Observed inappropriate behaviors during early medical exposure predict future academic performance

Although many factors associated with medical students' academic performance have been identified, to the best of our knowledge, no studies have examined the relationship between observable behaviors during early medical exposure (EME) and subsequent academic performance. Therefore, the aim of this study was to identify inappropriate behaviors during the EME program that predict subsequent students' academic performance.

We used a quantitative approach grounded in a postpositivist worldview and conducted a retrospective study involving 330 first-year medical students at Kochi Medical School (KMS) in Japan. The inappropriate behaviors recorded by faculty or staff included various types of behaviors, such as unexcused absence and tardiness, and failure to meet submission deadlines. There were two types of assignments with submission deadlines: reports and a questionnaire. However, they differed in nature, as reports contributed to the final grade, whereas the questionnaire did not. These behaviors were analyzed using univariate and multivariate analyses to identify predictors of first academic year repetition. The number of subjects with lower grades was also compared between students with and without the identified predictors.

Failure to meet submission deadlines of both the reports and questionnaire was independently and significantly associated with their first academic year repetition (HR: 2.23, p = 0.010, and HR: 2.65, p = 0.004, respectively). Students exhibiting either behavior also had significantly more subjects with lower grades than those without these behaviors (p < 0.001 for both).

Failure to meet the deadline (reports) may reflect deficits in time management skills related to self-regulated learning, whereas failure to meet the deadline (questionnaire) may indicate lower autonomous motivation as described in self-determination theory. These theories may also help explain the relationship between these behaviors and subsequent poor academic performance. These observable behaviors may help educators identify academically at-risk students early and provide theory-informed educational support.