Academic Engagement and Contextual Factors Associated with Academic Performance in First-Year Medical Students: A Cross-Sectional Study

Abstract

Purpose Academic performance in medical education reflects interactions among student background, academic engagement, and assessment context, particularly during the transition into medical training. This study examined associations among sociodemographic factors, academic engagement, and academic performance in first-year medical students. s2001 Methods A cross-sectional study was conducted among first-year medical students at the University of Buenos Aires. Academic engagement was assessed using the Utrecht Work Engagement Scale (UWES-9S), focusing on vigor. Sociodemographic variables included age, gender, nationality, living arrangements, and parental education. Performance was evaluated using partial and final examination scores and pass/fail outcomes across oral, written multiple-choice, and written open-ended examinations. Students contributed repeated subject-level performance observations across partial examinations; therefore, mixed-effects models with random intercepts for students were used, alongside linear and logistic regression models. s2002 Results Among 257 students, partial examination data were available for 227. Final examination data were available for a selectively progressed subset of 124 students and were analyzed secondarily. Higher vigor was associated with a greater probability of passing partial examinations (OR = 1.15, 95% CI 1.01 to 1.32), although it was not clearly associated with continuous examination scores. In the main mixed-effects model, cross-border/international students obtained modestly lower partial examination scores than Argentine students (β = −0.74, 95% CI −1.45 to −0.04), and students living with a partner and/or own children scored lower than those living alone (β = −1.06, 95% CI −1.97 to −0.15). An exploratory interaction suggested that performance differences between cross-border/international and Argentine students varied across assessment contexts; however, assessment context was structurally confounded with subject content and curricular timing. s2003 Conclusion Academic vigor and contextual factors, including nationality and living arrangements, were associated with early academic progression. Exploratory assessment-context findings require confirmation in longitudinal studies with controlled assessment designs before informing institutional policy. s2004 Plain Language Summary The first year of medical school is often demanding and stressful. Many students struggle to adapt to new academic expectations, social environments, and evaluation systems. Understanding the factors linked to academic performance may help universities provide better support during this critical stage of training. In this study, we explored how academic engagement and personal circumstances were related to academic performance among first-year medical students at the University of Buenos Aires. Academic engagement refers to the energy, motivation, and persistence students bring to their studies. We also examined whether performance patterns differed across oral and written examinations. Vigor refers to the energetic component of academic engagement, including students’ sense of energy, persistence, and resilience in their studies. Students with higher vigor were more likely to pass examinations. Living arrangements were also associated with performance and engagement. Students living with a partner or children tended to obtain lower academic scores, while students living with friends showed lower levels of vigor. In addition, differences between Argentine students and students from other countries were more apparent in oral examinations than in written assessments. These findings suggest that academic performance is related not only to individual effort, but also to contextual and social factors. Better understanding these influences may help medical schools design support strategies that improve student adaptation and academic progression during the first year of training. plain-language-summary