Objective: This study aimed to investigate the circadian typology of medical students at public universities from one of the northeastern states in Brazil, active in the morning and afternoon shifts, checking the compatibility between their study time, productivity, income and chronotype. Methods: To obtain the results, the assessment of the chronotype in 342 medical students of both sexes was considered. Each participant was submitted to the questionnaire developed by Horne and Ostberg, adapted by Cardinali, Colomberk and Rey. It’s composed of 9 questions, providing the general ranking of each individual. Based upon scored, the chronotypes were classified. Results: The sample was composed of 49.12% (168) male and 50.87% (174) female subjects, a similar gender distribution of enrolled students during data collection time. By applying the questionnaire, the prevalent rating among the medical students as moderately morning (29.82%) and intermediate (43.85%) has been relevant. The academic performance assessment in two morning-intermediate groups (8.16) had no significant distance from others considered afternoon active (8.20). Conclusion: The health sciences student, especially Medicine, faces constant adaptation of scheduling, in the attempt of fulfilling the requirements throughout the course, causing chronogram desynchronization effects and forced readaptation to each different school semester.
The preference for morning-afternoon shifts is the individual difference that explains the variation in the rhythmic expression of biological and behavioral patterns [
This occurs because light stimulates specific cells located in the retina (melatonin as photoreceptor) sending neural projections via retinohypothalamic tract directly to the suprachiasmatic nucleus (structure located in the hypothalamus). Due to the control of biological clock, light has been currently considered as the main synchronizer agent [
A proper functioning of this synchronization system allows an alignment between environmental cycles. It provides an anticipation capacity, which allows the organism obtain resources to be prepared for events and activities indispensable for life [
This is an observational study with cross-sectional approach. Participated in study medical studentd in Maceió, capital of Alagoas, a state in the Northeast region of Brazil. Maceió is a coastal city, with approximately 932,000 inhabitants, is located at 9˚39'59''S. The study was conducted from August 2015 to August 2016.
Participants were recruited following the inclusion and exclusion criteria, they were aware of participation and signed an application of Free and Informed Consent.
Each of 342 students has been submitted to the questionnaire proposed by Horne and Ostberg [
The academic performance has been analyzed using income coefficients from each student, provided by the Academic Division.
The study has been conducted following the ethical standards to chronobiological researches in humans, following the Declaration of Helsinki’s guidelines of the World Medical Association [
The study included 342 students, consisting 97.2% of 352 questionnaires, which
QUESTION ORDERING | OPTIONS | ||||
---|---|---|---|---|---|
A | B | C | D | E | |
1 | 1 | 2 | 3 | 4 | 5 |
2 | 1 | 2 | 3 | 4 | - |
3 | 1 | 2 | 3 | 4 | 5 |
4 | 1 | 2 | 3 | 4 | - |
5 | 1 | 2 | 3 | 4 | - |
6 | 4 | 3 | 2 | 1 | - |
7 | 4 | 3 | 2 | 1 | - |
8 | 1 | 2 | 3 | 4 | - |
9 | 4 | 3 | 2 | 1 | - |
09 to 15 -> Definitely morning; 16 to 20 -> Moderately morning; 21 to 26 -> Intermediate; 27 to 31 -> Moderately.
has been assigned and returned. Losses occurred due to incomplete and inconsistent filling. From the total amount of sample, 49.12% (168) were male and 50.87% (174) were female (
The ages of the students ranged from 18 to 61 years (24.11 ± 5.77; median = 24). Was observed a predominance of age in the range of 21 - 24 years (38.65%).
Chronobiological questionnaire showed that 8 (2.3%) were definitely morning (DM), 102 (29.82%) were moderately morning (MM), 150 (43.85%) were intermediates (I), 66 (19.29%) were moderately afternoon (MA) and 16 (4.67%) was definitely afternoon (DA) (
By analyzing the predominance of points according to their grouping, the frequency of scores displays a regular distribution (
Chronobiological Type | N# | % |
---|---|---|
Definitely morning | 8 | 2.3 |
Moderately morning | 102 | 29.82 |
Intermediate | 150 | 43.85 |
Moderately afternoon | 66 | 19.29 |
Definitely afternoon | 16 | 4.67 |
Total | 342 | 100 |
Caption: Frequency of chronotypes displayed by 342 medical students from public universities in the State of Alagoas, analyzed according to the questionnaire proposed by Horne & Ostberg, adapted by Cardinali, Colomberk & Rey.
Analysis of academic coefficients from all interviewed students revealed no correlation between academic developments with period of greatest productivity. Students classified as morning, intermediate and afternoon have obtained an academic coefficient average of 8.16, 8.23 and 8.20, respectively.
Age and gender from participants were no considerably different, probably due to a homogeneity presented in both male and female samples, and a predominant consistency of young individuals. A study by Monk and Kupfer [
Similarly, differences between preferences in both genders are observed in the results obtained by Mongrain et al. [
Classifying students as intermediaries’ chronotype means that this group has greater flexibility compared to other groups when schedules are changed. These students are able to awake earlier or later, and fulfill daily academic activities with a satisfactory alert level in every moment. However, performing activities outside to own chronotype period may result in learning difficulties, due to cognitive troubles like, memory, visual perception, mental skill or muscle strength [
Higher-Education students, especially Medicine, are often susceptible to schedule shifting, because there is a greater effort and time disposition required by the course. This may compromise a proper functioning of the body and affect the performance of such operations. Forced to change or switch the period that show higher productivity they may compromise the academic performance. Alam et al. [
When analyzing the income coefficient from individuals, according to chronotype in academic activity shifts, the afternoon-active shows a better performance (mean = 8.20) compared to morning and intermediate groups (mean = 8.16), however, there is no significant difference. In contrast, Ferreira and Martin [
In this context, courses in health sciences, especially Medicine, is constantly adapting the schedule, attempting to satisfy needs and exigencies throughout graduation. This, increase demand along the course and so, desynchronization with chronotype needing new adaptations by every semester. Hence, promoting biological deregulation and changes lead to compromise the process of learning in the academic life. As displayed by Parks et al. [
Due to increasing acknowledge of social significance in Chronobiology, an organization and a chronobiological planning for students’ daily activities is required, aiming both a better academic performance and therefore, elevated course fulfilment. The adjustment between social and biological time, will increase the welfare of students, triggered by respecting their physiology.
To the support from Institutional Program for Scientific Initiation Scholarships PIBIC/ CNPq 2015-2016 for this study. And the relevant support from the Faculty of Medicine’s Council in the Federal University of Alagoas, for the collection of data.
Gomes, J.R.M., Santos, F.K.F., de Freitas, I.F.M., de Oliveira, I.F., dos Santos, H.A., da Silva, J.C., Dal Pai, J., Zambrano, L.I., Filho, E.M.T. and Costa, M.V. (2017) The Assessment of Medical Stu- dents’ Chronotypes. World Journal of Neuroscience, 7, 275-281. https://doi.org/10.4236/wjns.2017.73023