The four levels of K model
Level 1 Satisfaction Analysis. Chinese medical students’ overall satisfaction with cultivating work was 4.19±0.993. Specifically, their satisfaction with seriousness of teaching (4.24±0.814) was the highest, followed by teaching level (4.19±0.809), the college ethos (4.07±0.905), the learning atmosphere (4.04±0.904) and importance the leaders attached to teaching work (4.04±0.904), then came the opening of teaching facilities (libraries, etc.) (3.98±0.996), suitability of requirements on students’ graduation (3.97±0.883); while their satisfaction with the condition of dormitory and other accommodation was relatively the lowest (3.37±1.300), followed by canteen and other food support (3.50±1.193), and then whether students’ choice being respected in teaching management and reform (3.77±1.063), the analysis and guidance the college provided on graduates’ employment and development (3.84±1.030), the assessment methods (3.85±0.940) and the campus culture (3.86±1.004), then came practical teaching such as practical training and social practice (3.90±0.965), curriculum resources (network courses, teaching materials, etc.) (3.93±0.985), the guidance and service for students on their study and life in college (3.94±0.964).
Level 2 Learning Motivation Analysis. The overall score was 1.95±0.568.
Level 3 Three Types of Learning Style Analysis. VARK sensory learning style: Chinese medical students were mainly single, accounting for 45.5%, followed by the quadruple (20.4%), then came the double (20.0%) and the triple (14.1%); among the single, the ratio of type V, A, R, K were respectively 4.2%, 13.3%, 9.5% and 18.5%, their standardized scores were respectively 0.227±0.131, 0.300±0.138, 0.273±0.138 and 0.324±0.144. MBTI personality type: the standardized score of Extroversion was 0.531±0.207, Introversion 0.469±0.207, Sensing 0.597±0.186, Intuition 0.402±0.185, Thinking 0.585±0.207, Feeling 0.414±0.206, Judging 0.662±0.225 and Perception 0.337±0.225. KLSI empirical learning style: the dominate type was the Diverging (80.1%), followed by Assimilating (13.1%), Accommodating (4.5%) and Converging (2.3%). The scores of the four learning links were 32.03±6.394 for CE, 33.41±6.486 RO, 34.13±6.650 AC and 34.00±6.600 AE.
Level 4 Comprehensive Quality Analysis. The overall self-rated scores of learning attitude and learning expectation were 2.68±0.781 and 2.14±0.953, the overall status of academic achievement scored 2.43±0.793.
The relations among the levels of K model
When VARK was taken as the representative of Level 3 in K model, SEM 1 (Figure 1) based on the theoretical hypothesis was constructed to explore relations between latent variables of cultivating works, learning motivation, sensory learning style and comprehensive quality, as well as between latent variables and observed variables.
The GFI of SEM 1 was 0.5742 and AGFI 0.5357 which were slightly low, the model didn’t fit well with the sample data model, thus we revised it by removing the f1 and overall satisfaction part and constructed SEM 2 (Figure 2), the GFI was 0.6870, the model reflected relations between variables well and was adopted as the final model after testing. It was showed that the measures proposed in this study of improving students’ comprehensive quality by promoting students’ learning motivation was effective and meaningful (being successfully-tested by SEM with high fit index), but sensory learning style was irrelevant to them.
By maximum likelihood estimation, fitting results of the measurement model were obtained and collated into Table 2, including the estimated value of factor load (i.e., the regression coefficient), standard error and t value, etc., they all had statistical significance (t>2), indicating high goodness of fit index, most of the observed variables had high factor loads and could define well corresponding latent variables. Based on the standardized regression coefficient, the most important observed variable for latent variable of medical students’ comprehensive quality was learning attitude (0.72260), followed by learning expectation (0.66376), academic achievement was relatively the least (0.63429). For latent variable of college cultivating works, observed variable SS15 canteen and other food support (0.79541), SS7 whether students’ choice being respected in teaching management and reform (0.79463), SS16 the condition of dormitory and other accommodation (0.79199) were comparatively more important, followed by SS14 the analysis and guidance the college provided on graduates’ employment and development (0.78007), SS10 the campus culture (social, scientific and technological activities, domestic and international exchanges, etc.) (0.77407), SS12 the guidance and service for students on their study and life in college (0.76124), SS9 practical teaching (0.75594), SS6 curriculum resources (0.75154), SS8 the assessment methods (0.74338), SS5 the opening of teaching facilities (0.73223), SS11 the college ethos (0.72185), SS13 the learning atmosphere (0.72054), SS2 importance the leaders attached to teaching work (0.71700), SS1 suitability of requirements on students’ graduation (0.70711), and then the least SS3 teaching level (0.63187) and SS4 seriousness of the teaching (0.60961).
