Ophthalmic & Physiological Optics ISSN 0275-5408

The inuence of learning styles, enrolment status and gender on academic performance of optometry undergraduates
Bhavna Prajapati, Mark Dunne, Hannah Bartlett and Robert Cubbidge
Ophthalmic Research Group, Aston University, Birmingham, UK

Citation information: Prajapati B, Dunne M, Bartlett H & Cubbidge R. The inuence of learning styles, enrolment status and gender on academic performance of optometry undergraduates. Ophthalmic Physiol Opt 2011, 31, 6978. doi: 10.1111/j.1475-1313.2010.00798.x

Keywords: academic performance, graduate, international, learning styles, undergraduate optometrists Correspondence: Bhavna Prajapati E-mail address: prajapab@aston.ac.uk Received: 1 March 2010; Accepted: 10 September 2010

Abstract Purpose: This cross-sectional study was designed to determine whether the academic performance of optometry undergraduates is inuenced by enrolment status, learning style or gender. Methods: Three hundred and sixty undergraduates in all 3 years of the optometry degree course at Aston University during 20082009 were asked for their informed consent to participate in this study. Enrolment status was known from admissions records. An Index of Learning Styles (http://www4.nscu.edu/ unity/lockers/users/f/felder/public/Learning-Styles.html) determined learning style preference with respect to four different learning style axes; active-reective, sensing-intuitive, visual-verbal and sequential-global. The inuence of these factors on academic performance was investigated. Results: Two hundred and seventy students agreed to take part (75% of the cohort). 63% of the sample was female. There were 213 home non-graduates (entrants from the UK or European Union without a bachelors degree or higher), 14 home graduates (entrants from the UK or European Union with a bachelors degree or higher), 28 international non-graduates (entrants from outside the UK or European Union without a bachelors degree or higher) and 15 international graduates (entrants from outside the UK or European Union with a bachelors degree or higher). The majority of students were balanced learners (between 48% and 64% across four learning style axes). Any preferences were towards active, sensing, visual and sequential learning styles. Of the factors investigated in this study, learning styles were inuenced by gender; females expressed a disproportionate preference for the reective and visual learning styles. Academic performance was inuenced by enrolment status; international graduates (95% condence limits: 6472%) outperformed all other student groups (home non graduates, 6062%; international non graduates, 5563%) apart from home graduates (5769%). Conclusion: Our research has shown that the majority of optometry students have balanced learning styles and, from the factors studied, academic performance is only inuenced by enrolment status. Although learning style questionnaires offer suggestions on how to improve learning efcacy, our ndings indicate that current teaching methods do not need to be altered to suit varying learning style preferences as balanced learning styles can easily adapt to any teaching style (Learning Styles and Pedagogy in Post-16 Learning: A Systematic and Critical Review. London, UK: Learning and Skills Research Centre, 2004).

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Introduction Improving student learning and teaching is a key issue in higher education.1 In order to do so efciently, it is necessary to have a better understanding of the factors that inuence academic performance in the rst place.2 There has been a considerable increase in the literature on this topic in recent years.3,4 However, there has been little work investigating optometry undergraduates (electronic searches of Google Scholar, ERIC Database, International Education Research Database, British Education Index, Science Direct and PubMed were made using the following search terms: optometry undergraduates, academic performance, factors, gender, international, home students, graduates, non-graduates and learning styles). Optometry schools typically enrol a mixture of student types; males and females, home (entrants from the UK or European Union), international (entrants from outside the UK or European Union), graduate (entrants with a bachelors degree or higher) and non-graduate (entrants without a bachelors degree or higher) students. It is likely that these student groups may also vary in their learning styles. Each individual student processes and learns new information in different ways.5 For example, some individuals prefer to learn by active participation, whereas others prefer to sit back and reect on ideas or theories; some prefer to make written notes, whereas others prefer to use diagrams or pictures. These differences are termed learning styles.6 It has been stated that all educators should have a thorough understanding of the spread of learning styles that exist in their teaching environment in order to provide the most efcient learning experience.7 Whether teaching methods should be adapted to complement the learning styles of the students is a controversial issue. There is much disagreement in the literature. While the majority of researchers support the logical assumption that matched learning and teaching styles will lead to more efcient learning,5,811 there are others who oppose this view.1214 There are two arguments against the matching approach. Firstly, every learning environment is likely to be made up of students with a variety of learning styles. Therefore, any attempt to match the learning style of one group will inevitably disadvantage learners of another style.14 Felder5 showed that students whose learning styles are mismatched tend to have greater difculty with the learning task. Secondly, learners will all have to encounter situations outside their comfort zone at some point in their lives. Therefore, mismatched learning and teaching styles will allow them to develop the ability to cope with such situations.11 It has also been argued that deliberate mismatch70

