ObjectivesTo assess learning approaches of 1st, 2nd, and 3rd-year medical students by using revised two-factor study process questionnaire, and to assess reliability and validity of the questionnaire.MethodsThis cross-sectional study was conducted at the College of Medicine, Riyadh, Saudi Arabia in 2014. The revised two-factor study process questionnaire (R-SPQ-2F) was completed by 610 medical students of both genders, from foundation (first year), central nervous system (second year), medicine and surgery (third year) courses. The study process was evaluated by computing mean scores of two research study approaches (deep & surface) using student’s t-test and one-way analysis of variance. The internal consistency and construct validity of the questionnaire were assessed using Cronbach’s α and factor analysis.ResultsThe mean score of deep approach was significantly higher than the surface approach among participants(t(770)=7.83, p= 0.000) for the four courses. The mean scores of deep approach were significantly higher among participants with higher grade point average (F(2,768)=13.31, p=0.001) along with more number of study hours by participants (F(2,768)=20.08, p=0.001). The Cronbach’s α-values of items at 0.70 indicate the good internal consistency of questionnaire used. Factor analysis confirms two factors (deep and surface approaches) of R-SPQ-2F.ConclusionsThe deep approach to learning was the primary approach among 1st, 2nd and 3rd-year King Saud University medical students. This study confirms reliability and validity of the revised two-factor study process questionnaire. Medical educators could use the results of such studies to make required changes in the curriculum.