Factors influencing the National License Examination step 1 score in preclinical medical students

E-learning modules to improve clinical reasoning and practice: a prospective comparative study

Background

Controversy remains about whether e-learning can improve clinical competences. Our study aimed to compare the effects of e-learning versus traditional education on medical students' reasoning and how they applied their knowledge to clinical competences, assess factors associated with e-learning that might influence exam scores, and evaluate medical students' satisfaction with these two learning methods.

Methods

Prospective study of 299 medical students in two fourth-year pediatric clerkship cohorts (2016-17 and 2017-18) in Switzerland.

Results

We found no evidence of a difference in students' reasoning or how they applied their knowledge to competences in clinical case resolution, whether they had followed e-learning modules or attended traditional lectures. The number of quizzes taken and being female were factors associated with better scores. Even though overall satisfaction with the two learning methods was similar, students claimed that they learned more in e-learning than in traditional lectures and that e-learning explained learning objectives better.

Conclusions

E-learning could be used as a supplement or alternative to traditional face-to-face medical teaching methods without compromising teaching quality. E-learning modules should be better integrated into medical students' curricula but avoid the risk of curriculum overload, especially in case of repeated COVID-like context.

A retrospective and correlative analysis of academic and nonacademic predictors of COMLEX level 1 performance

CONTEXT

National licensing exams (NLEs) including the Comprehensive Osteopathic Medical Licensing Examination (COMLEX) Level 1 evaluate student achievement. Scores have historically been utilized to stratify medical student applicants for residency. Grade point average (GPA), number of practice questions completed, and performance on practice exams have been shown to be predictive of NLE performance. Test anxiety and acute stress have been shown to negatively impact NLE performance. The role of study behaviors and other nonacademic factors in COMLEX Level 1 performance is unknown.

OBJECTIVES

This study aims to evaluate academic and nonacademic factors and to correlate them with COMLEX Level 1 performance. Additional analysis is conducted to associate COMLEX Level 1 performance with academic and nonacademic factors when controlling for GPA.

METHODS

An anonymous online survey was administered to third- (OMS III) and fourth-year (OMS IV) osteopathic medical students at Kansas City University that had completed the COMLEX Level 1 examination. In total, 72 students responded to the survey. Survey results were linked to student records of GPA and COMLEX Level 1 scores, resulting in 59 complete responses for analysis. Independent-sample t-tests and linear ordinary least squares regression were utilized to analyze the results.

RESULTS

The majority of participants are male (62.7%) and OMS III (98.3%) with an average age of 27.14 ± 2.58 (mean ± standard deviation). Further demographic data reveal hours per week spent for personal time during dedicated study (n=46, 19.7 ± 18.53), hours of sleep per night during dedicated study (7.34 ± 0.92), and money spent on board preparation ($1,319.12 ± $689.17). High ($1,600-$3,000), average ($1,000-$1,500), and low ($100-$900) spenders do not statistically differ and COMLEX Level 1 performance is not related to the number of resources utilized (F statistics <1; p>0.05). Pearson correlations reveal a statistically significant relationship between COMLEX Level 1 scores with GPA (0.73, p<0.001), number of practice exams completed (0.39, p<0.001), number of questions completed (0.46, p<0.001), number of weeks of study (0.55, p<0.001), and preparation cost (0.28, p<0.05). The regression analysis revealed that money spent on board preparation, number of questions completed, and time spent studying accounted for 75.8% of the variance in COMLEX Level 1 scores after controlling for GPA.

CONCLUSIONS

The data show the association of money spent on board preparation, numbers of questions competed, and time spent studying with a student's COMLEX Level 1 score. Additionally, these results highlight the amount of money students spend on extracurricular materials to prepare for COMLEX Level 1, yet the data show that the number of resources that students utilized is not related to a student's COMLEX Level 1 performance.

