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28 J Gandhara Med Dent Sci
ORIGINAL ARTICLE
January - March 2025
A FIVE-YEAR TREND OF MEDICAL BOOKS AMONG HOUSE OFFICERS OF ABBOTTABAD
IN THE PERSPECTIVE OF SELF-REGULATED LEARNING MODE
Tauqir Ahmad1, Mohsin Khan2, Niama Khan3, Iqra Jadoon4, Sultan Wahab5, Sehl Asher6, Hameed Ur Rahman7
ABSTRACT
OBJECTIVES
In the current study, the primary motive is to access the choices of medical
books and trends among house ocers retrospectively, from 1 st year to the
nal year of MBBS.
METHODOLOGY
After approval of the study from the ethical committee, the cross-sectional
study was undertaken in the public-private medical teaching hospitals of
Abbottabad-Pakistan. The study was conducted from January 2023 to
January 2024. The nonprobability purposive sampling technique was applied
for data collection on a predesigned written questionnaire. The data was
analyzed using SPSS software version 21.
RESULTS
Around 344 house ocers (n=344) participated in the present study. Most of
the participants were male {65% (225/344)}. About 300/344 use electronic
media with signicant female gender predominance (p=0.03). In terms of 5-
year academic performance, 60% of females (71/119) had average scores in
MBBS with a signicance of 0.003. The rate of below-average results was
32% (96/300) in participants who preferred electronic media, while the rate
was only 18% (8/44) in participants who used print media with a signicance
of 0.05. The fundamentals of gynecology by Arshad Chohan was signicantly
preferred by females as compared to Irfan Masood by males with a p-value of
0.04.
CONCLUSION
The majority of house ocers used the textbooks of international authors in
the rst 3 years of graduation as a standard primary book but here after
many preferred the books of local authors. The use of electronic media to
achieve the goal is common but the eect on academics was not productive.
KEYWORDS: E-Learning, Medical Students, Medical Books, Electronic
Media, Print Media
How to cite this article
Ahmad T, Khan M, Khan N, Jadoon I,
Wahab S, Asher S, etal . A Five-Year
Trend of Medical Books among House
Oicers of Abbottabad-In the
Perspective of Self-Regulated
Learning Mode. J Gandhara Med Dent
Sci. 2024;12(1):28-31.doi:10.37762
Date of Submission: 01-07-2024
Date Revised: 03-12-2024
Date Acceptance: 23-12-2024
1Assistant Professor, Medical Unit D,
Ayub Teaching Hospital, Abbottabad
2Resident, Pulmonologist, Ayub
Teaching ,
4Resident, Physician, Ayub Teaching
, Hospital, Abbottabad
5Resident, Pulmonologist, Ayub
Teaching Hospital, Abbottabad
6Registrar, Orthodontics, Abbottabad
International Medical and Dental
College, Abbottabad
7Resident, Physician, Ayub Teaching
Hospital, Abbottabad
Correspondence
3Naima Khan, Resident Gynecologist
Gynae Unit B, Ayub Teaching
Hospital, Abbottabad
+92-334-8973558
niamakhan05@gmail.com
INTRODUCTION
Medical education is the collection of comprehensive
knowledge and professional skills that should be
utilized for the benet of the community.1 Standard
medical education yields competent, skillful, and
knowledgeable doctors for the community. In medical
school, the students use dierent strategies for learning
to develop professional skills and knowledge. The two
most common learning strategies are self-directed
learning (SDL) and self-regulated learning (SRL).2 The
two terms are used synonymously but they are dierent
in many ways. In SDL the learner adopts the non-
traditional mode outside the school environment. It is
intrinsic and at the macro level. In SDL behaviors are
set by the learner itself. It is a single-person-based adult
education mode and is a passive mode of study. On the
other hand, in SRL students use institutional-based
approaches to learn actively and achieve the desired
targeted goals. It is at the micro level, aim-directed
behavior, which is imposed externally on the student by
the tutor.3 It is based on the student’s motivation and it
involves enacting strategies and meta-cognition. It's
achievable in the school environment and involves
multiple personality traits.4 With the advancement of
technology medical education transformed in many
prospectives. The dynamicity of the 21st century in the
learning environment is the digitalization of print data.
