FACTORS AFFECTING THE ACADEMIC ACHIEVEMENT OF THE

STUDENTS OF WOMEN MEDICAL AND DENTAL COLLEGE,

ABBOTABAD

By
4th Year MBBS (Batch B)
For
4th Professional MBBS Final Exam
Supervised by: Brig. Dr. Khalid Mehmood

Department of Community Medicine

WOMEN MEDICAL AND DENTAL COLLEGE ABBOTABAD
 EXAMINATION PERFORMA

1. Assessment by internal examiner

Date: __________ Prof. Iqbal Ahmad Khan: _____________

2. Assessment by external examiner

Date: __________ Professor: ______________________

i
 SUPERVISOR’S CERTIFICATE

It is to certify that Batch B of 4th Year MBBS has been working under my supervision. I
have gone through this dissertation and have found it satisfactory for submission to examiner
in partial fulfilment of 4th Year MBBS Professional Examination.

Date: ___________ Brig. Dr. Khalid Mehmood: _______________

Women Medical and Dental College, Abbottabad

ii
 DECLARATION BY STUDENTS

It is to certify that research project under the caption of “Factors affecting the academic
achievement of students of Women Medical and Dental College, Abbottabad”, was
successfully completed by the students of Batch B, 4th Year MBBS, of this institution that
included the following students:
STUDENT’S NAMES SIGNATURES
Kainat Rashid
Maleeha Ahmad
Mariam Ashraf Khan
Hajira Aziz Yousafzai
Mahpara Khalid
Mahnoor Rashid
Mahrukh Habib
Maryam Saboor
Manayel Badar
Javeria Malik
Maria Umer
Kainat Munir
Zunaira Daniel
Nadia Malik
Kashmala Sultan
Nadia Afridi
Hurmat-ul-Alain
Palwasha Khan
Savaira khan
Maryam Kiyani
Iqra Afzal
Maryam Safeer
Minsa Fatima Tareen
Memona Kamran
Maryam Maqsood
Malghalarah
Kainat Bakht Khan
Sana Afridi
Sana Nawaz
Sana Tahir
Mehr-un-Nisa
Summaia Ali
Mahnoor Fatima

Dated: ___________

iii
 All these students conducted research, had a team work and learned the art of drafting
proposal, development of questionnaire, data collection, data entry, analysis by MS Excel 2019
and writing a technical report. I wish them best of luck for their future academic and professional
careers.

_______________________ ________________________
Brig. Dr. Khalid Mehmood Brig. Dr. Iqbal Ahmad Khan
Women Medical and Dental College HOD Community Medicine
Women Medical and Dental College

iv
DEDICATED TO OUR TEACHERS AND FAMILY

v
 ACKNOWLEDGEMENT

“We are thankful to Allah who is the most beneficial and merciful, who by pen taught
men what he did not know.” (Al Quran)
First and foremost, we want to offer this endeavour to Almighty Allah for his countless
love and the wisdom he bestowed upon us, the strength, peace of mind and good health in order
to finish this project especially during the COVID-19 pandemic. Throughout this entire study, he
took care of everything that would have stopped us from our work and strengthened us through
our most difficult time.
The completion of this undertaking would not have been possible without the able
guidance, supervision and assistance of so many people whose names may not all be enumerated.
Their contributions are sincerely appreciated and gratefully acknowledged.
We are extremely thankful to our Head of Department Brig. Dr. Iqbal Ahmad Khan,
who constantly encouraged and supported us during this research project.
We would like to express our deepest gratitude and thanks to our keen supervisor Brig.
Dr. Khalid Mehmood from Community medicine; for his assistance, guidance and constant
supervision as well as for providing necessary information regarding this research. It was a great
privilege and honour to work under his guidance.
We would also like to appreciate and acknowledge the hard work put by all the
participants and showed great unity while searching and collecting the research material. We want
to extend our thanks to all the respondents for their honest and co-operatives response towards all
the questions solicited in this study. Special appreciation goes to our colleagues and people who
have willingly helped us out with their abilities during the project.
Finally, we would like to express our debt of gratitude to our parents for their support,
prayers, and sacrifices in educating us. They have played one of the most important roles in
completing this endeavour. This study has indeed helped us learn the art of conducting a research.
It was not just a research but a ladder for future projects and studies.

