An earlier study at Nottingham suggested that 10-15% of the medical student intake was likely to fail completely or have substantial problems on the course. This is a problem for the students, the Faculty, and society as a whole. If struggling students could be identified early in the course and additional pastoral resources offered, some of this wastage might be avoided. An exploratory case study was conducted to determine whether there were common indicators in the early years, over and above academic failure, that might aid the identification of students potentially at risk.
The study group was drawn from five successive cohorts. Students who had experienced difficulties were identified in any of four ways: from Minutes of the Academic Progress Committee; by scanning examination lists at key stages (end of the first two years, and finals at the end of the clinical course); from lists of students flagged to the Postgraduate Deanery as in need of extra monitoring or support; and from progress files of those who had left the course prematurely. Relevant data were extracted from each student's course progress file into a customised database.
1188 students were admitted over the five years. 162 (14%) were identified for the study, 75 of whom had failed to complete the course by October 2010. In the 87 who did graduate, a combination of markers in Years 1 and 2 identified over half of those who would subsequently have the most severe problems throughout the course. This 'toolkit' comprised failure of 3 or more examinations per year, an overall average of <50%, health or social difficulties, failure to complete Hepatitis B vaccination on time, and remarks noted about poor attitude or behaviour.
A simple toolkit of academic and non-academic markers could be used routinely to help identify potential strugglers at an early stage, enabling additional support and guidance to be given to these students.
10-15% of students struggle at some point in their medicine course. Risk factors include weaker academic qualifications, male gender, mental illness, UK ethnic minority status, and poor study skills. Recent research on an undergraduate medicine course provided a toolkit to aid early identification of students likely to struggle, who can be targeted by established support and study interventions. The present study sought to extend this work by investigating the number and characteristics of strugglers on a graduate-entry medicine (GEM) programme.
A retrospective study of four GEM entry cohorts (2003–6) was carried out. All students who had demonstrated unsatisfactory progress or left prematurely were included. Any information about academic, administrative, personal, or social difficulties, were extracted from their course progress files into a customised database and examined.
362 students were admitted to the course, and 53 (14.6%) were identified for the study, of whom 15 (4.1%) did not complete the course. Students in the study group differed from the others in having a higher proportion of 2ii first degrees, and scoring less well on GAMSAT, an aptitude test used for admission. Within the study group, it proved possible to categorise students into the same groups previously reported (struggler throughout, pre-clinical struggler, clinical struggler, health-related struggler, borderline struggler) and to identify the majority using a number of flags for early difficulties. These flags included: missed attendance, unsatisfactory attitude or behaviour, health problems, social/family problems, failure to complete immunity status checks, and attendance at academic progress committee.
Problems encountered in a graduate-entry medicine course were comparable to those reported in a corresponding undergraduate programme. A toolkit of academic and non-academic flags of difficulty can be used for early identification of many who will struggle, and could be used to target appropriate support and interventions.
Graduate-entry medicine struggler identification flags UK
Students who entered their freshman year for the first time in 1958 and in 1959, from all medical schools in Canada, and those entering the four Western schools in 1960 were studied from the time they matriculated until they either graduated or withdrew from medical school. The rate of attrition is about 15% of matriculants each year, with the lowest rate at the University of Western Ontario (1.7%) and the highest at the University of Ottawa (33.6%) over the time period studied. Attrition was classified as academic and non-academic. Significantly higher rates were found in the case of non-academic attrition for women and in the case of academic attrition for Commonwealth students. Significantly higher rates for both types of attrition were found for older students and students who had attended undergraduate colleges different from their medical school colleges. It would appear from available statistics that the factors which combine to produce attrition are the intellectual and personality characteristics of the student, school promotional policies and evaluation methods.
Students who fail to thrive on the Nottingham undergraduate medical course frequently suffer from anxiety, depression or other mental health problems. These difficulties may be the cause, or the result of, academic struggling. Early detection of vulnerable students might direct pastoral care and remedial support to where it is needed. We investigated the use of the short-form General Health Questionnaire (GHQ-12) as a possible screening tool.
