Failing medical finals : it’s not as bad as you think ; using mixed methods to understand the experience of failing

Abstract

Background A relatively static proportion of students fail the Newcastle University MBBS programme each year. The majority are successful at resit and so proceed to the postgraduate foundation programme. Little is known about the implications of first-time failure on the students’ experience of repeating their final year, or their experience in the foundation programme. Summary of methods A mixed methods approach explored how failing medical finals affects students and foundation-year doctors. The project used theories of self-esteem, professional identity and attribution bias. Questionnaire data on self-esteem and professional identity were collected from final-year medical students and foundation-year 1 (F1). Eighteen qualitative interviews were completed with students who had failed finals and who were repeating their final year, or who were F1s having previously failed. Interviews were conducted at three time points. Summary of results Qualitative analysis highlighted that participants who fail finals experience different stages of emotion as they come to terms with failing. Whilst self-esteem is affected initially, over time, confidence is enhanced by several aspects of the experience. Identity does not appear to be adversely affected; in fact, the resitter identity seems to have several positives. The quantitative data indicated that self-esteem and professional identity may be appropriate constructs to explore the experience of failure; however, they have limitations when trying to explore lived experiences. iv Discussion This work provides a theoretical model that describes the experience of failing finals as an ‘academic adjustment reaction’ using theories of self-esteem, professional identity and attribution bias to understand this phenomenon. Conclusions Failing finals is a difficult experience for medical students, but one through which they appear to undergo significant development. The work highlights that support for those who fail examinations should be bespoke in order to give the best opportunity to access the many positives that can come from the experience of failing.