ing of teaching and learning styles can, in fact, lead to improved learning outcomes. Grasha12 claimed that optimal learning occurs when there is a certain amount of challenge in the learning situation. Grasha also claimed that learners will become bored and will not be able to tolerate learning and teaching styles that are always matched. Desmeddt and Valke15 found that it is not essential for educators to match teaching methods to learning styles, as merely understanding or recognising the existence of different learning styles in a group can be benecial to the educational outcome. Ramsden16 and Sadler-Smith17 have also highlighted that students who are aware of different learning styles nd it easier to adapt to different learning situations. With the continual growth of research in the area of learning styles it is not surprising that there are over 70 different learning style models7 each with different denitions, theoretical concepts and measures. This makes the task of choosing an appropriate instrument for investigation in research more difcult.18 There is a vast amount of research regarding the validity and reliability of these measures. However, it has been said that the perfect learning style measure is a fantasy.7 Nevertheless, Bostrom et al.19 stated that important research cannot always wait for the perfect measure. As well as learning styles, another factor that may inuence academic performance is the enrolment status of the students. Universities tend to enrol both home and international students. International students play an important part in university life for a number of reasons. Firstly, they are nancially benecial to the university as they pay for their educational fees in full.20,21 International students also add to the university experience for both staff and other students. They can share their different cultural experiences and allow staff to widen their knowledge of how different educational systems operate in different countries.20,21 Therefore, there is a growing competition for UK universities to attract international students.20 For this reason, it is becoming increasingly important that universities try their hardest to enhance the learning experience for international students.20 There has been much research investigating the academic performance of international students in comparison to home students2224 but, again, nothing has been published comparing the educational performance of home and international optometry students (electronic searches of Google Scholar, ERIC Database, International Education Research Database, British Education Index, Science Direct and PubMed were made using the following search terms: optometry undergraduates, academic performance, international and home students).

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This study was designed to investigate some factors that could affect the academic performance of optometry undergraduate students at Aston University in order to determine whether there was any strong need to change current teaching methods. It was designed to determine: l The spread of learning styles that exist in optometry students in the rst, second and nal year of the course (20082009 cohorts) and whether they changed over the 3 years; l If learning styles varied between males and females; l If learning styles varied between students of different enrolment status; l If academic performance was inuenced by learning styles, gender or enrolment status. Methods Ethics Ethical clearance for this study was obtained from the Research Ethics Committee at Aston University. All students across all 3 years of study were invited to participate. Voluntary informed consent was obtained before any data was used. Subjects All 360 students from the 3 years of the optometry undergraduate course at Aston University (20082009 cohorts) were invited to participate in this study. This consisted of 126 rst year students, 109 second year students and 125 nal year students. Index of learning styles All students completed and submitted an Index of Learning Styles25 which was based on the model developed by Felder and Silverman.5 This measure was chosen over all others for a number of reasons. Firstly, the instrument has been validated with large scale studies by both the authors and also by external researchers. The testretest reliability2628 (the consistency of the outputs of the instrument when they are repeated) and the internal consistency2730 (correlations examining to what degree different items in the instrument are assessing the same attributes) are both well established in literature. Construct validity (the ability of an instrument to measure the learning styles) has been established by Litzinger et al. (2005).30 Rosati and Felder31 established criterion related validity (the relationship between this and another well established instrument) by comparing it to the Myer-Briggs MBTI. Furthermore, this instrument was designed specically to be used in the higher education setting. Many other instruments were designed for children or managers.

