In this chapter, the researcher reviews several aspects of the literature surrounding factors affecting students' academic performance. Firstly, the relationship that exists between factors and students' academic performance, which is the basis of this study, is examined. This is followed by a review of past studies pertinent to the research and a detailed explanation of the conceptual frameworks that underlie the study. It is hoped that on completion of the task, some insights may be gained into the problem from a global perspective.
Most students getting into MBBS program have a good academic track record upon entry into the medical school. In Malaysian medical school it is observed that each year about 10-15% of students have difficulty in completing their medical course on time and this is a concerned to medical educators and administrators. It is important to know the reasons why there is a marked change in their academic once they come to professional courses especially medicine. Clearly, there are numerous cognitive and non-cognitive factors that have a much stronger influence on medical students' academic performance. Identifying the factors associated with students' academic performance or academic achievement in the medical course will enable the medical educators, curriculum planner and policy marker to set up support systems to help them perform better.
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Many studies are carried out to explore factors affecting students' academic performance or achievement. All of the research reviews support the hypothesis that students' performance in the medical programme depend on different socio-economic and psychological factors (Syed Tahir Hijazi & Raza Naqri, 2006). Medical students are main assets of the medical schools or colleges. In view of that, the students' academic performance and achievement plays an important role in producing the best quality graduates who will become great leader and manpower for the country thus responsible for the countries economic and social development. The performance of students in universities should be a concern not only to the administrators and educators, but also to corporations in the labour market.
Literature Review on Factors Affecting Students' Performance
Up to date many studies have been developed concerning the factors influence students' performance such as demographic, active learning, student attendance, extracurricular activities, and peers influence and course assessment. A review of the literature have indicated that student attitudes toward study, study habits and strategic learning, student psychological characteristics, learning style, family background, teachers role and many others are closely related to students' academic performance (Eccles & Wigfield, 1985; Eccles & Harold, 1993; Hanson, 1994, Ali et al.,2009). Gough and Hall (1964) mentioned that prediction of student performance in the medical school can be made by mean of the California Psychological Inventory (CPI) and this is supported by Tutton study in 1993. Other instruments such as Eysenek Personality Inventory or the Minnesota Multiphasic Personality Inventory greatly enhanced the prediction of students' performance in the medical school (Roesslet, et al., 1978; Lipton et al., 1984; Weiss, 1988).
In this study the literature search for factors affecting students' academic performance will be concentrated on student's characteristics, parent's characteristics, teacher's characteristics and college factors.
Student's characteristic and academic performance
What are the key factors that promote academic success among students whose individual characteristics place them at high risk of failure in the medical programme? Much research in recent years has focused on identifying the key factors in the student characteristics that promotes academic success. Qualities such as psychological needs and social skills, namely self-efficacy, motivation, attitudes and behaviour, academic competency, communication skills, collaboration, cooperation, and team capabilities are important for the student in the medical programme. Students who possess these skills are able to work effectively with others and managed their studies efficiently (Lust & Moore, 2006). The medical colleges could target these factors in developing strategies in improving student learning and improve their academic performance. According to Womble (2003) academic competence, self-efficacy, motivation, students' attitudes and behaviour, time management and engagement in class activities are some of the factors that affect an individuals' academic performance.
18.104.22.168 Academic Competency
Kleijn et al (1994) pointed out that academic competence is associated with students' ability to manage their study load, i.e. student with better academic competence would probably have better academic performance. Review into the literatures has indicated that the skills, attitudes, and behaviors contributing to academic competence fall into one of two domains: (i) Academic Skills or (ii) Academic Enablers (DiPerna and Elliott, 1999).
Academic Skills Subscales
Always on Time
Marked to Standard
Academic Enablers Subscales
Figure 2.1: Academic Competence Model (DiPerna & Elliot, 1999)
DiPernia and Elliot model (1999) stated the following:
Motivation reflects a student's approach, persistence, and level of interest regarding academic subjects.
Engagement reflects attention and active participation in classroom activities.
