Knowledge and use of various learning techniques among medical students and their effect on academic performance: a cross-sectional study in Southeastern Nigeria

Learning is a dynamic process that requires the deliberate adoption of effective strategies to enhance understanding and long-term retention. Despite the availability of well-evidenced learning techniques, many medical students continue to rely predominantly on passive approaches with limited efficacy. This study investigated the awareness and utilisation of ten learning techniques among medical students in Southeastern Nigeria, and their association with self-reported academic performance. A descriptive cross-sectional study employing proportional stratified quota sampling was conducted among 631 medical students at all seven accredited Colleges of Medicine in Southeastern Nigeria. Awareness and frequency of use of ten learning techniques were assessed via a self-administered structured questionnaire using a four-point Likert scale. Academic performance was operationalised as a composite score derived from six self-reported binary items (range: 0 to 6). Bivariate associations were examined using independent samples t-tests with Cohen’s d effect sizes and 95% confidence intervals (CIs). Multiple linear regression was conducted to identify independent predictors of academic performance after adjusting for age, sex, institution, and year of study. Statistical significance was set at p < 0.05. This study was reported in accordance with the STROBE guidelines. The median participant age was 22 years (IQR: 21 to 24); 70.3% were clinical-year students. The most commonly recognised techniques were discussion groups (98.9%), re-reading (91.8%), and highlighting (90.3%). The most frequently used techniques were multiple encoding (91.0%), elaboration (89.1%), and rote re-reading (88.6%). Free recall and review (43.9%) was the least frequently used. In bivariate analyses, frequent use of retrieval practice via teaching others (|d| = 0.38, 95% CI: 0.22 to 0.54, p = 0.001), elaboration (|d| = 0.51, 0.26 to 0.76, p = 0.001), spaced practice (|d| = 0.33, 0.12 to 0.54, p = 0.003), relational processing (|d| = 0.32, 0.08 to 0.56, p = 0.010), retrieval practice via practice questions (|d| = 0.27, 0.10 to 0.43, p = 0.002), and discussion groups (|d| = 0.25, 0.08 to 0.43, p = 0.005) were significantly associated with higher performance. In the multivariable model (R² = 0.115, adjusted R² = 0.096, F(14, 595) = 4.87, p < 0.001), year of study (clinical vs. pre-clinical; β = -0.196, p < 0.001), retrieval practice through teaching others (β = 0.138, p = 0.001), elaboration (β = 0.130, p = 0.003), and multiple encoding (β = -0.101, p = 0.008) were independently associated with performance. Active learning strategies, particularly retrieval practice through teaching others and elaboration, were independently associated with better academic performance after multivariable adjustment. These findings support deliberate integration of evidence-based learning strategies into undergraduate medical education in similar settings. Prospective and interventional research is needed to confirm these associations and evaluate targeted educational programmes.