1 School of Management and Medical Education, Shahid Beheshti University of Medical Sciences, Tehran, Iran

2 Department of Medical Education, student’s research committee, Shahid Beheshti University of Medical Sciences, Tehran, Iran

3 Elderly Health Research Center, Endocrinology and Metabolism Population Sciences Institute, Tehran University of Medical Sciences, Tehran, Iran

4 Department of virtualization in Medical Education, Virtual School, Tehran University of Medical Sciences, Tehran, Iran


Introduction: Identifying the learners’ problems early enoughand providing advice from the beginning is definitely an importantinvestment in the training and progress of future practitioners. Thecurrent review aimed at examining factors related to academicfailure of the preclinical medical students.Methods: The study was carried out as a systematic search ofpublications in the following databases published from January1987 to January 2018: PubMed, Web of Knowledge, EducationalResources, Information Center and Scopus. No language limitationwas set for searching the resources. As a comprehensive search, thefollowing keywords were used for the abstract, title and keywordsections: academic performance, academic failure, academicachievement, drop out, academic engagement, learning disorder,medical student, struggle student and problem learner. A valid tool(STROBE) was used to determine the quality of the articles.Results: Most articles discussed personal causes, 7 discussedlearning style, 7 discussed personality traits, 6 discussedmotivational strategies and self-efficacy, 4 discussed quality ofsleep, 4 discussed the effect of stress, 9 discussed demographicfactors, 3 discussed physical activity, 1 discussed copingstrategies, 2 discussed class attendance and 4 discussed studystrategy. Twenty-five articles described instructional designcause, 3 described teaching strategies, 2 described courseassessments, 1 described the course structure, 3 described criticalthinking, 3 described blended learning, 13 described predictivecourses, 14 described admission tests, 1 described the learningenvironment, 2 described curriculum planning and 3 describedthe pre-matriculation program.Conclusion: Medical teachers often do not know which studentsare problem learners or what causes academic failure. The goalof this systematic review was to determine the origin of problemsin learning to identify problem learners. The results indicatesthat managers, policymakers, instructors and counselors canmonitor student academic achievement by careful planning ofinstructional design, attention to an educational environment, useof active teaching methods, continuous assessment of studentsand consideration of personal factors.Keywords: Academic failure, Medical student, Medical Education

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