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27 May 2024: Clinical Research  

Exploring the Educational Social and Physical Activities Among Health Care Undergraduates – a Cross-Sectional Study Among Saudi Students

Alya Alghamdi1BCE, Wajid Syed2ABCDEFG*, Osama A. Samarkhandi3ABCDEFG, Mohammed M. Albalawi4ABFG, Ibrahim Nasser Alsulaihim5ABCDEF, Shogair Mshal Almutairi4BCDEG, Mahmood Basil A. Al-Rawi6BCE

DOI: 10.12659/MSM.943399

Med Sci Monit 2024; 30:e943399




BACKGROUND: The time spent on diverse social, physical, and educational activities among healthcare undergraduates (HCUs) tremendously impacts their academic and personal lives. Therefore, this study aimed to assess the social, physical, and educational activities among HCUs at King Saud University (KSU) in Riyadh, Saudi Arabia (SA).

MATERIAL AND METHODS: A cross-sectional, self-prepared, and pre-tested e-questionnaire (electronic questionnaire) based study using a convenience sampling design in a university in SA from August 21 to November 21, 2023 was conducted to assess their various activities outside of classes, using a 16-item e-questionnaire to investigate time spent on social (4 items), physical (3 items), and educational activities (3 items).

RESULTS: A total of 452 HCUs completed the e-questionnaires, giving a response rate of 92.62%. Of them, 50.45% were females, the median age was 23 years, and 32.08% (n=145) were medical undergraduates. About 57% of the HCUs spent 1-2 h per day on educational activities during the day, while 32.7% of the HCUs spent 2 h per day on social media, and 62.6% spent 3-4 h per day with family. The findings revealed that the 140 females spent significantly more time (1-2 h) reading and writing compared to the 117 male HCUs (P=0.001). Age was found to be associated with time spent on education by HCUs (P=0.001).

CONCLUSIONS: Our findings among HCUs show that most spend a significant amount of time on educational activities during the day. Undergraduates also spend time with their families and participate in other social activities.

Keywords: academic performance, Caffeine, Internet Addiction Disorder, Sedentary Behavior, Golgin-67


The healthcare student’s life is characterized by busy schedules with heavy academic load, repeated exams, assignments, or presentations, and clinical rotations [1,2]. In the context of learning, academic activities need to be completed quickly, which can make undergraduates stressed both mentally and physically, possibly leading to academic failure, which can cause anxiety [2,3]. Furthermore, studies revealed various physiological and psychological disorders among healthcare undergraduates (HCUs) [4,5]. Therefore, leisure time and activities during leisure are very important in the context of healthcare education, as it was suggested that these activities serve as a buffer against the stress and burnout developed in an academically taxing environment [6,7].

Although leisure time, more commonly known as free time, in particular, refers to the gaps between regular activities like reading, eating, sleeping, and self-care [6]. As a result, it symbolizes time spent on freely permissible practical pursuits and away from employment, domestic duties, and/or business. [6]. Spending leisure time on diverse activities among healthcare students is challenging because healthcare programs are lengthy, with continual assessments and competition among students [7]. For example, medicine is a 6-year program that includes 1 year as a foundation year, 2 years of basic science, 3 years of clinical experience, and 1 year of internship [7,8]. The PharmD and Bachelor of Dentistry (BDS) programs require 201 and 197 credit hours, respectively, with a 6-year period that includes the first common year, 4 years of college, and the last year as an internship [9]. Nursing education at KSU consists of 4 years of classroom work, in addition to the clinical rotation [10].

Furthermore, healthcare programs such as medicine, nursing, pharmacy, and dentistry demand greater attention and extra time for learning due to shorter semesters and continual exams as compared to non-healthcare degrees. Earlier reports revealed different activities among HCUs during their free time. [1,6,11]. For instance, a previous study reported that undergraduates used their free time to study and review material covered in class. In addition, they are interested in and performed physical activities such as running, cycling, weightlifting, or yoga to stay healthy and reduce stress. Another recent study revealed that 60% of undergraduates performed extracurricular activities during their free time [12]. Engaging in social, physical, and educational activities is crucial for HCUs to manage their stress levels while maintaining a balance between academic life and quality of life. Additionally, engaging in leisure activities fosters growth of social, mental, emotional, and physical abilities [13,14].

Undergraduates’ use of social media helps the students to speed up the learning process by promoting group discussions, collaboration, and idea sharing among students. This can help students improve their academic performance by reinforcing their learning behavior and performance [15,16]. In a similar vein, students’ time with their families is important since it fosters emotional attachment, which aids in academic progress and supports their psychological welfare [17]. Furthermore, recent research revealed that students who dedicated 4 h a day to their academic pursuits achieved strong academic results [18]. Additionally, as previous research has shown, a student’s characteristics such as smoking, sleeping patterns, and level of physical activity also have an impact on psychological behaviors, which in turn affect their academic life [19].

