Differences between high- and low-achieving pre-clinical medical students: a qualitative instrumental case study from a theory of action perspective

High- and low-achieving international medical students' perceptions of the factors influencing their academic performance at Chinese universities

China has become an attractive destination for international medical students, particularly those from developing countries in Asia and Africa. These students are known to face difficulties in adapting to Chinese medical universities and they tend to score poorly on subsequent examinations to enter the medical profession in their home or in a third country. To date, limited research concerning the factors that affect the academic performance of this group of students in China has been conducted. In particular, there have been very few comparisons between high and low achievers to identify the factors that high- and low-achieving international medical students in all years of study perceive as affecting their academic performance. A qualitative research approach was implemented at two medical universities. Semi-structured interviews were conducted with 18 high achievers and 22 low achievers in their second, third, fourth, fifth, sixth, and post-graduation years. Interviews were audio-recorded, transcribed, and coded using a thematic analysis approach.A few key overlapping factors were identified: social support, learning motivation and interest, exam preparation and strategies, time management, and coping. The high achievers manipulated these strategies successfully while the low achievers did not. The high achievers demonstrated efficient learning methods (efficient use of class time, good note-taking habits, preview and review strategies, expanded learning, self-study and group learning, deep learning, choosing an appropriate study location, and focusing on basics and concepts). They also achieved a good balance between studying and leisure. The low achievers mentioned learning challenges, health issues, English language barriers, and problems with online classes. This study allowed us to identify important factors that international medical students at Chinese institutions perceive to influence their performance. The findings contribute to the literature on the topic and provide a solid basis for practice and policy development.

Coping Strategies of Failing International Medical Students in Two Chinese Universities: A Qualitative Study

Phenomenon: China hosts a large number of international medical students from low-income countries, and some fail examinations in the early stage of the Bachelor of Medicine and Bachelor of Surgery (MBBS) program. Little is known about how failing international medical students cope to recover their academic performance. It would be beneficial to investigate the coping strategies they use to help them recover their academic performance and progress. Approach: Semi-structured interviews were conducted with 21 international medical students at two universities in China from September 2020 to January 2021. These students had passed make-up exams or re-sits and progressed academically. A thematic analysis approach was used to identify major themes in the interview data. Findings: After failing initial exams or re-sits, students were found to adopt seven coping strategies to help them pass future examinations and recover their academic performance: (i) increased help-seeking behaviors, (ii) improved learning motivation and attitudes, (iii) improved learning strategies, (iv) improved exam preparation, (v) utilization of library resources, (vi) enhanced time management, and (vii) enhanced English language skills. Of the seven strategies, seeking help from friends, peers, seniors, and teachers was the strategy reported most frequently. Insights: The results of this study provide insights into the coping strategies that international undergraduate medical students adopt to recover from poor academic performance in Chinese universities. Host institutions should recognize the resilience and agency of such students to make positive changes. Furthermore, institutional efforts should be made to develop contextualized intervention plans that stimulate students' learning motivation and encourage them to adopt self-help strategies by incorporating useful resources (e.g., help from peers, seniors, and teachers). Enrollment should integrate specific English language proficiency criteria, and interviews and entrance exams should be conducted. For some failing students, it may be necessary to provide academic remediation.

Medical students' resilience level and its associated factors: A Tunisian study

INTRODUCTION

Resilience is one's ability to adapt to internal and external stressors and cope with challenges encountered throughout life.

AIM

Our work aimed to determine resilience levels at the Medical University of Ibn El Jazzar-Sousse (Faculty of Medicine of Sousse) Tunisia and to identify the key factors influencing resilience in order to help students improve their college experience, as well as their future career and eventually their quality of life.

METHODS

It's a cross-sectional study conducted during October and November 2021 at the FMS including all undergraduate medical students using a questionnaire elaborated in French language and composed of 02 major parts Socio-demographic and general health data and The Connor-Davidson Resilience Scale (CD-RISC). Data were collected using Google Forms platform via social networks (Facebook students' groups).

RESULTS

A total of 225 participants filled the questionnaire; the mean age was 21±5 years. Among them 75.1% were females (sex ratio=0.33). The total resilience mean score was 56.36±12.43. Comparison of resilience scores according to different covariates showed that resilience was positively associated with male gender, extracurricular activities, relationships with both colleagues and teachers and physical exercise, but negatively associated with imposed course of study and perception of both study difficulties and personal academic results. No correlation was found between resilience score and age.

CONCLUSIONS

This work encourages university administrators to devote more resources to promote resilience, and it emphasizes the importance of implementing new educational and entertaining interventions to improve students' ability to deal with academic challenges.