vi
 TABLE OF CONTENTS

❖ ABSTRACT
Chapter I: Page No.
❖ INTRODUCTION:
• Background............................................................................................................1
• Literature Review..................................................................................................2
• Rationale................................................................................................................4
Chapter II:
❖ METHODOLOGY:
• Aim and Objectives ...............................................................................................5
• Operational Definition............................................................................................5
• Study Design...........................................................................................................5
• Study Population.....................................................................................................5
• Study Site................................................................................................................5
• Study Duration........................................................................................................5
• Sample Size.............................................................................................................5
• Inclusion Criteria.....................................................................................................5
• Sampling Technique................................................................................................5
• Data Collection Instrument......................................................................................5
• Data Collection Procedure.......................................................................................5
• Variables of Interest.................................................................................................5
• Data Entry................................................................................................................5
• Data Analysis...........................................................................................................6
• Ethical Consideration ..............................................................................................6
Chapter III:
❖ RESULTS AND ANALYSIS ......................................................................................7
Chapter IV:
❖ DISCUSSION ..............................................................................................................32
❖ CONCLUSION............................................................................................................34
❖ RECOMMENDATIONS............................................................................................35
Chapter V:
❖ REFERANCES ...........................................................................................................36
❖ ANEXURES:
• Informed consent form ...........................................................................................38
• Questionnaire...........................................................................................................39

vii
 LIST OF FIGURES

Figure No. Title Page No.

1. Residential status of the students during the session........................................7
2. Average score annually.....................................................................................8
3. Stay at hostel during preps................................................................................9
4. Choice of Medical profession.........................................................................10
5. Study habits......................................................................................................11
6. Study hours per day..........................................................................................12
7. Preferred study timings....................................................................................13
8. Behaviour towards attending the lectures........................................................14
9. Attitude towards stages and modules...............................................................15
10. Frequency of attending classes.........................................................................16
11. Support of teachers in academic improvement................................................17
12. Leisure time......................................................................................................18
13. Time management............................................................................................19
14. Hours spent on social networking....................................................................20
15. Exercise............................................................................................................21
16. Stress in exams.................................................................................................22
17. Effects of stress on daily life studies................................................................23
18. Ways to reduce stress.......................................................................................24
19. Measures taken to focus on studies..................................................................25
20. Effect of peer pressure.....................................................................................26
21. Understanding with roommates.......................................................................27
22. Effects of electricity load shedding on studies................................................28
23. Change in behaviour after admission in Medical College...............................29
24. Utilization of Library facility................................................................30
25. Effects of family problems on studies..............................................................31

viii
ABSTRACT
 FACTORS AFFECTING THE ACADEMIC ACHIEVEMENT OF THE
STUDENTS OF WOMEN MEDICAL AND DENTAL COLLEGE,
ABBOTABAD

ABSTRACT
INTRODUCTION:
Medicine is one of the longest and most stressful course of undergraduate study program.
It is a demanding field that requires skilled and competent physicians. Although students with
high intellectual capacity and good past academic record are selected to study medicine, their
performance varies widely. In order to identify the reasons and factors being influential on
academic achievement, this study was carried out on the students of Women Medical and Dental
College with the hope of benefiting from results and assisting in reducing the failure rate in
medical students.

OBJECTIVES:

1. To determine the factors influencing academic performance of students of Women Medical

and Dental College.
2. To suggest measures in order to improve their performance based on factors identified.
METHOD:
A cross-sectional study was conducted over a period of 5 months from 01 st July 2020 to
th
25 November 2020. A sample of n=150 MBBS students of Women Medical and Dental College,
Abbottabad was taken through convenient sampling. Data was collected using self-structured
questionnaire and analysed using Microsoft Excel 2019.
RESULTS:
According to the study findings, various factors affect the performance of medical
students. Selection of profession by choice (57.0%), attending stages and modules regularly
(82.6%), time management (57.3%), daily studying (43%) and day time studying (49.3%) played
a positive role on student’s academic performance. Whereas selection of profession under
influence of family and relatives (18.1%), avoiding stages and modules (16.6%), prolonged use
of social media (69.32%), poor stress management (93.96%), lack of exercise (49.7%), peer
pressure (39.5%) and family problems (49.7%) led to lower academic achievement. 100% of the
respondents knew that by avoiding distractions and increasing study hours, they can achieve better
in their professional examinations.

CONCLUSION:
The final conclusion of the study is that it helped us to identify factors that correlate with
academic performances among medical students. Student who opt for medical education by
choice and properly manage hostel time, regularly attend classes and stages, take notes and study
in groups are more likely to achieve better results in their exams.

