The Relationship between Learning Styles and Career Decision-Making Self-Efficacy among Medicine and Dentistry Students of Ardabil University of Medical Sciences

Background and Objectives. -e career decision-making self-efficacy (CDSE) in medical, pharmacy, and dental students is more important than other disciplines due to professional sensitivity, direct involvement in decision-making for the treatment process, and the significant clinical involvement. It is also expected that learning styles can have a significant impact on the academic success, and the CDSE also affects the quality of clinical care. -erefore, the aim of this study was to examine the relationship between the learning styles and the career decision-making self-efficacy among medicine and dentistry students. Materials and Methods. -is cross-sectional study was conducted on 235 medical interns and fifthand sixth-year dental students of Ardabil University of Medical Sciences, Iran. -e data were collected using Kolb Learning Style Inventory and Betz and Luzzo career decision-making self-efficacy questionnaire. Statistical tests such as Kolmogorov–Smirnov, Spearman correlation coefficient, Chi-square, one-way ANOVA were used to analyze the data. Results. -e mean age of participants was 25.9 ± 1.30; a majority of them were dental students (134 persons, 59.3%), and 92 were medical students (40.7%). -e predominant learning styles in dental and medical students were assimilating (40.3%) and converging (47.8%), respectively. -ere was no significant relationship between students’ learning styles and career decision-making self-efficacy and none of its subscales (P> 0.05).-e Chi-square test results showed that a significant difference was observed between the field of study and learning styles of the participants (P � 0.024). Conclusion. -is study showed that there was no significant relationship between learning style and career decision-making self-efficacy of the participants.


Introduction
Learning styles reflect a person's preferred learning style, related to individual differences in mental and personality dimensions [1]. Previous research has highlighted the importance of learning styles [2][3][4]. It has already been proven that instructional outcomes can vary by considering learning styles [4][5][6]. Achieving the educational goals requires proper policy making, proper implementation of programs by professors, and proper receipt of this training by students [7]. Medical sciences such as medicine and dentistry are among the fields that need a high attention to the quality of education due to direct interventions performed on human tissue and the impacts on maintaining and preserving human health [8]. e learning process and its quality depend on several factors. Among these, learning patterns that enhance students' learning are important [8,9]. A learning style is a unique way to understand and retain information.
e ultimate goal of learning is to acquire the desired knowledge and skills [10]. Various models and classification approaches for learning styles have been described in the literature, including the models of David Kleb and Anthony Gregork and Gardner's multiple intelligences theory [11][12][13]. Nonetheless, most studies have focused on Kolb's learning study inventory (LSI), peculiarly in the the field of medical education [14]. e Kolb's LSI model classifies the knowledge acquisition process into four categories: assimilating، accommodating, converging, and diverging. is division is based on four stages of learning, including active experimentation (AE), abstract conceptualization (AC), concrete experience (CE), and reflection observe (RO) [15]. Accommodators favoring concrete experience and the dynamic experimentation are more pragmatic and rapidly adjust to an assortment of circumstances, appreciating new difficulties while depending on their own encounters and others' data. "Assimilators" utilize the two strategies of reflective observation and abstract conceptualization to learn, and these people are more likely to listen to lectures, read content, and explore analytical models. "Convergent" learning is based on abstract conceptualization and active experimentation with the precedence of hypothetical reasoning and deductive problem analysis. ey are best at finding reasonable applications for thoughts and hypotheses and pay little attention to the exchange of information between people interested in technical tasks. "Divergers" depend on the concrete experience and reflective observation. ey have a lot of creativity and imagination and are interested in communicating with people and are superior to others in seeing situations from different angles [11]. e difference in learning styles of medical students based on their cultural condition has been confirmed despite the difference in their learning styles at home and abroad [16].
One of the basic aspects of human development is career development, which is considered as a particularly crucial element of psychosocial advancement [17]. e term "career" refers to a combination of work tasks that people experience throughout their lives [18].
ere are many factors contributing to the individuals' career decision [19]. Self-efficacy beliefs include the psychological processes that can have a significant impact on the acquisition or change of behaviors [20]. Self-efficacy refers to an individual's beliefs about his/her abilities in order to be able to use these abilities to demonstrate behavior that can lead to the production of desirable and acceptable returns. According to Bieschke, people who think they are capable of getting things done are always interested in trying and getting things done successfully [21]. According to theory of social cognitive career, the self-efficacy is defined as one's belief in one's capability to succeed in the career field, which is considered as a fundamental variable that effectively predicts career performance [22]. According to Bandura (2006), career decisionmaking self-efficacy (CDSE) has been very influential in the area of career development as proposed by Taylor and Betz (1983) [23]. Taylor and Betz's (1983) theory is in fact a combination of Crites's career maturity model (1961,1965) and Bandura's theory of self-efficacy (1977) [24]. e fields of medicine and dentistry are related to the health of the community, and enhancing students' knowledge in these fields is associated with improving community health. It is thus important to pay more attention the education and learning of these students. Identifying the learning styles of these students can help determine the ways to improve their education. Also, due to the sensitivity of medical sciences, the CDSE of graduates in these fields is of special importance. Accordingly, the aim of this study was to examine the relationship between career decision self-efficacy and learning styles of medical and dental students.

