Medical students' knowledge and attitudes in relation to COVID-19 pandemic in Saudi Arabia: Multi-center online survey

Sultan Alsheikh; Walid Alorainy; Husam Alkahthlan; Khalid Alamri; Lina Neel; Nouf Alrumaihi; Fatma Alshahrani; Mona Soliman

doi:10.4103/ijas.ijas_15_21

ORIGINAL ARTICLE

Year : 2021 | Volume : 6 | Issue : 2 | Page : 25-30

Medical students' knowledge and attitudes in relation to COVID-19 pandemic in Saudi Arabia: Multi-center online survey

Sultan Alsheikh¹, Walid Alorainy², Husam Alkahthlan², Khalid Alamri³, Lina Neel⁴, Nouf Alrumaihi⁵, Fatma Alshahrani⁶, Mona Soliman⁵
¹ Department of Surgery, College of Medicine, King Saud University, Riyadh, Saudi Arabia
² Department of Medical Student, College of Medicine, King Saud University, Riyadh, Saudi Arabia
³ Medical Student, College of Medicine, King Saud University, Riyadh, Saudi Arabia
⁴ Medical Student, College of Medicine, Alfaisal University, Riyadh, Saudi Arabia
⁵ Departments of Medical Education, College of Medicine, King Saud University, Riyadh, Saudi Arabia
⁶ Department of Medicine, Head of Infection Control Unit, College of Medicine, King Saud University, Riyadh, Saudi Arabia

Date of Submission	21-Dec-2021
Date of Acceptance	10-May-2022
Date of Web Publication	07-Oct-2022

Correspondence Address:
Dr. Mona Soliman
Department of Medical Education, College of Medicine, King Saud University, Riyadh
Saudi Arabia

Source of Support: None, Conflict of Interest: None

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DOI: 10.4103/ijas.ijas_15_21

Abstract

Background: Medical students have an important role to provide training to other medical students and health workers, and to volunteer when there is a shortage in health care personnel. The aim of the study was to evaluate the knowledge of medical students in six medical colleges in Riyadh, Saudi Arabia, about the coronavirus-19 (COVID-19) pandemic.
Materials and Methods: An online survey was distributed to undergraduate medical students from August to October 2021. A total of 261 medical students participated in the study. The survey composed of 26 questions that evaluated students' knowledge about the COVID-19 pandemic in terms of symptoms, modes of transmission, diagnosis, management, and prevention.
Results: Two hundred and sixty-one medical students participated in the study with an overall response rate of 31.37%. Around half of the respondents (54%) being from 1^st to 4^rd medical years 81 (31.03%) and 60 (22.99%), respectively. The students' knowledge regarding COVID-19 was investigated in different domains. The mean knowledge score of the protection and prevention of the disease was the highest with a (mean = 79.85%) followed by the knowledge of the ways of the disease transmission (mean 71.31%). 140 (53.64%) of the participants knew how to properly diagnose COVID-19, while (48.35%) were able to identify the different possible symptoms that can be seen in COVID-19-positive individuals (47.32%) knew the different lines of treatment according to the case severity.
Conclusions: The results of the present study can be utilized to develop undergraduate medical curricula with the sufficient amount of knowledge about the COVID-19 pandemic.

Keywords: COVID-19, curriculum development, knowledge, medical students

How to cite this article:
Alsheikh S, Alorainy W, Alkahthlan H, Alamri K, Neel L, Alrumaihi N, Alshahrani F, Soliman M. Medical students' knowledge and attitudes in relation to COVID-19 pandemic in Saudi Arabia: Multi-center online survey. Imam J Appl Sci 2021;6:25-30

How to cite this URL:
Alsheikh S, Alorainy W, Alkahthlan H, Alamri K, Neel L, Alrumaihi N, Alshahrani F, Soliman M. Medical students' knowledge and attitudes in relation to COVID-19 pandemic in Saudi Arabia: Multi-center online survey. Imam J Appl Sci [serial online] 2021 [cited 2023 May 31];6:25-30. Available from: https://www.e-ijas.org/text.asp?2021/6/2/25/358063

Introduction

The pandemic of Coronavirus-19 (COVID-19) is considered the largest global crisis after world war-2.^[1] It is an airborne disease that is caused by the severe acute respiratory syndrome coronavirus 2.^[2] It is fast spread and relatively high morbidity and mortality rates have caused many governmental entities around the globe to adapt different interventions and preventions plans to control the spread and effect of the disease.^[3],[4]

The Saudi Universities have done a great job in facing the COVID-19 pandemic. One of the interventions that has been implemented was moving to online education and social distancing plans, which both had a considerable impact on education in terms of challenges and successes.^[5] One of these challenges was moving toward online education and assessment plus educating medical students regarding the current situation.^[6]

Many studies have explored the level of knowledge and perception of medical and dental students about COVID-19 pandemic and the necessity of educating them about this pandemic.^{[7],[8],[9],[10],[11],[12]} Medical students have an extremely large network of contacts including health colleges students, interns, staff, families, and society. Health care students are expected to have had received training on infection control and prevention.^[13] Thus, medical students are expected to play a major role in guiding those around them on how to deal safely with COVID-19 pandemic, to educate public regarding basic information about the virus and to serve as volunteers when there is a shortage in the health care team.

