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DISCUSSION

The present study results largely confirmed our initial hypothesis, and highlighted the existence of undeniable and statistically significant links between some study habits of medical students and the academic performance of these students, as reflected by their grades in exams. Indeed,

univariate and multivariate statistical analyses underlined strongly significant association between performance and class attendance, learning strategies, modes and techniques, skipping chapters, and above all the degree of personal involvement in one’s studies.

Our participants were female for two-thirds of the population studied, which reflects the current composition of medical students with a clear female majority that has been increasingly marked over the past fifteen years [12]. They were also well distributed between the 3 different cycles of medical studies and represented the five largest public faculties of medicine in Morocco.

In contrast with previous studies emphasizing that women generally demonstrate higher academic performance than men [13-14], the gender of our participants did not influence their performance. This could be explained by the fact that our evaluation of academic performance was based on student self-assessment. And it is already established that in the field of science, women generally tend to undermine their own level, skill or achievement less [15-16].

Our results also highlighted that not attending classes at all, increased the risk of academic difficulty by 2.6-fold compared to attending all classes. Class attendance is not compulsory in Moroccan medical schools. Hence, young students, who may lack necessary hindsight and judgement skills, are free to decide whether to attend or not, with consequences on their academic performance as shown by our results. That said, evidence from the literature was mixed on the issue of “class attendance” and its impact on the academic performance of medical students, with some studies pointing to a link between class absence and academic failure [17-18] and others not finding this link [19-20].

On the other hand, revision strategy plays a fundamental role in academic results. Different learning strategies have largely demonstrated their effectiveness in boosting memory retention capacity, including “spaced practice” [21-22]. Consequently, it appears necessary to introduce a specific course on learning techniques into the medical studies curriculum in order to better prepare medical students to become effective learners.

Working alone or in a group can have a significant impact on academic performance. Indeed, group work can boost episodic memory, thanks to the convivial context in which revisions take place [23], especially if the individuals in the study group use the elaboration technique (one person explains the lesson to the others), widely recognized for its very favorable effects on memory capacity [24]. In contrast, working alone may be more effective on concentration with fewer distractions caused by group interactions [25]. In our study, working alone was associated with better academic results in the univariate analysis, but this association was no longer significant when the other factors were incriminated (multivariate analysis).

Finally, the intrinsic motivation and the degree of investment of each student in his/her studies represent a major determinant in academic success. Indeed, our results showed that adopting the strategy of " passing exams with the least effort" was associated with a 23-fold increased risk of academic difficulty compared to those who were "very demanding of themselves regarding their studies". Logically, when we invest the most, we succeed the best.

CONCLUSION

Succeeding in medical studies requires the combination of different factors, some of which are directly related to the students themselves, their degree of commitment, their attendance to classes and involvement in revisions, as well as their learning strategies and techniques. However, other factors independent of the students’ efforts are also involved in success or failure, such as teaching and assessment methods, which require permanent reassessment by professors and faculty members in order to achieve the highest success rates for their students, and lighten the burden of devastating failure.

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