2. Shah et al. Attitude and perception of post-graduate residents toward thesis
National Journal of Physiology, Pharmacy and Pharmacology 2
2022 | Vol 12 | Issue 07 (Online First)
logical movements seem to be impossible. In fact, research
is the most important driving force of society in the path
of progress and is one of the most important indicators of
development.[1]
Dissemination of research and growing the
knowledge base in health sciences is important for patient
management and health policy development.[2,3]
Evidence
suggests that involvement in research activities during the
medical training leads to diverse postgraduate research
inclinations in the professional career.[4,5]
At present, most
of the research is being carried out in the Western countries
and comparatively very little research is visible in Asian and
Middle Eastern countries. Exposing students to a research-
promoting environment in the medical schools will help to
inculcate the habit of research in young doctors.[6]
Research dissertation or thesis writing is included as a
compulsory activity in the academics of post-graduate
(PG) students of medical colleges. There are high demands
during residency training in terms of patients work load and
energy. Thus, dissertation, thesis, or research project during
the residency remains lowest among the priorities of the
student only after the little time available from patient care.[7]
Due to hectic schedules of residency training programs, the
general trend observed among residents is that around 75%
of residents prefer to engage in other scholarly activities
as compared to research.[8]
Every year a noticeable number
of MD pass out from various medical colleges across the
country. Submission of research thesis is mandatory for PG
students.[9]
There are almost 268 medical schools with PG
courses in India with approximately 35,000 total medical
students from Government and private colleges.[10]
The apex
body of medical education in India, the Medical Council of
India, has stated that there is serious lack of research and
publications in the medical field. Thus, to increase research
productivity, there is inclusion of research dissertation or
thesis in PG academic curriculum. Hence, publications of
āresearchā papers in designated quality journals which adhere
to broad scientific and ethical guidelines are encouraged.
This will help in fostering research output and development
of the nation. During the period of post-graduation, students
are provided with academic support mechanisms and are
thus expected to complete an independent research project.
Support mechanisms that could increase productivity
include priority setting exercises, research supervision or
mentorship by a more senior academic, protected time for
research, obligatory requirement to publish, research grant
award, seminars for proposal development, peer review, data
analysis and manuscript writing.
Indiaās low ranking of 66 in Global innovation Index is a
reflection of feudal culture in science learning and research
which inhibits questioning and out of the box thinking.[10]
An
international survey conducted on medical students over their
perception on research and research-oriented careers revealed
a significant number of key barriers in research involvement
and pursuit of research-orientated careers.[10]
This sets up the
need to assess the perception of PG residents toward research
dissertation or thesis during residency training in order
to improve the research output in future. It will also prove
useful in framing guidelines for better academic schedules
during residency training.
MATERIALS AND METHODS
Study Design
The present study was a cross-sectional observational
questionnaire-based study. The study was initiated after
obtaining the permission from the Institutional Ethics
Committee (EC/OA/15/2019).
Study Participants
A project has been conducted on PG students of the 2nd
year
and 3rd
year. Students who had given written informed
consent were included in the study. In all instances, student
participants were briefed as to the objectives of the study,
and confidentiality of responses was ensured by maintaining
anonymity of responders.
Study Tool
The draft study questionnaire assessing the attitude and
perception of PG residents toward thesis/dissertation was
designed by the authors. This questionnaire was validated
by administering it to 10 subject experts. The experts graded
each question as very essential, essential or not useful. They
also provided their suggestions if they felt that the questions
were incorrectly framed or if some important question was
missing. Suggestions and responses given by the experts were
evaluated. The content validity ratio (CVR) per item was
calculated and items to be included in the final questionnaire
should have a CVR Ratio of ā„0.62 (For a panel consisting of
10 experts, the minimum CVR Ratio should be 0.62 or more)
1. The average CVR value for the finalized questionnaire
was 0.85.[11]
The final validated questionnaire consisted of 40 questions
with the following domains:
1. Awareness of university regulations: This domain
contained 5 close ended questions about rules and
regulations of studentās university for thesis/dissertation.