Key Words:
Medical students, Academic performance, Low academic achievement.

ii
CHAPTER I
 INTRODUCTION

Medical practice is regarded as a noble profession since it provides an opportunity to

serve the people in need.1 The goal of medical education is to create knowledgeable, skilled,
competent and professional physicians. Medicine is one of the longest and most stressful course
of undergraduate study program. It is a complex and demanding field of study and medical
undergraduates not only require skill and competence in multiple disciplines, but they also need
to acquire knowledge on a wide range of subjects over a limited time period. 2

The top academic achievers in pre-medical studies, filtered through an extensive

screening process make it to medical schools. However, once the students are enrolled to
medical colleges their performance varies widely, whereby some students manage to perform
good academically while the others barely manage to pass. Finding out why some students
cannot perform well academically is important as this knowledge can then be utilized to
promote the factors that contribute to high academic achievement. Extent of occurrence of low
achievement among the medical students as well as the contributory factors vary among
different institutions.3
Medical student’s academic performance attracts the attention of all those involved in
medical education. Many studies have been carried out to explore and identify factors affecting
students’ academic performance or achievement in medical school. Study characteristics, their
life style, learning environment and instruction activities contribute to their achievements. It
has been found that study skills, habits, attitudes and motivation has also got strong relationship
with academic performance.4
In order to identify the reasons and factors being influential in our institution, this study
was carried out due to lack of such information at Women Medical College Abbottabad. So,
this study was performed on educational performance in this college with the hope of benefiting
from results of this research for any related and interested persons. What exactly are the causes
of low achievement in this institution? Does the parental background and home-related issues
affect it or do the lifestyle factors plays a role? As defined by Collins English Dictionary, “a
set of attitudes, habits or possessions associated with a particular person or group”. 5
Generally, three groups of factors are associated with low academic achievement. The
first factor is related to the students themselves. It includes frequent absentees and lack of
academic motivation. The second factor is related to the university environment consisting of
no extra-curricular activities, poor attitude towards courses, and relationship with teachers and
friends. The last factor is associated with the students' family attitudes and consisted
overprotection and over control.6
Academic achievement levels of medical students are also affected by variables such
as intelligence ability, personality, family characteristics, school of graduation, habits,
environment, level of welfare, current basic training and the skill of benefiting from provided
vocational trainings.7 Factors such as loneliness, exam anxiety, current university’s level of
meeting the expectations of students in addition to other segments of society, and the pressure
of finding employment after graduation also affect academic achievement.8

Recognition of the factors that influence academic performance among students can
assist in reducing the failure rate in medical students. This would act in the best interest of the
nation’s investment.9

1
 LITERATURE REVIEW

Students’ academic achievements play a significant role in producing physicians who

can be great leaders, meet the future challenges, and contribute towards society in areas of
health and fitness.10 It occupies a very important place in education as well as in the learning
process. In fact, it is still the most topical debate in higher learning institutions that caused
great concern to educators and researchers due to the alarming examination performance of
students.11

What are the key factors responsible for affecting medical students' academic
performance both negatively and positively? Many studies have been carried out to answer this
question. Abdulghani and Hamza M., et al reported that Medical students’ academic
achievement is affected by motivational beliefs and emotions. They concluded that factors
leading to high academic achievement include attendance to lectures, early revision,
prioritization of learning needs, deep learning, learning in small groups, mind mapping,
learning in skill labs, learning with patients, learning from mistakes, time management and
family support. Internal motivation and expected examination results are important drivers of
high academic performance. Management of non-academic issues like sleep deprivation,
homesickness, language barriers, and stress is also important for academic success.12

Most cognitive theorists and researchers like Van der Veer and Valsinere have
acknowledged that poor academic self-concept, low self-esteem, negative attitudes towards
study or erroneous perception of students may be associated with poor academic
performance.13 Another study by Syed Tahir Hijaz and Raza Naqvi found that attitude towards
study has a significant influence on examination performance and thus confirmed the earlier
finding by Van Der Veer and Valsinere.14