This questionnaire classied all students learning styles along four continuous dimensions; active reective, sensing intuitive, visual verbal and sequential global. Active learners prefer immediate participation in learning tasks and learn best in groups. Reective learners, on the other hand, prefer to stand back and think ideas through alone. Sensing learners are practical and prefer to work with facts, whereas intuitive learners tend to be more innovative and enjoy understanding theories. Visual learners learn best through pictures, diagrams or charts, while verbal learners prefer words; either written or verbal. Finally, sequential learners absorb information in small logical steps, whereas global learners try to tackle the whole problem at once taking large, somewhat random steps, before putting everything together. The Index of Learning Styles consisted of 44 forced choice questions; 11 per learning style dimension. Each question gave two options (a or b) which corresponded to one or the other end of the learning style dimension. Counting the number of a responses for each dimension generated an integer score which ranged from 0 to 11. Using the rst dimension of active reective as an example, Felder and Spurlin6 have dened a score of 01 to represent a strong preference for reective learning, 23 a moderate preference for reective, 45 a mild preference for reective, 67 a mild preference for active 89 a moderate preference for active and 1011 a strong preference for active. Felder and Soloman32 have described a mild preference as being essential well balanced, therefore this scoring system was simplied so 03 was classed as having a preference for one end of the dimension, 47 was classed as a balanced learning style preference and 811 was classed as a preference for the other end of the learning style dimension. This scoring system generated three groups for each of the four learning style dimensions. For example, for the active reective dimension, the three groups were: active learners, balanced learners and reective learners. This allowed analysis of each of the four learning style dimensions individually. In order to achieve a broader picture of the distribution of learning style preferences, the four dimensions were grouped to generate a learning style prole. These were generated by using scores of 05 to represent a preference for one learning style and 611 as a preference for the opposing learning style in the dimension. This approach generated 16 possible learning style proles (Table 2). Student enrolment status The enrolment status of all students was determined by looking at their admissions records. Students were classied as home non-graduates, home graduates, international non-graduates and international graduates.
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There are many denitions of international students.33 While some studies base this determination on whether they are full fee paying students, others use the denition of whether they are living or have legal residence in the UK or not. The latter denition is used in this study in so far as students were classed as home if they had been resident in the UK or European Union for at least 3 years prior to starting the course. Graduate students were those who had previously completed a degree and non-graduate students were those who had not. Gender The cohorts were divided into groups of men and women based on biological assumptions (sex) but throughout the paper the term gender (a sociological construct) is used as learning style literature suggests that gender plays an important role in inuencing learning styles.34 Academic performance Each students academic performance was based on their overall average mark achieved across all modules in their respective year of study. Teaching and assessment methods at Aston University All teaching at Aston University across the 3 years of the optometry programme consisted of a mixture of both didactic lectures and clinical practical sessions. Practical sessions involved demonstration, tuition and practice of clinical skills either on real patients recruited by the university or on students. The approximate ratio of didactic to practical teaching was 1:1.3 across the 3 years. In our opinion, practical teaching would be better suited to active learners as it gives them the opportunity for immediate participation and group work whereas didactic teaching would be better suited to reective learners as this allows them time to think through ideas before having to put them into practice. Approximately 75% of the mark for academic performance was derived from written examinations and 25% was based on the examination of clinical skills. Statistical analyses All statistical analyses were performed using SPSS 16.0 and ndings were tested for statistical signicance at the 5% alpha level. The marks for academic performance were normally distributed and so parametric tests were used, however, the scores for learning style preferences were not and so non-parametric tests were used.
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KruskalWallis tests were used to determine whether there were any statistically signicant differences in the learning styles across the 3 years of study. Sign tests were used to determine if there were any statistically signicant preferences for any of the four learning styles. KruskalWallis tests were used to determine if learning styles varied with enrolment status and MannWhitney U-tests were used to determine whether learning styles varied with gender. One way Anovas were used to determine whether academic performance varied with learning style or enrolment status. An unpaired t-test was used to determine whether academic performance varied with gender. Power analyses were all computed using GPower 3.1.0 software36 at the 5% alpha level. Cohen37 dened effect sizes for a variety of statistical tests as small, medium and large; but he emphasised that the choice of the most relevant effect size should be based on the context of the research study. Any changes to teaching methods would require signicant resources, both time and nancial. Therefore, it would only be justiable to make changes to teaching methods based on statistically signicant ndings for large effects. Consequently, a large effect size was selected for all statistical power analyses. Post hoc power is quoted for all results that were not statistically signicant in order to ensure that power was always equal or above the conventional value of 80%.38,39 Results Subjects A total of 270 students (75% of those invited to participate) gave voluntary informed consent for their data to be analysed. This consisted of 106 (84%) rst year students, 89 (82%) second year students and 75 (60%) nal year students. Females represented 63% of the sample in all 3 year groups. The sample included 213 home non-graduates, 14 home graduates, 28 international non-graduates and 15 international graduates. 86% of the international students were Canadian and 84% of these Canadians were of Asian origin. The remaining 14% of international students originated from Africa (9%) and Asia (5%). Only 2 (0.8%) of the non-graduate students were mature students by UCAS (Universities and College Admissions Service) standards. Learning styles across the 3 year groups There were no statistically signicant differences in the spread of all four learning styles across the 3 year groups [KruskalWallis test, (active reective, p = 0.20, sensing intuitive, p = 0.67, visual verbal, p = 0.26, sequential global, p = 0.66) power = 95%]. Therefore, the data for all 3 years were pooled.