HCUs are future practicing healthcare professionals; having adequate physical health, social life, and educational engagement helps in achieving excellent grades and also has a significant impact on their academic careers. In addition to keeping their brains on track, avoiding burdens associated with their education, and becoming more energized and excited in their academic lives, healthcare students should participate in social, educational, and physical activities. There have been several reports published around the world on the physical and social activities of undergraduates, but to the best of our knowledge, no such research has been conducted among Saudi HCUs to examine this issue. Therefore, this study aimed to assess their social, educational, and physical activities during leisure time.

Material and Methods


Data analysis was performed using the SPSS statistical software package, version 26 (SPSS, Inc. Armonk, New York, USA). Descriptive analysis such as frequencies(n) and percentages (%) was used, the association between variables was assessed using the chi-square or Fisher exact test, and p<0.005 was considered statistically significant.



Table 2 shows the time spent on education-related activities. We found that 56.86% (n=257) of the HCUs spent 1–2 h per day on educational activities, while 15.04% (n=68) of them spent 2–3 h per day. During the weekend, over half (n=250, 55.31%) of them spent >4 h per day on educational activities, and 43.80% (n=198) of the undergraduates spent 3–4 h per day. Computers or laptops/tablets were used for academic activities <30 min by 25.66% of the undergraduates, while 19.69% of them used them for 30 min to 1 h, and 32.96% of them used them for 2–3 h (Table 2).


In this study, 19.25% of the HCUs spent 1 h on social media, while 32.74% of them spent 2 h, and 6.85% of them spent 3–4 hours on social media. On the other hand, 27.43% of the HCUs spent 2 h with their family, and most (62.61%) of them spent 3–4 h with family. Almost half (48.90%, n=221) of them spent >30 min watching television, while 31.41% (n=142) of them spent 1 h on television. Most (62.83%) of the undergraduates performed physical exercise 3–4 days a week, as shown in Table 3.

In this study, 51.3% of HSUs reported excellent overall health status, while 35.4% of them reported it to be good, whereas 17% reported having excellent mental health and 69.7% reported having very good mental health (Table 3).


The findings revealed that females (n=140) spent significantly more time (1–2 h) reading and writing compared to male (n=117) HCUs. Similarly, significantly more males (n=61) spent 2–3 h reading and writing compared to females (n=7) (P=0.001) (Figure 2A).

Similarly, the findings revealed a statistically significant association between age and time spent on educational activities during the day. For example, more (n=129) HCUs aged 20–22 years spent only 1–2 h reading and writing compared to 128 HCUs aged 23–25 years old. On the other hand, significantly more undergraduates aged 23–25 years spent 2–3 h or 3–4 h of time on educational activities compared to those aged 20–22 years (P=0.001) (Figure 2B).

The time spent on education was significantly associated with sleeping pattern; for example, undergraduates who spent >4 h in educational activities slept less (6–7 h) compared to others, (P=0.0001) (Figure 2C). Similarly, smoking status was significantly associated with time spent on educational activities; for instance, smokers (n=57) spent <1 h on educational activities compared to nonsmokers, who spent 2–4 h or even more (P=0.001).

Social media use was significantly associated with gender. Use of social media among males was significantly higher than among females (Figure 3A). Similarly, HCUs aged 23–25 years spent significantly more time on social media than those aged 20–22 years (P=0.001) (Figure 3B).


To the best of our knowledge, this is the first study to assess the time spent on educational, social, and physical activities among a small population of HCUs in the Kingdom of Saudi Arabia. Several studies on physical exercise and its implications on academic performance have been undertaken [19,20,22,24]. Although is little literature nationally and globally about time spent on education, social, and physical activities among HCUs, the majority of the material focused on physical exercise and sedentary behavior. The present study may provide an important contribution to the literature on academic and social activities among undergraduates in SA and other countries, and may serve as a reference for much-needed future research.

We found that 57% of the HCUs spent 1–2 h a day reading and writing, while only 14.8% spent 3–4 h a day. Only 0.4% of the HCUs spent >4 h a day on educational activities. These results were comparable to a previously published study by Stoffelsma in 2018 among university undergraduates, who reported that 3 h 51 min were spent outside the classroom in educational-related activities by 55.4% of the undergraduates [23]. Similarly, a 2020 study by Yeo et al among adolescents in Singapore reported they spent 2.87±1.46 h per day on educational activities during the weekdays, while 4.47±2.45 h were spent during the weekend [24]. We found that 43.8% of HCUs spent 3–4 h per day studying during the weekend and 55.3% of them spent >4 h per day studying during the weekend. Similarly, another study reported that Chinese university students spent more than 20 h per week on educational activities, while university students from the United States, Europe, and Australia spent less time on educational activities [24].

