Understanding the impact of academic difficulties among medical students: A scoping review

Abstract

Background Many medical students may encounter a range of academic and personal challenges during their course of study, but very little is known about their experiences. Our aim was to review the literature to inform future scholarship and to inform policy change. Methods A scoping review was conducted searching PubMed, MEDLINE, EMBASE, PsycInfo, British Education Index, Web of Science and ERIC for English language primary research with no date limits. This retrieved 822 papers of which eight met the requirements for inclusion in the review. Data were independently reviewed by two researchers and underwent thematic analysis by the research team. Results Three major themes emerged. Theme 1: ‘Identity preservation’ addressed students' aim to preserve their sense of self in the face of academic difficulty and their tendency to seek support. This connected the apprehension many students expressed about their educational institutions to Theme 2: ‘The dual role of the medical school’—medical schools are required to support struggling students but are predominantly seen as a punitive structure acting as the gatekeeper to a successful career in medicine. Students' apprehension and attempts to protect their identities within this complex landscape often resulted in ‘maladaptive coping strategies’ (Theme 3). Conclusion Understanding and exploring the academic challenges faced by medical students through their own experiences highlight the need for the development of more individualised remediation strategies. Educators may need to do more to bridge the gap between students and institutions. There is a need to build trust and to work with students to enhance their sense of self and remediate approaches to engagement with learning, rather than focusing efforts on success in assessments and progression.

When I say … Self

“…Some medical schools have already begun doing this by, for example, offering mindfulness meditation training, organising informal discussions between students and faculty and developing more tailored remediation mechanisms. Initial results appear encouraging 11–13 …”

“…Initial results appear encouraging. [11][12][13] Carefully attending to the 'Self' in our learners does not require teachers or institutions to revolutionise their practices. Rather, the approach we advocate mostly involves combining active teaching strategies with greater concern for students' welfare.…”

Student academic stress during the COVID-19 pandemic: a systematic literature review

“…This study explores students' academic stress with systematic literature review [20], [21]. Research on student academic stress with the latest systematic literature review that has been done is limited to coping strategies in students with a literature review [22], resilience in college students with a meta-analysis and metaregression study [23], music student workload with a systematic literature review study [24], the study of maladaptive coping of nursing students with an integrative review [25], the mental health of university students in Southeastern Asia with a systematic literature review [26], and impact of medical students' academic difficulties with scooping review [27]. This indicates that there is still a lack of studies on student academic stress with a systematic literature review.…”

First-year medical students’ perceptions of a self-regulated learning-informed intervention: an exploratory study

“…First-year students may enter medical school with significant variation in academic strengths and areas for growth [ 1 ]. Students’ success in the preclinical setting often requires acquisition and application of a considerable amount of complex clinical knowledge and even learners well-accustomed to meeting the demands of rigorous curricular standards may face new educational challenges [ 2 ].…”