Study skills are behaviours that facilitate the processing of new material and taking tests
Interpersonal skills include cooperative learning behaviours necessary to interact with others
In the study by Demaray and Elliot (1998) it can be conclude that teachers are able in predicting their students' achievement on standardized tests such as academic competence evaluation scale and distinguishing between students with low or high academic performance. In conclusion, having a good academic competence will therefore enhance the students' ability to manage their study load and to be successful in their study. In this study, academic competence is defined as a multidimensional construct composed of the skills, attitudes, and behaviours of the student that contribute to academic success in the class.
Student's attitudes toward study
Most cognitive theorists and researchers have acknowledged that poor academic self-concept, low self-esteem, negative attitudes toward study, or erroneous perceptions of students may be associated with poor academic performance (van der Veer & Valsiner, 1991). In another study by Syed Tahir Hijaz and Raza Naqri (2006), they found that attitude towards study has a significant influence on examination performance and thus confirmed the earlier findings by van der Veer and Valsinere (1991).
Engagement in learning - There is substantial evidence that engagement in medical school or college is important in promoting student success and learning and that a number of factors in the college environment foster high levels of engagement. Student engagement can be defined as the level of participation and intrinsic interest that a student shows in college (Newmann, 1992). Engagement in college involves both behaviours (such as persistence, effort, attention) and attitudes (such as motivation, positive learning values, interest, and pride in success) (Connell & Wellborn, 1991). Connell and Wellborn indicates that engaged students seek out activities, inside and outside the classroom, that lead to success and this has been supported by Dowson and McInerney (2001). It has been showed that the engaged students learn more, retain more, and enjoy learning activities more than students who are not engaged and they are the most successful (Kirsch et al, 2002). Many school-level studies have identified higher levels of student engagement as important predictors of scores on the students' academic performance. Therefore, it can be concluded that the more the student engaged in learning the more successful they will be in their academic.
Class attendance and academic performance - Class attendance is believed to have positive relationship with students' academic performance. It was expected that high absentees from the class would have a negative effect on the student's academic grades and would decrease their examination scores and grades. Many researchers recognized that class attendance is an important aspect in improving student's performance. A study conducted by Collett et al., 2007; Stanca, 2006; Chow, 2003; Rodgers, 2001; Durden and Ellis, 1995; Romer 1993, found that attendance have small, but statistically significant, effect on student performance. Marburger (2001) concluded that students who missed class were significantly more likely to respond incorrectly to questions relating to material covered that day than were students who were present. Moore (2006) indicated that class attendance enhances learning; on average, students who came to the most classes made the highest grades, despite the fact that they received no points for coming to class. Arulampalam et al. (2007) found that there is a causal effect of absence on performance for students: missing class leads to poorer performance. On the other hand, Martins and Walker (2006) mentioned that there are no significant effects from class attendance. This is also supported by Park and Kerr (1990) and Schmidt (1993) who found an inverse relationship between students' attendance and their course grades. Jennjou Chen (2006), in his study "Class attendance and exam performance: A randomized experiment", found that class attendance has produced a positive and significant impact on students' exam performance. His result revealed that, on average, attending lecture corresponds to a 7.66% improvement in exam performance. Most universities has taken into serious consideration regard percentage of class attendance and therefore imposed a policy of barring the student from examination when the percentage of the attendance is less than 80%.
Self-efficacy and motivation
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Self-efficacy is how people feel about themselves and how much they like themselves, especially socially and academically when it comes to college students. Through the many pressures and daunting responsibilities of being a student, one learns and understands the importance of having a high self-efficacy in college. Having one's academic achievement meet one's academic expectations and desires is a major key to most college students' self-efficacy. Having a high self-efficacy has many positive effects and benefits, especially among college students. Students who feel positive about themselves succumb less easily to pressures of conformity by peers, are more persistent at difficult tasks, are happier and more sociable, and most pertinent to this study is that they tend to perform better academically.
On the other hand, college students with a low self-efficacy tend to be unhappy, less sociable and are more vulnerable to depression, which are all correlated with lower academic achievement (Wiggins, 1994). Academic achievement is influenced by perceived competence, locus of control, autonomy, and motivation (Wiest, 1998).