Two consecutive cohorts (2006 and 2007) were invited to complete the GHQ-12. The questionnaire was administered online, during the second semester (after semester 1 exams) for the 2006 cohort and during the first semester for the 2007 cohort. All data were held securely and confidentially. At the end of the course, GHQ scores were examined in relation to course progress.
251 students entered the course in 2006 and 254 in 2007; 164 (65%) and 160 (63%), respectively, completed the GHQ-12. In both cohorts, the study and non-study groups were very similar in terms of pre-admission socio-demographic characteristics and overall course marks. In the 2006 study group, the GHQ Likert score obtained part-way through the first year was negatively correlated with exam marks during Years 1 and 2, but the average exam mark in semester 1 was the sole independent predictor of marks in semester 2 and Year 2. No correlations were found for the 2007 study group but the GHQ score was a weak positive predictor of marks in semester 2, with semester 1 average exam mark again being the strongest predictor. A post-hoc moderated-mediation analysis suggested that significant negative associations of GHQ scores with semester 1 and 2 exams applied only to those who completed the GHQ after their semester 1 exams. Students who were identified as GHQ ‘cases’ in the 2006 group were statistically less likely to complete the course on time (OR = 4.74, p 0.002). There was a non-significant trend in the same direction in the 2007 group.
Results from two cohorts provide insufficient evidence to recommend the routine use of the GHQ-12 as a screening tool. The timing of administration could have a critical influence on the results, and the theoretical and practical implications of this finding are discussed. Low marks in semester 1 examinations seem be the best single indicator of students at risk for subsequent poor performance.
To assess whether extended medical school duration, block/modular structure of subjects, not allowing students to transfer exams into the higher course year, and curriculum implementation in line with the Bologna Accord are associated with lower attrition and better academic outcomes of medical students.
We retrospectively investigated curricula at the University of Split School of Medicine and academic outcomes of 2301 medical students during a 33-year period (1979-2011). The following data were obtained: grade point average (GPA) at the end of the studies, duration of studies, graduation on time, and whether the student graduated or not.
After extension of medical curriculum from 5 to 6 years, students had significantly better grades (3.35 vs 3.68; P < 0.001), shorter study duration (7.0 vs 6.0 years; P < 0.001), and more students graduated on time (6.5% vs 57%; P < 0.001). Changes in the 6-year curriculum, such as stricter study regulations and adoption of Bologna Accord, were associated with better indicators of students’ academic success. The lowest attrition and the highest grades during the studied period were observed after the implementation of the Bologna Accord in 2005.
Introduction of a longer medical curriculum, block/modular subject structure, stricter regulations of exam transfer, and curriculum in line with the Bologna Accord may contribute to better academic outcomes and lower attrition of medical students.
Objective To identify potential predictors of undergraduate students who struggle during their medical training.
Design Case-control study. Cases were students who had experienced academic or personal difficulties that affected their progression on the course (“strugglers”). Controls were selected at random from the corresponding year cohorts, using a ratio of four controls for each struggler.
Setting University of Nottingham Medical School.
Participants Students who entered the course over five consecutive years.
Main outcome measures Likelihood ratios for independent risk factors for struggling on the course
Results 10-15% of each year's student intake were identified as strugglers. Significant independent predictors of students being in this category were negative comments in the academic reference (likelihood ratio 2.25, 95% confidence intervals 1.44 to 3.50), lower mean examination grade at A level (2.19, 1.37 to 3.51), and the late offer of a place (1.98, 1.19 to 3.30). Male sex was a less significant risk factor (1.70, 1.09 to 2.65) as was a lower grade at GCSE science (2.13, 1.12 to 4.05). In UK students whose ethnicity was known, not being white was a significant predictor of struggling (2.77, 1.52 to 5.05) but the presence of negative comments was not. Age at entry to the course and the possession of a previous degree were not predictive.
Conclusions Our results support retention of existing selection practices relating to academic achievement and critical review of students' references. We plan to undertake further investigation of the reasons why some students, including men, those with late offers and those from ethnic minority backgrounds, may do less well on the Nottingham course.
Student attrition represents a waste of career opportunity and, at times, results in a holistic loss of sense of self-worth for the students involved. The aim of this study was to evaluate the nature, causes, and impact of medical student attrition in Nigeria.