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Table 1. Spread of learning styles in cohort Strong preference for (a) (%) 24 46 35 40 Strong preference for (b) (%) 12 6 10 3

Learning style Active (a) Reective (b) Sensing (a) Intuitive (b) Visual (a) Verbal (b) Sequential (a) Global (b)

Balanced (%) 64 48 56 57

p < 0.01,) learning styles. Females were on average more likely to have a reective and visual learning style in comparison to males. Learning styles by enrolment status There were no statistically signicant variations in any of the four learning styles across the four enrolment status groups (KruskalWallis test, power = 96%). Academic performance by learning styles One way Anovas showed that there were no statistically signicant variations in the academic performance of students classed in each of the three learning style groups (preference for one end of the learning style dimension, balanced learners or preference for other end of the learning style dimension) for all four learning style dimensions (Table 3). There were also no statistically signicant variations in the academic performance of students with different learning style proles (one way Anova, F15, 269 = 0.86, p = 0.61, power = 99.6%). Academic performance by enrolment status There was a statistically signicant difference in the academic performance (mean standard deviation) of students with different enrolment status [One way Anova, F3, 269 = 4.62, p = 0.01] (Figure 2). Tukey HSD Post hoc testing revealed that international graduates (68 7, 95% condence limits: 6472%) performed better than both home (61 6, 95% condence limits: 60 62%, p < 0.01) and international (59 10, 95% con-

Pooled data (Table 1) showed that the majority of students (4864%) had a balanced learning style. However, there was a statistically signicant preference for the active (sign test, p < 0.01), sensing (sign test, p < 0.01) visual (sign test, p < 0.01) and sequential (sign test, p < 0.01) learning styles. The distribution of the integer scores for all four learning style dimensions is shown in Figure 1. Table 2 shows the spread of learning style proles in this group. Again, this shows that a large proportion of students had an active-sensing-visual-sequential learning style prole. Learning styles by gender There were no statistically signicant differences between the sensing intuitive (MannWhitney U-tests, Z = 0.99, p = 0.32, power = 99%) and the sequential global (MannWhitney U-test, Z = 1.17, p = 0.24, power = 99%) learning styles in males and females. However, there was a statistically signicant difference in the active reective (MannWhitney U-test, Z = 2.22, p = 0.03,) and the visual verbal (MannWhitney U-test, Z = 2.96,

Figure 1. Distribution of integer scores for each learning style dimension.

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Table 2. Percentage of students with each learning style prole REF, INT, VIS, GLO 2.6 REF, SEN, VIS, GLO 4.1 ACT, INT, VIS, GLO 3.0 ACT, SEN, VIS, GLO 7.4 REF, INT, VIS, SEQ 4.1 REF, SEN, VIS, SEQ 13.7 ACT, INT, VIS, SEQ 6.3 ACT, SEN, VIS, SEQ 28.9 REF, INT, VRB, GLO 1.5 REF, SEN, VRB, GLO 3.3 ACT, INT, VRB, GLO 0.4 ACT, SEN, VRB, GLO 1.1 REF, INT, VRB, SEQ 2.2 REF, SEN, VRB, SEQ 9.6 ACT, INT, VRB, SEQ 1.1 ACT, SEN, VRB, SEQ 10.7

ACT, active; REF, reective; SEN, sensing; INT, intuitive; VIS, visual; VRB, verbal; SEQ, sequential; GLO, global.

Table 3. One way Anova results examining variation in academic performance for different learning style preferences Learning Mean Standard style mark (%) deviation F Active Balanced Reective Sensing Balanced Intuitive Visual Balanced Verbal Sequential Balanced Global 59.0 61.5 61.6 60.5 61.4 62.2 60.5 61.2 62.1 60.9 61.0 61.8 8.0 8.9 7.6 8.8 8.2 10.0 8.5 8.8 7.5 8.1 9.1 6.4 Degrees of Power freedom p-value (%) 0.07 96

Academic performance by gender The academic performance (mean standard deviation) of males (60 8) and females (62 9) did not differ (unpaired t test, t = 1.25, df = 268, p = 0.21, power = 99%). Discussion

