Reading modality shows no GPA advantage among Syrian medical students

Medical students in Syria who favor digital reading over print do not perform measurably better or worse on their overall academic record, according to a cross-sectional survey of 550 students published in BMC Medical Education. The study, which covered students from years two through six, found no significant association between reading modality and grade point average, with a p-value of 0.327. In an era when medical curricula are increasingly delivered through screens, the result adds a data point from a resource-constrained setting where digital infrastructure and reading practices may differ from those documented in Western contexts.

The research team, led by Ahmad Alkheder and colleagues, used stratified consecutive sampling with proportional allocation across academic years to ensure balanced representation at each stage of training. Participants reported their study modality habits, academic performance including GPA and course failures, and completed the Strength of Motivation for Medical School-Revised instrument, a validated measure scored out of 75. The survey also captured a set of digital reading behavior constructs, allowing the researchers to probe not just what students read on, but how their attitudes and surroundings shape that engagement.

While overall GPA was statistically blind to modality, a more granular signal emerged in course failures. Students who reported that 76 to 100 percent of their study engagement was screen-based had the highest proportion of single-subject failures in the sample, at 42.8 percent. The authors are careful not to overinterpret this figure: it is a cross-sectional association, and the design cannot determine whether heavy screen reliance contributes to failing a course, whether struggling students migrate toward screens, or whether an unmeasured third factor drives both. Still, the pattern shows that the most digitally saturated learners were not protected from academic setbacks.

Motivation told a different story. The mean SMMS-R score across the sample was 52.77 with a standard deviation of 7.79 on the 75-point scale, and motivation scores were significantly lower among students in more advanced academic years, with a p-value of 0.003. Because the data were collected at a single point in time, the researchers cannot distinguish between a genuine erosion of motivation as students progress through medical school and cohort differences between year groups. The cross-sectional comparison leaves the direction of this year-level pattern open.

To understand what drives motivation, the team ran a multiple linear regression alongside t-tests, ANOVA, chi-square tests and Pearson correlations. Two digital-reading constructs emerged as positive predictors of motivation scores: willingness to use digital resources, with a standardized coefficient of 0.151 and a p-value of 0.022, and performance expectations, with a coefficient of 0.133 and the same p-value. In other words, students who wanted to engage with digital tools and who believed those tools would help them perform better tended to report stronger motivation for medical school itself.

One variable pointed the opposite way. Social environment impact, a measure of how students’ surroundings shape their digital reading behavior, was a negative predictor of motivation, with a coefficient of -0.124 and a p-value of 0.015. The full regression model, however, explained only 4.4 percent of the variance in motivation scores, with an R-squared of 0.044 and an overall model p-value of 0.003. The authors explicitly caution that these associations should be read in light of the limited explained variance and the inability of a cross-sectional design to establish the direction of effects. Motivation in medical school is clearly shaped by many forces beyond the digital reading landscape the survey captured.

Device access and geographic location were consistently associated with differences in digital reading behaviors across the sample, a finding that shows how unevenly digital learning resources and practices are distributed within a single student population. The authors argue that such contextual factors deserve attention when institutions consider evidence-based integration of digital resources into medical curricula, rather than assuming that findings from well-resourced Western universities transfer intact to settings where infrastructure and reading habits differ.

The study’s contribution lies partly in its setting. Existing evidence on digital versus print reading in medical education remains inconclusive, as the authors note in their background, particularly in resource-constrained settings where digital infrastructure and reading practices differ from Western contexts. By documenting modality habits, failure rates and motivation in a Syrian cohort, the study offers a locally grounded baseline for this literature. The absence of a GPA difference between print and screen readers is itself a finding: it suggests that neither format holds an inherent advantage for cumulative academic performance in this sample, even as heavy screen reliance coincided with more single-subject failures.

For medical educators, the takeaway is nuanced. The regression identified attitudes tied to motivation: students’ willingness to use digital resources and their expectations that those resources would improve performance were both associated with stronger motivation, while negative social influences around digital study were associated with weaker motivation. Because the design cannot establish the direction of effects, these relationships should be interpreted as associations rather than causes. For now, the study gives curriculum designers in constrained settings a measured, locally grounded picture of how their students actually read, fail, and stay motivated.

Subject of Research: Digital versus print reading modalities and their association with academic performance and motivation among medical students: a cross-sectional study from Syria

Article Title: Digital versus print reading modalities and their association with academic performance and motivation among medical students: a cross-sectional study from Syria

Article References: Alkheder, A., Hamdi, M., Fakher Eddin, A., Almoukdad, R., Alwen, A., Alghazolle, A., Algoumari, A., Nabelsy, A., & Yousfan, A. (2026). Digital versus print reading modalities and their association with academic performance and motivation among medical students: a cross-sectional study from Syria. BMC Medical Education. https://doi.org/10.1186/s12909-026-10693-x

Image Credits: AI Generated

DOI: 10.1186/s12909-026-10693-x

Keywords: Digital, versus, print, reading, modalities, association, academic, performance, motivation, medical, students, cross-sectional