AbstractAimsThe aim of this study was to explore the relationship between the application of learning strategies and the emergence of higher-order learning behaviours among medical students in Chinese provincial undergraduate colleges, while also examining the impact of social demographic variables on the development of higher-order learning behaviours and learning strategy preferences.MethodologyWe conducted a relevant cross-sectional study using the Chinese College Student Survey (CCSS) online questionnaire to evaluate higher-order learning behaviours and learning strategies in medical undergraduate students attending provincial colleges in China. A total of 992 valid questionnaires were collected and analysed using SPSS 22.0 (SPSS Inc., Chicago, IL). We performed statistical analysis using one-samplet-tests to compare the results with the national norm score for medical subjects in undergraduate colleges. We also conducted variance analysis and regression analysis.ResultsThe study found that the average scores for higher-order learning behaviours, enquiry-based learning and receptive learning behaviour among medical undergraduate students in provincial colleges were higher than the national norm score for medical subjects, indicating a positive trend. However, the average scores for other indicators were lower than the national norm score. The utilization of learning strategies and the development of higher-order learning behaviours among students were affected by various factors such as grade and gender. The study suggests that the preference for certain learning strategies, such as enquiry-based, receptive, integrative and collaborative, can have a significant impact on the emergence of higher-order learning behaviours.ConclusionsThe study has demonstrated a positive correlation between the utilization of learning strategies and the development of higher-order learning behaviours. This relationship has been observed in medical students attending provincial undergraduate colleges, where the adoption of enquiry-based, receptive, integrative and collaborative learning strategies has been found to significantly influence the emergence of higher-order learning behaviours.KEY MESSAGESThe implementation of learning strategies among medical students in provincial undergraduate colleges in China has a significant impact on high-level learning behaviours.The impact of high-level learning behaviours is reliant on comprehensive support from four distinct learning strategies: receptive learning, inquiry-based learning, comprehensive learning and collaborative learning.One of the most impactful learning strategies is receptive learning, particularly on high-order learning behaviours. On the other hand, reflective learning does not seem to have a significant effect.Changes in grades can significantly impact higher-order learning behaviours and affect the propensity for reflective and collaborative learning strategies.Females generally exhibit a greater preference for receptive learning strategies, while males tend to exhibit a greater preference for inquiry-based learning strategies