Discussion
Discussion
In this study of LECOM medical students , we identified several behaviors and attitudes contributing to success in gross anatomy during the COVID- 19 pandemic . Many of these factors are observable in successful medical students prior to the COVID- 19 pandemic while attending in-person programs . Therefore , this study provides insight into supporting gross anatomy students in both face-to-face and in virtual environments . These results also provide a springboard for deeper and more specific investigation of factors contributing to success in virtual gross anatomy cohorts .
EDUCATION BACKGROUND AND DEMOGRAPHICS
Medical schools in the United States attract students from a variety of backgrounds . Numerous studies have confirmed that undergraduate major does not influence success in medical school ( Hall , Woods , and Hanson , 2014 ; Muller and Kase , 2010 ; Smith , 1998 ). These findings were consistent with our virtual cohort of gross anatomy . Additionally , prior work and volunteer experience did not affect student success in the course . A similar investigation of histology students at the University of Michigan also found that past work experience did not affect students ’ final grades ( Selvig et al ., 2015 ). While length of time between undergraduate completion and matriculation did not affect student success in histology at the University of Michigan , a significant increase in gross anatomy grade was associated with attending medical school 0-2 years after undergraduate completion in our study ( Selvig et al ., 2015 ). We hypothesize that this effect is explained by the proximity to pre-medical courses taken during college , as well as familiarity with current educational technology . Though not statistically significant , those who finished undergraduate degrees 5 + years ago achieved the highest median final grade in gross anatomy compared to the 0-2 years and the 3-4 years postundergraduate groups . This effect may be due to increases in emotional intelligence and maturity that ameliorate the stress of virtual learning during the pandemic ( Shahid and Adams , 2020 ; Paterson-Brown et al ., 2015 ; Hoe , 2016 ).
STUDENT WELLNESS AND ACADEMIC CONFIDENCE
Negative consequences of mental distress on academic performance in medical students have been well documented ( Dyrbye et al ., 2014 ; Dyrbye and Shanafelt , 2016 ; Dyrbye , Thomas , and Shanafelt , 2005 ). The effects of mental distress demonstrated in our report mainly center on impaired academic confidence . As general indicators , students reporting greater life satisfaction and strong support systems exhibited superior academic performance in gross anatomy than those who did not , consistent with our current understanding of medical student wellness ( Dyrbye et al ., 2014 ). Interestingly , students with increased awareness of mental health resources at our institution had significantly lower final grades compared to those without such awareness . It may be that students with mental health issues have greater interaction with mental health resources . Poor academic performance is thus pursuant of their mental health issues rather than mental health resource knowledge . Increased fears of “ failing out ” and doing poorly on exams were associated with lower final anatomy grades . A cursory review of the literature demonstrates this fear is not unique to medical students during the pandemic ( Bynum et al ., 2019 ; Shahaf-Oren , Madan , and Henderson , 2021 ). However , the unique demands placed on those in medical fields may exacerbate any pre-existing internal expectations of performance ( Bynum et al ., 2019 ; Blake et al ., 2021 ). Fear of failing may also reflect a student ’ s correct interpretation of poor academic performance , thus resulting in an association with lower final grade . Deeply intertwined with fear of failure is a student ’ s sense of deserving a place in medical school . Our data suggest that students who feel they deserve to be in medical school perform significantly better in gross anatomy than those who do not . Again , this effect of self-merit is not unique to medical students during a pandemic ( Hu , Chibnall , and Slavin , 2019 ; Henning , Ey , and Shaw , 1998 ; Thomas and Bigatti , 2020 ). Like fear of failure , however , such feelings of inadequacy may have been exacerbated by the psychological burden of the pandemic ( Blake et al ., 2021 ).
Though fears of failure and feelings of inadequacy negatively impact academic performance , such feelings may also preclude students from seeking help . A report of student pharmacists found that help-seeking was most prevalent in students who had greater self-perceived academic confidence ( Payakachat et al ., 2013 ). Thus , students who