Strategic studying techniques may affect students’ performance positively in their

examination. Strategic studying is defined as the knowledge and application of effective study
skills or techniques by the students.15 According to researchers there are many efficient study
techniques that could be used by students based on the learning environment.16, 17 Another
factor associated with strategic studying technique is time management skills which include
activities performed by students such as planning in advance, prioritizing work, test
preparation, and following schedules.18 Balancing time management and study techniques may
achieve higher academic performance effectively as described by Entwistle & Ramsden. 19
Class attendance is believed to have positive relationship with students’ academic performance.
Jennjou Chen, in his study, found that class attendance has produced a positive and significant
impact on students’ exam performance. His results revealed that, on average, attending lecture
corresponds to a 7.66% improvement in exam performance. Most universities have taken class
percentage into serious consideration and have made a strict policy of barring the student from
examination when the percentage of the attendance is less than 75%.20 Subramaniam & Barathi
has shown that when the attendance mandate for the medical course in Melaka Manipal Medical
College, Manipal, India was increased from 75% to 90% there was a significant correlation
between attendance and the students who passed in the University exam. They concluded that
reducing absenteeism, probably contributed to the improved academic performance of the
students.21

2
 Various studies confirm that peers influence does have impact on student
performance.22, 23 Gonzales et. Al has shown that Peer support was positively related to
student’s examination score and grade.24 Wilkinson and Fung in their study concluded that
by grouping students in heterogeneous learning ability (low ability students grouped with
high ability students) will show an improvement in learning process and outcomes thus
highlighting the positive impact of peer learning.25

Al Shawwa and Lana, et al. in a study concluded that excellent medical students
have many different characteristics. For example, they do not use social networking for
prolonged periods of time, and they have strong motivation and study enjoyment.26

Yusoff et al. reported that excessive stress causes physical and mental health
problems. Persistent stress can impair students’ academic achievement and personal or
professional development. They found that the prevalence of stress among the medical
students was 29.6%.27 This fact was also observed by Abdulghani et al, that medical
education is perceived as being stressful and a high level of stress may have a negative
effect on cognitive functioning and learning of students in a medical school.28

Chinawa et al. reported that medical students are a population who are at great risk
of having bad sleep practices and hygiene due to demanding clinical and academic
activities.
They found unusual sleep practices such as sleep walking, talking or night terrors and
they concluded that this varying degrees of sleeping practice and behavior may affect
academic performance.29

In the year (2016) Zahedani and Zahra Zahed et al. found that several factors
affect the academic performance of college students. Parenting style is one significant
factor and that parents have an important role in identifying children’s talent and guiding
them.30 Jamali and Makiee et al. have investigated factors affecting academic self-
efficacy and its association with academic achievement. They concluded from their
results that academic self-efficacy was an effective factor on academic achievement and
it can be improved by designing appropriate interventions to control academic stress and
increase the level of support by family and teachers.31

3
 RATIONALE
Several studies have been published in the medical literature which have addressed
the problem of poor performance of medical students in various institutions. These studies
have revealed their limitations and the consequent need for providing measures in order to
rectify the factors that contribute to the academic failure.

However, no such study has been carried out in Women Medical and Dental College
and so far the factors affecting the academic performance of its students are not identified.
It’s very important to precisely identify those factors which leads to failure and poor
performance of students who otherwise had good previous academic record. By accurately
defining and identifying these factors we will enable the institution and faculty to develop
policies for rectification of these issues.

4
CHAPTER II
 METHODOLOGY
AIM:
To know about the factors that affect the performance of medical students.
OBJECTIVES:

1. To determine the factors influencing academic performance of students of Women Medical

and Dental College.
2. To suggest measures in order to improve their performance based on factors identified.
OPERATIONAL DEFINITION:

Achievement: It is the end result of effort exaggerated by students. It represents the outcomes
that indicate the extent to which a person has accomplished specific goals. Low academic
achievement means students who have scored less than 60%, got into supplementary or had
to re-take it next year.
STUDY DESIGN:
Cross Sectional study.
STUDY POPULATION:
Study was conducted on medical students.
STUDY SITE:
Women Medical and Dental College Abbottabad.
STUDY DURATION:
The study was carried out in a period of 5 months from 1st July to 25th November 2020.
SAMPLE SIZE:
A sample of 150 students of Women Medical and Dental College was collected.
INCLUSIVE CRITERIA:
Students of MBBS were included.
SAMPLING TECHNIQUE:
Convenient Sampling.
DATA COLLECTION INSTRUMENT:
Self-structured questionnaire.
DATA COLLECTION PROCEDURE:
An informed consent was taken from the respondents under study. Data was collected by
filling a preformed questionnaire including several variables of interest. The questionnaire
was kept anonymous and complete secrecy of the information was ensured.

