Results
revision . Finally , survey items were reviewed by three administrators at our institution with extensive experience in medical education . Demographic information collected by the survey included : student ID number , learning pathway , age , gender identity , undergraduate major and year of graduation , and experiences prior to matriculation . Students were then asked how much time they spent studying on weekdays , as well as weekends , in addition to the characteristics of their breaks during those study periods . Students were requested to identify a primary study method , as well as reporting any secondary methods they used . Some survey items were targeted to how students dealt with difficulties or stress . For example , students were asked whether they have sought academic help at LECOM . Additionally , they were asked to provide examples of how they coped with the stress of medical school . Lastly , students were asked if they were aware of mental health resources at our institution and whether they agreed that LECOM provides adequate mental health resources to students .
The remainder of the survey consisted of questions , detailed in Tables 1 and 2 , that evaluated the student ’ s wellbeing , academic confidence , and study techniques . Responses were provided on a Likert scale ranging from “ not at all typical of me ” to “ very typical of me ,” with “ not very typical ,” “ somewhat typical ,” and “ fairly typical ” as intermediates . The 57-item survey was distributed to the students after completion of the human gross anatomy course via Survey Monkey . Participation in the study was entirely voluntary and was not incentivized . Not all participating students responded to all survey questions , leading to variability in sample size depending on the survey item .
The principal investigator linked survey responses to final gross anatomy course grades , then immediately deidentified the data . Prior to survey administration , institutional review board approval was given to conduct this study ( Lake Erie College of Osteopathic Medicine IRB Protocol 27-067 ). A copy of our survey is included in the supplemental material of this report .
STATISTICAL ANALYSIS
Statistical analysis was performed using Prism 9 software . Descriptive statistics were first generated to summarize survey response data based on response groups . The D ' Agostino-Pearson normality test indicated that our data was non-parametric . Therefore , the Mann Whitney U and Kruskal-Wallis tests were used as appropriate . Kruskal-Wallis tests were followed by Tukey ’ s B post hoc analysis for multiple comparisons . Finally , the correlation between student age and final anatomy course grade was evaluated with a Spearman rank test . We used an alpha of 0.05 to determine statistical significance .
Results
EDUCATIONAL BACKGROUND AND DEMOGRAPHICS
Of the 493 medical students invited to participate , 141 students submitted survey responses for a response rate of 28.6 %. The medical students in this study had a mean age of 24.7 years and 57 % of respondents were female . The age of respondents was consistent with the national average for matriculating medical students in 2019 ( Murphy , 2019 ), whereas more respondents were female compared to 51.9 % for osteopathic medical schools on average ( Murphy , 2021 ). Overall , the mean final course grade for the 2020 gross anatomy cohort was 87 % with a standard deviation of 9.1 %. No significant correlation was found between age and final grade in gross anatomy ( r ( 140 ) = 0.08386 , p = 0.3240 ). Additionally , no significant difference in final course grade was found between male and female students ( U ( 140 ) = 2042 , p = 0.1220 ).
Students were asked to report their undergraduate majors , which were then categorized as biological science ( n = 98 ); science , non-biological ( n = 32 ); non-science ( n = 5 ); and allied health ( n = 6 ). Allied health majors included emergency medicine , nursing , and physician assistant studies . Cumulative final grade did not differ amongst these groups ( H ( 3 ) = 5.042 , p = 0.1688 ). Prior job or volunteering experience was stratified into healthcare ( n = 81 ); non-healthcare , non-science ( n = 22 ); science ( n = 21 ); and none ( n = 16 ). No difference in final course grade was found between these groups ( H ( 3 ) = 1.422 , p = 0.7003 ). Students were also stratified into three groups based on the amount of time elapsed since completion of undergraduate studies : 0-2 years ( n = 91 ), 3-4 years ( n = 20 ), and 5 + years ( n = 24 ). Students who graduated 0-2 years prior to matriculation earned a higher final grade ( 89 %) than students graduating 3-4 years prior to matriculation ( 84 %) ( H ( 2 ) = 7.569 , p = 0.0227 ). Students 5 + years