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Course Failure and Discontinuous Academic Trajectories in Six Medical School Graduating Classes

Fernández-Ortega Miguel Ángel , Ponce-Rosas Efrén Raúl, Ortiz-Montalvo Armando, Fajardo-Ortiz Guillermo, Dávila-Mendoza Rocío
American Journal of Educational Research. 2020, 8(3), 187-193. DOI: 10.12691/education-8-3-10
Received February 15, 2020; Revised March 20, 2020; Accepted March 28, 2020

Abstract

Low academic performance implies that students have not acquired the knowledge needed to solve problems in their area of study. When such difficulties persist, it is more probable that students will fail and repeat subjects in subsequent academic cycles, at the risk of suspending their studies. The objective: To identify the educational and sociodemographic factors related to course failure and discontinuous academic trajectories in six medical school graduating classes. This is a descriptive, transversal, retrospective, comparative study. Sample size: 5,295 students from the graduating classes of 2004 to 2009. A questionnaire was created with 62 variables, including sociodemographic and educational factors; professional achievements and satisfaction. It was sent by email within a ten-month response period. A discriminant analysis was conducted (multivariate technique), using SPSS V25 software to determine the variables that, in their collective interaction, explain the phenomena treated in this study. The following variables are significantly associated with course failure and the suspension of studies during a student’s academic career: being employed during one’s studies; having failed grades during basic education (from ages six to fourteen); being married; and having undertaken a medical specialty. The results of this study offer new information about the importance of basic education (primary and secondary school) in relation both to academic performance during medical school and to the student’s commitment to remain up-to-date after graduating.

1. Introduction

In Mexico, as in most countries, those who have a university degree enjoy better chances of getting a job and a good salary than those who do not. However, in recent decades, the phenomenon of doctor over qualification has been observed, which in many cases does not increase doctors’ wages or hierarchical position within an institutional chain of command 1.

According to the Organization for Economic Cooperation and Development, the Mexican system of higher education has experienced an accelerated growth. Between 1970 and 2017, the number of students enrolled jumped from 270,000 in 385 schools to close to 4.4 million in over 7,000 schools 1, 2.

Concurrent with this increase in the supply and demand of both students and programs in higher education, and alongside the new international standards to which NAFTA committed the country, an evaluation of Mexico’s higher education is indispensable. This was an objective of the 2013-2018 Education Sector Program (Programa Sectorial de Educación, PSE), which aimed to establish a culture of quality assurance among public and private Institutions of Higher Education (Instituciones de Educación Superior; IES). Some of these institutions are of renowned tradition and prestige, and make great effort to maintain and improve their accreditation standards, while other institutions face greater challenges in incorporating such quality control processes.

Follow-up programs with graduates are among such processes with which Institutions of Higher Education should comply. These serve as evaluation and feedback for various teaching/learning processes. Such programs may look at indicators five years after students graduate, and can identify the relevance and functionality of different programs; the need to adjust a major’s curriculum; the causes that affect the graduation rate; academic success or failure; and graduates’ insertion into the labor market, among other aspects 3.

Institutions of Higher Education find it imperative to improve their graduation rates, and identify causes that affect it. This includes academic failure, which, according to Castro, can be understood “(…) as the difficulties that some students display in acquiring information that is taught in school” (Castro, 1998, as cited in Martínez Maldonado, Vivaldo Lima, Navarro Padilha, González de la Fuente & Gerónimo Montes, 1998, p. 2), and can be observed in low academic performance (poor grades), course failure and dropping out of school 4, 5.

Low academic performance implies that the student has not acquired the necessary knowledge, tools and skills to solve problems in his or her area of study 6. When these difficulties in learning persist, there is a high probability that the student will fail a course and have to repeat it, or take extraordinary exams. Many students that have failed one or more courses are at risk of failing them again in the following school cycle; this can translate into suspension of studies, either temporarily or permanently 7. Permanent suspension, or dropping out, was calculated nationally for the period from 1999 to 2003 at 36% in public Institutions of Higher Education, and 28.8% in private Institutions of Higher Education 8.

The causes of academic failure are many, and can be attributed to various factors: a) personal, relating to the student (such as inadequate study techniques, lack of motivation, health concerns, addictions, age, sex, marital status, the work-school balance, low academic performance in high school, a bad choice of major, late entry into the university, and individual personality, among others); b) family-related (parents’ educational levels, family economic situation, domestic violence, and commute times, etc.); and c) institutional (curriculum, student-teacher relationships, a professor’s capacity to transmit knowledge and to induce a student to learn, and a professor’s or school’s teaching resources, etc.) 4, 5, 6, 7, 8, 9, 10, 11, 12, 13, 14, 15.