DATA ENTRY:
Data was entered into Microsoft Word.
DATA ANALYSIS:
Data was analyzed using Microsoft Excel.
5
ETHICAL CONSIDERATION:

The proposal was submitted to the Ethical Committee of Women Medical and Dental
College, Abbottabad for consideration and approval. An informed written consent was
obtained from the respondents under study. It was assured that no harm was being given to
the participants. And no one was forced to participate in the survey.

6
CHAPTER III
 RESULTS AND ANALYSIS

The analysis of factors influencing students' academic performance is summarized and

presented in the figures below:

1. Study population; 34.9% of the students are day scholars while 65.1% stay at the hostel.

Hostel

Figure No. 1: Residential status of students.

 7
2. On average, 46.6% of the respondents scored 60-70%, 33.3% scored 70-80%, and
15.3% scored 50-60% while 4% scored below 50% in their annual examinations.
Frequency

Responses

Figure No. 2: Average score annually.

 8

3. 51.6% of the subjects stay at hostel during their preparatory leave while 45.1% prefer
staying at home.

Figure No. 3: Stay at hostel during preps.

9
4. 57% of the respondents’ opted Medical profession on their own interest, 23.5% opted
to serve humanity as ambition while 18.1% opted under the influence of
family/relatives. 1.4% considers Medical profession as a good source of making money.

Figure No. 4: Choice of Medical profession.

10
5. 53.7% of students responded that they study in isolation, 40.3% study both in groups
and isolation while only 6% prefer combined study.

Figure No. 5: Study Habits.

11
6. 40.3% study at least 2 to 4 hours per day, 32.9% study 4 to 6 hours per day and 16.1%
study for 6 to 8 hours per day. Results showed that only 10.7% of the students study to
a maximum of 8 to 10 hours per day.

Figure No. 6: Study hours per day.

12
7. 49.3% preferred studying during day time, 32.6% study at night time and 17.3% of
the students mostly study early in the morning.

Frequency

Responses

Figure No. 7: Preferred study timings.

13
8. 38.9% prefer taking hand-written notes during the lecture while according to 28.2%,
carefully listening to lecture and reviewing the topic at home is more important than
taking notes. 16.8% responded that they only listen to the lecture while 16.1% do not
listen at all.

Figure No. 8: Behaviour in attending the class.

`14
9. 82.6% prepare regularly for their stages, 14.6% tend to avoid stages while 2% do not
appear in their stages at all.
Frequency

Responses

Figure No. 9: Attitude towards stages and modules.

15
10. According to 36% of the subjects under study, attending lectures is important and they
do not skip them at all, 54.6% try not to skip their lectures while 8.6% seldom attend
their classes.

Frequency

Responses

Figure No. 10: Frequency of attending classes.

16
11. 55.33% of the respondents’ agree that the easy approachability of teachers play an
important role in academic improvement while 27.3% strongly agree with this
statement. 12.66% don’t think that teacher’s approachability is important while 4%
strongly disagree with the above statement.
Frequency

Responses

Figure No. 11`: Support of teachers in academic improvement.

17
12. 32.9% of the respondents’ spend their leisure time mostly in sleep, 30.9% prefer
spending time with friends, 6.8% mostly use internet while 9.4% are in favour of
physical activities.

Figure No. 12: Leisure time.

18
13. 33.33% students manage their time by making to-do lists/schedules and timetables,
24% do this by avoiding unnecessary distractions, 29.3% completely fail to manage
their time while 12.66% subjects have a haphazard routine.
Frequency

Responses

Figure No. 13: Time management.

19
14. According to the results, 96.66% of the medical students are daily users of social media.
Among these, 48.66% uses it around 3-4 hours daily while 20.66% spend most of their
time on social media i.e. 5 to 7 hours daily. The remaining 2.66% do not use social
networking sites at all.
Frequency

Responses

Figure No. 14: Hours spent on social media.

20
15. Most of the medical students (49.7%) do not exercise at all while among the remaining
50.3%, 16.8% exercise 3-5 times a week, 20.8% practice it less than 3 times a week
while 12.8% exercise daily.

Figure No. 15: Exercise.

21
16. According to our study, 70.66% of the medical students get stress during exams,
17.33% of them experience it sometimes while 11.33% didn’t complain of any stress
during their examinations.
Frequency

Responses

Figure No. 16: Stress during exams.

22
17. It was observed that majority of the subjects under study (99.4%) have experienced
effects of stress on their daily life and studies. Among these, 55.7% answered that they
can’t concentrate well on their studies due to stress, 18.1% becomes irritable, 12.8%
becomes insomniac while the other 12.8% are affected to an extent that they leave
studying. Very few students i.e. 0.6% didn’t complain of any stress effects.