Past research has shown that self-efficacy and academic achievement correlate directly to a moderate degree (Wiggins, 1994). Self-efficacy studies are very popular for educational research and it has been shown that it played a very important role in academic achievement (Oxford et al., 1993). During the past decade, self-efficacy beliefs have received increasing attention in educational research, primarily in the area of academic motivation (Pintrich & Schunk, 1995).
In the case of education, self-efficacy is seen to have a relationship with effort, persistence and achievement. Chemers, Hu & Garcia (2001), in their work on mathematical problem solving, have shown that children with higher self-efficacy strived for longer periods and used more effective problem solving strategies than students with lower self-efficacy.
Studies have investigated the relationships among efficacy beliefs, related psychological constructs, and academic motivation and achievement. Findings also support Bandura's (1986) contention that efficacy beliefs mediate the effect of skills or other self-beliefs on subsequent performance by influencing effort, persistence, and perseverance (Bandura & Schunk, 1981; Lent, Brown, & Larkin, 1984; Schunk & Hanson, 1985; Bouffard Bouchard, 1990). Berry (1987) stressed that self-efficacy enhances students' memory performance by enhancing persistence. In the studies by Lent et al (1984 and 1986) demonstrated that college students with high self-efficacy achieved high academic achievement. Researchers have established that self-efficacy is a strong predictor of academic performance achievement (Pintrich & De Groot, 1990; Multon et al., 1991; Zimmerman et al., 1992; Pajares & Miller, 1994). Researches also show that self-efficacy beliefs have positive effects on student motivation and academic performance.
Strategic Studying Techniques
Strategic studying techniques may help students achieve a higher score in the examination. Strategic studying is defined as the knowledge and application of effective study skills or techniques by the students (Kleijn et al, 1994). There are many efficient study techniques that could be used by students based on the learning environment (Alvermann, 1991 and Ogle, 1986). These study strategies include Know-Want-Learn (K-W-L), Survey-Question-Read-Recite-Review (SQ3R), summarizing and note-taking, using graphics, and self-questioning. Extensive course loads and the comprehensive information covered in today's medical curricula necessitate the use of effective study strategies for academic success (Lay, 1993).
Active learning has received notably attention over the past several years. In the context of the college classroom, active learning involves students in doing things and thinking about the things they are doing (Bonwell & Eison, 1991). In the medical programme active learning involves the students to solve problems, answer questions, formulate questions of their own, discuss, explain, debate, or brainstorm during class. Bonwell and Eison (1991) concluded that active learning leads to better student attitudes and improvements in students' thinking and writing. A study by Wilke (2003) also indicated students in both the treatment and control groups demonstrated a positive attitude toward active learning, believed it helped (or would help) students to learn the material. Felder et al. (2000) recommended that active learning is one of the learning strategy methods that work. In addition, Felder and Brent (2003) mentioned that as little as five minutes of active learning in a 50-minute class session can produce a major boost in learning. According to them, active learning wakes students up. However, DeLong's (2008) study did not support the hypothesis that active learning based teaching methods will affect positive change on student performance as measured by course final grade and non-intellectual learning factors as measured by the TRAC-R (Test of Reactions and Adaptations to College-Revised), an overall measure of college adjustment. He found that factors such as professor-student rapport and professor understanding of non-intellectual factors may have influenced the current results.
Another factor associated with strategic studying technique is time management skill. Time management skills are also important to academic success. Time management skills include activities performed by students such as planning in advance, prioritizing work, test preparation, and following schedules (Kirscenabaum & Perri, 1982). Balancing time management and study techniques may achieve higher academic performance effectively (Entwistle & Ramsden, 1983; Powell, 2004). Syed Tahir Hijazi and Raza Naqri (2006) in their study found that attitude towards time allocation for study has a significant influence on examination performance, i.e. the longer duration of time allocation in studies improved the performance score.
Learning style - One of the arguments frequently put forward to explain why some students do not do as well in their academic is because they do not know how to study. Ramsden and Entwistle (1981) have shown that adopting correct learning styles do influence good achievement in examination. Learning style predict performance in medical school (McManus et al, 1998). Heidi and Stephen (2006) mentioned that medical students do have different methods of learning styles and adopting this learning style as one of the methods of strategic studying will influence their academic performance. Therefore, Blackmore (1996) suggested that it is important for educators to develop appropriate learning approaches for the students and to encourage them to adopt this preferred learning style as their strategic studying techniques.