The aim of the study was to evaluate the knowledge of medical students in six medical colleges in Riyadh, Saudi Arabia, about the COVID-19 pandemic in terms of symptoms, modes of transmission, diagnosis, management, and infection control.

Materials and Methods

Ethical considerations

This study was approved by the College of Medicine Institutional Review Board (KSU-IRB Ref. No. 21/0680/IRB) and was done according to the international code and standards of research ethics. All participants were asked for their consent and their identities remained confidential.

Study design

The present study was a cross-sectional study.

Study setting

An online survey was distributed to undergraduate medical students in six medical colleges in Riyadh, Saudi Arabia in August to October 2021. A total of 261 medical students participated in the study.

[Table 1] lists the four universities in Riyadh region, Saudi Arabia included in the study: King Saud University, King Saud bin Abdulaziz University for Health Sciences, Imam Muhammad ibn Saud Islamic University, Alfaisal University, Almarifa University and Vision Colleges.

Table 1: Demographic data of the medical students participated in the study from six Universities in Riyadh, Saudi Arabia August-October 2021

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Target population/sample size

The study included all medical students meeting the inclusion criteria during the study period. Inclusion Criteria: all undergraduate medical students in college of medicine. The exclusion Criteria: postgraduate, medical students from universities outside Riyadh region.

Survey

The survey included six sections of close-ended questions. The first section had 5 questions on demographic information from the participants: gender, age, marital status, name of university and which year in medical college [Table 2].

Table 2: Individual factors of participating medical students and their association with knowledge score

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The second section had 21 questions on the knowledge about COVID-19. Five items assessed the knowledge of the symptoms, eight items assessed the knowledge of the mode of transmission of COVID-19, one item assessed knowledge of COVID-19 diagnosis, 2 assessed knowledge of COVID-19 treatment and five items assessed the knowledge of prevention of COVID-19. The response for each item was scored either 1 (correct) or 0 (incorrect).

Data collection/data source

The survey was designed on Google forms or Survey Monkey. It was distributed electronically after approving it to all medical students through E-mail. A gentle reminder was sent to the students within 1-week interval through E-mail by the researchers to have better response rate and to remind those who did not fill it to participate in the study if they want to.

Questionnaire

The questionnaire was designed by the research team based on extensive literature reviews and was validated by the researchers by multiple revisions and editing.

We calculated the percentages of correct responses. The responses were plotted as bar graphs. We compared the knowledge domain percentages using multivariate analysis of variance.

Statistical analysis

Data were analyzed using SPSS 24.0 version statistical software (IBM, Chicago, IL, US). Descriptive statistics (mean, standard deviation, frequencies, and percentages) was used to describe the quantitative and categorical variables. Bivariate statistical analysis was carried out using appropriate (Chi-square, Student's t-test, one-way analysis of variance and Pearson's correlation) statistical tests, based on the type of study and outcome variables. A P < 0.05 and 95% confidence intervals will be used to report the statistical significance and precision of results.

Results

There were 261 responses from six Medical Colleges in six different Universities in Riyadh region, Saudi Arabia. The response rate ranged from 11.3% in King Saud University to 1.97% in Vision Colleges with an overall response rate of 31.37% [Table 1].

[Table 2] shows that 177 (67.8%) were male and 84 (32.18%) were female. One hundred and twenty respondents (45.98%) were 18–21, 124 (47.51%) were 22–25, and 17 (6.51%) were 26–30 years old. 3 (1.15%) respondents were married, 256 (98.08%) were single, 2 (0.77%) were divorced. 122 (11.3%) were medical students from King Saud University, 12 (4.6%) were medical students from King Saud Bin Abdulaziz University for Health Sciences, 32 (3.5%) were medical students from Imam Muhammad ibn Saud Islamic University, 70 (7%) were medical students from Alfaisal University, 14 (3%) were medical students from Almarifa University and 11 (1.97%) were medical students from Vision Colleges. 81 (31.03%) respondents were 1^st year medical students, 14 (5.36%) respondents were 2^nd year medical students, 26 (9.96%) respondents were 3^rd year medical students, 60 (22.99%) respondents were 4^th year medical students, 46 (17.62%) respondents were 5^th year medical students and 34 (14.4%) respondents were interns.

