Identifying medical students at risk of underperformance from significant stressors

• Published in: BMC medical education 2016-02, Vol.16 (43), p.43-43, Article 43
• Main Authors: Wilkinson, Tim J, McKenzie, Jan M, Ali, Anthony N, Rudland, Joy, Carter, Frances A, Bell, Caroline J
• Format: Article
• Language: English
• Subjects: Academic Achievement; Alcohol Drinking - epidemiology; Allied Health Occupations Education; At Risk Students; College Students; Communities of Practice; Construct Validity; Coping; Depression (Psychology); Disasters; Earthquakes; Education, Medical, Undergraduate - methods; Education, Medical, Undergraduate - organization & administration; Education, Medical, Undergraduate - standards; Educational Environment; Educational Measurement - methods; Educational Measurement - statistics & numerical data; Health education; Humans; Learning Motivation; Marital Status; Medical Students; Multivariate Analysis; New Zealand - epidemiology; Outcome Measures; Posttraumatic Stress Disorder; Practice; Protective Factors; Psychiatry; Psychophysiology; Public Health; Quality of Life; Residence Characteristics; Resilience (Psychology); Resilience, Psychological; Resistance (Psychology); Risk Factors; Seismology; Social Adjustment; Social Support; Stress (Psychology); Stress Disorders, Post-Traumatic - diagnosis; Stress Disorders, Post-Traumatic - epidemiology; Stress Disorders, Post-Traumatic - etiology; Stress Disorders, Post-Traumatic - psychology; Students, Medical - psychology; Surveys and Questionnaires; Validity; Vietnamese People
• ISSN: 1472-6920; 1472-6920
• DOI: 10.1186/s12909-016-0565-9

Stress is associated with poorer academic performance but identifying vulnerable students is less clear. A series of earthquakes and disrupted learning environments created an opportunity to explore the relationships among stress, student factors, support and academic performance within a medical course. The outcomes were deviations from expected performances on end of year written and clinical examinations. The predictors were questionnaire-based measures of connectedness/support, impact of the earthquakes, safety, depression, anxiety, stress, resilience and personality. The response rate was 77%. Poorer than expected performance on all examinations was associated with greater disruptions to living arrangements and fewer years in the country; on the written examination with not having a place to study; and on the clinical examination with relationship status, not having the support of others, less extroversion, and feeling less safe. There was a suggestion of a beneficial association with some markers of stress. We show that academic performance is assisted by students having a secure physical and emotional base. The students who are most vulnerable are those with fewer social networks, and those who are recent immigrants.