Not all students who suspend their studies drop out of school. In many cases, students’ academic trajectories are interrupted for a variety of temporary situations, such as the low academic performance of students who don’t adapt quickly to new scholarly dynamics; this situation can be reversed. Other temporary circumstances obligating students to suspend their studies occur frequently (pregnancy, family or economic crises, health situations, etc.). In these situations, the expected academic trajectory (in consonance with the duration of a major) is affected. This gives rise to what Chain, of the University of Veracruz, has called discontinuous academic trajectories, a variant of the normal academic trajectory, referring to those interruptions that do not affect a student’s ability to graduate, but may result in the conclusion of his or her studies over a longer time period 14, 15, 16. Rodríguez Lagunas, of the Autonomous Metropolitan University (Universidad Autónoma Metropolitana; UAM), calculated the rate of discontinuous trajectories of the students at the school’s campus in Ixtapalapa to be at 42% 8. While these delays are not viewed with the same severity as dropping out of school, the costs generated and the educational impact are clear; such delays should be avoided and reduced as much as possible. To do this, it is necessary to understand the roots of the phenomenon, in the context of the characteristics of each school.

1.1. Objective

To identify the educational and sociodemographic factors related to course failure and discontinuous academic trajectories in six medical school graduating classes at the School of Medicine at the National Autonomous University of Mexico (UNAM).

2. Materials and Methods

This is a descriptive, transversal, retrospective and comparative study. Sample size: 5,295 graduates of the School of Medicine who completed their studies and graduated from 2004 to 2009. A questionnaire was created with 62 variables related to graduates’ educational and sociodemographic characteristics, professional achievement and satisfaction in their field. A pilot test was conducted with a group equivalent to the graduates studied (n=15), and using those results, semantic adjustments were made and questions were reworded. The content was validated by eight professors from the School of Medicine, each with over ten years’ teaching experience. Because this is an exploratory study in its initial phase, determining the validity of the criteria or the construct was not considered. A directory of graduates was prepared using information from the files provided by the School of Medicine’s Department of School Services. Next, the questionnaire was sent via email to each of the graduates, setting a ten month-deadline for their response. Doctors who wished to participate and did not respond by email filled out the questionnaire in person.

A discriminant analysis (multivariate technique) was conducted using SPSS Statistics V25 software to determine the most important variables that could, in their collective and synergistic interaction, explain the phenomena explored in this study. The project was approved by the Research and Ethics Commission of the School of Medicine’s Research Division, and assigned registry number 041/2013. The study adhered to the Ethical Standards of the American Educational Research Association (2000); the Code of Professional Responsibilities in Educational Measurement (2003) of the National Council on Measurement in Education; and the Code of Fair Testing Practices in Education prepared by the Joint Committee on Testing Practices (2004) 17, 18, 19.

3. Results

Out of all the surveys sent, information was received only from 1,434 members of the six graduating classes (2004 to 2009). Twenty-eight independent variables were selected (demographic characteristics, parents’ educational levels, students’ academic trajectories, their entry into postgraduate studies, their opinions about their educational performance and success); while the dependent variables were course failure and suspension of studies for at least one year.

Of the 1,434 graduates, 60% (861) never failed a class during their studies and 40% failed at least one; a statistically significant percentage difference (binomial test p < 0.0001). Likewise, 88.4% (1,268 graduates) never suspended their studies, while 11.6% (166) did so for at least one year, also a statistically significant percentage difference (binomial test p < 0.0001).

A multivariate discriminant analysis was conducted using this information, employing a stepwise inclusion method. The fundamental objective was to generate an equation (linear prediction model) that would allow for the establishment of the substantial variables associated with each of the dependent variable conditions.

The results of the discriminant analysis are presented in Table 1.

The predictive discriminant function is linear and summative; to determine the predictive equation for each particular case (graduate), the discriminant function coefficients obtained are to be used following the model:

In which:

K =the model constant;

Vn = each of the predictive variables for course failure and suspension of studies that were included and analyzed in this study;

Cn = each Canonical Discriminant Function coefficient obtained.

The characteristics of the discriminant analysis undertaken, which are specified in Table 1, indicated a good predictive qualifying model (70% or more correct classification, a canonical correlation above 0.50 and a significant chi-squared test, although the centroids indicate a separation that significantly overlaps cases). Both the phenomenon of course failure and of suspension of studies during medical school will be analyzed below.

