Abstract
Background As textbooks constitute a foundational component of medical education, it is imperative to conduct a rigorous evaluation of their efficacy by examining the fundamental elements and tools utilized within these textbooks and how multiple factors may alter the effectiveness of such components. Materials and methods We conducted a cross-sectional, survey-based study where 251 subjects anonymously rated the effectiveness of different tools and elements/factors used in medical textbooks using 5-point Likert scales. The population surveyed included year 1 to 5 medical students at Alfaisal University, where students are admitted to medical school directly after high school, with an approximately equal male-to-female admission rate. Students were asked to rate the effectiveness of the following tools: chapter summary, end-of-chapter questions, tables of contents, graphic elements, diagrams, tables, flowcharts, mind maps, sidebars, and links to online resources. In admission, they were asked to rate textbooks regarding the following elements/factors: text clarity, directness to the concept intended, flow of ideas, language complexity, and clinical (vertical) and multidisciplinary (horizontal) integration. The Chi-square, post-hoc, Spearman's correlation, and Kruskall-Wallis tests were used in the statistical analysis to determine the differences and correlations in the students' self-ratings of different variables. Results The students rated tools such as diagrams and graphic elements as the most effective. Graphic elements were rated as significantly more effective by first- and fourth-year students. This corresponds to being exposed to new environments (the first exposure to the study of medicine and the first exposure to clinical clerkship), indicating their effectiveness in introducing new concepts and setting of change. Furthermore, end-of-chapter summaries and questions were rated significantly as being more effective by females (P<0.05). The aim behind using textbooks and the frequency might be governed by how students rate textbooks regarding multiple elements or factors, including directness to the concept intended, flow of ideas, and language complexity. Interestingly, all the above findings were consistent throughout all grade point average groups. Discussion In the rising age of e-learning, our study shows that the tools employed by textbooks remain effective. Our findings are partially consistent with existing literature, which underscores correlations between demographic variables and learning styles. We show that the effectiveness of various tools employed in textbooks can vary depending on the educational setting. While demographic factors generally did not impact students' perceptions of tool effectiveness, gender-specific differences were observed in the perceived effectiveness of end-of-chapter summaries and questions, with female students rating them as more effective, which aligns with existing literature. Conclusions Our study shows that students still perceive the tools employed by textbooks as effective. The perceived effectiveness of various tools utilized within textbooks may be influenced by certain demographic factors and settings, with graphics often proving the most efficacious. This study provides valuable insights for authors of medical textbooks, helping them optimize the usage of various tools by considering the specific characteristics and requirements of the intended audience.