Exploring Psychosocial Stressors, Exam Performance, and Grit Among Preclinical Medical Students.

Authors

Richard J Iwuagwu, Madison F Clark, Ryan R Landoll, Christopher Jonas, Kade Thornton, Dario Torre, Steven J Durning

Published in

Advances in medical education and practice. Volume 17. Pages 627973. Epub Aug 04, 2026.

Abstract

Medical students encounter high levels of stress linked to poor academic performance. Institutional resources, such as faculty mentors and academic advisors play a critical role in enhancing students' performance and well-being. Despite this, there is a dearth of research incorporating academic advising notes to explore the interplay between medical students academic and psychosocial functioning. Guided by Cognitive Appraisal Theory, this study examined the impact of psychosocial stressors on exam performance and coping potential among medical students.
Utilizing an embedded mixed-methods design, researchers analyzed National Board of Medical Examiners (NBME) scores, grit scores, and advising notes of 60 pre-clerkship students at an allopathic medical school. Advising notes were thematically coded to identify psychosocial stressors. Independent sample t-tests were used to compare average exam performance (NBME scores) and coping potential (Grit scores) between students who did and did not report psychosocial stressors in academic advising.
Thematic analysis identified four primary stressor domains: physical health, mental health, relational, and environmental. There was an absence of evidence for differences in NBME scores (t (58) = -1.06, p =0.293, 95% CI [-5.29, 1.63]) or Grit scores (t (58) = -0.942, p =0.35, 95% CI [-0.45, 0.16]) between students who did or did not report a psychosocial stressor.
These consistent findings call into question the assumption that personal stressors universally diminish academic achievement, suggesting that institutional support and high individual grit may act possibly provide a buffering role. Future longitudinal studies are warranted to further examine these potential effects. This could include specific components of institutional support systems that may help students mitigate the effects of personal challenges on their academic trajectories.

PMID:
42572710
Bibliographic data and abstract were imported from PubMed on 10 Aug 2026.

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