Responses per to each question was a Yes/No type
2. Attitude toward thesis: This domain comprised of 4 close
ended questions for studentās general perception toward
thesis/dissertation whose responses were in Yes/No type
3. Perception toward benefits of thesis: This domain dealt
with how students perceive the given 15 statements as
benefits while participating in thesis/dissertation study.
Each statement opinion was rated on a 5-point Likert
scale from Strongly agree to Strongly disagree
4. Perception toward obstacles of thesis: This domain deals
3. Shah et al. Attitude and perception of post-graduate residents toward thesis
3 National Journal of Physiology, Pharmacy and Pharmacology 2022 | Vol 12 | Issue 07 (Online First)
with how students perceive the given 13 statements as
obstacles while participating in thesis/dissertation study.
Each statement opinion was rated on a 5-point Likert
scale from Strongly agree to Strongly disagree
5. Practices in regard to thesis: This domain has 3 questions
which include 2 close ended questions over practices of PG
students toward thesis/dissertation whose answers were in
Yes/No type. The questionnaire ended with a concluding
question for any suggestions to modify the conduct of thesis.
The questionnaire was administered to the participants
of the study directly by the investigators after obtaining
written informed consent. The questionnaires filled by the
participants were collected approximately after 30ā40 min.
Participants were provided privacy and extra time if needed
to fill the questionnaire.
Statistical Analysis
The collected data were entered in to Microsoft excel sheet.
Data entry was done by two separate individuals and data
clean-up was performed before statistical analysis. There
were no missing data. Data analysis was done using GraphPad
version 8. Percentage of the participants for each item in each
domain was calculated. Comparison between pre/preclinical
versus clinical variables was performed using Chi-square
test. A P < 0.05 was considered as a significant value.
RESULTS
Of the total 150 pre/paraclinical and 350 clinical PG students
in the institute questionnaire was distributed to 100 pre/
paraclinical and 200 clinical students. Of these 55 pre/
paraclinical and 70 clinical PG students (n = 125) returned
completely filled questionnaire. Thus response rate was 55%
for pre/paraclinical and 35% from clinical PG students.
The demographic characteristics of the 125 participants are
given in Table 1. All students were above 25 years of age.
The mean age of the students was 27.40 Ā± 2.20 with minimum
age 24 years and maximum age 36 years. Majority, that is,
64.85% of participants who responded were from the 2nd
year
whereas 35.20% were of 3rd
year. 56% participants were from
clinical whereas 44% were from pre/paraclinical branches.
Majority of PG students preferred observational studies (80%)
over interventional study for thesis (19.2%). Only one student
had opted for animal research whereas none of the participants
had selected retrospective study design for their studies
[Table 2]. The preference for observational studies was higher
in clinical PG students and preference for interventional studies
was higher in non-clinical PG students (P < 0.05) [Table 2].
As illustrated in Table 3, all of the students from both clinical
and pre/paraclinical agreed that it was mandatory requirement
of the university to submit thesis as well as to obtain ethical
approval before commencement of the study. Similarly,
majority of the students were aware that it is mandatory
to submit progress report to university (82.4%), attend
Research Methodology (RM) and good clinical practice
(GCP) workshop (97% and 98%, respectively). Nearly, all
students received training in RM before starting thesis study.
Students also agreed that they have complied with university
and ethics regulations while conducting the thesis study.
As stated inTable 3, 61.6% PG students felt that thesis should be
mandatory.62.4%studentsagreedthatGCPandRMworkshops
were satisfactory however 37.6% PG students felt that GCPand
RM were not satisfactory. Majority of students (88%) perceived
observational study more feasible than interventional (14.4%).
However, the higher number of clinical PG students perceived
that interventional studies are more feasible (P = 0.001).
As mentioned in Table 4, majority of students agreed to
benefit of thesis which helps them to develop skills such as
literature search (92.8%), data processing (84%), statistical
analysis (73.6%), interpretation of results, and discussion
(80.8%). PG students also agreed that conduct of thesis will
help them for the developing of new/modified treatment
guidelines (71.2%) as well as diagnostic tools (70.4%) and
for improving their CV (88%). The perception of clinical as
well as pre/paraclinical PG students for all the above items
was similar except for developing of new/modified treatment
guidelines. The students agreeing for usefulness of thesis for
the development of diagnostic tools were higher from the
clinical than the pre/paraclinical branches (P = 0.039).