Family background factors such as the educational level of the parent, family income or financial, parent support and educational expectation seem to exert some influence on student's academic achievement and this has been supported by several past and recent studies (Hossler & Stage, 1992; Eccles & Harold, 1993; Beyer, 1995; Paulson, 1996; Hossler et al., 1999; Checchi, 2000; Ermisch & Francesconi, 2001; Agus & Makhbul, 2006).
The relationships of parent level of education, parent educational expectation for their children, parental involvement and support and students' achievement are proposed by the Chen's Model of family influence s on student academic achievement (Chen, 1995).
Table 2.1: A Proposed Model of Family Influences on Students' Academic Performance Achievement
(Adapted from Chen (1995)
Books at home
Facilities such as computer
Attitudes toward medical education
Self-confidence in study
Parent expectations and involvement
Attitudes toward medical education
The literature review will look into the influence of these family factors on the students' performance in depth.
Influence of parent's education level on student's academic performance
In the earlier studies, Hossler and Stage (1992) and Beyer (1995) indicated that there is a positive relationship between the parent's educational level and their children success in their academic. In an extension to the earlier study, Ermisch and Francesconi (2001) found an interesting finding in their study where there is significant gradient between each parent's education level and their child's educational achievement. From Ermisch and Rrancesconi study it can be concluded that mother's education has a stronger association with her child's educational achievement than the education of the father. This result is supported by Agus and Makhbul (2002). In another study by Syed Tahir Hijazi and Raza Naqri (2006) they indicate that the level of education of mother has been found to exert the strongest influence on academic achievement as compared to level of education of father. Mothers' educational level is chosen because literatures suggest that mother's level of education is a stronger predictor of children's learning outcomes (PISA, 2000). Studies has also shown that students whose mothers have completed tertiary education performed even better in their academic than hose whose mothers have completed secondary education level. From the literature search on the impact of parent's education level on student's performance mother's education level is a strongest predictor factor and it was assumed that educated mothers can help their children to improve and keep proper check on their activities. This study is undertaken to look into the influence of the parent's level of education on the student's performance within the Malaysian context.
Family income and student's academic performance
The United States Department of Education (2000) found in a study that the relationship between family income and student's performance is not simple and direct. Johnson (1996) opined that low income of parent is a major impediment to academic success and development on the part of the students. This is because poverty or low income of parents has elastic effects on their children academic works as they lack enough resources and funds to sponsor their educational requirements and this leads to poor performance of their children.
An investigation conducted by Agus and Makhbul (2002) indicated that students from families of higher income levels perform better in their academic performance as compared to those who come from families of lower income brackets. Checchi (2000) also concluded family income provides an incentive for better student performance; richer parents internalize this affect by investing more resources in the education of their children. Once the investment is undertaken, the student fulfill parents' expectations by perform better in their studies. Based on the research done by him, he demonstrated that children from richer families perform better than those from poorer families. On the other hand, Syed Tahir Hijazi and Raza Naqvi (2006) found that there is negative relationship between student performance and student family income. Research done by Beblo and Lauer (2004) also found that parents' income and their labour market status have a weak impact on children's education. With these conflicting findings the question to be answered is 'Do family income is an issue to students' achievement in academic?' To explore the correlation between family income and students' academic performance the purpose of this study is to test the hypothesis that family financial status is associated with the academic performance of a medical student in the Malaysia.
Parent involvement, educational expectation and support
Other family factors that may influence students' academic achievement are parental involvement, educational expectation and support (Paulson, 1996). According to Eccles and Harold (1993) active involvement from the parents in their children education plays a critical role in the student's academic achievement and success. Eccles and Harold finding is supported by the studies from Beyer (1995) and Paulson and Marchant (1998).
Involving parents in the education of their children directly affects student achievement in school, college and university. It has been shown that involving parents in the education of their children helps to increase the student's achievement and self-esteem.