Although university students’ time is precious, achieving good grades is only possible by studying in the classroom and in their free time. Furthermore, it is common for university undergraduates to spend more than 3 h on academic work per night, and this behavior is associated with good academic outcomes as well as greater academic stress and less sleep [21–25]. In addition, the amount of time spent on education and other activities varies among studies, and it is influenced by a variety of factors such as the study method, types of respondents, and demographic characteristics such as culture, age, and gender. Furthermore, it has been demonstrated that seniors spend more time than junior undergraduates.

According to the findings of the study, 6.9% of HCUs spent 3–4 h per day on social media, while 32.7% spent no more than 2 h per day. A recent study of medical undergraduates, on the other hand, discovered that they spend a significant amount of time exploring social media [26]. Salih et al, for example, found in 2022 that university undergraduates spent more than 10 h per week on social media [26], while another survey among American university undergraduates revealed that they spent less than 10 h per week on social media [27]. Similarly, Gupta et al found that 59.09% of freshman college undergraduates spent 1–2 h per day on social media [28], whereas in 2019 Ayeni stated that 2 h per day were spent on social media [29]. According to Bhola and Mahakud, 78% of undergraduates spent 2–4 h on social media [30], demonstrating a predisposition toward addiction processes to social media due to the intrinsic activation of the brain’s reward system.

In this study, social media use was significantly associated with gender, where male gender was significantly associated with higher use of social media compared to females. These findings were similar to previous findings by Saadeh et al among medical and dental undergraduates in 2020, who reported that gender was significantly associated with social media and the time spent per day on social media use [31]. As a result, HCUs’ usage of social media does not always represent a desire to pass the time or merely browse social sites; it is more likely that undergraduates utilize it for academic goals or to seek health-related information. This could be explained by undergraduates’ beliefs that social media are a dependable source of information.

Roughly 60% of HCUs spent 30–60 min per day on coffee or desserts, even though student use of coffee or tea was observed to be high [31–34]. For example, in a recent survey, 42.8% of medical undergraduates said that their preferred caffeine source was tea, and their daily caffeine intake was fewer than 5 cups [32]. Drinking tea or coffee can provide energy and alertness; it is a habit acquired in the family since childhood, and those who are habituated may feel discomfort if they do not have their accustomed daily intake [33]. According to the literature, excessive consumption of caffeinated products can have negative effects and cause addiction [32,33]. As a result, undergraduates must be aware of its negative effects, withdrawal symptoms, and benefits.

The time spent on the family was reported to be 2–4 h by 90% of the undergraduates. These findings were comparable to previous findings reporting a mean time of 1.23±0.92 h spent on the family during a day, while it was 2.70±1.95 h during the weekend among undergraduates [24]. With regards to physical fitness activity, 62.7% of the HCUs exercised 3–4 days a week, whereas a previous study by Yeo et al among Singapore undergraduates in 2020 reported they exercised 0.86±0.86 h per day during weekdays and 0.91±0.97 h during weekend days [24].

This current study has certain limitations. We examined the time spent by HCUs on various activities after school, and these activities may help to attain higher academic performance and a healthy lifestyle by combating academic stress through various social and physical activities. The findings were based on a self-administered online questionnaire, which raised the possibility of biases such as social desirability bias or recollection bias. Therefore, we suggest an alternative data collection method that might remove or minimize this problem (for example, the use of interviews or focus groups) in future studies. Future studies should have a larger sample size and use a one-tailed test to tackle the issue of type I inflation regarding the multiple comparisons. The conclusions were based on a single Saudi university, rendering them unrepresentative of other academic institutions at both the national and international levels and thus are not internationally applicable. Lastly, the convenience sampling approach may be one of the limitations of the given sample in the study. According to current research, undergraduates need educational, social, and physical activities after school to help them overcome scholastic stress and boost their self-confidence. To provide a better level of proof, it is suggested that this study be repeated with larger representative samples from various locations in Saudi Arabia.


Our findings among HCUs show that most of them spend a significant amount of time on educational activities during the day. Undergraduates also spend time with their families and participate in other social activities. It was also discovered that spending long hours studying was related to unfavorable sleeping patterns, and smokers spent much less time on educational activities compared to nonsmokers. Furthermore, the use of social media was higher among male HCUs than females, and females spent more time than males on educational activities. Changes in undergraduates’ habits could improve health and academic outcomes that are important for college work-life balance and well-being. Future studies should examine interventions to reduce undergraduates’ workload, help them achieve better health, and lower academic stress.


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