JMIR Publications

ABSTRACT

Background:

The fruition of an undergraduate medical student into an adept physician is perpetual, demanding and stressful. Several studies have indicated that medical students have a higher predominance of mental-health problems than other student groups of the same age, where medical education acts as a “stressor” and may lead to unfavorable consequences such as depression, burnout, somatic complaints, decrease in empathy, dismal thoughts about quitting medical school, self-harm and suicidal ideation, and poor academic performance. Therefore, it is imperative to determine the association between the important psycho-educational variables and academic performance in the contexts of medical education, to comprehend the response to academic stress.

Objective:

The aim of the present proof-of-concept study is to determine the relationship between Resilience, Learning Approaches, and Stress-coping Strategies, and how they can collectively predict achievement in undergraduate medical students, founded on the Competence of Learning, Studying, and Performing under Stress (CLSPS) model. Specifically, the following research questions will be addressed in the present study: i. What is the correlation between the three psycho-educational variables i.e. resilience, learning-approaches and stress-coping strategies? ii. Can academic performance of undergraduate medical students be predicted through the construction of linear relationships between the defined variables employing the principles of empirical modeling?

Methods:

The study population will consist of 234 students registered for the MBBS program at MBRU, distributed over four cohorts. Newly registered MBBS students will be excluded from the study. The various psycho-educational variables will be assessed using pre-validated questionnaires. For Learning Approaches assessment, Approaches and Study Skills Inventory for Students (ASSIST) questionnaire will be employed. Similarly, Resilience and stress-coping strategies will be evaluated using Wagnild-Young resilience scale and coping strategies scale derived from Holahan and Moos’s Coping Strategies Scale respectively. Score of independent variables (Resilience, Stress-coping Strategies and Learning- Approaches) will be calculated. All the scores will be tested for normality by using normality (Shapiro–Wilk test). Inter-items correlational matrix of the dependent and independent variables to test the pairwise correlation will be formed by Pearson’s bivariate correlation coefficients. Regression models will be used to answer our questions with Type II ANOVA test in tests involving multiple predictors. Regression analyses will be checked for homogeneity of variance (Levine’s test), normality of residuals and multicollinearity (variance inflation factor). Statistical significance will be set at the conventional 5% threshold (α = 0.05). Effect sizes will be estimated with 95% confidence intervals.

Results:

The study will commence in the spring semester (January to May) of 2020. Currently, the questionnaires (psycho-educational instruments) are being framed in Google-forms to be circulated to the students, prior to which the questionnaires will be test-run among the members of the study-team. Additionally, the project will be submitted to the MBRU institutional review board for review in the fall of 2019, for exemption under the terms of reference defined by MBRU-IRB. Data collected following the commencement of the study will be analyzed and communicated to suitable journal(s) in the discipline of medical education/education in the fall of 2020.

Conclusions:

Signficance and Limitations: Results from the different psycho-educational instruments will institute the associative and extrapolative multidimensionality of the different variables in envisaging academic performance of undergraduate medical students. Till date, no such study has been pursued, most studies have explored unidimensional association. The investigated variables: Resilience, Learning-approaches and Stress-coping strategies; are individual traits and how the students obtained the past learning with which they joined MBRU will be unknown, and the strategized methodology won’t be able to address this specific aspect.