The factor loads in SEM were all statistically significant (t>2, p<0.05). It could be seen from the standardized regression coefficient that college cultivating works had an influence on students’ learning motivation (0.12069), and motivation had certain negative influence on comprehensive quality (-0.29132), excessive motivation could lead to decline of comprehensive quality. Therefore, the influence of cultivating works on students’ learning motivation and comprehensive quality was obvious. However, none of the f1 part appeared in the model, which meant that sensory learning style was irrelevant to learning motivation, comprehensive quality and cultivating works.
By combining the standardized regression coefficients of measurement model and SEM, the path graph and standardized solution of SEM 2 for cultivating works, learning motivation, sensory learning style and comprehensive quality were drawn (Figure 2), each solid-line path represented a corresponding hypothesis and the path parameters were listed next to them.
“Importance - Satisfaction” analysis
It could be found that the satisfaction obtained by general statistical method (Chi-square test, variance analysis, etc.) was not consistent with the importance gained by SEM based on standardized regression coefficient. In order to clarify the importance and satisfaction of specific cultivating works, we sorted them according to their importance to the superior indices and students’ satisfaction on them. Table 3 listed the rankings and weight of importance (the standardized regression coefficient of this item/the sum of all items at this index level) and the rankings and scores of satisfaction (actual implementing performance), accordingly various works were divided into four types: A important and satisfactory, B important but unsatisfactory, C satisfactory but unimportant, D neither important nor satisfactory. The judgment criterion was the total ranking, the first 50% were recorded as important or satisfactory and the last were unimportant or unsatisfactory. There was only one work falling into category A: the guidance and service for students on their study and life in college; 7 works fell into category B: curriculum resources, whether students’ choice being respected in teaching management and reform, practical teaching, the campus culture, the analysis and guidance the college provided on graduates’ employment and development, canteen and other food support, the condition of dormitory and other accommodation; Category C included suitability of requirements on students’ graduation, importance the leaders attached to teaching work, teaching level, seriousness of teaching, and the opening of teaching facilities, the college ethos and learning atmosphere; only one item fell into category D: the assessment method.
When MBTI was taken as the parameter of Level 3, SEM 3 (Figure 3) for cultivating works, learning motivation, personality type and comprehensive quality was preliminarily built. The E-endpoint of the first dimension was used as contrast to identify and modify the model. The GFI was 0.5870 and AGFI 0.5462, which basically met the model adaptation standard, the hypothesized causal model was acceptable and basically satisfied with the sample data model.
Table 4 shows the fitting results, the regression path hypothesis test showed that the path coefficient difference were all statistically significant (t>2, P<0.05) except f5→f2 between latent variables (f4→f2 just came to pass) and T→f2, J→f2 between latent variable and observed variable. As expected, these variables could define well corresponding latent variables.
After the removing of bad fitting part, the path graph and standardized solution of SEM 4 for medical students’ cultivating works, learning motivation, personality type and comprehensive quality were drawn (Figure 4, with E as the reference). It shows that relation between cultivating works and students’ personality type was slight, For personality type, the Extroversion (E) was the most important (0.70722), far more than other dimensions; Sensing (S 0.02493) only had a slight contribution, while Thinking (T) and Judging (J) had no relation with personality type.
When KLSI was taken as the parameter of Level 3, SEM 5 (Figure 5) for cultivating works, learning motivation, empirical learning style and comprehensive quality was preliminarily built. CE was used as the contrast to identify and modify the model. The GFI was 0.5809 and AGFI 0.5395, basically meeting the model adaptation standard, the hypothesized causal model was acceptable and satisfied with the sample data model.
Table 5 shows the fitting results, the regression path hypothesis test showed that the path coefficient difference were all statistically significant (t>2, P<0.05) except f5→f3 between latent variables. As expected, these variables could define well corresponding latent variables.
After the removing of bad fitting part (f5→f3), the final path graph and standardized solution of SEM 6 for cultivating works, learning motivation, empirical learning style and comprehensive quality were drawn (Figure 6), it shows that cultivating works were related to empirical learning style, but learning motivation was not. For empirical learning style, CE was the most important (0.70875), the importance of other dimensions were similar: RO (0.10563), AC (0.10537) and AE (0.10667), far lower than CE. For comprehensive quality, learning attitude was comparatively most important (0.72978), followed by learning expectation (0.71599) and academic achievement (0.67847).