Determinants of Large Lecture Hall Seating Preferences and Academic Performance in an All-Female Medical College: Development of the Socio-spatial Synergy Zone Concept through a Mixed-Methods Study

Abstract

Background: Seating choice in large lecture halls reflects a complex interplay of environmental, psychosocial, and behavioral factors and has been linked to student engagement and academic performance. However, evidence from all-female medical institutions remains limited. The objective of this study was to investigate the determinants of seating preferences among female medical students and to explore their association with academic performance in an all-female public-sector medical college in Central Punjab. 
Participants and Methods: This convergent parallel mixed-methods study was conducted at Fatima Jinnah Medical College, Lahore, from July 2023 to June 2024. All consenting students from first to final year with ≥75% attendance were included. A validated Classroom Seating Preference and Participation Questionnaire comprising Likert scale items for quantitative and open-ended questions for qualitative component was used as data collection tool. Purposive quota sampling was used. Questionnaire was administered at the end of scheduled lectures. Seating preferences were categorized into front, middle, and back zones. Academic performance was assessed using self-reported examination scores. Quantitative data was analyzed using descriptive and inferential statistics. Following preliminary analysis of open-ended responses, three focus group discussions were held. Qualitative data underwent thematic analysis. Findings were integrated through methodological triangulation.
Results: Of 1,200 eligible participants, 948 (79%) completed the study. Seating preferences differed significantly across academic years (p<0.001). First-year students preferred front zone, whereas middle zone dominated from second to final year. Five factors independently determined seat selection (p<0.001): visibility, peer proximity, psychosocial consideration, environmental comfort, and habitual seating behavior. Psychosocial and environmental factors became increasingly important determinants with academic progression. Academic performance showed a zonal transition; front-zone students achieving the highest scores in first year (78 ± 6%) while middle-zone students performed better in subsequent years (74–77%; p<0.005). Qualitative findings supported shift from dependence on teacher proximity toward peer affiliation, psychosocial comfort, and strategic autonomy. 
Conclusion: Seating preferences evolve with academic progression and are determined by visibility, psychosocial comfort, peer affiliation, environmental factors, and habitual seating behavior. Middle zone of large lecture halls in all-female medical learning environment serves as socio-spatial synergy zone and was associated with better academic performance in senior academic years.