Figure No. 17: Effects of stress on daily life and studies.

23
 18. It was found that 53 students (35.3%) relieve their stress by consumption of tea/coffee
and 90 students (60%) use sleep as a means of escape from stress. 30 students (20%)
practice exercise and physical activities while 13 students (8.66%) use medication to
reduce their stress.
Frequency

Responses

Figure No. 18: Ways to reduce stress.

24
19. 83.33% under study consume tea/coffee/smoke in order to maintain focus on studies
while 15.3% of the students don’t use such things in this regards.
Frequency

Responses

Figure No. 19: Measures taken to focus on studies.

25
20. This study showed that 39.5% of the students were negatively affected by peer pressure
while 29.5% were positively affected. 28% remained unaffected.
Frequency

Responses

Figure No. 20: Peer pressure affects.

26
21. 48.66% of the hostelites responded that they feel comfortable with their roommates
while 20.6% completely disagreed with this statement. 30% of the subjects stated that
the situation depends at times.
Frequency

Responses

Figure No. 21: Understanding with roommates.

27
22. Majority of the students’ i.e.74.66% were greatly affected due to electricity load
shedding while 24.66 students remained unaffected.
Frequency

Responses

Figure No. 22: Effect of electricity load shedding on studies.

28
23. According to the results, 50.3% students responded that their parents/siblings have
observed change in their behaviour after admission in Medical College while 40.7%
didn’t complain of any change.

Figure No. 23: Change in Behaviour after admission in medical college.

29
24. 38.9% of the subjects under study prefer room for studying, 24.8% visit library at times
while 36.3% do not visit library at all.

Figure No. 24: Utilization of library facility.

30
25. According to our study, most of the medical students i.e. 84.5% responded that social
norms/family problems affect their studies, 4% of the students were not sure in this
regards while 11.5% of the students remained unaffected.

Figure No. 25: Effect of social norms/family problems on studies.

31
CHAPTER IV
 DISCUSSION
The research regarding factors affecting the academic achievement of students was
carried out among MBBS students in Women Medical and Dental College, Abbottabad.
Students from first till final year MBBS were included in the study. In this study, daily habits,
time utilisation, study patterns and behaviour of medical students was assessed which helped
in identifying the factors that directly affect the performance of medical students.
This study was conducted on 150 students with mean age of 21.5 years, the youngest
participant being 18 years old, whereas the oldest participant was 25 years old. All the
participants were females. On average, 46.6% of the respondents scored 60-70% in their annual
examinations. The study showed that most of the students (65.1%) stay at the hostel during
their college session while 34.9% students are day scholars. Also, the results showed that 51.6%
students stay at hostel during their preparatory leave (preps) before exams. During the study, it
was observed that competition among students at hostel is higher as compared to day scholars.
At hostel, students find no unnecessary distractions and strictly adhere to their study timetables.
While during stay at homes, family friends and other relatives often come to meet up on certain
occasions and events which acts as a source of distraction for students due to which they cannot
concentrate on their studies. In contrast, there are no such distractions in hostel which the
students find beneficial since they get ample time for study. At hostel, students have free access
to college library and they can easily borrow reference books. In short, all the essential facilities
are available at hostel and students get a study-friendly environment there which lead to good
academic performance.
During the study, it was found that 57.0% students opted medical profession primarily
on their own interest whereas 18.1% of students selected it under the influence of family and
relatives. The students who opt medical profession under the influence of their parents and
have no interest in medical studies themselves have low academic performance which leads to
stress and anxiety. In our study the level of stress was assessed. 106 students get stressed during
their exams. Stress affects the learning capability of students and ability to retain information
since most of the students (55.7%) responded that they can’t concentrate well on their studies.
According to the findings, 53 students (35.5%) of the students relieve their stress by
consumption of tea/coffee and 90 students (60%) use sleep as a means of escape from stress. It
was observed during the study that 74 students (49.7%) do not exercise at all while 31 students
(20.8%) exercise less than three times per week.
The results of this study showed that 80 students (53.7%) prefer studying in isolation
over group study while 60 students (40.3%) like to study in both ways i.e. study in isolation as
well as combined study. It was found that many of the students were persistent in daily studying
and 60 students (40.3%) studied for a minimum of 2-4 hours per day which led to a higher
academic performance. It was observed that the students preferred day time studying overnight
time as 74 students (49.6%) students studied during the day.
A research conducted in 2014 by Kumar M at Indian Journal Physical pharmacology
showed that detention in any subject due to low attendance failing before attaining final medical
degree brings extra burden on the students as well on the parents. Poor academic performance
and poor attendance often indicates difficulties in adjusting to new environment.
32
 During the study, we found that 124 students (82.6%) prepare regularly for their stages
and modules while 22 (14.6%) tend to avoid stages and 4 students (2%) do not appear in stages
at all. The students who regularly take lectures of their teachers and take notes attains good
grades in class stages. During the lectures 38.9% students prefer to take hand-written notes,
while according to some (28.2%) carefully listening to lecture and reviewing the topic at home
is more important than taking notes.
Time management is very crucial when it comes to being a medical student. It was
assessed that 50 students (33.33%) manage their time by making proper schedule, timetables,
to-do lists, 24% do this by avoiding unnecessary distractions while some students (29.3%)
completely fail to manage their time. The study of Entwistle conducted in 1983 showed that by
balancing time management and study techniques one may achieve higher academic
performance effectively.19
According to the results, 96.66% of the medical students are daily users of social media.
Among these, 48.66% uses it around 3-4 hours daily while 20.66% spend most of their time on
social media i.e. 5 to 7 hours daily. The remaining 2.66% do not use social networking sites at
all. Although, many of them consider social media bad towards study practices as they
responded that they experience disturbance in study routines due to distraction caused by its
usage. Al Shawwa, Lana et. al in 2015 conducted a research in which they concluded that
excellent medical students have many different characteristics. For example, they do not use
social networking for prolonged periods of time and they have strong motivation and study
enjoyment.26

