Factors Shaping Learning Enthusiasm of the Medical Students: A Comparative Study of Eight-Year and Five-Year Programs

Understanding the drivers of medical students' learning enthusiasm is crucial amid concerns about the physician workforce. This study compares China's five-year and eight-year medical programs, focusing on curriculum design and the effectiveness of assignments.

To compare learning enthusiasm between the two programs and analyze how assignment design and curriculum influence active learning and critical thinking.

A cross-sectional study surveyed 504 medical students (98 eight-year, 406 five-year) using the Self-Assessment Scale for Active Learning and Critical Thinking (SSACT).

Significant differences emerged between five-year and eight-year students in geographical origin (χ² = 22.11, P < 0.001, Cramer's V = 0.209) and program preference (χ² = 67.26, P < 0.001, Cramer's V = 0.366). Eight-year students were more often from provincial capitals (39.80% vs 17.98%) and had chosen their program as a first preference (88.78% vs 68.23%), with stronger clinical career commitment (57.14% vs 36.45%). Lecture engagement was higher in the eight-year cohort. The assignment evaluation showed that both groups invested more than 5 hours per week. Review writing showed differences between the two groups (χ² = 22.49, P < 0.001, Cramer's V = 0.212), but eight-year students found it more meaningful (49.49% vs 28.07%). Using the reliable SSACT (Cronbach's α = 0.892), eight-year students scored higher in active learning (managing study, P = 0.037; summarizing discussions, P = 0.025) and critical thinking (formulating questions, P = 0.034; generating solutions, P = 0.014; connecting knowledge, P = 0.018; developing hypotheses, P = 0.004).

Assignment overload and limited self-study time in the current model may undermine critical thinking and active learning. Reforms should balance task quality with volume to better support educational goals.