Materials and Methods
is cross-sectional study was conducted on the medical interns and fifth-and sixth-year dental students of Ardabil University of Medical Sciences, Iran, who were selected by census sampling method. After providing the sufficient explanations about objectives of the study, participants were asked to complete the questionnaires accurately and honestly. e data were collected by Kolb Learning Style Inventory, Betz and Luzzo career decision-making self-efficacy scale (CDSE), and demographic questionnaire. Kolb et al. confirmed the validity and reliability of the initial version of the learning styles questionnaire (LQS) [25]. In Iran, various studies examined the validity and reliability of the Persian version of this questionnaire [26][27][28].
is questionnaire consisted of twelve phrases with four options. Participants rated each phrase on a Likert scale of 1-4 based on their opinions. Individual orientation scores for each learning style were determined according to the relevant benchmarks and charts. e validity and reliability of the CDSE scale have also been confirmed by various studies [29,30]. is scale has 25 sentences containing 5 subscales with 5 sentences. Participants rated their success or disapproval of each of the statements on a five-point Likert scale (from not at all to absolutely sure). Statistical tests such as Kolmogorov-Smirnov, Spearman correlation coefficient, Chi-square, and Oone-way ANOVA were used to analyze the data.

Results
A total of 235 students were participated in this study. 226 out of 235 participants had completed all the questionnaires. e mean age of the subjects was 25.9 + 1.30 years. e study population comprised slightly more females than males (51.3%). Dental and medical students made up 59.3% and 40.7% of the participants, respectively. A majority of the students (62.8%) were living in Ardabil. e GPA average of  students was 16.20. e frequency of different learning styles of the participants based on the field of study is shown in Figure 1.
e results of Chi-square test showed that there was a significant difference between the field of study and learning styles of the participants (P � 0.024, X 2 � 9.41, df � 3). e predominant learning styles in dental and medical students were assimilating (40.3%) and converging (47.8%), respectively. e mean scores of CDSE and all its subscales in both medicine and dentistry students were average scores (61.96 ± 16.60). No significant differences were found between the participants with respect to gender, age, grade point average, and native status with learning styles (P > 0.05) (1). ere is no significant relationship between students' learning styles and career decision-making selfefficacy and none of its subscales based on one-way ANOVA test (P > 0.05) ( Table 1). Also, there was no significant difference between the study participants with respect to gender, age, grade point average, native status, and field of study (P > 0.05) ( Table 2). Self appraisal and problem solving had the highest and lowest mean of CDSE dimension with self-efficacy scores, respectively, 13.9 and 11.93.