The Mandal A in 2012 conducted a research which indicates that the academic
performance of medical students is affected by multiple factors including academic burden,
parental and peer pressure and even psychological diseases.33 The influence of peers has an
impact on the performance of students. This study showed that 59 students (39.5%) were
negatively affected by peer pressure, 44 students (29.5%) were positively affected by peer
pressure, while 42 students (28%) remained unaffected.

This study showed that stress and attitude of students towards their classes plays the
most important role in affecting academic achievement of medical students. According to the
results, most of the students did not know how to cope up with stress and did not adopt physical
activities like exercise in order to reduce stress. It was observed that the students who did not
take their classes and stages/modules on regular basis had low academic performance in
comparison to those students who took them regularly.

33
 CONCLUSION

The final conclusion of this study is that it helped us to identify factors that correlate
with academic performances among medical students. It was concluded that several factors
pose a high influence on the academic achievement of the medical students. Those who opt for
medical education by choice and properly manage hostel time, regularly attend classes and
stages, take notes and study in groups are more likely to achieve better results in their annual
exams. To attain a greater level of academic performance many different strategies need to be
pursued by a medical student and the institution. Students should be encouraged to adopt such
positive attributes and should be trained in stress management.

34
 RECOMMENDATIONS

We recommend rectification of the identified factors and support system that will help
improve performances of low achieving students, such as:

Educating parents and raising awareness regarding the negative effects of familial pressure
in career choices of their children such as long term burnout and lower academic
performances.
Developing small “medical school preparation course” that would teach premedical and
preclinical students various skills and effective study habits to help them attain greater level
of academic achievement.
All faculty members and lecturers in a medical school should be familiarized with the ways
to enhance active learning skills and should use interactive teaching patterns.
Counselling should be provided to students having problems with lack of interest, issues
with time management and other personal problems that can potentially affect their
professional life.
Awareness should be raised in medical students regarding the usage of social media and its
impact on their studies.
Students should be educated regarding the importance of attendance, stages/modules and
participation in physical activities.
Students should be encouraged to adopt such positive attributes and should be trained in
stress management.

We hope that our findings will enable our college and other medical institutions to conduct
larger studies in order to further deepen our knowledge on the topic.

