Evaluation the Attitude of the Students of Shahid Sadoughi University of Medical Sciences about Their Art of Expression in 2014-2015

Document Type : Original Article


1 Education Development Center, Shahid Sadoughi University of Medical Sciences, Yazd, Iran

2 Education Development Center, Isfahan University of Medical Sciences, Isfahan, Iran


Background: Communication is a key element in education. Quality of expression in teachers and learners is an important aspect of this communication. The aim of this study was to determine the attitude of students of Shahid Sadoughi University of Medical Sciences about their expression quality.
Methods: This descriptive cross-sectional study was performed among 382 students of the Shahid Sadoughi University of Medical Sciences in the academic year 2014-2015. These students were selected randomly based on their school with stratified sampling. Data collection was performed using a researcher made questionnaire. Its content validity was confirmed by experts, and its reliability was calculated as 0.77 by Cronbach's alpha. Analysis of data was performed using one-sample T-test and ANOVA by SPSS16 software.
Results: Students in this study were satisfied from their quality of their expression, and reported it as suitable (P < 0.000). Gender had no effect on students' attitude about the quality of their expression (P = 0.163), but educational level (P = 0.001) and the school (P = 0.002) were effective.
Conclusions: The expression quality of students is effective in teaching and learning process, and this should be considered. Students’ perceptions from their expression quality could be effective in classroom behavior, education participation, teaching and learning process.



The ability to communicate properly is one of the most important life skills, so that some experts believe that the basis of human growth, personal injuries and human development are in the communication process (1). Communication skills are behaviors that aid the person to express emotions, needs and individual goals (2). Communication patterns in formal and informal situations, suggests that there is a tendency for oral communication rather than written communication in all over the world. Oral communication is easier and more effective than written ones (3).

Language is one of the most important tools of communication and interaction with others. Speaking is a concept that can help people to advance the goals and plans. Behavior, attitude, dressing and the way of looking could be displaying some parts of the personal characteristics, but by dialogue and words and how to apply them, sound modulation, transparency or suffocation could transfer the depth of thought and feeling. Human voice clearly states our thoughts and feelings (4). One of the most widely used classifications for communication is verbal and nonverbal (5).

In the classroom, two types of interaction, verbal and nonverbal are being used (6). Nonverbal communication includes facial expression, eye contact, posture and intonation (7). Verbal interaction includes oral and written interaction. Writing interaction is a kind of interaction that learner writes his own ideas, and communicates with others through his writing. In contrast, in oral interaction learner communicate by talking in the classroom, answering and asking questions, comment and participate in discussions (6).

Sound is an instinctive habit, and manner of speaking is an acquired skill (8). Whatever the speech is more efficient, the purpose is better expressed (4). During speaking, must be noted to grammar, including sentence construction, arrangement of words, syntax and language fluency and accuracy. Speech must relevant to the subject, and has appropriate length. Turns in speaking and speech transparency are important also. During speaking, social rules, such as use of appropriate words must be considered. Avoidance of multi-lateral and ambiguity must be considered also. During speaking must carefully noticed to explicit and implicit meanings of the words (3). Letters, words, and sentences are things that the beauty, order and accuracy in their selection encourage the listener to hear, and so concepts quickly sit on his heart (9).

Expression in classical literature consists of five parts: innovation, organization, rhetoric, remembering, and audio transmission. Firstly, the speaker reviews the topic deals, secondly, make-up and organizes the details. In the third stage, determine a verbal form for it. In the fourth stage, memorize it, and in the last stage, expresses it (8).

Communication skills are the most important features for the students, teachers and employees of the health system (1). Training without a communication would be meaningless (10). Appropriate expression is one of the factors affecting better communication in education (11, 12). Suitable expression in the classroom in relation to the teacher (11) and the student can be considered. But in the study of literatures, relevant studies about the evaluation of the quality of expression in the students were not found. Therefore, this study aimed to evaluate the quality of expression in the students of Shahid Sadoughi University of Medical Sciences.



This study was a descriptive survey, which was carried out among 382 participants from 5700 students of Shahid Sadoughi University of Medical Sciences in the academic year 2014-2015. Stratified random sampling was conducted based on their faculty. The sampling of each faculty was conducted as simple random sampling. The minimum sample size based on the Kerjesi-Morgan's table was 361 persons. Due to the exiting of the samples during the sampling process, 400 questionnaires were distributed and Finally 382 questionnaires were analyzed.

The research instrument was a 14 items researcher made questionnaire, which was about the features of expression. This questionnaire was in a five-item Likert scale (from 5: strongly agree with 1: strongly disagree). In this questionnaire, accent, spoken problems, vocabulary, rhythm, tone, tone of voice, and fluency of expression were evaluated.

Sex, faculty, and level of education were asked in demographic section. The validity of the questionnaire was confirmed by experts, and its reliability was calculated through Cronbach's alpha as 0.77. To analyze the data, descriptive statistics (frequency, percentage and mean) and inferential statistics (one-sample t test, t-test and ANOVA) were used through SPSS16 software.



In this research, from 382 persons, 260 participants (68.1%) were women and 122 participants (31.9%) were male. The frequency and percentage of participants based on their faculty are shown in table 1. The frequency and percentage of participants based on the level of education are shown in table 2.



