Study sample: This survey-based cross-sectional study was conducted among 205 first year medical students of a tertiary level medical school in Chennai. The study was approved by the Institutional Ethics Committee (IEC-NI/14/DEC/44/91) of Sri Ramachandra Institute for Higher Education and Research (SRIHER). Every year the institute have 250 students admitted to MBBS course. The survey was planned to be conducted among 250 first year medical students of the batch 2017-18. After getting the informed consent, the questionnaire was administered to the available students on 2 tutorial sessions to cover 125 students on each session (2 sessions-4 hours) during the first week of January 2018. Participation in the study was made purely voluntary.

Out of 250, only 219 of them were available to fill out the questionnaire (response rate 88%). Fourteen questionnaires (5.6%) were partially completed and therefore excluded from the analysis. The total number of valid questionnaires was 205. out of which 112 female and 93 male students participated in the study. This survey was conducted as a needs assessment process to plan a ‘structured research training program’ for undergraduate medical students from first year at our University.

Development of questionnaire: The questionnaire was prepared after extensive literature search [3,12-14] for the items which consisted of details on demographic data, four true or false type, three open-ended type questions for knowledge, Likert scale of point 1-5 to assess the perceived promoting factors and barriers to take up research during under graduation and yes or no type questions to assess the willingness to practice research. The questions were simple and easy to understand for first year students. The questionnaire was validated by internal and external content experts in the field of Physiology, Community Medicine and Medical education. Reliability of the questionnaire was assessed using Cronbach’s Alpha (α=0.74).

Analysis of data was done using SPSS version 16.0 and the output is expressed in proportions. The five point Likert’s scale scoring has been added to get three point score.

This survey-based cross-sectional study was conducted among 205 first year medical undergraduate students. The study included 93 male and 112 female students in the age group of 18-20 years (mean age: 18.7±1.1) The study participants were from different boards of higher secondary education, Central Board of Secondary Education (CBSE)-57% (117), State board-26% (55) and others, Indian Certificate of Secondary Education (ICSE) and International Baccalaureate (IB)-16% (33) and from different states of India.

The [Table/Fig-1] shows the knowledge score of the participants on scientific research: The knowledge base was tested using items on different steps in conducting research. The very basic item on what do their understanding of the term ‘research’ was answered by almost 89% of them. The answer code for this item was derived from standard articles and books [15-19]. Almost all of them (97%) have agreed that research is important for the practice of medicine. About 88% of them could name one organisation {Indian Council of Medical Research (ICMR)} which provides research grants for student projects. The knowledge of core topics in conducting research like ‘hypothesis testing’ and statistical methods was lacking among the first year students. The items on ‘Ethics’ were also answered fairly well (84%) by the participants.

The [Table/Fig-2] shows the factors promoting a positive attitude to take up research during under graduation. In the participants’ understanding research is interesting as it is different from normal curricular learning (97%), almost all of them have agreed that practising research will contribute to innovations in a medical field (99%) and an important tool to practise evidence-based medicine (96%). They felt it will also provide an opportunity to develop interpersonal skills through team based learning approach (88%) and help them to adapt to self-directed learning which is a core skill required among medical students to be a lifelong learner. A 91% of them also felt taking up research will expose them to complex real-life medical problems which will aid them in developing critical thinking.

The [Table/Fig-3] describes the Parameters for perceived barriers. Most of the first year students felt the main barrier was a lack of awareness on basic research skills (87%) and a lack of structured research training (85%). The factors like lack of time (79%) and complexity in understanding the principles of research methodology (69%) were also felt equally as barriers.

The [Table/Fig-4] shows the parameters promoting attitude to practice research during under graduation. Almost 84% of the participants agreed that research training should be part of the undergraduate curriculum and they all want regular conduct of research training workshops. Almost 50% of the study participants opined that research training can be started as early as from first year of medical schooling and they opted their area of interest in research in different fields, maximum being in Cardiology.

