Cox Justin, Grover Sarika, Kharileh Sophie, Haber Katherine, Savage Nicola, Fuller Jonathan
Barts and The London School of Medicine and Dentistry, Queen Mary University of London, London, GBR.
Medicine and Surgery, George Eliot Hospital NHS Trust, Nuneaton, GBR.
Cureus. 2025 Jul 15;17(7):e87996. doi: 10.7759/cureus.87996. eCollection 2025 Jul.
Background Academic failure is a common and often constructive part of medical education. For many students, encountering setbacks can serve as valuable learning experiences that foster resilience, self-awareness, and professional growth. Medical students, often high achievers, typically struggle with a fear of failure. This is usually driven by misconceptions of the consequences and of remediation. This, in turn, results in psychological distress, anxiety, and burnout. Despite its inevitability, perceptions of academic failure remain poorly understood and under-discussed. This study aims to evaluate medical students' understanding of academic failure, perceived consequences, and suggestions for improving institutional transparency and support. Methods A cross-sectional study was conducted in October 2023 via convenience sampling, using a semi-structured questionnaire to assess the perceptions of United Kingdom-based clinical medical students on their perceptions of the consequences of academic failure and their recommendations for institutional change. Data were thematically analysed to identify a consensus, common patterns, noteworthy responses, and alignment with literature. Results A total of 30 students were included in the study, of whom 19 (63%) self-reported a good understanding of academic failure, while 11 (37%) indicated poor understanding, largely due to institutional ambiguity. Key academic concerns included deregistration (n=11, 37%) and exam retakes (n=7, 23%). Twenty-two (73%) students perceived little to no career impact. Personal consequences were more prominent, with 17 (57%) citing mental health decline and 16 (53%) noting loss of self-worth. Twenty (67%) students emphasized the need for procedural transparency regarding failure and remediation, with 11 (37%) calling for clearer information, and 15 (50%) suggesting cultural shifts away from perfectionism. Many recommended open discussions about failure (n=13, 43%) and tailored support for struggling students (n=11, 37%). Conclusion Medical students demonstrate varied understanding of academic failure, with personal consequences outweighing academic or professional concerns. Uncertainty about remediation procedures exacerbates fear and distress. Increased institutional transparency and efforts to reduce the stigma, without trivialising failure, and proactive, targeted support could modulate fear of failure and improve outcomes. Future research should broaden the student cohort and scope, for example, to include a wider range of medical students at multiple stages of education to further inform comprehensive support strategies in medical education.
背景 学业失败是医学教育中常见且往往具有建设性的一部分。对许多学生来说，遭遇挫折可以成为宝贵的学习经历，培养韧性、自我认知和职业成长。医学生通常成绩优异，却常常因害怕失败而挣扎。这通常是由对后果和补救措施的误解所驱动的。这反过来又会导致心理困扰、焦虑和倦怠。尽管学业失败不可避免，但人们对其认知仍知之甚少且讨论不足。本研究旨在评估医学生对学业失败的理解、感知到的后果，以及对提高机构透明度和支持的建议。方法 2023年10月通过便利抽样进行了一项横断面研究，使用半结构化问卷评估英国临床医学生对学业失败后果的认知以及他们对机构变革的建议。对数据进行主题分析，以确定共识、常见模式、值得注意的回答以及与文献的一致性。结果 共有30名学生参与了该研究，其中19名（63%）自我报告对学业失败有较好的理解，而11名（37%）表示理解不佳，主要原因是机构规定不明确。关键的学业问题包括被取消注册（n = 11，37%）和重考（n = 7，23%）。22名（73%）学生认为对职业影响很小或没有影响。个人后果更为突出，17名（57%）提到心理健康下降，16名（53%）指出自我价值丧失。20名（67%）学生强调在失败和补救方面需要程序透明，11名（37%）要求提供更清晰的信息，15名（50%）建议从完美主义文化转变。许多人建议就失败进行公开讨论（n = 13，43%）并为 struggling 学生提供量身定制的支持（n = 11，37%）。结论 医学生对学业失败的理解各不相同，但个人后果比学业或职业问题更为突出。补救程序的不确定性加剧了恐惧和困扰。提高机构透明度并努力减少耻辱感，同时不轻视失败，并提供积极、有针对性的支持，可以调节对失败的恐惧并改善结果。未来的研究应扩大学生群体和范围，例如，纳入更广泛的处于不同教育阶段的医学生，以进一步为医学教育中的综合支持策略提供信息。