Table 1: The frequency and percentage of participants based on their faculty


Frequency (%)


74 (19.4)

Nursing and Midwifery

31 (8.1)


88 (23)


57 (14.9)


31 (8.1)

International Branch

61 (16)


16 (4.2)

Meybod School of Nursing

7 (1.8)

Abarkooh Paramedical

17 (4.5)


382 (100)




Table 2: The frequency and percentage of participants based on the level of education

Level of education

Frequency (%)


161 (42.2)


42 (11)


149 (39)


23 (6)


7 (1.8)


382 (100)



Evaluated items and this study finding in association with each item are given in table 3.






Table 3: Evaluated items and this study finding in association with each item (PV<0.001)


Mean (±SD)


My accent is understandable to those around me.

4.32 (±0.74)


My voice during speaking is not too loud or slow.

3.67 (±0.97)


I have a wide range of domain of vocabulary.

3.40 (±0.92)


I do not speak slash.

3.96 (±0.87)


I carefully choose my sentences during speaking.



I use from "pause" and "emphasize" on the words timely and properly during speaking



My talking style is not slow or dull.



I pronounce and express the words correctly.



I express my subject fluently during speaking.



My Speaking rhythm is not monotonous.



I do not use meaningless letters such as  during speaking.



My tone is not offensive or defensive during speaking.



I do not have speech problems such as stuttering.



I think I have a good voice.



Total expression quality (final score)




According to the findings in table 3, students believed that they have good conditions in all variables associated with the quality of expression (P<0.001). The highest mean in students’ attitudes was "not having speech problems" and "understandable accent". In general, based on the results of one-sample t test, participating students in the study believe that they have appropriate quality of expression (P<0.001).

Based on the findings of an independent t test, gender had no effect on students' attitudes towards quality of expression (P=0. 163). The results of ANOVA, reflects the impact of education level (P<0.001) on quality of expression. LSD post hoc tests showed that the attitudes mean score of residents, significantly different from others and was higher for all of them. The attitudes mean score of undergraduate students was lower from all other grades. The attitudes mean score of PhD students was not significantly different from other grades, but was significantly less than the residents. The attitudes mean score of medical and master students were significantly lower than residents and higher than bachelors. The results of ANOVA, reflects the impact of faculty (field of study) (P = 0.002) on quality of expression. Comparison of the means of the LSD post hoc test showed that attitude mean score in the students of the faculty of health were not significantly different from Dentistry and Meybod faculties, but was significantly lower from other faculties.



This study aimed to evaluate the quality of university students’ expression. According to this study, students of Shahid Sadoughi University of Medical Sciences believed that their speech qualities are good. Gender had no effect on this attitude, but grade of education and faculty were effective. Residents and undergraduate students had the highest and lowest mean respectively.

Quality of expression of every person has significant impacts on his behavior. Especially in the classroom, the expressive quality of teacher and learner could be effective in the participation of the learners in the educational process. Some researchers (13, 14, 15, and 16) believe that suitable expression and verbal skills are effective in the classroom with silence behavior and lack of learner’s participation in the training process. Despite the importance of this issue in the training process, in search of available literature, we have not found items that evaluate the student’s expression. Negative image of oneself is effective in interpersonal relationships, socio-emotional growth and self-perceived value (17). Learners, who have “proper vocabulary and melodious voices, properly apply the words, have good expression, properly use pause and stress on the words, and have control of rising, falling, intensity, and volume of their voice”, are more likely to be of interest to others, and have higher self-esteem. Therefore, their participation in daily and class activities will be more.

Adverse word quality and unpleasant sound will cause the person to lose their public participation. Learners, who have verbal weaknesses, are more likely to be reticent and isolated in the class. Examples of such conditions could be found clearly in people with stuttering. Such problems could have negative impacts on person’s self-concept, and learner deal with the mental challenge of fear of negative evaluation. In this way, not only the individual motivation for participation in the classroom will be reduced, but also he or she will be driven to self-imposed silence.

The scope of vocabulary is one of the factors affecting speech quality. Inappropriate verbal communication of parents with their children, low study, limited communications, and inappropriate utilization of audiovisual media are the main factors in the weakness of vocabulary storage. This causes verbal weakness such as slurred speech, because one must spend more time for searching the right words in his mind, and may finally fail to find the right words. Such people are weak more than others in pronunciation and fluency of speech, and thus expressed words in fluently. The starting point of individual's expression skills is from motherly and fatherly subtle whispers. Parents should have wide verbal communication with their children. This will help not only to enrich one's vocabulary, but also have far-reaching effects on psychological aspects and emotional connection between parents and their children. In addition to good verbal communication of parents with their children, they need to be in a wide network of friends and their peers. Parents must help them so they can correctly use from theological media. In addition to addressing the great literary texts, must be emphasized on the applied linguistic aspects also, and not merely relied to a set of theories.

Today, the expression is a science. Features of speech, such as intonations, rhythm, speed, fluency and tone, all "skills" that could be learned. Therefore, research in this area can develop our knowledge in this field. This study was conducted due to the lack of similar examples. Meanwhile, the population of the present study is limited to the students of only one university. It is recommended to evaluate the expression quality among students and teachers from different views, and based on its results with the help of experts in this field; improve the quality of expression and thereby improving the quality of communication between teachers and students.

Appropriate expression is one of the primary tools in efficient and effective communication. It will affect the teaching and learning process. Therefore, it should be considered more carefully about teachers and students.



The authors would like to acknowledge the students that participated in this study.

Research committee approval and financial support

This study was approved by Shahid Sadoughi University of Medical SciencesResearch committee approval. There is no financial support for this study.

Conflict of Interest

The authors declare that there is no conflict of interest regarding the publication of this article. 

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