3.1. Course Failure

The results of the discriminant analysis showed that seven variables are associated with the phenomenon of course failure. Using the canonical discriminant coefficients of the classification function, these seven variables obtained the coefficients shown in Table 2.

Cross tables of the interest variables were calculated; ‘one or more courses failed’ and ‘all courses passed’ were analyzed by the following variables: whether the graduate worked during his or her studies, their marital status during their studies, the number of years they were held back in primary and/or secondary school, and if the graduate undertook a medical specialty. The results are shown in Table 3.

As can be seen in Table 3, the variables of having worked while studying, the number of years held back in primary and / or secondary school, and whether the graduate undertook a medical specialty, showed statistically significant differences with respect to the number of unaccredited courses during their major.

3.2. Discontinued Academic Trajectories (Suspension of Studies)

Similarly, the results of the discriminant analysis showed that nine variables are associated with the suspension of studies. Using the canonical discriminant coefficients from the classification function, the variables obtained the coefficients presented in Table 4.

Additionally, cross tables of variables were calculated; the suspension of studies for at least one year was analyzed by the following variables: gender, marital status during undergraduate studies, whether the student worked during his or her studies, and the number of unaccredited courses. These results are shown in Table 5.

As Table 5 shows, the marital status variable (being married or living in cohabitation) is significantly associated with suspension of studies (27.7%), as compared to those who were unmarried or divorced, only 10.4% of whom suspended their studies. Working during one’s studies and the number of courses failed during a major showed statistically significant differences with respect to the number of years of suspension of studies.

The suspension of studies during the major was also analyzed by graduating class year. Two groups were created:

Group 1, students from the Classes of 2004, 2005 and 2006

Group 2, students from the Classes of 2007, 2008 and 2009

Statistically significant differences regarding the suspension of studies between the two groups were not found, Chi-squared = 1.424, p= 0.233.

Statistically significant differences with respect to course failure were found between the two groups; of the 573 graduates who failed at least one course during their studies, 33.7% belonged to group 1 and 66.3% to group 2, Chi-squared = 12.152, p = 0.0005

4. Discussion

The results observed in the discriminant analysis with respect to course failure are associated with seven variables, of which four are particularly clear, such as the increase in the number of years spent completing the major; having suspended one’s studies at some point; a lower probability of having undertaken a medical specialty; and not having studied outside Mexico. It should be noted that the requirements for studying outside Mexico are being a regular student in good standing, and high academic performance 6, 7, 8.

In addition, an association was also found between course failure during a college major, and having had a low grade average in high school. This has been reported by other authors such as Vries, who also associates low high school grade averages with dropping out of school during a major 20. García López, of the Technological Institute of Sonora in northern Mexico, refers to academic performance in high school as a predictor for success or failure during a college major. 21, while Gatica-Lara concluded that the better one’s grades in high school, the better the student will perform during his or her first two years of medical school 22. Similarly, the results of this study showed an association between course failure and having to work while in medical school 9. Vélez, at Rosario University in Colombia, found a relationship between students that worked every day and having to abandon one’s studies 11. In 2013, Guadalupe Mares, at the Iztacala School of Higher Education in Mexico, identified that holding down a job while studying was the principal cause of course failure and suspension of studies 13.

One of the most relevant findings revealed by this study is the association between course failure during medical school and having been held back during childhood in primary and/or secondary school (basic education, from 6 to 14 years). Hughes reported that, in a longitudinal study performed in Texas, students who were held back during primary education were much more likely to drop out of school before they turned 17, and their income throughout their life would be lower than that of those who had not been held back 23. Moreover, Olave-Arias has pointed to the strong relationship between early reading and writing comprehension and success or failure in a college major; that is to say, the origins of students’ difficulties understanding the material during their major may lie in formative deficiencies generated during childhood and basic education 24.

An association was found between discontinuous academic trajectories (suspension of studies for at least one year) and nine variables; one obviously being that they completed their studies in a longer time period. Associations were also found, mentioned earlier, with failing courses and with a lower probability of having under taken a medical specialty.

A relationship was also observed between the age of the youngest students and the suspension of studies, this not being the case for those 35 and older (61.6%). This is owing to the lower proportion of students over 35, and these percentages would need to be standardized to conduct a valid comparison.