As shown in Table 4, many PG students felt that there are
few obstacles in their thesis such as inadequate lab facilities
Table 1: Demographic characteristics of the participants
Year Number of residents
n=125 (%)
Age above 25 years 120 (96) MeanĀ±SD=27.40Ā±2.20
Range: 24ā36 years
Age below 25 years 5 (4)
2nd
year PG students 81 (64.85)
3rd
year PG students 44 (35.20)
Pre and paraclinical branches PG
students
55 (44)
Clinical branches PG students 70 (56)
Table 2: Type of thesis study undertaken by postgraduate
students
Type of study/
branch
Non-clinical
n=55 (%)
Clinical
n=70 (%)
Total
(n=125)
Observational 37 (67.27) 63 (90) 100 (80%)
Animal 1 (1.818) 0 (0) 1 (0.8%)
Interventional 17 (30.90)* 7 (10) 24 (19.2%)
Retrospective 0 (0) 0 (0) 0
P<0.05, Chi-square test
4. Shah et al. Attitude and perception of post-graduate residents toward thesis
National Journal of Physiology, Pharmacy and Pharmacology 4
2022 | Vol 12 | Issue 07 (Online First)
(66.4%), inadequate study tools (62.4%), and incompetent
technical staff (55.2%).The number of the students perceiving
these difficulties was statistically high in the clinical branches
than pre/paraclinical branches (P < 0.05). Other obstacles
as agreed by majority students of both branches were lack
of protected research time (80.8%), lack of adequate funds
(69.6%) and difficulty in dealing with patientās involvement
like obtaining consent or lack of follow-up (70.4%).
DISCUSSION
Thesis is the one of the main connecting factors between
PG students and university. Besides, understanding the
PG students points of view in regard to thesis which is an
important aspect, knowing about their experiences and
expectations are other important factors which cannot be
ignored. The obtained information can provide few directions
to understand and solve observed problems faced by the
PG students while conducting thesis. The present study
was conducted to evaluate studentās perception toward the
thesis conduction process and attitude toward its university
regulations. The results of the study indicated some of the
problems, weak points, and also, the strong points in higher
education and necessary changes in the present university
program in relation to thesis.
Table 3: Awareness, attitude, and practices of postgraduate students toward university regulations
Branch Number of PG
sudents saying
Yes out of
125 (%)
Number of
PG sudents
saying No out of
125 (%)
Non-clinical n=55 (%) Clinical n=70 (%) P-value
Question Yes No Yes No
Awareness about university regulation among postgraduate students
Mandatory requirement
of your university to
submit thesis title and
synopsis
125 (100) 0 55 (100) 0 (0) 70 (100) 0 (0) 0
Mandatory requirement
of your university to
submit progress report
103 (82.4) 22 (17.6) 49 (89.09) 6 (10.90) 54 (77.14) 16 (22.85) 0.132
Mandatory requirement
of your university to
obtain ethics approval
125 (100) 0 (0) 55 (100) 0 (0) 70 (100) 0 (0) 0.00
Is attending RM
mandatory?
122 (97.6) 3 (2.4) 54 (98.18) 1 (1.81) 68 (97.14) 2 (2.85) 0.706
Is attending GCP
training mandatory in
your college?
121 (96.8) 4 (3.2) 54 (98.18) 1 (1.81) 67 (95.71) 3 (4.28) 0.790
Attitude of postgraduate students toward Thesis
Should thesis be
mandatory?
77 (61.6) 48 (38.4) 29 (52.72) 26 (47.27) 48 (68.57) 22 (31.42) 0.104
Should RM and
GCP training made
mandatory?
78 (62.4) 47 (37.6) 37 (67.27) 18 (32.72) 42 (60) 28 (40) 0.515
Found observational
study more feasible?
