Biomedical Students in their First Year of Study: Factors Explaining Performance in a High Stakes Examination

Abstract

Strong theoretical arguments, such as the expectancy-value theory, support the idea that high-stakes examinations can cultivate competitive behavior and have an impact on wellbeing and motivation, especially in courses that demand high grades for admission. Academic achievement in a high-stakes examination can be explained by cost factors (measured in reference to quality of life variables), persistence factors (measured in terms of competiveness and motivational beliefs), and a utility and choice variable (related to choice of course). All students (N = 1036) studying in a population health course within the biomedical first year course were invited to participate in an online survey in 2014. A questionnaire elicited information regarding gender, age, ethnicity, grade achievement, importance of selection into medicine, motivation, competitiveness, and quality of life (QOL). The main analysis incorporated a structural equation modeling procedure to consider how the aforementioned variables could explain grade achievement. The response rate was 33%. The emergent model was consistent with the theoretical model. Physical QOL generated a negatively oriented regression weight with respect to test anxiety, whereas psychological QOL was positively associated with respect to self-efficacy, intrinsic value, and enjoyment of competition and negatively associated with test anxiety. Social relationship QOL was positively associated with test anxiety, but environmental QOL produced no significant regression weights. Self-efficacy and intrinsic value yielded a positive regression weight in reference to importance of medicine, which in turn generated a positive regression weight when explaining grade attainment. The findings suggest that students who have minimal cost factors in terms of QOL experiences will likely harness efficient persistence strategies resulting in more focused study strategies, which will inevitably lead to a better academic outcome. The findings also suggest that a model based on the expectancy value theory predicted the data well. This study additionally promotes the argument for the need for a comprehensive and integrated strategy for further promoting QOL, learning support, and career advice and to further understand the impact of competitive learning environments on students’ study and social behaviors.