Patel R S, Tarrant C, Bonas S, Shaw R L
Department of Medical and Social Care Education, University of Leicester, Leicester, UK.
Department of Health Sciences, University of Leicester, Leicester, UK.
BMC Med Educ. 2015 May 12;15:86. doi: 10.1186/s12909-015-0371-9.
Failing a high-stakes assessment at medical school is a major event for those who go through the experience. Students who fail at medical school may be more likely to struggle in professional practice, therefore helping individuals overcome problems and respond appropriately is important. There is little understanding about what factors influence how individuals experience failure or make sense of the failing experience in remediation. The aim of this study was to investigate the complexity surrounding the failure experience from the student's perspective using interpretative phenomenological analysis (IPA).
The accounts of three medical students who had failed final re-sit exams, were subjected to in-depth analysis using IPA methodology. IPA was used to analyse each transcript case-by-case allowing the researcher to make sense of the participant's subjective world. The analysis process allowed the complexity surrounding the failure to be highlighted, alongside a narrative describing how students made sense of the experience.
The circumstances surrounding students as they approached assessment and experienced failure at finals were a complex interaction between academic problems, personal problems (specifically finance and relationships), strained relationships with friends, family or faculty, and various mental health problems. Each student experienced multi-dimensional issues, each with their own individual combination of problems, but experienced remediation as a one-dimensional intervention with focus only on improving performance in written exams. What these students needed to be included was help with clinical skills, plus social and emotional support. Fear of termination of the their course was a barrier to open communication with staff.
These students' experience of failure was complex. The experience of remediation is influenced by the way in which students make sense of failing. Generic remediation programmes may fail to meet the needs of students for whom personal, social and mental health issues are a part of the picture.
在医学院未能通过一场高风险评估，对于经历此事的人来说是一件大事。在医学院挂科的学生在专业实践中可能更易遇到困难，因此帮助个人克服问题并做出恰当应对很重要。对于哪些因素会影响个人如何体验失败或在补考中理解失败经历，人们了解甚少。本研究的目的是从学生的角度，运用解释现象学分析（IPA）来探究围绕失败经历的复杂性。
对三名未能通过期末考试补考的医学生的叙述，采用IPA方法进行深入分析。IPA用于逐案分析每份成绩单，使研究者能够理解参与者的主观世界。分析过程突出了围绕失败的复杂性，同时还有一段描述学生如何理解这段经历的叙述。
学生在临近评估及期末考试失败时所面临的情况，是学业问题、个人问题（特别是经济和人际关系）、与朋友、家人或教师关系紧张以及各种心理健康问题之间的复杂相互作用。每个学生都经历了多方面的问题，每个问题都有其独特的组合，但他们将补考视为一种只专注于提高笔试成绩的一维干预。这些学生需要的是临床技能方面的帮助，以及社会和情感支持。对课程被终止的恐惧阻碍了他们与教职员工的坦诚沟通。
这些学生的失败经历很复杂。补考经历受学生理解失败方式的影响。通用的补考计划可能无法满足那些个人、社会和心理健康问题也是其中一部分的学生需求。