This survey-based cross-sectional study has assessed the knowledge of basic research skills and the attitude to practice research during under graduation among 205 first year medical students in a tertiary care medical college in Chennai. The knowledge base of first year medical students regarding basic concepts was good except that the items on core research methodology principles like hypothesis testing and statistical methods were not adequate. The first-year medical students were motivated to take up research during different phases of medical course as they opined that conducting research will put them in real-life problem-solving situations which are different from normal curricular learning. They also felt, it is advantageous to involve them in research as it gives them the opportunity to develop interpersonal skills through a team-based approach and life-long learning skills through the self-directed learning. They also felt literature search during the conduct of research will help them to adapt to the method of evidence-based practice which is an essential skill needed to practice medicine. The good level of awareness on research and positive attitude can be attributed to study participants prior experience in research, as 57% (117) and 16% (33) were from CBSE and other boards (ICSE and IB) of higher secondary education. Project Based Learning is part of their curriculum in these boards of higher secondary education as understood essential principle of adults learning is prior experience [20].

Previous studies [12-14] have shown similar results with respect to the knowledge and attitude of the present study participants. Ivana Vodopivec I et al., outlined in his study conducted in first-year medical students where the participants were not aware of basic facts about the scientific methods and communication in medicine, but they had a positive attitude towards scientific research. This he attributed to, as the participants in his study were of high ranked students in the admission test and motivated to do scientific research [12]. Soe HH et al., has reported a moderate level of knowledge and a positive attitude towards the conduct of research among medical and dental students in the private medical college in Malaysia. He could relate the positive attitude of students with Indian ethnicity and moderate knowledge to the higher academic year of study and elder age group [13]. A recent survey by Vairamani CB et al also demonstrated a positive attitude to conduct research among his postgraduates and interns to guide their future career and for improving patient outcomes [14].

The present study reports that the major perceived barriers by participants for conducting medical research are lack of motivation as there is no instant credit, lack of appropriate knowledge and research skills in scientific methods, lack of time and academic overload for the practice of research. The present study results are consistent with the authors’ findings in previous studies. Mitwalli HA et al., in his study reported that the main barriers for conducting research among Physicians and residents in Riyadh hospital are lack of research training, lack of time, work-related stress and lack of Mentors to support the research work [21]. Giri PA et al., among his post-graduate participants found lack of financial support which was an added barrier in conducting research on top of the other aforementioned obstacles [22]. Kumar HH et al., in his study among undergraduate medical students brought out those key factors to improve knowledge and basic research skills among undergraduates, is, to adapt to good research skills training within the curriculum. He has also found that providing a good financial support system and structured research training programs could enhance the chances of students involving themselves in research during their under graduation and also pursue research as their career choice [23].

[Table/Fig-5] compares the present study with others on the perceptions and perceived barriers of undergraduate students towards conduct of research during under graduation [3,13,24-27]. This highlights the positive attitude of undergraduates towards health research and also the common barriers to be overcome, to facilitate the conduct of research during under graduation.

To develop an Indian Medical Graduate (IMG) who is a life long evidence-based practitioner in the field of medicine, the medical students should be introduced to practising research skills as early as from first year of the medical course. Student’s participation in research will put them on active learning strategies like learning –by doing, team-based approach and self- directed learning which is different from normal pedagogic learning. The process of conducting research will also aid medical trainees to become critical thinkers who can evaluate the complex real-life medical situations and develop higher-order problem-solving skills [4]. It is an essential tool to inculcate interpersonal, leadership and communication skills through collaborative learning among medical students during under graduation [28].

It is very much evident from the results of present study that there is a need for a research-driven curriculum for medical undergraduates in India. To promote a positive attitude and to overcome the barriers towards conducting research, a ‘structured research training program’ for medical undergraduates should be introduced from first year of medical schooling with mentorship guidance and financial incentives for students. There should be a protected time for research activities in the schedule to overcome the main perceived barrier, lack of time. Periodic conduct of research training workshops for both faculty and students will empower and also keep them updated on research skills.

The limitation of this study is that it involved only the first year medical students from one private medical institution; therefore, the findings cannot be extrapolated to institutions with different academic environments. Multicentric studies involving study participants in different academic set-up, government, and private institutions, and across different years of the medical course will give more understanding on the attitude and perceived barriers among medical undergraduates towards research.

The study highlights a need for structured research training program from first year of medical curriculum in India. The study participant’s moderate awareness towards research skills and a very positive attitude to take up research during their under graduation can be promoted by periodic research skills training and effective support system including funding. These initiatives will motivate undergraduate medical students to undertake research and also pursue a career in research in future.