Why Did They Fail? A Case Study on Undergraduate First Year Medical Students

Background: Academic struggle is a concern for students, medical schools and the society. As academic struggle is not idiopathic and instantaneous, qualitative research could provide an in-depth understanding on why it occurs. This qualitative research aimed to explore the reasons for why Year 1 medical students failed in their studies.Methods: This study adopted a single, embedded case design. Six medical students repeating their Year 1 studies performed a written reflection describing their experiences and behaviours during Year 1. Semi-structured interviews were then conducted with each student and data was analysed by two researchers. Independent analysis was compared, and discrepancies were resolved through discussions between the researchers. Results: Each student narrative demonstrated difference in behaviours and experiences. Students engaged less in studies or had ineffective learning methods. Narratives indicated various reasons such as being overconfident or unmotivated to study for these behaviours. However, interpreting based on Theories of Action, the students’ failures could be explained by three types of invalid governing variables found in the data. Students may have performed their actions based on either inadequate knowledge, possessing misbeliefs or have no rationales at all. Invalid governing variables may have led to ineffective actions, and subsequently resulted in unintended consequences. Hence, all students failed the mid-year and/or end-year assessments. Conclusion: Struggling students lacked the valid governing variables in rationalising their actions. One suggestion based on the Theories of Action is the recommendation that students perform double loop learning to deeply assess and alter their governing variables.