High- and low-achieving international medical students’ perceptions of the factors influencing their academic performance at Chinese universities

ABSTRACT

China has become an attractive destination for international medical students, particularly those from developing countries in Asia and Africa. These students are known to face difficulties in adapting to Chinese medical universities and they tend to score poorly on subsequent examinations to enter the medical profession in their home or in a third country. To date, limited research concerning the factors that affect the academic performance of this group of students in China has been conducted. In particular, there have been very few comparisons between high and low achievers to identify the factors that high- and low-achieving international medical students in all years of study perceive as affecting their academic performance. A qualitative research approach was implemented at two medical universities. Semi-structured interviews were conducted with 18 high achievers and 22 low achievers in their second, third, fourth, fifth, sixth, and post-graduation years. Interviews were audio-recorded, transcribed, and coded using a thematic analysis approach.A few key overlapping factors were identified: social support, learning motivation and interest, exam preparation and strategies, time management, and coping. The high achievers manipulated these strategies successfully while the low achievers did not. The high achievers demonstrated efficient learning methods (efficient use of class time, good note-taking habits, preview and review strategies, expanded learning, self-study and group learning, deep learning, choosing an appropriate study location, and focusing on basics and concepts). They also achieved a good balance between studying and leisure. The low achievers mentioned learning challenges, health issues, English language barriers, and problems with online classes. This study allowed us to identify important factors that international medical students at Chinese institutions perceive to influence their performance. The findings contribute to the literature on the topic and provide a solid basis for practice and policy development.

KEYWORDS:

• International medical education
• undergraduate
• high achievers
• low achievers
• academic performance
• Chinese universities
• higher education

Acknowledgments

We are grateful to all of the student participants and staff who helped us with the study.

Disclosure statement

No potential conflict of interest was reported by the author(s).

Consent for publication

Consent to publish details of the interviewees has been obtained from all the participants.

Contributions

Qinxu Jiang collected the data, analysed and interpreted the data, drafted the paper, revised it critically for intellectual content, and gave final approval of the version to be published. Hugo Horta analysed and interpreted the data, drafted the paper, revised it critically for intellectual content, and gave final approval of the version to be published. Mantak Yuen drafted the paper, revised it critically for intellectual content, and gave final approval of the version to be published. All authors agree to be accountable for all aspects of the work.

Data availability statement

Due to the nature of this research, participants of this study did not agree for their data to be shared publicly, so supporting data is not available. Requests for data can be considered and if considered reasonable are available from the corresponding author Hugo Horta ([email protected]) or Qinxu Jiang (e-mail: [email protected]).

Ethics approval and consent to participate

Ethical approval was obtained from the Ethics Committee of Xuzhou Medical University and the Academic Ethics and Ethics Committee of Nanjing Medical University. All participants gave written informed consent to participate before interviews began. The entirety of the research, including data collection and methods was carried out in accordance with relevant guidelines and regulations.

Notes

1. It is relevant to note that both high and low achievers said that some disciplines were harder to understand than others. However, neither group perceived the sheer volume of study material as overwhelming. It seems as though the amount of study material was taken as a given by the students, perhaps seen as a natural outcome of the development of health sciences and the medical profession.

Additional information

Funding

The author(s) reported there is no funding associated with the work featured in this article.