Medical students' perspectives about the traditional and the integrated learning programs in the college of medicine- University of Bisha

Ayman Mohamed Alashkar (  aymanpara@yahoo.com ) College of medicine, University of Bisha, KSAFaculty of medicine, Ain Shams University, Cairo, Egypt. https://orcid.org/0000-0003-4815-8731 Abdullah Abdelazim Hashish College of medicine, University of Bisha, KSA https://orcid.org/0000-0003-1531-3918 Adel Aborgela College of medicine, University of Bisha, KSA Ashraf Salah Metwally College of medicine, University of Bisha, KSA https://orcid.org/0000-0002-4548-0357 Hany Sonpol College of medicine, University of Bisha, KSA https://orcid.org/0000-0002-8031-3765 Ahmed Sinbel College of medicine, University of Bisha, KSA https://orcid.org/0000-0003-4178-2988 Mushabab Al-Ghamdi College of medicine, University of Bisha, KSA https://orcid.org/0000-0002-8675-5871


The methods
Online survey was done for the 2nd and 3rd year medical students in UBCOM. This includes detailed questionnaire about both of traditional and integrated programs in the college of medicine, University of Bisha. The questionnaire was exposed to a validation procedure that included its perusal by medical students, interns, and experts in the medical education eld. The questionnaire was checked for item appropriateness and comprehensiveness (face and content validity). A ve-point Likert scale (0=strongly disagree; 4=strongly agree) was adopted within the questionnaires.

The study design
Quantitative research 4. The statistical methods used The collected data were computerized and statistically analyzed using Graph Pad Prism 5.01.Chi-square test that was used to compare the qualitative variables between groups. P values less than 0.05 was considered statistically signi cant.

Ethical considerations
Ethical approval: obtained from the ethical committee of the college of medicine-University of Bisha "UBCOM/H-06-BH-087 (4/17)". The permission was taken from the Institution research board. An agreement of the students to be enrolled was considered as informed consent.

Results
The total student's population targeted was 82 students with 55 responding (67%).
Collectively, agreement of the ILP exceeded the TLP and disagreement of the ILP was much lower than the traditional one as described in ( g. 1 B).
(Total responses in traditional program and integrated program are 336 and 349 consecutively). The neutral stage of satisfaction was excluded to avoid bias in the results. Summation of agree and strongly agree results was considered agreement, as well as the results of disagree plus strongly disagree were summated as disagreement (Details in supplementary le).
The ILP showed trustfulness among the medical students rather than the TLP. They mainly agreed with ILP in improving the communication skills, dealing with new technologies, reinforcement of competencies in the research eld with percentages 69.1%, 63.6%, and 65.5% respectively compared to 27.9%, 38.2%, and 25.4% respectively for TLP with high statistically signi cant difference between the 2 programs (table1, g. 2, 3, 4, 5).  The medical students chose the ILP as the preferable learning tool for its suitability to be applied in medical schools nowadays, development of desired doctor skills to deal with patients and for provision of good approach for medical practice with percentages of agreement 60%, 74.6%, and 67.3% respectively in contrast to 30%, 28.5%, and 38.2% respectively TLP with moderate signi cant difference between the 2 programs (table1, g. 2, 3, 4, 5).
Suitability to identify and deal with the community needs parameter was selected by the medical students to be reinforced by the ILP outcome with 61.8% agreement; however 49.1% select the TLP to reinforce that parameter with low signi cant difference between both programs (table 1, g. 2, 4).
Professionalism is the only learning parameter that showed no signi cant statistical difference between both of the learning programs. 50.9% considered the ILP capable of establishing such value while, 36.3% considered the TLP is the capable one (table 1, g. 3, 5).

Discussion
The Legacy curriculum relied mainly on lecture-based approach, rote learning with few activities [17,18].
New approaches in medical education adopt self regulated learning (SRL), learn by doing and small group problem solving in order to stimulate the higher cognitive skills of the medical students to prepare them to be the future professional physicians [19]. Nevertheless, some other researchers believed that ILP may or may not lead to learning enhancement in students [20].
Studies reach a consensus that the main in uence of the students ≤ arn ∈ gisthestudents perception of the educational context rather than the context itself [21,22].
So, this study results may help the medical education specialist to know more regarding the students` perspectives about the TLP and ILP.
The medical students chose ILP to be more effective than the TLP in improving their communication skills, dealing with new technologies and reinforcement of competencies in the research eld with high statistically signi cant difference between the 2 programs. This concur with reports described the positive effects of ILP on development of good communication skills to deal with peers, and instructors [23,24]. This is in congruence with a review study that revealed the importance of new technologies in the conduction of the ILP activities like PBL [25]. The study results agreed with studies that revealed the importance of ILP to develop a future physician and researcher [26,27].