111 (88.8) 14 (11.2) 46 (83.63) 9 (16.36) 65 (92.85) 5 (7.14) 0.181
Found interventional
study more feasible
18 (14.4) 107 (85.6) 8 (14.54) 47 (85.45) 60* (85.71) 10 (14.28) 0.001
Practice of postgraduate students in regard Thesis
Received training in
RM
120 (96) - 55 (100) 0 (0) 65 (92.85) 5 (7.14) 0.118
Have you complied
with the university
regulations for the
conduct of thesis
121 (96.8) 4 (3.2) 52 (94.54) 3 (5.45) 69 (98.57) 1 (1.42) 0.448
Have you complied
with the Ethics
regulations for the
conduct of thesis
122 (97.6) 3 (2.4) 53 (96.36) 2 (3.63) 69 (98.57) 1 (1.42) 0.832
GCP: Good clinical practice, *P<0.05 *Using Chi-square test. RM: Research Methodology
5. Shah et al. Attitude and perception of post-graduate residents toward thesis
5 National Journal of Physiology, Pharmacy and Pharmacology 2022 | Vol 12 | Issue 07 (Online First)
As seen from the results, (100%) students were aware of the
university regulation and nearly all (82%) students had stated
that they complied with university and ethical regulations
(18%) while conducting research. Most of the universities
require periodic progress report of students. Better monitoring
of the progress of students in their program is done by means
of progress report which also makes it possible to evaluate the
progress made during their 1 year and to define the objectives
for the subsequent years. The information provided in the
report ensures that all students are making systematic and
consistent progress in their academic research. Obtaining the
right knowledge and building the right attitude for clinical
research among PG students is of immense importance.
Arranging training program for students for RM concepts and
GCP helps to develop this attitude and basic knowledge in
the research, and ethics. In our study, the attitude toward RM
and GCP workshop was positive with 68% stating that these
training program should be mandatory. In a study conducted
Table 4: Perception of postgraduate students toward benefit and obstacles while conducting thesis
Branch Number of PG
students saying
Yes out of 125 (%)
Non-clinical
n=55 (%)
Clinical
n=70 (%)
P-value
Questions Agree Disagree Agree Disagree
Perception of postgraduate students toward benefit of thesis
Development of critical thinking 91 (72.8) 42 (76.36) 13 (23.64) 49 (70) 21 (30) 0.554
Development of analysis skills 100 (80) 45 (81.81) 10 (18.19) 55 (78.58) 15 (21.42) 0.821
Development of data processing 105 (84) 45 (81.81) 10 (18.19) 60 (85.72) 10 (14.28) 0.730
Development of statistical skills 92 (73.6) 42 (76.36) 13 (23.64) 50 (71.43) 20 (28.57) 0.676
Improvement in literature search skills 116 (92.8) 51 (92.72) 4 (7.28) 65 (92.86) 5 (7.14) 0.977
Testing of hypothesis 77 (61.6) 32 (58.18) 23 (41.89) 45 (64.29) 25 (35.71) 0.609
Interpretation of discussion and results 101 (80.8) 44 (80) 11 (20) 57 (81.43) 13 (18.57) 0.840
Essential for the development of new/modified
treatment guidelines
89 (71.5) 37 (67.27) 18 (32.73) 52 (74.29) 18 (25.71) 0.508
Essential for the development of new/modified
diagnostic test
88 (33.44) 33 (60) 22 (40) 55* (78.58) 15 (21.42) 0.039
Important for physician in improving clinical
practice
82 (72.2) 33 (60) 22 (40) 49 (70) 21 (30) 0.327
Gathering epidemiological data 102 (81.6) 49 (89.09) 6 (10.91) 53 (75.72) 17 (24.28) 0.092
Awareness of emerging problem in society 98 (78.4) 48 (87.27) 7 (12.73) 50* (71.43) 20 (28.57) 0.055
Improving my CV/Resume 110 (88) 48 (87.27) 7 (12.73) 62 (88.58) 8 (11.42) 0.824
To build my future career in research 94 (75.2) 41 (75.54) 14 (25.46) 53 (75.72) 17 (24.28) 0.880
Obtaining research publication 109 (87.2) 47 (85.45) 8 (14.55) 62 (88.58) 8 (11.42) 0.804
Perception of postgraduate students toward obstacles while conducting thesis
Inadequate lab facilities 83 (66.4) 29 (52.72) 26 (47.28) 54* (77.15) 16 (22.85) 0.007
Inadequate instrument or study tools 78 (62.4) 27 (49.90) 28 (50.10) 51* (72.86) 19 (27.14) 0.011