[Table 3] shows the levels of medical students' knowledge regarding COVID-19. 105 (40.23%) knew that fever is a mandatory symptom to diagnose COVID-19. While 114 (43.68%) identified chest pain as a known symptom of COVID-19. 113 (43.30%) knew that confusion could be a symptom of COVID-19. 212 (81.23%) knew that respiratory syndrome is a known complication of COVID-19 and 87 (33.33%) knew that kidney failure can be a complication. 261 (100%) knew that coronavirus can be transmitted from person to person. 229 (87.74%) knew the correct incubation period of coronavirus. 219 (83.91%) knew that an infected asymptomatic person can infect others. Only 31 (11.88%) knew that children and young adults are at risk if infection with coronavirus. 230 (91.58%) knew the mode of transmission of coronavirus. While 45 (17.24%) knew that if somebody has flu symptoms, he should isolate him/herself and avoid contact with others, 237 (90.80%) knew that if a person comes into contact with an infected person with COVID-19, he or she would inform his or her supervisor and isolate him/herself. 228 (87.36%) knew that despite overall good health condition, a person can still get infected with COVID-19 if he or she have a contact with a confirmed positive case if he/she were not wearing a mask. 140 (53.64%) knew the proper timing of doing the swab for diagnosis of coronavirus. While 168 (64.37%) knew there is a specific valid antiviral treatment against COVID-19, 79 (30.27%) knew what is the treatment of moderate-to-severe coronavirus. 184 (70.5%) knew that regular influenza vaccines provide protection against the coronavirus, 226 (86.59%) knew that washing hands frequently with soap or hand sanitizer can protect me from the coronavirus, 229 (87.74%) knew that wearing a face mask can prevent the transmission of coronavirus, 223 (89.27%) knew that social distancing can help in reducing the spread of the coronavirus and 170 (65.13%) knew what is the appropriate distance to keep between people to maintain social distancing.

Table 3: Individual factors of participating medical students and their association with knowledge score

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[Figure 1] demonstrates the mean percentage scores in each of the knowledge domains: symptoms, transmission, diagnosis, treatment, and prevention. The percentage score of knowing the symptoms of coronavirus disease (mean 48.35%), transmission (mean 71.31%), diagnosis (mean 53.64%), treatment (mean 47.32%), and prevention (mean 79.85%).

Figure 1: Percent scores of knowledge of medical students about coronavirus-19: symptoms, transmission, diagnosis, treatment and prevention

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Discussion

The present study showed that knowledge of medical students about COVID–19 pandemic is overall high. However, there are certain deficiencies that need improvement. The results of the present study can be utilized to develop undergraduate medical curricula with the sufficient amount of knowledge about the pandemic in the deficient areas identified. Rapid race of the pandemic mandate the need to revise the medical curricula to include the important essential information about the COVID-19 pandemic needed for medical students.^[14] Medical curricula are important to revise and develop to prepare medical students as first-line responders in case of emergencies and shortage of the healthcare providers.^[8],[9] In the present study, medical students had high knowledge of COVID– 19. However, the results of the study showed areas of deficiencies in knowledge that need to be addressed.

A major strength of the study is the large sample size and the inclusion of several medical colleges from different universities in Riyadh region that adopt different types of medical curricula. This allowed us to demonstrate differences in medical student knowledge of the pandemic based on the contents of the medical curricula. However, the pandemic is rapidly evolving, which means that the information assessed in the study may have already been outdated by the time the study gets published. The results of the present study are valuable for the development of the undergraduate medical curriculum for the medical students on COVID– 19 and for identifying areas of weakness in knowledge where emphasis and development are needed. This information will provide medical curriculum design development bodies with a highlight on the knowledge of medical students of core information regarding COVID–19. It will also help provide the necessary information for medical students who work as first-line volunteers for health care in case of deficiencies needed. The medical student also plays a major role in educating people around them including patients, staff, family, and other health work team members. Several studies assessed the medical students' knowledge of COVID– 19 information. The present study is the first, up to our knowledge to assess the knowledge of medical students in Riyadh region, Saudi Arabia. However, further studies are needed to assess the medical students' knowledge of COVID–19 in Saudi Arabia and to associate that with the number of reported cases and the type of medical curricula adopted in the colleges. The high knowledge about COVID–19 in the present study may be attributed to the global nature of the COVID–19 pandemic and the widespread of updated information through webinars, social media, and extensive media coverage.

The rapid pace of COVID–19 outbreak and information about it and the development of the vaccines, emphasize the importance of accurate sources of information^[14] and implementation of elements within the medical curriculum.

Training of medical students and providing them with accurate necessary information is especially important in regions where there is a shortage of health care professionals and medical students are trained to be first-line responders in public health emergencies.^[15]

One of the limitations in this study was the low response rate, that may reduce the statistical significance. This also limits the generalizability of the results. The low response rate may be explained by the medical students busy and comprehensive academic responsibilities.^[16] Several reminders were sent to address the low response rate. Previous studies reported low response in online surveys conducted on medical students and healthcare providers.^[17]

Conclusions

Knowledge of medical students about COVID–19 pandemic is generally high. However, there are certain deficiencies that need improvement. The results of the present study can be utilized to develop undergraduate medical curricula with the sufficient amount of knowledge about the COVID-19 pandemic.

Ethics approval and informed consent

This study was approved by the College of Medicine Institutional Review Board (KSU-IRB Ref. No. 21/0680/IRB) and was done according to the international code and standards of research ethics. All participants were asked for their consent and their identities remained confidential.

Author contributions

All authors contributed to data analysis, drafting, or revising the article gave final approval of the version to be published, and agree to be accountable for all aspects of the work.

Acknowledgments

The author would like to express sincere thanks to all medical students at the Colleges of Medicine in Riyadh who participated in this study for their cooperation.

Financial support and sponsorship

Nil.

Conflicts of interest

There are no conflicts of interest.

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