A pilot analysis was undertaken using the records of students who failed at medical school as a result of inability to pass the second MBBS examination at Ebonyi State University, Abakaliki, Nigeria, between 2002 and 2007. Some of these students were interviewed using a structured questionnaire.
Data analysis showed that 58 (7.8%) of the students admitted into preclinical class withdrew from their study. Thirty-six (62.1%) were males and the rest were females. Thirteen of those withdrawn were interviewed, and 53.8% of them believed they had poor academic ability, while 15.4% attributed their withdrawal to family pressure. No record of guidance or counseling session programs was noted for these students either at the point of withdrawal from the faculty and on the choice of a new career path.
As a result of the high attrition rate due to low academic ability, efforts should be made to check students for evidence of this at the point of admission to medicine training. Also, more accommodating teaching programs should be encouraged in faculties to accommodate students with such challenges. Good guidance and counseling programs should be encouraged to handle these inevitable cases of attrition when they occur, to avoid the demoralizing low self-esteem that plagues these individuals for the rest of their lives.
medical students; attrition; medical education; Nigeria
Student attrition at colleges across the United States poses a significant problem for students and families, higher educational institutions, and the nation's workforce competing in the global economy. Heavy drinking is a highly plausible contributor to the problem. However, there is little evidence that it is a reliable predictor of attrition. Notably, few studies take into account indicators of collegiate engagement that are associated with both heavy drinking and persistence in college. Event-history analysis was used to estimate the effect of heavy drinking on attrition among 3,290 undergraduates at a large midwestern university during a 4-year period, and student attendance at a number of college events was included as covariates. Results showed that heavy drinking did not predict attrition bivariately or after controlling for precollege predictors of academic success. However, after controlling for event attendance (an important indicator of collegiate engagement), heavy drinking was found to predict attrition. These findings underscore the importance of the college context in showing that heavy drinking does in fact predict attrition and in considering future intervention efforts to decrease attrition and also heavy drinking.
college attrition; heavy drinking; suppression; event-history
Graduate entry medicine is a recent innovation in UK medical training. Evidence is sparse at present as to progress and attainment on these programmes. Shared clinical rotations, between an established 5-year and a new graduate entry course, provide the opportunity to compare achievement on clinical assessments. To compare completion and attainment on clinical phase assessments between students on a 4-year graduate entry course and an established 5-year undergraduate medicine course.
Overall completion rates for the 4 and 5 year courses, fails at first attempt, and scores on 14 clinical assessments, were compared between 171 graduate-entry and 450 undergraduate medical students at the University of Nottingham, comprising two graduating cohorts. Percentage assessment marks were converted to z-scores separately for each graduating year and the normalised marks then combined into a single dataset. Z-score transformed percentage marks were analysed by multivariate analysis of variance and univariate analyses of variance for each summative assessment. Numbers of fails at first attempt were analysed aggregated across all assessments initially, then separately for each assessment using χ2.
Completion rates were around 90% overall and significantly higher in the graduate entry course. Failures of assessments overall were similar, but a higher proportion of graduate entry students failed the final OSLER. Mean performance on clinical assessments showed a significant overall difference, made up of lower performance on 4 of 5 knowledge-based exams (as well as higher performance on the first exam) by the graduate entry group, but similar levels of performance on all the skills-based and attitudinal assessments.
High completion rates are encouraging. The lower performance in some knowledge-based exams may reflect lower prior educational attainment, a substantially different demographic profile (age, gender), or an artefact of the first 2 years of a new graduate entry programme.
Students of Ayurveda and qualified Ayurveda practitioners were assessed for awareness about bibliographic databases. One hundred and four volunteers (age range 17–64 years; group mean±SD, 24.3 ± 7.9 years; 62 females) participated in this cross-sectional study. There were 3 groups. Group I had 60 undergraduate students of a bachelor's level course in Ayurveda, Group II had 20 graduate students of a 1-year Panchakarma course, and Group III had 24 Ayurveda physicians who were working in a yoga and Ayurveda center. An 8-question questionnaire was used for assessment. Undergraduates were found to be the best informed, followed by those who were working, while those doing post-graduation were the least well informed. The sample was from one institution; however, the findings emphasize the importance of updating the knowledge of post-graduates or those in practice.