Incompetent technical staff 69 (55.2) 24 (43.63) 31 (56.37) 45* (64.29) 25 (35.71) 0.033
Lack of time alongside medical studies/clinical
work
96 (76.8) 40 (72.72) 15 (27.28) 56 (80) 14 (20) 0.457
Lack of protected research time 101 (80.8) 39 (70.90) 16 (29.10) 62* (88.58) 8 (11.42) 0.023
Lack of necessary skills/training 66 (52.8) 27 (49.09) 28 (50.91) 39 (55.72) 31 (44.28) 0.578
Lack of adequate funds 87 (69.6) 35 (63.63) 20 (36.37) 52 (74.29) 18 (25.71) 0.276
Family constraints 23 (18.4) 11 (20) 44 (80) 12 (17.15) 58 (82.85) 0.859
Lack of interest in participating in thesis 41 (32.8) 16 (29.09) 39 (70.91) 25 (35.72) 45 (64.28) 0.554
Lack of adequate training in RM and
GCP (including research skills, statistical
support and research interpretation)
53 (42.4) 19 (34.54) 36 (65.46) 34 (48.58) 36 (51.42) 0.163
Lack of mentor guidance 35 (28) 13 (23.63) 42 (76.37) 22 (31.43) 48 (68.57) 0.445
Difficulty in dealing with patients involved in
research (Difficulty while obtaining consent,
lack of follow-up of patients etc.)
88 (70.4) 35 (63.63) 20 (36.37) 53 (75.72) 17 (24.28) 0.203
Difficulty in obtaining IRB approval for thesis 71 (56.8) 27 (49.90) 28 (50.91) 44 (62.86) 26 (37.14) 0.173
*P<0.05 *Using Chi-square test, GCP: Good clinical practice. RM: Research Methodology
6. Shah et al. Attitude and perception of post-graduate residents toward thesis
National Journal of Physiology, Pharmacy and Pharmacology 6
2022 | Vol 12 | Issue 07 (Online First)
by Gupta et al.[12]
and Giri et al.,[13]
73.3% and 74% of
students, respectively, agreed that RM workshops should be
compulsoryforPGstudents.Similarpositiveattitudewasseen
in dental PG students for RM training in a study conducted
by Sharma et al.,[14]
higher in 3rd
year dental PG students than
in the 2nd
year dental students (3.34 Ā± 0.76 vs. 2.92 Ā± 0.85,
P = 0.0002). Universities in India have made it compulsory
for PG students to have training in GCP and RM at the start
of PG course. Hence to abide, these regulations all students
who participated in our study have attended GCP and RM
workshops (96%) conducted by their respective departments/
institution. More ever (98%) students have also agreed that
they have followed these regulations/ethics while conducting
thesis research.Attitude change regarding these two important
aspects, that is, research and ethics among PG students could
be because of the trainings conducted before PG students
start the actual process of conduct of thesis.
For the question pertaining to if thesis should be mandatory
although 63% agreed to this statement, it is important to
understand why remaining 38% think that thesis should not
mandatory for doing postgraduation. In a study conducted by
Behera et al.[15]
in 63% students agreed to the statement that
āthesis should be made optional.ā
Thesis has been introduced in the postgraduate curriculum not
only to improve research and clinical skill but entire process
of thesis conduct helps the students to develop various skills
including leadership, organization, etc. In the present study
students have agreed for the statement of benefits of thesis,
that is, Research (data processing: 84%, statistical skills: 73%,
literature search skills: 93%, Testing of hypothesis: 67%,
Interpretation of discussion and results: 81%), and clinical
(development of new/modified treatment guidelines: 71%,
development of new/modified diagnostic test: 70%, improving
clinical practice: 66%, awareness of emerging problem in
society: 78%). The students agreeing to clinical advantages
for the thesis were more in number from clinical branches
than in nonclinical branches. In a study conducted by
Habineza et al.[16]
interns and residents have agreed that
conducting research helps to improve self-confidence and
developing skills such as working independently and problem
solving. Students in this study have also agreed that research
is important for patient care.
