. Attitudes toward conducting medical research
percentage of subjects agreeing and totally agreeing varied were assessed using Likert response scale from 1 to 5 (1= totally disagree; 2=
from 15% to ,70% among the studied students. disagree; 3= neutral; 4= agree; 5= totally agree).

Table 1 Characteristics of studied students

Table 3 presents the percent distribution of the studied
attitude items among the studied subjects by their sex. With
Characteristics N=233
the exception of the attitude item named “Medical students
Age in years, mean ± SD (range) 22.6±1.1 (20–25)
Sex
should not be involved in medical research”, there have been
Male 119 (51.1) statistically significant differences between male and female
Female 114 (48.9) students regarding their reporting about all studied attitude
Study year
items. For that item, the percent of female students reported
Third 68 (29.2)
Fourth 79 (33.9) that they totally disagree and disagree was higher (70.0%)
Fifth 86 (36.9) compared to that reported among male students (50.0%).
Marital status Table 4 displays the average attitude score among the
 Single 217 (93.1)
studied subjects by their sex and study year. The average
Married 16 (6.9)
Notes: Data are presented as mean ± SD or as n (%).
attitude score was significantly higher among fourth- and
Abbreviation: SD, standard deviation. fifth-year medical students compared with that of the

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Table 3 Frequency distribution of male and female students in research attitude scale
Attitude items Student sex 1 2 3 4 5 P-value
1. Role of research in the medical field is Female 4.3 4.4 5.3 19.3 66.4 0.50
important. Male 4.2 3.4 6.7 11.4 74.6
2. Conducting a research during medical school Female 4.4 5.3 16.7 30.7 43.0 0.54
is important. Male 5.9 10.9 10.9 26.0 41.2
3. Research participating should be made Female 11.4 11.4 23.7 26.3 27.2 0.75
compulsory to all medical students. Male 10.1 14.3 28.6 26.0 21.0
4. Teaching research methodology should be Female 6.1 9.7 19.3 22.8 42.11 0.70
part of the curriculum. Male 7.5 7.6 16.8 30.2 37.8
5. Research conduction during medical school Female 7.0 5.3 15.8 32.4 39.5 0.47
has positive impact on medical students. Male 5.9 11.0 19.3 26.8 36.9
6. Your research record should be an important Female 11.4 12.2 32.5 22.8 21.1 0.47
criterion for acceptance in residency. Male 18.4 13.5 32.0 21.8 14.3
7. Research conduction reinforces teamwork Female 4.4 13.1 21.0 30.7 30.7 0.18
spirit. Male 1.7 6.7 26.0 39.5 26.1
8. Research will be a part of long-term career Female 5.3 5.2 21.0 32.5 36.0 0.51
goals. Male 1.7 8.4 21.0 35.3 33.6
9. Anticipate a good understanding of research Female 4.4 11.4 40.3 26.3 17.5 0.69
methodology. Male 2.5 8.4 38.7 33.6 16.8
10. Patient outcome improves with continued Female 3.5 1.7 16.7 37.7 40.4 0.75
medical research. Male 3.4 2.5 19.3 29.4 45.4
11. Medical student should not be involved in Female 50.0 20.0 13.2 7.8 9.0 0.03*
medical research. Male 32.8 17.2 17.6 15.6 16.8
12. Undertaken research increases burden Female 7.0 13.2 37.7 28.1 14.0 0.95
in already over-curriculum (heavy load – Male 8.4 10.1 37.8 28.6 15.1
educational or clinical) medical student.
13. Medical student can plan and conduct Female 36.8 32.5 16.7 9.6 4.4 0.35
research project without supervision. Male 26.9 30.3 24.3 13.5 5.0
14. You encouraged by your seniors to get Female 17.5 27.2 21.1 24.5 9.7 0.30
involved in any research activity. Male 18.5 16.8 22.7 26.0 16.0
Notes: *Statistically significant. Data are presented as % (with the exception of the P-values). Attitudes toward conducting medical research were assessed using Likert
response scale from 1 to 5 (1= totally disagree; 2= disagree; 3= neutral; 4= agree; 5= totally agree).

third-year students. Although the average attitude score was with a higher percent of female students reporting contribu-
higher among male students (4.5±5.3) compared with that tion in previous medical researches (79%). There have also
among female students (4.1±5.3), there was no statistically been statistically significant differences in students’ practice
significant difference (P=0.45). of medical research by their study year. The higher proportion
Table 5 presents the distribution of the studied subjects of students participating in research was among fifth-year
according to their practice of medical research. There has ­students (86.0%), followed by fourth-year students (64.5%).
been a statistically significant difference between male and Table 6 presents the barrier predictors preventing stu-
female students regarding their practice of medical research, dents from contributing to or conducting medical research.

Table 4 Average attitude score among the studied students by Table 5 Distribution of the studied students by their research
their characteristics practice
Student characteristics Mean ± SD P-value Characteristics Research practice, n (%) P-value
Sex Yes (n=164) No (n=69)
Male 4.5±5.3 0.45 Sex
Female 4.1±5.1 Male 74 (62.0) 45 (38.0) 0.01*
Study year Female 90 (79.0) 24 (21.0)
Third 3.0±5.3 0.04* Study year
Fourth 4.9±4.9 Third 39 (57.0) 29 (43.0) 0.0002*
Fifth 4.9±5.2 Fourth 51 (64.5) 28 (35.5)
Note: *Statistically significant.
Fifth 74 (86.0) 12 (14.0)
Abbreviation: SD, standard deviation. Note: *Statistically significant.