Ayurveda; bibliographic databases; complementary and alternative medicine
In a study of 60 students who entered the intercalated honours BSc course in pathology at the University of Edinburgh over 10 years the conventional criteria of academic excellence and motivation were shown to be appropriate for the selection of honours students. When compared with classmates who did not take the intercalated year but who had shown similar high academic ability in the preclinical course the students who had taken the honours BSc did better in the remainder of the undergraduate curriculum. Of 42 honours students, 18 (43%) entered academic careers, particularly in pathology and medicine, but there was no observed tendency for students without honours BSc to do so. Although it is impossible to establish a causal relation between taking the honours course and subsequent academic distinction, the results suggest that the intercalated honours BSc in pathology serves a useful function in introducing able students into academic careers. The findings justify the financial support made available to such students during their intercalated year by the Medical Research Council and the Scottish Education Department.
At Nottingham University more than 95% of entrants to the traditional 5-year medical course are school leavers. Since 2003 we have admitted graduate entrants (GEM) to a shortened (4-year) course to 'widen access to students from more disadvantaged backgrounds'. We have recently shown that the GEM course widens academic and socio-demographic diversity of the medical student population. This study explored whether GEM students also bring psychological diversity and whether this could be beneficial.
We studied: a) 217 and 96 applicants to the Nottingham 5- and 4-year courses respectively, applying in the 2002-3 UCAS cycle, and, b) 246 school leavers starting the 5-year course and 39 graduate entrants to the 4-year course in October 2003. The psychological profiles of the two groups of applicants and two groups of entrants were compared using their performance in the Goldberg 'Big 5' Personality test, the Personal Qualities Assessment (PQA; measuring interpersonal traits and interpersonal values), and the Lovibond and Lovibond measure of depression, anxiety and stress. For the comparison of the Entrants we excluded the 33 school leavers and seven graduates who took the tests as Applicants.
Statistical analyses were undertaken using SPSS software (version 16.0).
Graduate applicants compared to school leaver applicants were significantly more conscientious, more confident, more self controlled, more communitarian in moral orientation and less anxious. Only one of these differences was preserved in the entrants with graduates being less anxious. However, the graduate entrants were significantly less empathetic and conscientious than the school leavers.
This study has shown that school leaver and graduate entrants to medical school differ in some psychological characteristics. However, if confirmed in other studies and if they were manifest in the extreme, not all the traits brought by graduates would be desirable for someone aiming for a medical career.
Organic chemistry has been shown to correlate with academic success in the preclinical years of medicine, dentistry, and graduate physiology. The purpose of this study is to examine the relationship between undergraduate organic chemistry grades and first-semester biochemistry grades at a Midwest chiropractic doctoral program.
Students enrolled in a first-semester biochemistry course who had completed the prerequisite courses in organic chemistry offered at this same institution were entered into the study. The total grade for each of the three courses was calculated using the midterm and final exam raw scores with a weighting of 50% each. Analysis consisted of obtaining correlation coefficients between the total grades of organic 1 with biochemistry and organic 2 with biochemistry. Using the biochemistry total grade, the students were divided into quartiles and course grades for both organic chemistry 1 and 2 were calculated.
For the 109 students in the study, the correlation coefficient between the biochemistry and organic chemistry 1 and biochemistry and organic chemistry 2 courses was r = 0.744 and r = 0.725, respectively. The difference in organic chemistry grades between those in the first and fourth quartiles was 63.2% and 86.9% for organic chemistry 1 (p < .001) and 60.9% and 79.4% for organic chemistry 2 (p < .001).
This study shows that organic chemistry can be used as an indicator of future academic success in a chiropractic biochemistry course. Knowledge of such a relationship could prove useful to identify students who may potentially run into academic difficulty with first-year biochemistry
Achievement; Biochemistry; Chemistry, Organic; Chiropractic
To explore the trend and composition of post-graduate Iranian students who received governmental scholarship during the last two decades.
Detailed information about the awarded scholarships and also about the number of post graduate students in clinical and basic sciences in domestic universities were collected from the related offices within the ministry of health and medical education and their trends were triangulated.
