Exploring factors that affect learning process of high achievers and low achievers and the role of medical teachers : Indian Journal of Health Sciences and Biomedical Research kleu

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Exploring factors that affect learning process of high achievers and low achievers and the role of medical teachers

Shrivastava, Saurabh RamBihariLal; Shrivastava, Prateek Saurabh1

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Indian Journal of Health Sciences and Biomedical Research (KLEU) 16(1):p 175-178, Jan–Apr 2023. | DOI: 10.4103/kleuhsj.kleuhsj_534_22
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The syllabus in the medical curriculum is extremely vast, and in order to attain the intended learning competencies, students have to take intensive efforts to continue or expedite the learning process.[1] Learning in itself is a complex process, as a number of factors play their part to ensure that a medical student can understand and apply the concepts or even perform the skills/procedures.[1] Moreover, it is important to acknowledge that all medical students do not learn in a similar manner, and it is very much a possibility that some of them learn at a fast pace while others at a slow pace.[2,3] This is expected to influence their academic performance in the planned assessments and based on the marks secured in examinations eventually students can be categorized as high achievers and low achievers.[4] This categorization is done not to stigmatize students, but to identify those students that need additional curricular or psychological support (low achievers) or who need additional opportunities to excel (high achievers).[5]

Factors Affecting the Learning Process

In general, factors affecting the learning process have been broadly categorized into intrinsic (viz. learning style) and extrinsic (such as learning environment and support from teachers).[2,3,6] These factors range from proper planning of syllabus, informing about assessments to students in advance, mentioning specific learning objectives at the start of the session to promote focused learning, and providing a wide range of learning experiences to the students to suit all types of learners.[7,8] From the students' perspective, the presence or absence of self belief, inner desire and commitment to learn and become a better version of themselves, and vision to enter into residency and planning accordingly by reading with more focus and from entrance related books or coaching classes, are the important factors. In addition, the desire to make parents feel proud, prior success (viz. I have done well in the past, I can do even in the future), and fear of failure in exams is extremely important attributes in determining learning.[9,10]

Moreover, appreciation by teachers that act as a motivation to replicate the performance in the future, mentoring from teachers, and provision of constructive feedback from teachers also play a crucial role in augmenting learning among students.[11,12] Moreover, infrastructure, learning resources (such as a learning management system and access to online resources/journals), and presence of an enabling learning environment are also significant.[13] Further, being aware of own strengths (like picture memory) and weaknesses (such as lack of self-belief as not having command over the English language) and accordingly working on them (metacognition) is also an important factor to augment learning.[10,14] Furthermore, supporting colleagues/understanding roommate/seniors/school friends who took medicine and support from family members (viz. parents/siblings) is also essential to augment learning.[15]

Further, the presence of a role model in the family (viz. either parent as a doctor or siblings) or among seniors or within their own batch can also prove to be a strong motivating factor. In fact, the approach toward learning (like the use of mnemonics or referring to notes from the seniors or class notes) can also prove to be a major supporting factor to enhance learning.[15] However, exposure to an emotional event can prove to be double-edged sword, either being detrimental (viz. losing someone close or a relationship failure and thus deterioration in learning) or an encouraging (such as getting bullied in school, and thus a student deciding to focus all energy on just reading) factor to continue learning, and is expected to vary from one student to another. Moreover, the emergence of COVID-19 pandemic has also proven to be an important attribute in influencing the learning process. Within a short time, e-learning has become a significant mode of learning and this has affected both students and teachers. This becomes even more important considering that students have been forced to stay indoors during the lockdown period.[16]

Similarities and Differences in the Learning Process between High Achievers and Low Achievers

It has been observed that support from family members and friends is crucial to continue/augment the learning process regardless of the fact that the student is a high or a low achiever.[17] In continuation, teachers occupy a key role in enhancing learning and thus their contribution in motivating, mentoring, facilitating, giving feedback, encouraging reflection, or being the role model can never be undermined.[17,18,19,20] Further, exposure to a traumatic emotional event in the recent past or currently is also expected to negatively affect the learning process. Finally, self-belief is one of the most critical determinants to continue or augment learning.[10] However, there are multiple differences in terms of the approach and the vision that high achievers have when compared with low achievers and all of these are described in Table 1. It becomes extremely crucial that teachers should be aware of these differences to ensure that learning can be facilitated among both types of students.[5]

Table 1:
Differences in the learning process between high achievers and low achievers

Role of the Teachers to Support Students Learning

In general, teachers occupy the most crucial role in shaping the learning process and also the future of medical students as well as the quality of the health-care delivery system. Thus, if we want to augment learning, we have to involve all teachers in the process.[21,22] As medical educators, teachers can identify the learning style of the students and depending on that provide a wide range of stimuli (learning experiences) to benefit them. In the capacity of mentor, teachers can plan shared learning goals along with their mentees and then just facilitate the learning process.[22,23] Further, teachers can motivate the students to continue the learning process, and advise (if suppose there are any barriers at a personal or academic level). Moreover, teachers should not miss any opportunity (viz. classroom, practical, clinical sessions, community settings, and postassessments) to give constructive feedback to the students and help them to understand their strengths and identify the areas where they need more attention.[21,23]

Teachers can also encourage students to reflect upon the learning process, as it will significantly aid in the process of converting working memory to long-term memory. Teachers should employ those teaching–learning methods that promote active engagement of students, instead of a passive passage of information.[5,23,24] Teachers can also adopt methods to encourage self-directed learning, as it will play a crucial role in making them lifelong learners. In addition, they can provide a list of standard learning resource materials that students can refer to (if required).[22] It is important to note that teachers can also adopt e-learning methods, as the current generation of students is more fascinated with technology than conventional methods. More importantly, maintaining a healthy teacher-student relationship and providing a safe learning environment for the students can play a defining role in augmenting the learning process.[21,22,23,24]


A number of factors are responsible to impact the learning acquisition process among medical students. It is important that a teacher should be aware of these wide gamut of factors so that they can play a defining role in neutralizing some of these factors and encourage students to continue to learn.

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Conflicts of interest

There are no conflicts of interest.


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High achievers; learning; low achievers; medical education

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