2.65 2, 269

0.51 2, 269

0.60

96

0.44 2, 269

0.65

96

0.05 2, 269

0.95

96

Figure 2. Academic performance (mean marks) by enrolment status. Error bars represent 95% condence interval.

dence limits: 5563%, p < 0.01) non-graduates. However, there was no difference in their performance in comparison to home graduates (63 10, 95% condence limits: 5769%).
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Although the Index of Learning Styles is a valuable tool in education, it is worth noting that it can only identify learning style preferences. These preferences only suggest behavioural tendencies rather than being concrete predictors of behaviour.6 For example, individuals with an active learning style preference may still, in certain situations, use a reective learning style. Therefore, in this study, although the Index of Learning Styles identied learning style preferences, it cannot be said with any certainty that all students adopted these preferred styles in their learning. Only a questionnaire investigating each students self perception of the learning styles adopted in the course could address this issue, but research has shown that the accuracy of self perception is poor and can be subject to bias.40 Some literature suggests that learning styles are exible and can be changed or may adapt as students experience different learning environments.41 This cross-sectional study showed no statistically signicant differences in learning styles across the 3 years, however, a longitudinal study would be required to investigate this further. Although a large proportion of optometry undergraduates had balanced learning style preferences, there was a distinct preference for the active, sensing, visual and sequential learning styles. This is consistent with the ndings of other studies examining the learning style preferences of students studying health science programs.42 Brown et al. investigated the learning style preferences of students studying 11 health science programs including occupational therapy, physiotherapy, paramedics, social work, nutrition & dietetics, pharmacy, radiation therapy, radiography, nursing, midwifery and Bachelor of nursing/ Bachelor of emergency. Although Brown et al. have not

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commented on this, it seems intuitively obvious to us that whether you choose to be a doctor, dentist, nurse or optometrist, the core skills are the same; they all involve the application of clinical knowledge in the eld of health and social sciences in order to make tentative diagnoses and relevant management plans. Regardless of the speciality they are all health care professionals. Although these are our opinions, we have not found any other study that support them, however, these similarities in the learning style preferences of students studying health sciences support Kolbs43 theory which states that people already have an understanding of their learning style preferences and so tend to choose to enter disciplines and careers that are consistent with these. In keeping with previous research that has looked at the learning style preferences of students studying health science programs, the largest group (28.9%) of optometry students had an active-sensing-visual-sequential learning style prole. Unlike previous research, however, our study ags up two additional signicant learning style proles; reective-sensing-visual-sequential and active-sensing-verbal-sequential. Examination of these two proles shows that both only differ from the main prole according to one aspect of their learning style; so it appears that they are subgroups of the main prole. One of these subgroups is simply reective rather than active; that is they prefer to sit back and think ideas through over immediate participation. The other subgroup is simply verbal rather than visual; that is they prefer words and text over pictures and diagrams. All three proles together, 53.3% of our students, have in common a preference for sensing and sequential learning; that is, they prefer to work with facts delivered in a logical order. In our opinion, this is not at all surprising given the way optometrists carry out their daily tasks. They are focussed on arriving at diagnoses from presenting symptoms and signs. This, often confusing, clinical information is most easily handled if it is approached in a logical sequence using factual knowledge about the way symptoms and signs are connected to specic diagnoses. That there should be subgroups which differ subtly in the way they prefer to be taught these clinical facts is also, in our opinion, not at all surprising. Having settled on some form of explanation as to why these three proles might exist, we urge readers to take this information with caution as these proles only emerged when students with mild preferences were included; mild preferences meaning balanced learners. No groups emerged when students with mild preferences were removed from the analyses. So while these three proles appear to exist, they are primarily made up of balanced learners. Therefore, we feel it is more accurate to say that the majority of students are balanced learners and no strong proles really exist. This then means that