Developing a Framework of Relationships Among Noncognitive Factors in Doctor of Pharmacy Students' Academic Performance

Objective. To develop a framework of the effects of select noncognitive factors (grit, perceived stress, internal locus of control, and select Big Five personality traits) on pharmacy students' academic performance.Methods. A survey measuring select noncognitive factors was administered to two cohorts of first professional year (P1) pharmacy students (entering classes of 2019 and 2020, n=374) during fall orientation. Demographics, pre-pharmacy GPA, and P1 fall semester GPA were collected from student records. Structural equation modeling was conducted to assess the proposed framework.Results. Academic performance was directly influenced by students' (n=367; 98.1%) perceived stress and neuroticism and indirectly influenced by internal locus of control and neuroticism (via perceived stress as mediator). Neuroticism has a complex relationship in the models as it was directly and positively associated with academic performance, and indirectly contributed to decreased academic performance via a positive association with perceived stress. Squared multiple correlations indicated 13% and 9% of the variance in academic performance in the first final model (academic performance measured by pre-pharmacy GPA and P1 fall GPA) and second final model (academic performance measured by P1 fall GPA), respectively, were explained by the predictor variables.Conclusion. Evidence provided by structural equation modeling supports the conclusion that select noncognitive factors, namely perceived stress, neuroticism, and internal locus of control, have direct and indirect effects on the academic success of P1 students. The model variances of 9% and 13% represent 36% to 52% of the predictive value of the most accepted cognitive measures used to determine students' potential for academic success.

Systematic review of noncognitive factors influence on health professions students' academic performance

Increased importance has been placed on noncognitive skills in professional development and by accrediting bodies of health professions programs in recent years. Therefore, the purpose of this study was to conduct a comprehensive systematic review of evidence examining effects of academic resilience, grit, perceived stress, locus of control, and Big Five Personality Traits on academic performance of health professions students. A literature search of peer-reviewed, English-language articles describing select noncognitive factors was performed using seven databases. Searches were performed from the earliest index date through May 2020. The following data from included studies were extracted and summarized: research design hierarchy, hierarchy of study outcomes (modified from Kirkpatrick), association between noncognitive factors and academic outcomes, and quality assessment criteria. 149 articles met inclusion criteria. Almost 80% of studies were Level III (observational). Medical students were the most frequently studied population (n = 73 articles). The most studied academic outcome was grade point average (n = 61). Perceived stress and Big Five Personality Traits accounted for greater than 50% of studies. Most studies were rated as fair to good quality. Associations between noncognitive factors and academic outcomes were largely inconsistent, although greater perceived stress was generally associated with poorer academic performance outcomes, while higher conscientiousness, academic resilience, and grit were generally associated with better outcomes. This systematic review represents a large body of evidence concerning select noncognitive factors and their association with academic performance of health professions students. Support services addressing noncognitive factors should be deliberated and tailored for specific health professions education programs and student populations.

Longitudinal examination of perceived stress and academic performance of first-year student pharmacists

INTRODUCTION

First-year pharmacy students (P1s) may experience a number of stressors that may affect academic performance due to the transition into a professional program. Study objectives were to evaluate student demographic and pre-pharmacy factors associated with perceived stress among P1s, analyze relative change in perceived stress over the P1 year, and assess associations between perceived stress and academic performance.

METHODS

The Perceived Stress Scale (PSS-10) was administered three times to P1s: during orientation, midpoint of fall semester, and midpoint of spring semester. Data were also collected using school records, including demographics, P1 fall grade point average (GPA), P1 spring GPA, and P1 year GPA. Paired-sample t-tests, independent samples t-tests, Analysis of Variance, correlational analysis, and multiple linear regression were conducted.

RESULTS

Of 202 P1s, 201 (99.5%) completed the orientation survey administration and 110 (54.5%) completed all three administrations. PSS-10 score significantly increased across survey administrations. Differences in PSS-10 scores at orientation were noted based on gender and race/ethnicity (P < .05), with female and minority students experiencing greater levels of stress. PSS-10 score (spring administration) was significantly, inversely correlated to P1 fall GPA, spring GPA, and year GPA (P < .05). Undergraduate science GPA, PSS-10 score (orientation administration), and age were included in the final version of the regression model as significant predictors of P1 year GPA.

CONCLUSIONS

Perceived stress increased over the P1 year, and higher perceived stress was associated with lower P1 academic performance. Future studies should examine strategies to assist P1s in managing stress.