Fehrmann et al (1987) examines the effects of parental involvement on a larger sample of high school students and formulated that the more intensively parents are involved in their children education the more beneficial are the achievement effects. This finding holds true for all types of types and ages of students and is supported by the study of Henderson (1987). All research studies, which address these areas, found that parent involvement has positive effects on student attitudes and behaviour (Sattes, 1985; Ferhrman et al., 1978; Henderson, 1987).
The students' perception of parent educational expectation and support for learning has a strong impact on their achievement (Mau & Bikos, 2000). According to Beyer (1995) parent's educational aspirations for and expectations of their children's academic performance positively correlates with the children's grades, educational aspirations, motivation. Beyer further indicated that these parental factors encourage self-esteem and motivate the students to perform well in their academic. In summary, most of the studies reviewed indicate that students from families with high expectations and support would have higher academic achievements.
Teachers' expectation and support
The expectations teachers have for their students and the assumptions they make about their potential have a tangible effect on student achievement. Since the late 1960's researchers have been concerned with the influence of teacher expectations on student performance. Study by Bamburg (1994) clearly establishes that teacher expectations do play a significant role in determining how well and how much do students learn. Students tend to internalize the beliefs teacher have about their ability. This is supported by Raffini (1993) who clearly stated that when teachers believe in students, the students believe in themselves and this agreement between students and teachers is a significant contributor for the student success in their academic achievement. There is a tendency for teachers to get what they expect from their students. This happens because teachers have (often unconscious) tendencies to treat students differently based on how likely they think it is that students will be successful. Conversely, when students are viewed as lacking in ability or motivation and are not expected to make significant progress, they tend to adopt this perception of themselves (Gonder, 1991). Omatoni and Omatoni (1996) make a point that having high expectation does not magically equalize students' innate abilities and learning rates. Therefore, teachers were advised to routinely project attitudes, beliefs, expectation to the extent that they treat their students as if they already are eager learner and these teachers' characteristics will encourage the student to become more eager learners. This study will investigate teacher expectancy effects on the academic achievement of medical students.
Factors in the college environment that support students' academic performance
Quaglia and Perry (1996) and Wilson (1992) have investigated the significance of the school or college environment on the students' academic performance. It has been documented that factors in the school or college environment may hinder or support student's development and academic success (Esposito, 1999; Goodenow, 1993; Mouton & Hawkins, 1996).
Various studies had been done and found that peers influence does have impact on student performance (Hanushek et. al, 2002; Goethals, 2001; Gonzales et. al., 1996) and also been shown that peer influence has more powerful effects. Peer support was positively related to students' examination score and grade. Wilkinson and Fung (2002) 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. This finding can be argued tap top students can positively affect less able students by providing an assistance and mentoring. In another study, Schindler (2003) found that mixing abilities will affect weak students positively however the effect for good students is negative. Schindler finding is contradicting with Goethals (2001) study, who found that students in homogeneous group (regardless of high ability or low ability) perform better than students in heterogeneous group. Supporting the findings from Fung (2002) and Schindler (2003), Giuliodori, Lujan and DiCarlo (2006) added that peer interaction could increase student ability on solving problem-solving questions and the peer instruction will also promotes student's participation and improve student's performance.
Challenging educational environment
Research shows that students are more motivated to learn when teachers ask them to wrestle with new concepts, explain their reasoning, defend their conclusions, or explore alternative strategies and solution (National Research Council, 1999). Furthermore, students enjoy learning more when their teachers employ active pedagogical strategies. Meece suggested that when classroom instruction draws on students' pre-existing knowledge and real-life experiences the learning session will be become more interesting and enjoying which result in the student learn more better and achieved better grades in examination and academic (Meece, 1991). Cohen (1994) strengthen this finding that when students can put their heads together rather than work in isolation they are receptive to challenging assignments which will directly boost their performance.
Summary of Literature Review
Factors affecting student's academic performance is an important issue in higher education especially in the medical programme. There has been extensive research on the influences of key factors on students' academic performance. It is interesting to note that all of the research reviews support the hypothesis that students' performance in their academic depend on different socio-economic, psychological and environmental factors. A review of the literature indicated that students' learning style, family background, students' characteristic, and school or college experience factors are related to students' academic performance.