When the wheels fall off – Medical students’ experiences of interrupted academic progression

Abstract

Introduction

There is limited published research on medical students’ perspectives of a significant interruption to their academic progression. This study sought to identify the factors that contribute to difficulties with academic progression and to understand how medical students successfully respond.

Methods

This interpretive phenomenological study reports on the findings from in-depth interviews of 38 final year medical students who had experienced a significant academic interruption.

Results

The two superordinate themes were: the factors contributing to the interruption and their experience of the interruption. Factors identified as contributing to the interruption were: workload, learning in medicine, motivation for medicine, isolation, adapting to local culture, health and external factors. Their experience of the interruption focused on stages of working through the process: ‘what happened,’ ‘how it felt,’ ‘managing the failure,’ ‘accepting the failure’ and ‘making some changes.’

Discussion

Each factor affected how the participants reacted and responded to the interruption. Regardless of the origins of the interruption, most reacted and responded in a comparable process, albeit with varying timespans. These reactions and responses were in a state of fluctuation. In order to succeed many stated they shifted their motivation from external to internal, in direct response to the interruption, resulting in changed learning behaviours.

Conclusions

The process of working through an interruption to academic progression for students may benefit from a model of interval debriefing, restorative academic and personal development support. Facilitation of this process could enable students to face an interruption constructively rather than as an insurmountable emotionally burdensome barrier. Medical schools could utilise these findings to implement further support strategies to reduce the number of significant academic disruptions.

Keywords:

• Academic progression
• failure
• student support
• undergraduate
• medicine

Acknowledgements

We acknowledge the generous and brave approach of our research participants.

Author contributions

SC drafted the paper with AW, BC, DB, DC, AC, BD, ML and TW contributing to each draft. All authors collaborated on the generation of the collaborative research.

Disclosure statement

The authors report no conflicts of interest. The authors alone are responsible for the content and writing of this article.

Additional information

Funding

ANZ UMAT Consortium for funding the research around medical students Narratives of Progression.

Notes on contributors

Sandra E. Carr

Sandra E. Carr, BSc, MPH, PhD, SFHEA, is Head, Discipline of Health Professions Education at The University of Western Australia.

Andy Wearn

Andy Wearn, MBChB, MMedSc, is Head of programme, MBChB, The University of Auckland.

Ben J. Canny

Ben J. Canny, MBBS, PhD, is an experienced medical educator, formerly Deputy Dean, Monash University and Dean, University of Tasmania.

Dianne Carmody

Dianne Carmody, MPH, is a Research Fellow, Health Professions Education at The University of Western Australia.

Deborah Balmer

Dr. Deborah Balmer, Faculty of Medical and Health Sciences, Clinical Skills Centre, The University of Auckland, Auckland, New Zealand.

Antonio Celenza

Antonio Celenza, MBBS, MClinED, is an experienced medical educator, formerly MD Course Director and Head of Medical Education, The University of Western Australia.

Basia Diug

Basia Diug, BBioMedSci (Hons), PhD, GCAP, PFHEA, is Head, Undergraduate Courses at the School of Public Health and Preventive Medicine, Monash University.

Michelle Leech

Professor Michelle Leech, MBBS (Hons), FRACP, PhD, is Deputy Dean Faculty Medicine Nursing and Health Sciences and Head of the Medical Course, Monash University.

Tim J. Wilkinson

Tim J. Wilkinson, MBChB, University of Otago Medical School, Christchurch School of Medicine & Health Sciences, Dunedin, New Zealand.