Medical student next to the words "Why am I failing med school?"

Why Am I Failing Med School?

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The answer may be more complex than you think — but we can help

In part 1 of this series, we explored some of the reasons smart students perform poorly in health professions programs. In my academic coaching, I use the BACEIS (Behavior, Affect, Cognition, Environment, Interacting Systems) model when working with struggling students. This system helps frame the issues I see, determine core issues for poor academic performance and offer solutions.1 Here, we’re examining the specific components of this model system. We’ll dig into examples of problems associated with each area that can impact learning. We’ll also explore possible solutions students can use to reduce or eliminate their negative impact. A quick note – it’s important to remember the model system described below is complex and interactive. Issues with internal and external factors and systems can impact others in the model.

External Factors

Academic Systems

Let’s face it. You don’t get to make the rules as a student in a health profession. The courses you take, your instructors, and the pedagogical approaches they use in the classroom can majorly impact your academic success. You can’t control what you are learning or the way you’re assessed. Basically, you have very little control over these variables.

At best, you’ll have excellent teachers, well-versed in teaching, learning, and assessment strategies, who are committed to your success and mindful of all the other work you must do. At worst, it can be a living nightmare.

You can control the strategies and approaches you use to respond to the challenges of poor teaching and learning approaches. Based on interactions Ryan, Dave, and I have had with students, one of the most common challenges is the quality and quantity of lecture materials provided by instructors.

We can all relate to how difficult it is to interface with long, dense, and disorganized PowerPoint slide shows or handouts. The key to navigating this challenge is learning to find and extract the framework from that lecture material. Once created, this framework can enhance learning. With frameworking, students can develop a deeper understanding of concepts, stay on track in class, improve note-taking, and engage in retrieval practice.

Frameworking is one of the many strategies that Ryan and Dave specialize in teaching students in the STATMed Study Skills course. Working with learning specialists like them is a great way to develop strong learning and productivity skills and operationalize evidence-based learning approaches like retrieval practice and interleaving. This can go a long way in mitigating many of the adverse effects of these academic systems factors.

Nonacademic Systems

The student population I work with is highly diverse, with young men and women from all over the world. They represent numerous cultures and a wide range of socio-economic backgrounds. Understanding their traditions, beliefs, values, and challenges is critical when helping them set and achieve their goals. In addition to attending pharmacy school full time, many of my students are parents with small children and work one or more jobs. For these students, acquiring skills and strategies to promote efficiency and productivity are critical factors for success. Some of my students come from cultures or families where asking others for help is frowned upon. These students tend to delay asking for help until they are in serious academic difficulty. If you are one of these students, don’t wait to seek help.

In part 3 of this blog series, we will take a closer look at the important internal supersystem factors, examples of each and possible solutions for dealing with them.

  1. Hartman H, Sternberg RJ. A Broad BACEIS for Improving Thinking. I. Instr Sci. 1993;21:401-425.

Interested in learning more about how we can help you improve your study habits and the way you approach medical education? Check out the STATMed Study Skills Class!

Ready to improve your studying and get better results? Get in touch!

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