Comparison of Cognitive Learning Strategies of Dental Students at the Beginning and at the End of Their University Course ()
1. Introduction
For students, university represents a new context of study into which they must quickly integrate. Indeed, the student’s rapid adaptation to this new world, and in particular the adaptation of his or her learning strategies is one of the keys to academic success [1] . Researchers have been interested in learning strategies since the 1970s [2] . Several authors have proposed a definition of the concept of learning strategies. Authors define learning strategies as behaviors or thoughts that the learner uses during learning to influence his or her information encoding processes. It is also defined as “activities performed by the learner to facilitate the acquisition, storage, recall and application of knowledge at the time of learning” [3] . Four categories of learning strategies have been identified:
➢ cognitive strategies,
➢ meta-cognitive strategies,
➢ affective strategies,
➢ resource management strategies.
Cognitive strategies are techniques that are used to facilitate the execution of learning processes and thus ensure the acquisition of knowledge or the development of a skill. It aims to facilitate the encoding of information or to build links between new knowledge and old knowledge. These types of strategies are also used to help retrieve previously acquired information [4] . Cognitive strategies can be divided into six sub-categories:
・ Memorization or repetition strategies involve reproducing what is, in particular by recalling, reciting or revising knowledge. As part of these activities, the student will take notes (word by word, essential...), underline, shade important notions, recite, make lists of terms, symbols, repeat several times (mentally, in a low voice or out loud)...
・ Elaboration strategies aim to develop the knowledge acquired in order to give meaning to learning or improve comprehension. Elaboration strategies use the student’s ability to paraphrase or rewrite in his or her own words the information to be retained and to invent questions.
・ Organizational strategies involve structuring ideas by trying to link them together, either through some form of grouping, categorizing or hierarchizing, by making diagrams and schemas, or by looking for the main ideas in a text.
・ Generalization strategies involve extending knowledge to other contexts, by identifying and inventing examples and finding similarities.
・ Discrimination strategies are used to determine in which situations it would or would not be appropriate to use a concept. They involve identifying and inventing counter-examples and finding the differences. These last two strategies involve a higher level of complexity than the other categories of cognitive strategies.
・ Knowledge compilation strategies involve making a list of the steps to follow, practicing small steps at a time, and finally practicing the whole procedure.
Based on research into these strategies, two types of approaches have been identified, the deep and the superficial learning [5] . The superficial approach can be recognized by the privileged use of superficial processing strategies such as recall or memorization. The student is essentially concerned with meeting the requirements of the task, which is seen as externally imposed: he or she tries to memorize the various elements without really understanding them, with the sole aim of being able to reproduce them during evaluation. Nor does he takes the time to reflect on the relationships between the various elements, or to ponder the possible implications of what he learns [6] . The in-depth approach translates into a predominant use of cognitive strategies that induce active processing of information, such as the elaboration and organization of knowledge. The task is no longer seen as an external constraint, but rather as something that enables the student to develop. Students focus on the meaning of what they are learning, organizing and structuring content to integrate it in their own way. They establish relationships between their prior knowledge and what they are currently learning. Finally, they critically examine the relationships between arguments and the evidence that is supposed to support them [6] .
In higher education, and particularly at the Faculty of Dentistry in Casablanca, the academic results of some students are disappointing. Our aim was to understand why these students were finding it difficult to study effectively, by looking at their learning strategies. Our final objective was to improve their academic success and help teachers in their fundamental task of conveying knowledge. The aim of this 1st part of the study was to assess the cognitive learning strategies of dental students of the Faculty of Dentistry of Casablanca and another part of the work will be dedicated to the study of other strategies.
2. Materials and Methods
To accomplish this work, a descriptive cross-sectional study was conducted. Our study targeted 1st year and 5nd year classes at the Faculty of Dentistry of Casablanca, Morocco, during the 2021-2022 academic year, because lectures begin in the first year and end at the 5th year, the 6th year of the university course being dedicated only to clinical internships. To collect the data required for the study, a questionnaire was developed on the various aspects of cognitive strategies. It was designed based on Biggs’s questionnaire [7] . Data collection took place between 5th May 2022 and 25th May 2022. Contact with 5th year students took place in the various departments of the university Hospital, during clinical shifts, after obtaining permission from all the teachers concerned. The questionnaire was distributed at the start of the shift and collected at the end of the same shift. For the 1st year students, contact took place on all second-semester examination days. Results were entered and analyzed using SPSS 10.0 software (Statistical Package for the Social Sciences) at the Epidemiology and Biostatistics Laboratory of the Faculty of Dentistry, Casablanca. Analysis was descriptive for all variables.
3. Results
The participation rate was 98.8%. Our sample comprised 177 students in 1st year and 141 students in 5th year. The female rate was 53% in 1st year and 57.4% in 5th year. Detailed data on the cognitive strategies used are summarized in Tables 1-4.
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Table 1. Note-taking during the course.
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Table 2. Memorization strategies and tips.
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Table 3. Reviewing notes before a lesson or exam.
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Table 4. Resources and strategies used to revise a course.
