Abuse and empowerment in the academic field on the academic performance of medical students: a cross-sectional study

Academic abuse remains a concerning and under-recognized factor affecting medical students' well-being and academic achievement. Empowerment, on the other hand, may mitigate negative experiences and enhance performance. This study aimed to examine the relationship between academic abuse, empowerment, and academic performance among medical students in a Latin American setting.

A cross-sectional study was conducted among 255 medical students at a private university in Lima, Peru. Participants were selected using stratified sampling by year of study. Academic performance was assessed using the RAU Scale, academic abuse through the Teacher Abuse Questionnaire, and empowerment using the Instrument of Perception of Empowerment (IPE). A Poisson regression model with robust variance was used to directly estimate prevalence ratios (PR) and their corresponding 95% confidence intervals (95% CI). The model included academic abuse and its dimensions as the main explanatory variables and was subsequently adjusted for sociodemographic and academic covariates (sex, age, nationality, and having failed a subject).

Of the participants, 72.2% exhibited adequate academic performance, while 76.5% reported low levels of abuse and over 90% demonstrated high empowerment. Multivariate analysis after adjustment showed that high academic abuse (PR = 0.84; 95% CI: 0.74-0.96; p = 0.011) and female sex (PR = 0.81; 95% CI: 0.69-0.94; p = 0.005) were associated with a lower probability of adequate academic performance, whereas older age (PR = 1.02; 95% CI: 1.00-1.03; p = 0.013), Peruvian nationality (PR = 1.16; 95% CI: 1.02-1.33; p = 0.028), and having failed at least one subject (PR = 1.21; 95% CI: 1.05-1.39; p = 0.008), were associated with a higher probability of adequate academic performance. Academic empowerment did not show a statistically significant association with academic performance after adjustment for covariates.

Academic abuse negatively impacts student performance, while empowerment appears to be widespread yet insufficient to fully buffer these effects. Addressing academic mistreatment and fostering a supportive and empowering educational environment should be priorities in medical education reform.