Ink or Pixels: Preferences of medical students between printed books and e-books

For students reading not only serves as a means of acquiring information but also helps develop critical thinking and reflective abilities. In recent years, the educational landscape has undergone major changes, particularly with the rise of digital learning materials such as e-books. This shift is evident in medical colleges, where libraries have transitioned to e-libraries, and online education platforms have become increasingly prevalent.¹ However, this transition raises questions about students’ preferences for study materials, especially in medical education. Understanding these preferences is crucial for optimizing educational resources and enhancing learning outcomes. We investigated the preferences of medical students between printed books and e-books in the Delhi National Capital Region (Delhi/NCR).

The participants included MBBS students in their third and fourth years, and internship phase from medical colleges in Delhi/NCR. Data were collected from 294 students over 2 months after obtaining approval from the institutional ethics committee and informed consent from the participants. The data was gathered using an online survey.

The questionnaire had 3 sections: demographic details (age, gender, year of study, residence, and parents’ occupation), 15 questions assessing students’ preferences for reading medical books and lecture delivery modes, and 9 questions analysing factors influencing preferences between e-books and printed books. Questions were inspired by prior studies^1–3 and developed with the input of professional experts. The survey included multiple-choice and Likert scale options. Statistical analysis was done with significance set at p<0.05.

Among the respondents, 48.6% were females and 51.4% males. A majority of students (87.4%) had tablets, 48.6% had laptops, 12.6% had desktops, and 4.4% had Kindles. Most participants (84.7%) resided in urban areas, while 11.6% were from semi-urban regions. Statistical analysis revealed no significant correlation between gender, residence, occupation of parents or type of device owned and reading preferences.

Medical students increasingly rely on both e-books and printed books for studying complex texts. Traditional printed books remain the preferred choice for in-depth study (30.3%), while 69.7% favour e-books for their convenience and accessibility. E-books are especially popular for quick reference (86.1%) and academic texts (55.8%). Printed materials are predominantly used for academic study (81%) and leisure reading such as novels (44.9%).

Social influence played a notable role in the adoption of e-books, with 61.9% reporting that most of their social circle used e-books. Students expressed a preference for offline, face-to-face education (61.2%) over online recorded or live lectures (38.8%). Daily reading habits were almost evenly split between e-books (49.3%) and printed books (50.7%). Mobile phones were integral to medical education, with 68.7% using these frequently for academic purposes. Additionally, students used alternative educational tools, including YouTube podcasts (55.8%), research articles (57.8%), audiobooks (9.2%), and academic apps or coaching platforms. Popular applications included YouTube (84%), PubMed (58.8%), SlideShare (48.6%), and Wikipedia (39.8%).

Approximately 42.9% of students preferred printed books for primary text delivery, while 35% favoured e-books. For lecture delivery, 57.8% preferred online formats, while 42.2% favoured face-to-face interactions. Social media influenced e-book preferences, with 63.2% agreeing that it played a role. Despite growing digital integration, 44.2% of students were uncomfortable with a complete shift to soft copies, while 35.4% supported the transition.

Our findings indicate a stronger preference for e-books over traditional printed books, consistent with trends in previous studies. E-books were favoured for their cost efficiency, portability, up-to-date information, ease of searching, environmental benefits, and multimedia features. Students appreciated the ability to use multiple books simultaneously, constant availability, and the convenience of reading in the dark. However, students who preferred printed books cited reduced eye strain, better retention during revision, and a sense of permanence as key advantages. Printed books were particularly valued for extended study sessions and in-depth reading. These observations align with studies highlighting higher cognitive engagement and comprehension associated with print materials.^4,5

While a subset of students advocated for online lectures due to their flexibility, the majority preferred offline learning for its human interaction and structured environment.⁴ Students reported using e-books and printed books in nearly equal measure, with e-books primarily for academic reading and printed books for both academic and leisure purposes. Social media and mobile applications have further influenced the shift toward e-books, enabling students to combine traditional methods with modern, flexible tools.^1,3

The pandemic accelerated the adoption of digital learning resources, yet many students emphasized the importance of handwritten notes and offline education. A hybrid approach integrating both digital and traditional formats may offer the most effective and flexible educational experience.¹ These findings underscore the need for educational institutions to consider diverse preferences and provide a balanced mix of resources to optimize learning outcomes.

Our study was limited to medical students in the Delhi/NCR region, which may affect the generalizability of the findings to other regions or disciplines. Additionally, reliance on self-reported data may have introduced biases, such as socially desirable responses. We focused primarily on e-books and printed books, excluding other learning formats such as podcasts or interactive platforms.

The feedback from students highlights the strengths and limitations of both e-books and printed books. While technological advancements have driven a shift toward digital resources, printed books continue to hold value for many students. A hybrid approach that integrates both formats is likely to provide the most effective and flexible educational experience.