Comparison of Academic Performance Between Hard Copy and E-Learning Approaches Among Final Year MBBS Students at DG Khan Medical College DG Khan

Background: The choice of learning resources significantly influences medical students’ academic achievement. Traditional hard copy materials continue to dominate, but the rapid adoption of e-learning has raised questions about its effectiveness in comparison to conventional approaches. Objective: To compare the academic performance of final-year MBBS students using hard copy study materials versus those relying on e-learning resources. Material and Methods: A comparative cross-sectional study was conducted at DG Khan Medical College, Pakistan, in 2024. A total of 140 final-year MBBS students were enrolled, with 70 using primarily hard copy resources and 70 using e-learning methods. Academic performance was assessed through written examination, clinical examination, internal assessment, and overall weighted scores. Descriptive statistics, independent samples t-tests, chi-square tests, and multiple linear regression were performed using SPSS version 26. Results: The mean overall score was significantly higher in the e-learning group (72.28 ± 4.42) compared to the hard copy group (67.08 ± 4.63; p < 0.001). Written (73.51 ± 7.50 vs. 67.71 ± 7.49; p < 0.001), clinical (70.12 ± 6.82 vs. 67.32 ± 6.90; p = 0.017), and internal assessment scores (72.46 ± 7.68 vs. 65.17 ± 6.82; p < 0.001) were also significantly higher among e-learning students. All students in the e-learning group passed, compared to 94.3% in the hard copy group (χ² = 4.118, p = 0.042; Fisher’s Exact p = 0.120). Regression analysis confirmed e-learning as an independent predictor of higher performance (B = 5.04, p < 0.001). Conclusion: E-learning was associated with superior academic performance compared to hard copy study methods, and remained an independent predictor after adjusting for confounders. These findings support the integration of digital learning tools into undergraduate medical education.