The nursing program at USM offers the student-centered approach and more opportunities for small group work, assignments, discussions and team approach in fieldwork and clinical settings compared to the more conventional teacher-centered approaches in the ZBMU nursing program. A tendency to sociable or group learning style suggests a variety of teaching-learning methods in the USM nursing program. Group learning is common in Malaysian classrooms. The solitary learning style was more preferred by the ZBMU students and the sociable learning style by the USM nursing students. Thus, the instructors should offer more time to students when lecturing or giving assignments. The analytic learners need time to take notes, do assignments, and respond to the questions. On the other hand, the ZBMU educational system seems more conventional and encourages more rote learning, resulting in more passive and superficial learning. These factors, thus, may offer more opportunities and responsibilities for USM nursing students to be more detailed or analytic deep learners. Instructors publish the results as soon as possible after exams. There is also no dissertation course for them. They seldom have essay questions on exams. They also have a practical exam for the clinical courses. However, the ZBMU nursing students usually sit for a multiple-choice exam for each course at the middle or end of the semester. The USM nursing students usually have a comprehensive exam at the end of each semester with different kinds of questions including multiple choice, modified essay questions, short and long essays, objective structured clinical examinations, and a short dissertation in the fourth year of the program. Student-centered teaching and learning methods are more common in USM educational environments. The finding suggests USM nursing students were more detailed in their learning approaches. The findings support Yong ’s argument that Malaysian students are analytic. The USM nursing students were more analytic than ZBMU’s. In order to establish an effective teaching and learning environment, the instructors should provide a variety of learning experiences and assignments, and apply appropriate learning opportunities based on the students’ learning style preferences. The majority of nursing students preferred the perceptual style, which is consistent with other studies. The ZBMU nursing students’ preference for the perceptive learning style may indicate more reliance on the immediate experience of observing and doing, facts, and empirical evidence, with involvement in practical nursing care and educational technology such as PowerPoint as a new phenomenon in the classrooms. Using multimodal learning approaches indicates that adult learners integrate the information they receive via the senses. As sensory modalities are the common ways of acquiring information, perceptive learners gain advantages through multisensory learning and teaching materials such as PowerPoint, demonstrations, and being involved in tasks. The perceptive learning style was more preferred by the ZBMU nursing students than the USM ones. Significant differences were found in the median scores of perceptive, solitary, and analytic learning styles between the two study populations. USM nursing students highly preferred the competitive, analytic, and imaginative learning styles. However, one-fourth of ZBMU’s nursing students preferred the low imaginative learning styles. ZBMU’s nursing students highly preferred the perceptive, solitary, and imaginative learning styles. Table 3 shows the middle range (40-60) of the learning styles was preferred by most of the nursing students at both universities. However, no significant differences were found in the competitive and imaginative learning style preferences between the two groups (both P>0.05). In addition, a medium effect size (r=-0.21) for the analytic learning style indicates the differences are trustworthy. Table 2 shows significant differences in perceptive (P 0.3), which suggests a true difference between the ZBMU and the USM nursing students. Therefore, the Mann-Whitney U-test was used to compare the learning styles between them.

The Shapiro-Wilk test showed that the distribution of perceptive, solitary, analytic, competitive, and imaginative learning styles were significantly non-normal for both of the study populations ( Table 1).

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