Recognition of the factors affecting the medical students' academic success is one of the most important challenges and concerns in medical schools. Hence, this study aimed to investigate the mediating effects of metacognitive learning strategies and learning-related emotions in the relationship between academic self-efficacy with academic performance in medical students. Methods: The present study was carried out on 279 students of medicine studying at Shiraz University of Medical Sciences. The students filled out three questionnaires: academic emotions (AEQ), metacognitive learning strategies, and academic self-efficacy questionnaires. The data were analyzed using SPSS and Smart PLS3. Results: The results of structural equation modeling revealed that the students' self-efficacy has an impact on their learning-related emotions and metacognitive learning strategies, and these, in turn, affect the students' academic performance. Moreover, learning-related emotions influence the metacognitive learning strategies, which in turn mediate the effect of emotions on academic performance. Discussion: The results of this study revealed that metacognitive strategies and learning-related emotions could play a mediating role in the relationship between students' self-efficacy and academic performance.

Introduction Since the onset of the COVID-19 pandemic, many higher education and health centers have faced challenges. Educational leaders have tried to manage the new situation, but the human infrastructure was not ready for such an event. This study aims to explain the challenges and opportunities of the COVID-19 pandemic for medical education. Method This qualitative study used conventional content analysis to collect data from face-to-face and semi-structured interviews. The interviews continued until data saturation was reached. The participants were 12 students and 14 faculty members at Shiraz University of Medical Sciences. To ensure data rigor, we used member checks, peer checks and an external observer. Results Three main categories and 15 subcategories were extracted. The findings showed that four subcategories, e.g. perception on feasibility of e-learning, standardizing of e-learning, dedicated teaching, and networking and interdisciplinary collaborations, affected the development of medical e-learning. The main opportunities from the COVID-19 pandemic for medical education were classified into five subcategories: attitudes to e-learning and adaptability, preventing students’ separation from the educational environment, documentation and monitoring education, take control of own learning, and increasing perceived usefulness. The main challenges were divided into four subcategories, e.g. noncompliance with virtual classroom etiquette, inadequate interactions, time limitations, and infrastructure defects and problems. Finally, participants believed that methods of evaluation in e-learning were more suitable for diagnosis and formative evaluations. Generally, two subcategories were extracted, e.g. formative and summative. Conclusion Medical schools have necessarily moved towards e-learning to compensate for the interruption in classroom education, such that traditional classes have been replaced with e-learning. These rapid, extensive changes in teaching and learning approaches have consequences for medical schools.

Background: Procrastination is prevalent among university students and it affects different aspects of their personal and academic life. Objectives: This study aimed to determine the prevalence of academic procrastination among medical students and its relationship with their academic achievement. Methods: This is a cross-sectional correlational study of 317 medical students at Shiraz University of Medical Sciences. To collect the data, we used Solomon and Rothblum academic procrastination questionnaire (1984). The questionnaire’s validity and reliability were confirmed by experts. We used descriptive statistics and inferential statistics (Pearson correlation coefficient, Independent t-test, and one-way analysis of variance) to analyze the data by SPSS version 14. Results: The results showed that 29.25% of the students had academic procrastination (nearly always or always). Moreover, 47.9% of the students stated that academic procrastination at a moderate level had caused a lot of problems for them. There was a significant negative relationship between academic procrastination and academic achievement in medical students (P < 0.01). Male students and those living in the dormitory had higher levels of procrastination than females and those living at home (P < 0.01). Conclusions: The findings of the present study revealed that a considerable number of students had high levels of procrastination, leading to permanent problems and reduced academic achievement.

Today, role modeling is an essential component of medical education that facilitates the students' learning and affects their attitudes and behaviors. Hence, this study aimed to examine the characteristics of positive and negative role models using a mixed method approach. In the quantitative part, data were collected using a questionnaire with 24 items. The research population included medical students who were in their clinical period between May 2017 and December 2018 at Shiraz University of Medical Sciences (n = 750). A total of 282 questionnaires were completed by these students, and in the qualitative part, 26 semi-structured interviews were conducted with them. The most important components of role modeling for students included: individual characteristics, clinical skills and competence, teaching skills and professionalism, in that order. The qualitative analysis confirmed the results of the quantitative analysis. The findings showed that the characteristics of a negative role model can also be classified in four main components. The results demonstrated that 46.8% of the students identified one or more medical teachers as negative models. Students paid attention to not only the positive characteristics of their teachers, but also their negative features, stating that they had been influenced by both. Therefore, it can be concluded that clinical teachers should improve their performance as positive role models through reducing these negative effects and reinforcing positive characteristics

BACKGROUND: There is growing acknowledgment that medical education can be a stressful experience for students and may have a devastating effect on their psychological well-being. The present article, therefore, aimed at investigating students' academic resilience as a mediating variable in self-efficacy-test anxiety relation. MATERIALS AND METHODS: In this cross-sectional correlational study, a convenience sample of 243 medical students was selected and participated, three prevalidated questionnaires were applied, that is, general self-efficacy questionnaire, academic resilience questionnaire, and test anxiety questionnaire. To analyze the data, Pearson's correlation coefficient as well as structural equation modeling (SEM) were used. RESULTS: According to Pearson's coefficients, self-efficacy was found to be positively correlated with academic resilience ( r = 0.437, P ≤ 0.01) and negatively with test anxiety ( r = −0.475, P ≤ 0.01). SEM results also indicated that self-efficacy positively impacts on academic resilience (β = 0.43, P < 0.001) and negatively on test anxiety (β = −0.37, P < 0.001). In addition, results demonstrated the mediating role of academic resilience in self-efficacy-test anxiety relationship (β = −0.108, P < 0.001). CONCLUSION: This study showed that academic resilience could play a mediating role in students' self-efficacy-test anxiety relationship.