Attitude towards research among 4th & 7th semester MBBS students and house surgeons in a Government Medical College in Kerala, India

Background: The Indian Medical graduate as a lifelong learner, should be familiar with basic clinical and translational research that can be applied for caring patients. They should be made aware that research is so crucial to health care which will help to build a positive attitude towards research. Objective: To compare the attitude towards research among the MBBS students of 4 th & 7 th Semester and House surgeons in Government Medical College, Alappuzha during the year 2018. Materials and Methods: A Cross sectional study was carried out among MBBS students of 4 th & 7 th Semester and House surgeons. There were 355 participants. Validated Revised Attitude towards Research (R-ATR) scale was used for data collection. Results: There were 59% females and 41% males. Mean age was 22.2 with SD 1.7. Total median score was found to be decreasing from 62 to 59 and then to 53 from 4 th semester, 7 th semester and to interns. Domain wise median score for Usefulness, Anxiety and positive predisposition, were also found to be declining.A higher proportion (77%) agreed to the usefulness of research. Almost half of the study participants perceived research to be anxious and found it stressful and difficult. Positive predisposition was found to be 40.7%to 50.8%. Conclusion: There is a change in attitude towards research from 4 th semester medical students to house surgeons. Though a high proportion perceives research to be useful, only half of them had positive predisposition towards research. Majority perceive the research process as stressful and anxious.


Introduction
Health research is essential to improve health care. Unfortunately, health research has a low priority in the developing world [

A total of 355 medical students and interns
Participated in the study. Majority of the participants were in the age group 22 to 24 years. Mean age of the study population was 22.2 years with SD 1.7 years (Table 1).   Median score with IQR of total R-ATR score and domain scores were calculated separately for 4thsemester, 7th semester medical students and interns [ Table 4]. Median of total score for 4th semester students was 62. Median score decreases in 7th semester and for interns.
The domain wise median scores for 3 domains also showed a declining trend from 4thsemester ,7th semester and to House Surgency. The difference was tested with Kruskal Wallis Test and found to be statistically significant.
The Likert scale points were grouped in to Agree, Disagree and Neutral. The proportion of study participants who Agree, Disagree and Neutral to each item of R-ATR scale are shown in Table 5, Among the studyparticipants,77.7% agreed that research was useful.
About 83.9% agreed that research is connected to my field And for (48%) research courses make anxious.
Around 50% enjoyed and found that doing research is interesting.
Of study and 82% agree the skills acquired in Research will help in future. More than half agreed (54%.) that doing research is stressful and difficult     [15].
It was interesting to note that almost half of the study participants perceived research to be anxious and found it stressful and difficult. Another important finding was that a high proportion of students feel their current skills in research are inadequate for future use.
This informs that academic programmes of student research methodology should aim to reinforce the Importance of research continuously from 4th semester to house surgency so that the declining interest over the academic years may be prevented.
The study did not find out any association between gender and attitude towards research as reported in literature showing that attitude to research is similar among boys and girls whether positive or negative.
These are important findings to inform modification in research methodology teaching programme.
Teachers and guides need to continuously take feed back of the teaching process and modify it so that students are adequately equipped, supported and motivated to do research. Under the Medical University, medical students are given research methodology training during their 4th semester posting. They are trained to formulate a research protocol under the guidance of a faculty. They will be doing the study there after and will be presenting the research report during 7th semester. After 4th semester there will not be much thrust on research.
Again after 7th semester the students are exposed to research while doing their Post graduation for doing their thesis. That may be the reason, the Attitude score showing a declining trend as the progress from 4thsemester through 7th semester and to house surgency. The Strength of the study was using a validated tool covering most of the participants and as it is self-reported data, responses may be varied to some extent is the limitation of the study.

Conclusion
There is a decline in attitude towards research among 4th semester medical students to 7th semester and house surgeons. The students perceive the research process as stressful and anxious though half of them enjoy the process.
Even when a high proportion perceives research to be useful, almost half of them feel that their research skills are inadequate for future use. The study did not find out any association between gender and attitude towards research.
What this study adds to the existing knowledge The Indian Medical graduate to be a lifelong learner Hence the students should be competent to do research not only during Under Graduate training but also during their Post graduate training and in their real practice. The present study shows that there is a declining trend in Attitude score among 4th semester,7th semester and in interns. Hence they should be continuously exposed to research in their postings in different departments and during their internship.

Recommendations Acknowledgements
The author wishes to express gratitude to Dr.R.