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 Dovepress Perceptions, barriers, and practices of medical research

Table 6 Barriers of not contributing in medical research: results of predictive logistic regression analysis
β coefficient* Score test SE** P-value
value
All students
 Inadequate facility for research 0.67 5.40 0.29 0.02***
 Difficulty in obtaining a research supervisor 0.48 3.85 0.29 0.10
 Unavailability of the samples (or patients) 0.69 4.90 0.31 0.02***
Male students
 Inadequate facility for research 1.20 9.5 0.40 0.002***
 Inadequate support by mentors/assistant 0.75 3.83 0.38 0.004***
Female students
 Lack of rewarding and/or motivation 1.22 5.10 0.54 0.02***
 Difficulty obtaining approval for the study 1.83 9.40 0.60 0.002***
 Unavailability of the samples (or patients) 1.50 6.60 0.58 0.01**
Notes: *Beta-coefficient of the predictive regression model; **SE; ***statistically significant.
Abbreviation: SE, standard error.

­ ccording to predictive regression analysis, the most

A by 74% of studied subjects, which is a similar meaning of
important obstacle predictors implicated in not conducting item number 11.7
research among all the studied subjects were inadequate The present study has also revealed a direct relationship
facility for research, lack of interest by faculty or guide, and between students’ practice of medical research and their
unavailability of the samples or patients. These obstacles academic year. In addition, the study has shown a significant
showed significantly increased probability of not conducting relationship between students’ sex and practice of medical
a research according to the obtained statistical parameters. research, where female students were more practicable to
The obstacle items named inadequate facility for research medical research in TU.
and inadequate support by mentors or assistant were the In our study, the studied male and female students’
most important obstacles among male students, and the reported significant barriers impeding research during under-
items named lack of rewarding and/or motivation, difficulty graduate education, such as inadequate facility to research
obtaining approval for the study, and unavailability of the and unavailability of the samples (or patients). A possible
samples or patients were the most important barrier predic- explanation of this finding could be due to under-construction
tors among female students. of a new forward-looking university. Our study also shows
that inadequate support by mentors or assistant to be the
Discussions second major obstacle that prevents male medical students
Research is an extremely crucial element in advancement from conducting research. This finding has appeared to be
and improvement of health care services provided to the consistent with findings of other studies.1,14–17 On the other
public.1 An adequate level of knowledge, positive attitude, hand, Al-Shalawy18 reported in his research that the major
and reasoning skills play an important role in carrying out barriers to females conducting medical research were the
research.6 This study aimed to assess perceptions, barriers, lack of rewards and/or motivation and difficulty in obtain-
and practice of Taibah medical students toward medical ing approval for the study. The reason for the obstacle to
research. Encouragingly, out of 233 medical students, positive research among females was explained by Abu-Zaid and
attitude toward medical research have been shown in about Altinawi,19 who noticed a strict separation of males and
70% in our study. In the present study, attitude score of medi- females in the work environment, and both were supervised
cal students toward medical research significantly improved by a male manager.
with more senior students in the advanced academic year. In A recent research by Mitwalli et al,2 included 191 physi-
the present study, although attitude score among males was cian and residents in Riyadh hospitals, reported that a major-
better than among females, no statistically significant differ- ity of studied physicians and residents (97.9%) agreed that
ence was found, with the exception of the studied eleventh research is essential and improves health care and 86.9%
item. Vujaklija et al16 have also reported similar findings, agreed that it helps in building a future academic career. In
where they documented an increase in attitude score as junior that study, the most important barriers in doing research were
students moved to senior students.16 Also, a study by Nel et al7 lack of research training (93.2%), lack of time (89.5%), work-
showed that the importance of research participation was felt related stress (83.2%), and lack of supervisors (73.3%). The

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practice of studied residents and physicians showed only 58 performed by their colleagues in data collection. There was
(30.4%) to have had any involvement in research. no fund taken from any institution to carry out this study.
The inadequate support by mentors or assistants observed This paper and the abstract of this paper were presented at
as a major barrier to conducting research among male stu- the “Preparatory Forum of Sixth Scientific Conference for
dents in this study was also reported by Shahab et al20 who Students of Higher Education in Kingdom of Saudi Arabia”,
concluded that proper guidance should be given to making Taibah University, Medina, Saudi Arabia, as an oral presenta-
conducting research easier. tion with interim findings.
The present study appeared to have a number of strengths.
The study questionnaire was comprehensive and addressed Author contributions
almost all medical research perception items as well as wide Muatasim M Noorelahi conceived the idea. All authors con-
range of personal and institutional barrier factors. Also, the tributed toward data analysis, drafting and critically revising
study questionnaire has been validated by an epidemiologist the paper, and agree to be accountable for all aspects of the
and medical research experts. To the best of our knowledge, this work.
study is the first to study the perceptions, barriers, and practice
of medical research among medical students in Saudi Arabia. Disclosure
Moreover, the use of predictive regression models helps to The authors report no conflicts of interest in this work.
examine and quantify the most important barriers implicated in
not conducting research among medical students. Dissemination References
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