Both clinical and nonclinical Students perceived that
observational studies are more feasible and interventional
studies are not feasible. This perception is in line with the
types of studies opted by PG students as their thesis, that
is, 72% of students choosing observational study design for
their thesis topic including clinical and nonclinical branches.
The similar results were seen in a study by Habineza et al.[16]
wherein 55% residents opted cross-sectional study design,
22% qualitative design with none opting for interventional
study design.[15]
The main reasons for this preference in our
study mainly as stated in perception about obstacles for thesis
in our study as well as study by Behera et al.[15]
could be,
for example, difficulty in ethical approval and difficulty in
dealing with patients involved in research (consent process,
follow-up, etc.) Interventional studies may require more
financial support (payment for participation, study related
injury, study drugs, investigations, etc.) laboratory facilities
and time compared to observational studies which could be
main hindrance for taking these designs as thesis topics.
The main two obstacles as perceived by PG students of both
branches who participated in this study, lack of protected
research time (81%), and lack of funding (70%) are similar
to findings of other studies conducted on postgraduate
students not only in India but also in other countries such
as Bangladesh Matin et al.,[17]
Pakistan Saeed et al.,[18]
and Habineza et al.[16]
The obstacles such as inadequate
laboratory facilities (63%,77% vs. 51%: P = 0.004),
inadequate study tools/instruments (55%,73% vs. 50%:
P = 0.011), and incompetent technical staff (66%, 64% vs.
44%: P = 0.033) were perceived by majority of students but
more so by clinical PG students than pre/paraclinical PG
students. Similarly, a lack of protected research time was
more of a concern perceived by clinical than pre/paraclinical
PG students (89% vs. 71%: P = 0.023). Lack of guidance
by mentor (disagree: 72%) and family constrain (disagree:
82%) for thesis were least concerns of PG students. These
findings are similar to studies conducted by most of the other
authors except a study conducted by Saeed et al.[18]
where
PG students felt that faculty are uncooperative (Agree: 31%,
Neutral: 46%) and faculty lack the research knowledge
(Agree: 53%). PG students face various scientific, technical,
operational as well as personal problems while conducting
thesis. A study by Sidhu et al.[19]
found that PG students from
Malaysia looked for supervisors who are more motivator and
confidence booster whereas students from the UK stressed
the need for a supervisor to be an expert in their specific
field of study. A supervisor should guide, motivate, ensure
scientific quality, give quality time for discussion, and provide
emotional support to the student. In our study, we have not
asked for marital status of the PG students, however in a
study by Saeed et al.[18]
study result indicate that PG students
who were married had more social/family commitments as
84.8% married doctors agreed with this question as compared
to unmarried colleagues 45.6% (P = 0.001).
Most importantly, majority of the students did not agree for
the statement lack of interest for thesis (disagree: 68%) thus
bringing to notice that students are motivated to carry out
research.
Limitations of the Study
The present study was conducted in one medical college
only. Furthermore, the response rate for the study was less
especially from the clinical PG students. This restricts the
generizability of the study results.
7. Shah et al. Attitude and perception of post-graduate residents toward thesis
7 National Journal of Physiology, Pharmacy and Pharmacology 2022 | Vol 12 | Issue 07 (Online First)
CONCLUSION
It is important to take actions at the institution/department
level to take care of obstacles faced by PG students. Facilities
of the institution/department should be strengthened; options
should be made available to PG students for funding their
thesis, a dedicated time should be provided for research to
students by taking care that clinical work is not affected.
However, most importantly guides/supervisors should take
active part in the thesis conception and conduct and also
motivate, guide PG students so that thesis would be learning
experience for the students and not just burden.
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How to cite this article: Shah A, Patankar R, Tripathi R,
Jalgaonkar S, Sangtani N, Gajbhiye S. Attitude and perception
of post-graduate residents toward thesis: A cross-sectional
study. Natl J Physiol Pharm Pharmacol 2022;12 (Online First).
DOI: 10.5455/njppp.2022.12.11430202129112021
Source of Support: Nil, Conflict of Interest: None declared.