A sharp drop was observed in the number of awarded scholarships, from 263 in 1992 to 46 in 2009. In the beginning, almost all of scholarships fully supported students for a whole academic course; while in recent years most of scholarships supported students for a short fellowship or complementary course (more than 80%). Students studied in a wide range of colleges within 30 countries; more than 50% in Europe. Although one third of students studied in UK in the first years, only 4% of students selected this country in recent years. conversely, the number of scholarships to Germany and sweden have increased more than 10 and 3 times during this period. In parallel, the capacity of domestic universities for training of post-graduate students has been expanded dramatically.
Although expanding post-graduate education has been one of the main strategic objectives of the ministry of health and medical education in last two decades, it was obtained using different approaches. By time, more attention was to expanding the capacities of Iranian universities, and choosing less but more targeted students to continue their studies abroad.
Scholarship; Abroad; Post- graduate; Iran
Undergraduate public health and global health studies are usually found at universities with graduate programs in the disciplines. Following the experience of teaching a short course in global health within the liberal arts, we reviewed global and public health offerings at 50 liberal arts colleges for the 2009–2010 academic year. Forty-two percent had a track, concentration, or program, and 30% had global or public health student organizations. All colleges listed at least one course in the fields, with the highest number in the social sciences. However, many colleges had not coordinated them into a theme. Values of a liberal arts education are found in the study of global and public health: social responsibility, critical thinking, ethical reasoning, and knowledge of the wider world. We propose identifying these programs within the undergraduate liberal arts as global public health. Capturing interest in global public health will enhance the curriculum and student experience.In this day and age, when the world is so fluid with regard to news and information, the knowledge that unnecessary deaths are occurring and that health care lags so far behind in some regions cannot be ignored. From the standpoint of basic human rights, suffering and inequity cannot be tolerated.Williams College student during a global health short course
To determine attrition and predictors of academic success among medical students at University of Split, Croatia.
We analysed academic records of 2054 students enrolled during 1979–2008 period.
We found that 26% (533/2054) of enrolled students did not graduate. The most common reasons for attrition were ‘personal’ (36.4%), transfer to another medical school (35.6%), and dismissal due to unsatisfactory academic record (21.2%). Grade point average (GPA) and study duration of attrition students were significantly associated with parental education. There were 1126 graduates, 395 men and 731 women. Their average graduation GPA was 3.67±0.53 and study duration 7.6±2.44 years. During 5-year curriculum only 6.4% (42/654) of students graduated in time, and 55% (240/472) of students graduated in time after curriculum was extended to 6 years. Variables predicting whether a student will graduate or not were high school grades, entrance exam score and year of enrollment. Significant predictors of graduation grades were high school grades and entrance exam score. Entrance exam score predicted length of studying.
Preadmission academic qualifications and year of enrollment predict academic success in medical school. More attention should be devoted to high attrition.
We examined the relation between demographic characteristics and the career choices of medical students who entered McMaster University medical school between 1969 and 1975. In contrast to earlier work, this study found no significant differences in sex, age, marital status at the time of entry into medical school, undergraduate major, whether prerequisite premedical courses had been taken, undergraduate grade point average and academic performance between the graduates who chose primary care and those who chose a specialty. This suggests that many medical school graduates in the 1970s entered primary care by choice rather than by default.
The Meyerhoff Scholarship Program (MSP) is widely recognized for its comprehensive approach of integrating students into the science community. The supports provided by the program aim to develop students, primarily Blacks, into scientists by offering them academic, social, and professional opportunities to achieve their academic and career goals. The current study allowed for a rich understanding of the perceptions of current Meyerhoff students and Meyerhoff alumni about how the program works. Three groups of MSP students were included in the study: 1) new Meyerhoff students participating in Summer Bridge (n=45), 2) currently enrolled Meyerhoff students (n=92), and 3) graduates of the MSP who were currently enrolled in STEM graduate studies or had completed an advanced STEM degree (n=19). Students described the importance of several key aspects of the Meyerhoff Scholars Program: financial support, the Summer Bridge Program, formation of Meyerhoff identity, belonging to the Meyerhoff family, and developing networks - all of which serve to integrate students both academically and socially.