4. Discussion
The results of this study showed that there was a significant difference (p < 0.05) between 5th year and 1st year students in terms of note-taking during the course: 17% of 5nd year students listened without taking notes, compared with 42.4% of 1st year students (Table 1). Vanmuylder et al. compared the learning strategies used by ULB (Université Libre de Bruxelles) medical students during the first three years of medical studies (CM1/CM2/CM3) and the learning strategies of 1st year medical students (CM1) with first year medical biology graduate students (BM1) and nursing school students (I/A1). A comparison of the results obtained from CM1, BM1 and I/A1 students respectively showed that the use of “memorization” strategies appeared identical. On the other hand, a comparison of the results obtained respectively among CM1/CM2/CM3 students showed that the use of “memorization” strategies decreased over the three years of study [8] . Dilk concluded in 2010, at a university college in Saint-Boniface, Canada, that the use of these cognitive rehearsal strategies proved to be fairly characteristic of all the subjects in his study [9] .
For memorization, our study showed that there was no significant difference between 1st and 5th year students in terms of their strategies for learning a course (p = 0.917). 81.8% of 1st year students and 82.3% of 5th year students preferred to understand the lecture before memorizing (Table 2). According to a similar study carried out in 2016 on the learning strategies of dental students at the two faculties of Casablanca and Rabat, 86.5% of students understood before memorizing, compared with 13.5% of students who memorized directly [10] . Another study carried out at Bahria University in 2018, with the aim of comparing learning approaches (deep and superficial) in junior and senior dental students, showed that the two cohorts did not differ significantly in deep and superficial learning approach [11] . In a descriptive study published in 2008, on the learning practices of 4th year medical students at the University of Nantes, the researchers found a predominance of the deep learning approach: students try to understand, with the aim of retaining information as long as possible [12] .
For the cognitive strategy of elaboration, a comparison of the results obtained by the 1st and 5th year students in our study showed that there was no significant difference. Effective mnemonic means were used by 37.6% of senior students and 31.1% of junior students, and the “paraphrasing” strategy by 24.1% of 5th year students and 26% of 1st year students (Table 2). On the other hand, the ability to invent questions that could be asked on the exam is used by 64.5% of 5th year students and 58% of 1st year students (Table 3). In a study carried out at the Collège d’enseignement général et professionnel (Cégep) in Montreal, the aim was to describe the learning strategies used by nursing students and to track the evolution of their strategic choices over the first three terms of training. The results of the study showed a marked improvement in elaboration strategies during group work. During individual work, elaboration strategies were also more widely used between the first and the third sessions, but still too few students used them in the third session [2] .
In our study, a similarity between 1st and 5th year students was found with regard to the majority of cognitive strategies for repetition or memorization. In fact, 62.7% of 1st year students compared with 69.5% of 5th year students preferred to read a course several times as an aid to memorization. Only 26.1% vs. 17% of 5th graders often reread their notes just before a lesson. A significant difference was noted between the two years (p = 0.014): 67.4% and 80.9% of 1st and 5th year students respectively preferred to reread notes before the exam to refresh their memory (Table 3).
Furthermore, there was no significant difference (p ≥ 0.05) in the use of cognitive organization strategies, which remained infrequent for students in the two classes. Indeed, after reading a lecture, 22.6% of 1st year students and 16.3% of 5th students made summaries or diagrams (Table 4). However, as an effective tool of thinking, mind-map can develop human potential and the students’ thinking ability greatly. Mind-map is made up of lines, symbols, text, color and graphics elements. One can visualize the storage, organization, arrangement, study, and review and memorize information by applying this effective means of thinking. It is based on the related way of thinking style that one can construct his own knowledge system [13] .
Several studies have highlighted the influence of organization and elaboration strategy on student performance. Larue et al separated students into strong and weak performers according to their final course grade, and then compared the strategies used by these two groups. Strong and weak students mainly used memorization strategies. Strong students, however, used more organizing and elaborating strategies than weak students, suggesting that these strategies were related to performance [14] . Trottier compared the strategies used by strong and weak undergraduate students in several disciplines, including health sciences. They found that the use of organizational strategies was associated with success in all disciplines. Then, specifically in Health Sciences, strong students used significantly more elaboration strategies than weak students [4] . Mc Nulty et al. looked at the learning strategies used by first- and second-year medical students at Loyola University Chicago. The researchers used two categories of strategies, memorization strategies that use repetition to integrate information and construction strategies that use organization, integration and adopting an overview to gain a deep understanding of the content. Researchers observed that the use of construction strategies was related to performance, while the use of memorization strategies was negatively correlated with performance [15] .
5. Conclusions
The learning strategies adopted by 1st and 5th year dental students of the faculty of dentistry of Casablanca are largely similar. For the first part of the work, we recommend the organization of workshops and seminars to:
・ raise awareness of the value of different cognitive strategies in learning,
・ help junior students to improve their note-taking skills during lectures,
・ improve memorization techniques in both classes,
・ improve course reading and revision in both classes,
・ improve elaboration and organization strategies in both classes.