Discussion
In the present study, the dominant learning style was "assimilating" in dental students and "converging" in medical students, and there was a significant correlation between learning styles and field of study of the participants. A review of past studies has shown that the results are controversial. A study performed by ALQahtani and Al-Gahtani in Saudi Arabia reported that "diverging" is the most common learning style among dental students [31]. While the studies of Meyari et al. [16] and Kalbasi et al. [32] showed that most medical students have a convergent learning style that was consistent with our findings. In their study, Nasirzadeh et al. found no difference between medical and dental students with respect to the learning styles, and most students had a converging learning style [33]. On the other hand, studies performed by Engels and de Gara [34] in Canada and Gurpinar et al. [35] in Turkey reported that the learning style of most medical students was assimilating. Our results are consistent with the studies conducted in Turkey; thus, the differences in students' learning styles may be due to cultural differences.
In the present study, there was no statistically significant association between sex, age, grade point average, native status, and learning styles. e results of the study of ALQahtani and Al-Gahtani [31] confirmed that no significant association was found between age, sex, and students' learning style. In contrast, Adesunloye et al.'s study demonstrated that LSI Kolb is gender-sensitive [10]. e findings show small but real difference in learning styles between the females and males: abstract conceptualization was preferred by men more than women. However, the two studies that  Education Research International used early versions of the LSI found no difference between learning styles by gender [36,37]. e study of Hosseini et al. [38] and Al-Qarafi et al. [31] found no significant relationship between learning styles and GPA of dental students which was consistent with our results. e learning strategy of "assimilators" includes abstract conceptualization and reflective observation [39]. Furthermore, an assimilator is keen on ideas and theories while not paying much attention to their application [25]. However, assimilators are highly skilled in systematic planning and logic and are interested in lecturing, reading, and conceptualizing theoretical models. e preferred method of learning in convergent students is both abstract conceptualization and active experimentation. Due to their high problem-solving skills, they are able to actually implement theories. ey are interested in lab sessions and experiments [11,25,39].
In the field of career decision-making self-efficacy, in all aspects of self-appraisal, occupational information, goal selection, planning, and problem solving, students showed a moderate level, meaning that medical and dental students have a relatively good assessment of their abilities. ey strive for their professional goals and do not give up quickly; they set short-term, medium-term, and long-term goals for themselves and find their ideal jobs or job opportunities and are able to overcome obstacles to achieving goals logically. But this self-efficacy is not at a high level and will be vulnerable. ese findings are consistent with those of Shafiee et al.'s study [29]. We found no significant association between gender and CDMS. e findings of some studies were similar [29,40], but some studies showed a significant relationship between gender and CDMS [41,42]. erefore, the findings were controversial. e findings of this study showed no relationship between learning styles and CDMS of students. Considering that this topic is new and no study has been done in this field so far, it is not possible to be satisfied with the results of this study, and it is recommended that further studies are needed in order to examine relationship between learning styles and CDMS. Attention to two key variables in medical education, considering the importance of career decision-making of students in this field and the special place of this profession in the health and well-being of society, is one of the strengths of this study. erefore, it is important to find ways to improve CDMS in medical and dental students. Studies conducted by Wang et al. [43] and Breaux [44] showed that group training and cooperative education have a significant effect on improving students' CDMS. One of the limitations of this study is relying on the questionnaire as the only tool for data collection and not using semistructured interviews to discover the live experiences of students in this field. In order to reduce the effect of the mentioned limitation, the most relevant and comprehensive tools in the field of learning styles and career decision-making self-efficacy were selected.

Recommendation
Kolb mentioned that assimilators prefer structured, systematic, logical, and comprehensive information, but convergers preferred learning by PBL method, case analysis, and brainstorming [35]. Given that evidence has shown that students' learning styles change in relation to time, we suggest that, at the beginning of each course, students' learning styles can be identified to tailor their teaching methods to their curricula. ere is a hypothesis for us that more learning happens in groups with the same learning styles. We suggest that more studies be done on this topic. And if the hypothesis is proved, student groupings in clinical education should be considered based on the learning style factor.

Conclusion
is study examined the relationship between learning style and career decision-making self-efficacy and found no relationship between the two variables. As this was the first study conducted in this field, the results are not conclusively reliable, and further studies are needed.

Data Availability
We can make data available on request through a data access committee, institutional review board.

Conflicts of Interest
e authors declare that they have no conflicts of interest.