Higher education; STEM; underrepresented minority; academic success; qualitative research
The North Carolina State University Biotechnology Program offers laboratory-intensive courses to both undergraduate and graduate students. In “Manipulation and Expression of Recombinant DNA,” students are separated into undergraduate and graduate sections for the laboratory, but not the lecture, component. Evidence has shown that students prefer pairing with someone of the same academic level. However, retention of main ideas in peer learning environments has been shown to be greater when partners have dissimilar abilities. Therefore, we tested the hypothesis that there will be enhanced student learning when lab partners are of different academic levels. We found that learning outcomes were met by both levels of student, regardless of pairing. Average undergraduate grades on every assessment method increased when undergraduates were paired with graduate students. Many of the average graduate student grades also increased modestly when graduate students were paired with undergraduates. Attitudes toward working with partners dramatically shifted toward favoring working with students of different academic levels. This work suggests that offering dual-level courses in which different-level partnerships are created does not inhibit learning by students of different academic levels. This format is useful for institutions that wish to offer “boutique” courses in which student enrollment may be low, but specialized equipment and faculty expertise are needed.
It has been suggested that studying non-science subjects at A-level should be compulsory for medical students. Our admissions criteria specify only Biology, Chemistry and one or more additional subjects. This study aimed to determine whether studying a non-science subject for A-level is an independent predictor of achievement on the undergraduate medical course.
The subjects of this retrospective cohort study were 164 students from one entry-year group (October 2000), who progressed normally on the 5-year undergraduate medical course at Nottingham. Pre-admission academic and socio-demographic data and undergraduate course marks were obtained. T-test and hierarchical multiple linear regression analyses were undertaken to identify independent predictors of five course outcomes at different stages throughout the course.
There was no evidence that the choice of science or non-science as the third or fourth A-level subject had any influence on course performance. Demographic variables (age group, sex, and fee status) had some predictive value but ethnicity did not. Pre-clinical course performance was the strongest predictor in the clinical phases (pre-clinical Themes A&B (knowledge) predicted Clinical Knowledge, p < 0.001, and pre-clinical Themes C&D (skills) predicted Clinical Skills, p = < 0.01).
This study of one year group at Nottingham Medical School provided no evidence that the admissions policy on A-level requirements should specify the choice of third or fourth subject.
Despite many retention studies, little is known about the performance of students in academic difficulty (SDs) who recover and graduate. In this study (1973-1982), the authors tracked 213 women, minorities, and older students in academic difficulty, those with three or more failures. Improvement measures were retention, National Board scores, and class rank at graduation.
Minority students had significantly more difficulty, lower retention, and impaired recovery. Older students had considerable difficulty, but those who survived did well. Sixty-eight percent of majority women, 54 percent of all majorities, and 14 percent of minority women SDs recovered completely, graduating with a class rank of average or above. Minority men made significantly better recovery than minority women. Minority women's complete recovery rate rose from 6 to 23 percent. Incidence of difficulty for minorities decreased, though not significantly.
Results suggest that many minority students, especially women, experience academic difficulty and have trouble recovering, but that the situation is ameliorating over time.
Emotional intelligence (EI) is increasingly discussed as having a potential role in medicine, nursing, and other healthcare disciplines, both for personal mental health and professional practice. Stress has been identified as being high for students in healthcare courses. This study investigated whether EI and stress differed among students in four health professions (dental, nursing, graduate mental health workers, medical) and whether there was evidence that EI might serve as a buffer for stress.
The Schutte Emotional Intelligence and the Perceived Stress scale instruments were administered to four groups of healthcare students in their first year of study in both the autumn and summer terms of the 2005-6 academic year. The groups were undergraduate dental, nursing and medical students, and postgraduate mental health workers.
No significant differences were found between males and females nor among professional groups for the EI measure. Dental students reported significantly higher stress than medical students. EI was found to be only moderately stable in test-retest scores. Some evidence was found for EI as a possible factor in mediating stress. Students in different health profession courses did not show significant differences in Emotional Intelligence.
While stress and EI showed a moderate relationship, results of this study do not allow the direction of relationship to be determined. The limitations and further research questions raised in this study are discussed along with the need for refinement of the EI construct and measures, particularly if Emotional Intelligence were to be considered as a possible selection criterion, as has been suggested by some authors.
