Adv Physiol Educ 31: 158 –160, 2007;
How We Learn
Learning styles of first-year medical students attending Erciyes University
in Kayseri, Turkey
Zeynep Baykan and Melis Naçar
Submitted 24 May 2006; accepted in final form 19 February 2007
Baykan Z, Naçar M. Learning styles of first-year medical students
attending Erciyes University in Kayseri, Turkey. Adv Physiol Educ
31: 158 –160, 2007; doi:10.1152/advan.00043.2006.—Educational re-
searchers postulate that every individual has a different learning style.
The aim of this descriptive study was to determine the learning styles
of first-year medical students using the Turkish version of the visual,
auditory, read-write, kinesthetic (VARK) questionnaire. This study
was performed at the Department of Medical Education of Erciyes
University in February 2006. The Turkish version of the VARK
questionnaire was administered to first-year medical students to de-
termine their preferred mode of learning. According to the VARK
questionnaire, students were divided into five groups (visual learners,
read-write learners, auditory learners, kinesthetic learners, and multi-
modal learners). The unimodality preference was 36.1% and multi-
modality was 63.9%. Among the students who participated in the
study (155 students), 23.3% were kinesthetic, 7.7% were auditory,
3.2% were visual, and 1.9% were read-write learners. Some students
preferred multiple modes: bimodal (30.3%), trimodal (20.7%), and
quadmodal (12.9%). The learning styles did not differ between male
and female students, and no statistically significant difference was
determined between the first-semester grade average points and learn-
ing styles. Knowing that our students have different preferred learning
modes will help the medical instructors in our faculty develop appro-
priate learning approaches and explore opportunities so that they will
be able to make the educational experience more productive.
visual, auditory, read-write, kinesthetic; VARK; medical education;
learning modes
THE TERM “learning styles,” as used in the literature during the
past 30 years or so, has labeled a very board and relatively
diffuse concept (2). Keefe (2, 12) defines learning style as the
“composite of characteristic cognitive, affective, and physio-
logical characters that serve as relatively stable indicators of
how a learner perceives, interacts with, and responds to the
learning environment.” Educational researchers postulate that
everyone has different learning styles (6, 16, 20). One charac-
terization of learning styles is to define the learners’ preferred
mode of learning in terms of the sensory modality by which
they prefer to take in new information (14). Fleming and Miles
(11) defined four sensory modalities of learning: visual, audi-
tory, read-write, and kinesthetic. Visual learners prefer the use
of diagrams and symbolic devices such as graphs, flow charts,
hierarchies, models, and arrows that represent printed informa-
tion. Read-write learners prefer printed words and texts as a
means of information intake; they also prefer lists, glossaries,
textbooks, lecture notes, or handouts. Auditory learners prefer
“heard” information and, thus, enjoy discussions, lectures, and
tutorials when acquiring new information. Kinesthetic learning
is a multimodal measurement employing a combination of
Address for reprint requests and other correspondence: Z. Baykan, Faculty
of Medicine, Dept. of Medical Education, Erciyes Univ., Kayseri, Turkey
(e-mail: zbaykan@erciyes.edu.tr).
158 1043-4046/07 $8.00 Copyright © 2007 The American Physiological Society
Downloaded from www.physiology.org/journal/advances (115.164.177.051) on April 22, 2019.
doi:10.1152/advan.00043.2006.
sensory functions. Kinesthetic learners have to feel or live the
experience to learn; they prefer simulations of real practices
and experiences, field trips, exhibits, samples, photographs,
case studies, “real-life examples,” role-plays, and applications
to help them understand principles and advanced concepts.
Some learners have a preference for one of these learning
modalities, whereas multimodal learners do not have a strong
preference for any single method. They rather learn via two or
more of the modalities (11, 21).
As medical instructors, it is our task to assess and teach
knowledge, attitudes, and skills, and lectures will be more effec-
tive when the educational needs of all students are met (13, 15,
20). Student motivation and performance improves when instruc-
tion is adapted to student learning styles (1, 4, 5, 16, 21).
In the literature, numerous and diverse inventories of learn-
ing styles have been reported (2). Learning style inventories
are predicated upon information-processing models that essen-
tially aim to describe an individual’s preferred intellectual
approach to assimilating information (18). One of the com-
monly used inventories is the visual, auditory, read/write and
kinesthetic (VARK) questionnaire developed by Neil Fleming
(10a). It can be used to guide instructors in their selection of
learning and assessment strategies. VARK preferences can be
used to help learners develop additional and effective study
skills to take in information and, as a result, perform well in
examinations (21).
The aim of this descriptive study was to determine the
learning styles of first-year medical students using the Turkish
version of the VARK questionnaire.
METHODS
This study was performed at the Department of Medical Education
of Erciyes University in February 2006. The Turkish version of the
VARK questionnaire was administered at the beginning of the second
semester to first-year medical students to determine their preferred
mode(s) of learning. All 162 first-year medical students were invited
to participate in the study. The purpose of the study was explained to the
students. Of the 162 students, 155 students (95.7%) completed the
questionnaire. The VARK questionnaire (http://www.vark-learn.com;
http://www.vark-learn.com/Turkish/page.asp?p⫽questionnaire)
was selected because it is concise and quick to complete (only 13
questions) (10a). Each question aims to place respondents in a “learn-
ing” situation. The respondents are permitted to omit a question or to
choose two or more options if appropriate. Questionnaires were eval-
uated on the basis of previously validated scoring instructions and a
chart (10a).
A Kruskall-Wallis test was performed to determine whether an
association existed between the learning style and the grade point
average of the student, and a ␹2-test was performed to deter-
mine whether there was an association between sex and learning
style.
 How We Learn
HOW MEDICAL STUDENTS LEARN IN CENTRAL ANATOLIA, TURKEY 159

Fig. 1. Distribution of learning styles.