The association between being married or living with a partner, and course failure and suspension of studies, has been reported by other authors. Nava Bustos, reports that 30% of students who fail courses are married 9, and Mares refers to getting married or deciding to live with a partner as causes of suspension of studies 13. Various authors have reported on the association of students’ mothers’ educational levels with students’ academic success; in this case, an inverse relationship exists, showing higher academic success as related to the fathers’ educational level instead 6, 9, 11, 12, 13.

The association between students who suspended their studies for at least one year and a lack postgraduate continuing medical education activities was another important finding of this study; antecedents to this discovery were not found in the literature.

Finally, the variable of graduating class year was seen to be associated with suspension of studies, although there were no statistically significant differences in the different class years studied. However, looking at course failure by graduating class year, it was found that the number of students who failed courses increased significantly between 2007 and 2009. It is important to look deeper into this situation; a directly causal factor, such as a curriculum change, does not appear at first glance.

5. Conclusions

As often occurs in this type of study, the data is limited by the low participation of doctors, several years after they have graduated. Nevertheless, the results obtained offer new information about the importance of basic education (primary and secondary school), and its relationship both to low academic performance in medical school (course failure and suspension of studies) and to the commitment to staying up-to-date after graduation via continuing medical education activities. This information can be used to improve the selection of undergraduate students, increase graduation rates and, of course, improve the professional profiles of graduates.

Acknowledgments

We are grateful for the invaluable contribution of Dr. María del Carmen Hernández Argueta for her participation in the documentary research, and for that of Elena Gabriela Gómez Peña, for the final editing of this article.

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Published with license by Science and Education Publishing, Copyright © 2020 Fernández-Ortega Miguel Ángel, Ponce-Rosas Efrén Raúl, Ortiz-Montalvo Armando, Fajardo-Ortiz Guillermo and Dávila-Mendoza Rocío

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Fernández-Ortega Miguel Ángel, Ponce-Rosas Efrén Raúl, Ortiz-Montalvo Armando, Fajardo-Ortiz Guillermo, Dávila-Mendoza Rocío. Course Failure and Discontinuous Academic Trajectories in Six Medical School Graduating Classes. American Journal of Educational Research. Vol. 8, No. 3, 2020, pp 187-193. http://pubs.sciepub.com/education/8/3/10
MLA Style
Ángel, Fernández-Ortega Miguel, et al. "Course Failure and Discontinuous Academic Trajectories in Six Medical School Graduating Classes." American Journal of Educational Research 8.3 (2020): 187-193.
APA Style
Ángel, F. M. , Raúl, P. E. , Armando, O. , Guillermo, F. , & Rocío, D. (2020). Course Failure and Discontinuous Academic Trajectories in Six Medical School Graduating Classes. American Journal of Educational Research, 8(3), 187-193.
Chicago Style
Ángel, Fernández-Ortega Miguel, Ponce-Rosas Efrén Raúl, Ortiz-Montalvo Armando, Fajardo-Ortiz Guillermo, and Dávila-Mendoza Rocío. "Course Failure and Discontinuous Academic Trajectories in Six Medical School Graduating Classes." American Journal of Educational Research 8, no. 3 (2020): 187-193.
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  • Table 2. Classification function canonical discriminant coefficients: Unaccredited courses during major (course failure)
[1]  OECD. Higher Education in Mexico: Labour Market Relevance and Outcomes, Higher Education, OECD Publishing, Paris, 2019. Available: https://doi.org/10.1787/9789264309432-en [Accessed May. 17, 2019].
In article      View Article
 
[2]  Secretaría de Educación Pública. Sistema Educativo de los Estados Unidos Mexicanos: Principales Cifras 2016-2017 [The Educational System of the United States of Mexico: Primary Data 2016-2017]. Mexico City: Secretaría de Educación Pública (SEP), 2017.
In article      
 
[3]  Asociación Nacional de Universidades e Instituciones de Educación Superior, ANUIES. Esquema básico para estudios de egresados en Educación Superior, ANUIES, México, 1998
In article      
 
[4]  Martínez Maldonado, M. L., Vivaldo Lima, J., Navarro Padilha, M. G., González de la Fuente, M. V., & Gerónimo Montes, J. A. Análisis Multirreferencial del fenómeno de la reprobación en estudiantes universitarios [Multireferenti alanalysis of course failure among university students]. Psicol. Esc. Educ. 2(2) 1998. [Online]. Available: http://www.scielo.br/pdf/pee/v2n2/v2n2a10.pdf. [Accessed May. 22, 2019].
In article      
 
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