35
CHAPTER V
 REFERANCES

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2014; 58(1)

37
 ANNEXURES

DEPARTMENT OF COMMUNIT MEDICINE

WOMEN MEDICAL AND DENTAL COLLEGE, ABBOTABAD
INFORMED CONSENT FORM

Name of Respondent: …………………………………………………………………….……

Age: ………………………………………… Sex: ……………………………………..…….
Designation: ……………………………………………………………………………………
Contact Information: ………………………………………………………….………………
We are conducting ………………………………………………………… (Research Topic)
Regarding this study, you will be asked a few questions. It will ace about ……………… of
your time.
You are requested to answer these questions to the best of your knowledge. If you have any
queries you can ask to elaborate.
There is no risk involved in this study except your valuable time. There is no direct benefit to
you as well. However, the results of this study may help to formulate guidelines for improving
….................................. (Recommendations). You are free to choose or refuse to participate in
the survey.
The information provided by you will remain confidential. Nobody except the principal
investigator will have access to it. Your name and identity will not be disclosed at any stage.
The data obtained in this study will be used for research purpose only.
If you have understood the Risks, Purpose and Benefits of this study. Please sign below to
show your willingness to participate in the study.

Participant’s Signature: ………………………...

Name: ……………………………………………. Date: ……………………………………

Interviewer’s Signature: ………………………..

Name: ……………………………………………. Date: ……………………………………

38
QUESTIONNAIRE
FACTORS AFFECTING THE ACADEMIC ACHIEVEMENT OF STUDENTS
OF WOMEN MEDICAL AND DENTAL COLLEGE ABBOTTABAD
QUESTIONNAIRE
Instructions: Please put a tick (✔) in the box next to the answer of your choice or write in
the space provided as the case may be. Please answer the questions as accurately as
possible. Your time and efforts are appreciated!

DEMOGRAPHICS:
Age: ______
Year: _______
1. Regarding your residential status during the session, you stay at:
Hostel
Home (Day scholar)
2. Your average score ANUALLY is:
< 50%
50 to 60%
60 to 70%
70 to 80%
3. Do you prefer to stay at hostel during preps?
Yes
No
• In either case, please specify the reason:
_______________________________________________________________________
_______________________________________________________________________
4. You opted for medical profession because:
I always had an interest in this field.
My parents/family members influenced me.
It’s my ambition to serve humanity.
I think that medical profession makes the most money

5. Regarding study habits, what do you prefer?

Studying in isolation
Group study
Both of the above
6. How many hours per day, do you study?
2 to 4 hours
4 to 6 hours
6 to 8 hours
8 to 10 hours
39
7. At what time do you study usually?
Day time
Night time
Early in the morning
8. How do you attend your teacher's lecture?
According to me, carefully listening to the teacher is very important
I prefer taking hand written notes while listening to the lecture
I just listen to the lecture
I do not listen to the lecture at all
9. Regarding your class stages/modules:
I prepare for my stages regularly0
I tend to avoid attending my stages
I don’t attend stages at all

10. How often do you skip your classes?

I never skip my classes
I try not to skip my classes
I seldom attend my classes

13. Easy approachability of your lecturer/demonstrator helps in the improvement you’re

your academic performance?
Strongly agree
Agree
Disagree
Strongly disagree
11. You prefer spending your leisure time in:
Using internet
Physical activities
Spending time with friends/family
Sleep
12. How do you manage your time?
I manage my time by making a to-do list/schedules/timetable
I manage my time mostly by avoiding unnecessary distractions
I often fail to manage my time as I cannot abide by my timetable
I have a haphazard routine

13. How many hours in a day do you spend on social networking sites?
< 2 hours
3-4 hours
5-7 hours
I don’t use social networking sites at all

40
14. How often do you exercise?
Everyday
3-5 times a week
< 3 times a week
I don’t exercise

15. Do you get stress during exams?

_______________________________________________________________________
_______________________________________________________________________
16. How does this stress affect your daily life/study?
_______________________________________________________________________
_______________________________________________________________________

17. While facing stress during exams/preps, you tend to reduce it with the help of:
Exercise/physical activities
Tea/coffee/Smoking
Sleep
Medication
18. What measures do you take to increase your focus on studies?
_______________________________________________________________________
_______________________________________________________________________
19. How does peer pressure affect your educational choices?
Positively
Negatively
Does not affect at all
20. During your stay at hostel, do you feel comfortable with your roommates?
Yes
No
Depends at times
21. Does electricity load-shedding, noise and lack of water supply affect your studies?
Yes
No
22. Have your parents/siblings ever complained of any change in your habits after your
admission in medical college?
Yes
No
• If you have answered yes, please elaborate whether it was a positive one or negative:
________________________________________________________________________
________________________________________________________________________
23. How often do you utilize the library facility at the hostel?
_______________________________________________________________________
_______________________________________________________________________

41
24. Do you think family problems/social norms affect your studies?
_______________________________________________________________________
_______________________________________________________________________

THANK YOU!

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