RESULTS preferred three modes of information presentation, 14.2% (14

Figure 1 shows the distribution of the learning styles of the
students. Of the study group, 63.9% of the students preferred a
multimodal learning style.
Of the students who preferred a multimodal learning style,
99 students have different combinations of the mode of infor-
mation presentation.
Of the students who preferred two modes of information
presentation, 20.2% (20 students) of the students were
auditory and kinesthetic, 10.1% (10 students) of the students
were visual and kinesthetic, 7.1% (7 students) of the stu-
dents were read-write and kinesthetic, 4.0% (4 students) of the
students were auditory and read-write, 4.0% (4 students) of
the students were visual and auditory, and 2.0% (2 students)
of the students were visual and read-write. Of the students who
students) of the students were auditory, read-write, and
kinesthetic; 11.1% (11 students) of the students were visual,
auditory, and kinesthetic; 3.1% (3 students) of the students
were visual, read-write, and kinesthetic; and 4.0% (4 students)
of the students were visual, auditory, and read-write. Of the
students who preferred multimodal learning styles, 20.2% (20
students) of the students preferred all four modes of learning
together.
Table 1 shows the comparison of learning styles and char-
acteristics of the medical students.
The learning styles did not differ between male and female
students (P ⬎ 0.05, ␹2 ⫽ 3.180), and no statistically significant
difference was determined between first-semester grade point
averages and learning styles (P ⬎ 0.05).

Table 1. Comparison of learning styles and characteristics of medical students

Learning Styles

Characteristics Visual Auditory Read-Write Kinesthetic Multimodal P Value

Age, yr
Means ⫾ SD 18.2 ⫾ 0.4 19.3 ⫾ 1.1 18.3 ⫾ 1.1 19.1 ⫾ 1.0 19.0 ⫾ 1.3 ⬎0.05*
Median 18.0 19.5 19.0 19.0 19.0
Sex, %male 60.0 (n ⫽ 3) 75.0 (n ⫽ 9) 33.3 (n ⫽ 1) 63.9 (n ⫽ 23) 54.5 (n ⫽ 54) ⬎0.05†
Grade point average
Means ⫾ SD 79.1 ⫾ 8.6 72.1 ⫾ 4.8 70.7 ⫾ 6.5 72.7 ⫾ 7.1 74.1 ⫾ 6.4 ⬎0.05*
Median 70.1 70.6 74.4 72.5 73.0

n, Number of students. P values were determined by a Kruskal-Wallis test (ⴱ) or ␹2-test (†).

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How We Learn
160 HOW MEDICAL STUDENTS LEARN IN CENTRAL ANATOLIA, TURKEY
DISCUSSION
Knowing the learning style of students is a valuable skill in
education. Knowledge of learning styles may help educators
identify and solve learning problems among students, thus help-
ing their students to become more effective learners (7, 11).
In the present study, 63.9% of the students exhibited multi-
modality, indicating that they use a combination of learning
styles when learning information. These findings are compat-
ible with other studies (9, 14, 16) that have used the VARK
questionnaire as a learning style inventory. Dinakar (9) found
multimodality to be 58.0% in the caregivers of asthmatic
children; Lujan (14) found it to be 63.8% in first-year medical
students; Erkuş (10) found it to be 53.2% in medical students
in their first 3 yr; and Murphy (16) found it to be 56.0% in
dental students. Fleming (10a) has included 31,243 entries in
his website, and the ratio of single to multimodal preference
has been stated as 42:58 (16). In Turkey, students have to
perform an examination to enter university. To win a place at
a medical faculty, the grade they have to get is high. We
believe that multimodal students are more successful in this
university entrance examination, and, consequently, our mul-
timodal percentage is higher than that of other studies. Further
studies on medical students in all years and on students in other
faculties will better explain this difference.
Multimodal students prefer information to arrive in a variety
of modes. These students do not learn by simply sitting in a
classroom listening to the educator, memorizing assignments
(15). To achieve meaningful learning, these students must talk
about what they are learning, write about it, relate it to past
experiences and knowledge, and apply it to their daily lives (8,
15). In a passive lecture format, the method generally used in
our faculty, all students are assumed to be auditory learners,
although in the present study only 7.7% of the students were
found to be single auditory learners. It is important to empha-
size that students will only remember 20% of what they read,
30% of what they hear, 40% of what they see, 50% of what
they say, and 60% of what they do. This average increases to
90% for information they say, hear, see, and do (19).
Studies (3, 14, 15) have shown that students learn better by
using active learning strategies, because active learning strat-
egies reach all types of learners. Active learning strategies
promote thinking through reasoning and improve problem-
solving and decision-making skills. In large classes, active
learning strategies can also be applied. Discussion in class,
cooperative learning exercises, role play, simulations, models,
debates, and games are active learning strategies that can be
used in larger classes (3). These activities also promote group
work and generate high levels of motivation and enthusiasm.
For medical students, who will always be working in team
environments, these learning experiences are invaluable.
In conclusion, here at Erciyes University Faculty of Medi-
cine, the education system is integrated, but in the first 3 years
theoretical courses are administered in large classes using a
passive lecture format. In a passive lecture format, all students
are assumed auditory learners. In the present study, only 7.7%
of the students were found to be auditory learners. Patient-
based clinical education in small student groups is started in the
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fourth and fifth years, and students then become problem
solvers and more active.
In this study, 63.9% of the students were found to be
multimodal, which means that active learning strategies have
to be applied to a greater extent in the first 3 years of our
educational curriculum to reach all types of learners. To
achieve this, we are proposing drastic reductions in passive
lecture hours and preparing a more problem-based curriculum.
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