Academic Reading Format Preferences Among Syrian Medical Students: A Cross-Institutional Survey.

Introduction: Despite the global shift toward digital education, many university students continue to report a preference for printed academic materials. In Syria, where higher education has been affected by conflict and variable digital access, understanding students' reading format preferences may help inform more responsive educational planning. This study examined academic reading format preferences, self-reported reading behaviors, and language-related influences among undergraduate medical students across Syrian institutions. Methods: A cross-sectional survey of 2,201 undergraduate medical students across Syrian universities was conducted using an adapted Arabic version of the Academic Reading Format International Study (ARFIS) questionnaire, distributed in both digital and paper formats. Data were analyzed using IBM SPSS Statistics for Windows, Version 24.0. Analyses included descriptive statistics, 95% confidence intervals for key proportions, Chi-square tests with Cramér's V, multivariable logistic regression, and Welch ANOVA with Games-Howell post-hoc testing. Results: Most students (81.1%) reported a preference for printed academic materials. Students also reported better perceived focus (79.9%) and recall (72.1%) when reading in print. Despite frequent smartphone use for digital reading, 71.2% of students reported printing digital materials for study. Preference for print was stronger for longer texts (7 pages or more; 65.1%), while language-related responses showed more variable format preferences, including a moderate preference for foreign-language texts in print (41.8%). Adjusted analysis showed that sex, university type, medical specialty, and selected device-use variables were independently associated with print preference. Conclusion: Syrian medical students in this cross-sectional survey most commonly reported a preference for printed academic reading materials, particularly for longer texts and for perceived focus and recall. These findings suggest that student preferences should be considered when planning academic reading resources, while digital integration should account for local context and student access. Because the study relied on self-reported perceptions, non-probability sampling, and a cross-sectional design, the findings should not be interpreted as evidence of objective learning effectiveness. Further longitudinal and experimental research is needed to assess comprehension, academic performance, and the role of digital access barriers.