these ndings have no implications on teaching and learning as learning styles did not affect academic performance. Gender only inuenced the active reective and the visual verbal learning style dimensions where, on average, females had more of a reective and visual learning style than males. This is inconsistent with the ndings of other studies. While some have found that female health science students were more likely to have a verbal44 and active learning style,45 others have found no gender differences.46 We have reected on these ndings and are still at a loss for an explanation as all studies used the same measure, the Index of learning styles, had sufcient sample sizes to support their ndings and it is unlikely that errors could have been made while classifying students into the two cohorts of males and females. In our sample of optometry students, of the factors investigated, learning styles had no inuence on academic performance. It is most likely that this was because a large proportion of students had balanced learning style preferences. This means that they would easily adapt to any teaching style.7 Only the active reective learning style dimension came close to being statistically signicant, with reective learners having a higher academic performance than active learners. The teaching methods at Aston University are a mixture of both didactic lectures and clinical practical sessions with an approximate ratio of 1:1.3. Intuitively, active learners would prefer clinical practical sessions as these involve group work and collaborative learning whereas reective learners would prefer the didactic lectures as these give them the opportunity to think through ideas alone before having to put them into practice. Therefore, there is a slight bias towards the active learners in our teaching style. However, surprisingly, these students had a lower academic performance. We believe that this is likely to be due to the examination styles rather than due to teaching styles. Approximately 75% of the mark for academic performance was based on written examinations while only 25% was based on the examination of practical skills. Therefore, this is likely to favour reective learners. Nevertheless, these results imply that there is no strong reason to alter current teaching methods for optometry undergraduates with regard to their learning styles as the majority of students have balanced preferences; but further investigation on the inuence of examination methods is required. Of the factors investigated, academic performance was only inuenced by enrolment status. Across all 3 years, international graduate students outperformed both home non-graduate and international non-graduate students. However, there was no statistically signicant difference between the performance of international and home graduates. Clearly, learning styles were not responsible for
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these differences as learning styles were independent of enrolment status. One reason for these differences may be that international graduates have had more experience with degreelevel examinations. This notion is supported by the nding that international and home graduates had similar academic performance. Graduate students are also mature students and studies have established that mature students are more likely to have a higher academic performance.47 Again, this notion is supported by the fact that <1% of the non-graduate students were mature by UCAS standards. Another reason may be that international graduate students are full fee-paying students who have chosen to complete a second degree. Therefore, they are likely to have greater determination and motivation to work harder in order to be successful.48,49 A positive correlation between student motivation and independent study time has been reported.50 It then follows that as international graduates tend to have greater motivation, they are more likely to spend extra time studying independently; and greater independent study leads to higher academic performance.50 This gives a possible explanation as to why international graduates had higher academic performance. Again, this is supported by the nding that international and home graduates had similar academic performance as home graduates also have to pay full fees. Other studies investigating the academic performance of international students in comparison to UK home students have found mixed results. Some have concluded that international students have far better academic performance23,51 and suggested that this may be due to them having greater motivation, a greater level of support from the family and higher expectations of success. Some studies have found that international students did not perform as well as their home counterparts52,53 and suggested that this may be due to difculty with English language skills and problems adjusting to a new academic and cultural environment. Other studies have found no differences between international and home students.22 It has been argued that it is not logical to make a general comparison between home and international students, mainly because there is greater diversity in the latter group.33 The group classed as international students could originate from a variety of countries and so are likely to have varied educational and cultural backgrounds. This means that broad generalisations are not valid when making comparisons of this diverse group to UK home students. This may explain why previous studies have found such mixed results. Moreover, because international and home students have usually taken different examinations before entering their degree course, it is often difcult to make direct
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comparisons of their academic ability at the start of the degree programme. Therefore, in most studies, the natural academic ability of students entering the course is likely to be a confounding variable as the two groups may not be matched. At Aston University the majority of optometry undergraduate international students are Canadians of Asian origin (84%). Given the small proportion of international students enrolled each year, further large scale longitudinal studies would be required in order to examine the inuences of cultural and educational background on the academic performance of international students. De Vita54 compared 43 international students representing 20 different nationalities to UK home students and found statistically signicant differences in their learning styles. This was not the case for this sample of optometry students. The learning styles were found to be independent of enrolment status. Again, it is more than likely that this may be due to the diversity of the group classed as international students in both studies. Conclusion Our research has shown that the majority of optometry students have balanced learning style preferences and that of the three factors studied, academic performance is only inuenced by enrolment status. Although learning style questionnaires offer suggestions on how to improve learning efcacy, our ndings indicate that current teaching methods do not need to be altered to suit varying learning style preferences as balanced learning styles can easily adapt to any teaching style. Further large scale studies are required to investigate the inuence of educational and cultural differences between international and home students on academic performance. Acknowledgements This research was funded by a teaching grant awarded to Hannah Bartlett by the Centre for Learning Innovation and Professional Practice at Aston University. This paper contains material that was presented at the Research Symposium organised by the College of Optometrists and British Congress for Optometry and Vision Sciences held in York on 19th April 2010. We thank Michael Dunne for his help in preparing the database used in this study. References
1. Dermo J. e-Assessment and the student learning experience: a survey of student perceptions of e-assessment. Br J Educ Technol 2009; 40: 203214.

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