Stephen King was a pioneer in inventing the rst online
e-learning tool in 1970.5 The growing use of
smartphones, and laptops and the availability of
advanced e-book resources on the internet signicantly
impacted the change in trends of study among medical
students.6 The e-book has several advantages over the
printed book. In 2019 the Association of American
Publishers generated 26 billion dollars by the
publication of printed books while e-books for 2.04
million $.7 Besides cost-eectiveness, the digitalization
of books enhances the understanding of 3D human
anatomy models. Moreover, the data is easily
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29
January - March 2025 J Gandhara Med Dent Sci
accessible, convenient, easy to store, easy to share, and
easy to carry. Besides several benets, the e-book has
some limitations, like screen tiredness, and requiring
the availability of some electronic gadgets.8 In recent
few years, a paradigm shift of preference from print
media to digital library has been observed among
students.9 Before the implication of any learning model
and implementation, it’s important to assess the current
trend of books among house ocers. The main aim of
this study is to assess the current practice of medical
books among house ocers retrospectively and to
assess the preference for online sources on printed
books.
METHODOLOGY
This cross-sectional prospective study was conducted
among house physicians and house surgeons in three
public and private teaching hospitals. The practicing
house ocers belong to Abbottabad Medical Complex
(Abbottabad International Medical College), Shaheena
Jamil Teaching Hospital (Frontier Medical College),
and Ayub Teaching Hospital (Ayub Medical College).
The duration of the study was one year i.e. from
January 2023 to January 2024. Ethical approval was
obtained from the research and ethics committee,
college of Ayub Teaching Hospital before data
collection (Ref.No.RC-2022/EA-01/196). The criteria
for sample collection included the doctors who had
completed their nal year MBBS and a minimum one -
house job rotation in major clinical elds like surgery
or medicine so they have optimal clinical exposure as
well. The purpose and aim of the study were explained
and consent was obtained from the doctors before data
collection. None of the identifying information was
collected from the doctors. The data regarding the
medical books and other academic resources like e-
library, they had used in student life for ve-year
MBBS professional exam was collected from each
participant. Moreover, the average academic
GPA/Percentage through ve years was also recorded.
The data was collected on the predesigned written
questionnaire and the data collection team comprised of
participants who were post-graduate residents and had
substantial knowledge about medical literature. The
doctors who were suering from mental illness, who
did not sign consent, and those who were not available
were excluded from the study. The dental house oces
were also excluded. The data collected was entered in
SPSS version 21 and statistically analyzed using
descriptive statistics (frequency, percentages, mean, and
standard deviation) to describe the participants’
demographics and book choices. Inferential statistics
using chi-square was used to describe the relationship
between the demographic variables and the choice of
study material. A p-value less than 0.05 was considered
signicant.
RESULTS
In the present study, we interviewed 400 house ocers
among which only 344 (n=344), met the inclusive
criteria and became part of the study. The mean age of
participants was 25Years±2Years. Most of the subjects
were male 65% (225/344). The commonest source used
was electronic media (300/344), with the assumption
that the educational goals are readily achievable-
120(34%). The detail is shown in Table 01.