Medical school attrition is important - securing a place in medical school is difficult and a high attrition rate can affect the academic reputation of a medical school and staff morale. More important, however, are the personal consequences of dropout for the student. The aims of our study were to examine factors associated with attrition over a ten-year period (2001–2011) and to study the personal effects of dropout on individual students.
The study included quantitative analysis of completed cohorts and qualitative analysis of ten-year data. Data were collected from individual student files, examination and admission records, exit interviews and staff interviews. Statistical analysis was carried out on five successive completed cohorts. Qualitative data from student files was transcribed and independently analysed by three authors. Data was coded and categorized and key themes were identified.
Overall attrition rate was 5.7% (45/779) in 6 completed cohorts when students who transferred to other medical courses were excluded. Students from Kuwait and United Arab Emirates had the highest dropout rate (RR = 5.70, 95% Confidence Intervals 2.65 to 12.27;p < 0.0001) compared to Irish and EU students combined. North American students had a higher dropout rate than Irish and EU students; RR = 2.68 (1.09 to 6.58;p = 0.027) but this was not significant when transfers were excluded (RR = 1.32(0.38, 4.62);p = 0.75). Male students were more likely to dropout than females (RR 1.70, .93 to 3.11) but this was not significant (p = 0.079).
Absenteeism was documented in 30% of students, academic difficulty in 55.7%, social isolation in 20%, and psychological morbidity in 40% (higher than other studies). Qualitative analysis revealed recurrent themes of isolation, failure, and despair. Student Welfare services were only accessed by one-third of dropout students.
While dropout is often multifactorial, certain red flag signals may alert us to risk of dropout including non-EU origin, academic struggling, absenteeism, social isolation, depression and leave of absence. Psychological morbidity amongst dropout students is high and Student Welfare services should be actively promoted. Absenteeism should prompt early intervention. Behind every dropout statistic lies a personal story. All medical schools have a duty of care to support students who leave the medical programme.
Medical school attrition; Dropout; Exit interviews; Student welfare services; Academic difficulty; Absenteeism
Functional analysis methodology is a powerful assessment tool for identifying contingencies that maintain a wide range of behavior disorders and for developing effective treatment programs. Nevertheless, concerns have been raised about the feasibility of conducting functional analyses in typical service settings. In this study, we examined the issue of skill acquisition in implementing functional analyses by evaluating an instructional program designed to establish a basic set of competencies. Eleven undergraduate students enrolled in a laboratory course in applied behavior analysis served as participants. Their performance was assessed during scripted simulations in which they played the roles of "therapists" who conducted functional analyses and trained graduate students played the roles of "clients" who emitted self-injurious and destructive behaviors. To approximate conditions under which an individual might conduct an assessment with limited prior training, participants read a brief set of materials prior to conducting baseline sessions. A multiple baseline design was used to assess the effects of training, which consisted of reading additional materials, watching a videotaped simulation demonstrating correct procedural implementation, passing a written quiz, and receiving feedback on performance during sessions. Results showed that participants scored a relatively high percentage of correct therapist responses during baseline, and that all achieved an accuracy level of 95% or higher following training that lasted about 2 hr. These results suggest that basic skills for conducting functional analyses can be acquired quickly by individuals who have relatively little clinical experience.
The objective of this study was to examine possible associations between students' self-reported behaviors and opinions towards academic dishonesty, and their attitudes towards curriculum, assessment, and teaching within the pharmacy program.
A questionnaire was developed and distributed to undergraduate (pre-licensure) students at 4 schools of pharmacy in Canada, including students enrolled in the international pharmacy graduate program.
More than 80% of respondents indicated they had participated in one or more of the act of academic dishonesty described in the questionnaire. A weak to moderate correlation was found between students' attitudes towards pharmacy education and their self-reported behaviors related to academic dishonesty.
This study confirmed previous findings suggesting widespread academic dishonesty as well as a hierarchy of values with respect to students' perceptions regarding severity and importance of academic dishonesty. Despite methodological limitations inherent in examining academic dishonesty, there is a definite need to continue to examine this important issue. While this study indicated only a moderate correlation between attitudes towards curriculum and dishonest behaviors, the problem of academic misconduct is multifactorial and will require ongoing study.
academic dishonesty; plagiarism; pharmacy education; attitudes; curriculum