Table 1: Characteristics of Study Participants
Gender Male 225(65%)
Female 119(35%)
Media print 44(13%)
electronic 300(87%)
Reason for
electronic
media
Goal easily achievable 120(35%)
accessible 100(29%)
cheap 76(22%)
Time safety 28(8%)
Habit 20(8%)
Academic
abilities
average 240(70%)
Below average 104(30%)
The most common books used for medical physiology,
anatomy, and biochemistry were Guyton and Hall
{284(82%)}, Richard S. Snell {259(60%)}, and
Satyanarayana {232(67%)} respectively. For forensics,
the Handbook of Forensic Medicine and Toxicology by
Dr Amir Saleem accounts for 37% (128). For general
and special pathology Robbins & cotran {172 (50%)}
and Pathoma by Husain A. Sattar164(48%)}
respectively commonest. For Microbiology Warren
Levinson accounts for 88% (304), pharmacology Tara
V Shanbhag accounts for 70% (240), for Medicine
Step-up to Medicine {160(46.5%)} commonest book
used by students. For surgery, gynecology, obstetrics,
pediatrics, eye and Ear nose throat (ENT), participants
prefer Abdul Wahab Dogar{320(92%)}, Fundamentals
of Gynecology by Arshad Chohan{92(26%)},
obstetrics by Ten Teachers{288(83%)}, Basics of
Pediatrics by Pervez Akbar{172(50%)}, Clinical
ophthalmology Jatoi {332(96.5%)}and Disease of ear
nose throat by P.L Dhingra{248(72%)}respectively,
detail shown in Table 02.
A Five-Year Trend of Medical Books among House Officers
30 J Gandhara Med Dent Sci
January - March 2025
Table 2: Frequencies of dierent books used by the participants
year MBBS to nal Year MBBSfrom 1st-
Book Frequency
Anatomy Richard S. Snell 234(68%)
B.D.Chaurasia 62(17%)
Student Gray’s 44(13%)
Kaplan Anatomy 08(2.3%)
Physiology Guyton and Hall 284(82%)
Firdaus 48(14%)
Linda S. Costanzo 08(2.3%)
Satyanarayana 234(68%)
Biochemistry Pankaja Naik 48(14%)
MN Chatterjee 24(07%)
Lippincott 26(7.5%)
Past paper 12(3.4%)
Amir Saleem 128(37%)
Forensic Parikh’s 127(36%)
Islami Jamiat Talba 40(12%)
Nasib R. Awan 32(9%)
Nagesh Kumar Rao 20(6%)
Robbins & Cotran 172(50%)
General
Pathology
Husain A. Sattar (Pathoma) 92(26%)
Irfan Masood 36(10.5%)
Inam danish 36(10.5%)
Edward F. Goljan 08(2.3%)
Husain A. Sattar (Pathoma) 164(48%)
Pathology
special
Robbins & Cotran 124(36%)
Irfan Masood 48(14%)
Edward F. Goljan 08(02%)
Warren Levinson 308(90%)
Microbiology Sketchy Micro 24(7%)
Dr Faiz Ullah Kharoti 08(2.3%)
Kaplan 04(1.2%)
Tara V Shanbhag 240(70%)
Pharmacology Kaplan 44(13%)
Shah Nawaz 28(8%)
Katzung and Trevor’s 20(6%)
Lippincott illustrated review 12(3.5%)
Excel by Dr M Naveed Alam 285 (82%)
Community
Medicine
K. Park 50(15%)
Past papers 8(2%)
Eye Ophthalmology by Jatoi 332(96%)
Naseem Sherzad 12(4.5%)
ENT P.L Dhingra 348(72%)
Iqbal Hussain Udaipurwala 88(26%)
Naseem Sherzad 4(1.2%)
Past paper 4(1.2%)
Medicine Step-up 160(47%)
Irfan Masood 100(29%)
Kaplan 44(13%)
Davidson’s 40(12%)
Obstetrics Ten Teacher 288(84%)
Kaplan 56(16%)
Irfan Masood 136(40%)
Arshad Chowan 92(27%)
Ten teachers 60 (17%)
Kaplan 52(15%)
Past paper 4(1.2%)
Pediatrics Irfan Masood 172 (50%)
Pervez Akbar khan 144 (42%)
Short Nelson 16(5%)
Kaplan 12(3.5%)
Surgery Abdul Wahab Dogar 320(93%)
Bailey and love’s 12(3.5%)
Irfan Masood 08(2.3%)
Christian de Virgilo 4(1.2%)
DISCUSSION
Medical learning is a complex, multidimensional
process in which students not only gain theoretical
knowledge but also develop dierent medical skills.
Students bear signicant stresses to bring themselves to
a standard level. Reading skills impact academic
performance and it increases the thinking process to
improve the medical essentials.10 In the present study,
we accessed our house ocers regarding the mode of
learning and the choices of books they used in dierent
years of gradation. The majority of subjects who
participated in the study were male (70%). When the
gender and trends of books were compared there was
no signicant dierence noted except gynecolog y. The
use of textbooks declines as the years of graduation
females signicantly preferred -Fundamentals of
progress. Participants used textbooks of international
authors in the rst 3 years but in 4th and nal years the
use students used the books of country-based local
authors. Gynecology was the only subject in which
Gynecology” by Arshad Chohan, as compared to
Gynecology by Irfan Masood by male gender with a p-
value of 0.04. The reason for this dierence could be
the gender-based lack of interest in gynecology as a
specialty in the future. 87% of subjects (300/344) prefer
to use the electronic media. Handley L et al. state that
the majority of students adopt e-learning tools available
on electronic media.7 Wynter et al. state that the
majority of students use electronic media for online
question banks.11 The main reason for the use of
electronic media was to achieve the goals easily. Males
(35/225) signicantly use more print media than
females (9/119) with a p-value of 0.03. This is contrary
to a large study done in Arbs reported that 80% of girls
prefer textbooks, the reason could be demographic
dierence.12 Surprisingly the participants who preferred
electronic media had signicantly poor academic
performance. Only 18% of subjects (8/44) who use
print media got below the average result as compared to
electronic 32% (96/300) with a p-value of 0.005. other
studies state that the students who passed all modules of
the exams signicantly read the printed textbook
(p=0.005) as compared to the students who failed the
modular exam.13,14,15 Tanner, M. J. also concluded that
print books are still the best suited to the metacognitive
requirements of reading brains, while e-learning lacks
such property.16 The male gender has signicantly
better results as compared to the female gender. 48/119
(40%) produce below than average results as compared
to male 25% (56/225) with a p-value of 0.003, the
reason could be the use of electronic media as
previously discussed. Moreover, the female gender also
has to face a lot of social, cultural, and religious norms
and very few opportunities are available for medical
female subjects to participate in outdoor physical
A Five-Year Trend of Medical Books among House Officers
31
J Gandhara Med Dent Sci
January - March 2025
activities.17,18
LIMITATIONS
Due to a lack of national data, it’s not possible to
compare all studied variables with local studies. Yearly
academic performance wasn’t recorded in the present
study, which would reect the more precise academic
performance and correlation with the use of a precise
textbook. The study is single-centered. The study didn’t
assess the use and accessibility of electronic devices
and the capability of using a virtual learning
management system (LMS). Further behavioral studies
are needed to be conducted especially on females to
improve academic abilities.
CONCLUSIONS
The majority of house ocers used the textbooks of
international authors in the rst 3 years of graduation as
a standard primary book but here after many preferred
the books of local authors. In medical professionals the
use of electronic media to achieve the goal is common
but the eect on academics is not productive. Female
students prefer electronic media as compared to males.
The academic capabilities are poor in females as
compared to male students.
CONFLICT OF INTEREST: None
FUNDING SOURCES: None
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CONTRIBUTORS
1. Tauqir Ahmad - Concept & Design; Supervision
2. Mohsin Khan - Data Analysis/Interpretation; Final Approval
3. Niama Khan - Critical Revision
4. Iqra Jadoon - Drafting Manuscript
5. Sultan Wahab - Data Acquisition
6. Sehl Asher- Data Acquisition
7. Hameed Ur Rahman - Data Acquistion
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A Five-Year Trend of Medical Books among House Officers
