Intended for healthcare professionals


Medical students' compliance with simple administrative tasks and success in final examinations: retrospective cohort study

BMJ 2002; 324 doi: (Published 29 June 2002) Cite this as: BMJ 2002;324:1554
  1. Neil Wright (N.P.Wright{at}, lecturer in paediatrics,
  2. M S Tanner, professor of paediatrics
  1. Sheffield Children's Hospital, Sheffield S10 2TH
  1. Correspondence to: N Wright
  • Accepted 6 February 2002

Medical students at the University of Sheffield are asked to provide a recent passport photograph at the start of their paediatric module. The pictures are collated, photocopied, and distributed to the wards, teachers, and hospitals within the paediatric programme. This makes identification easier and facilitates pastoral support and assessment.

We studied whether students who were unable to comply with simple administrative tasks—for example, supplying a photograph—were more likely to struggle and subsequently to fail their end of year examinations.

Methods and results

All students received a written and a verbal request for a photograph at registration for the module. In the introductory week, verbal reminders were given twice, and a list of those who had not supplied a photograph was displayed on a notice board, downstairs from the venue for the introductory course, on which the week's timetable is also posted. A photograph booth was situated in the students' union building, about 120 metres away from the venue for the introductory week.

In 1998 and 1999, a total of 393 students started their paediatric module. Passing the final examinations at the end of the year is prerequisite to entering the final year of the course. We checked whether or not a photograph had been provided by the end of the introductory week against the pass and fail lists.

A total of 366 (93%) students handed in photographs, and of these 29 (8%, 95% confidence interval 6% to 11%) failed or were disqualified from sitting the examination at the first attempt because they did not satisfactorily complete the clinical component of the course. Of the 27 students who failed to provide a photograph, 13 (48%, 29% to 67%; P<0.001, Fisher's exact test) failed the end of year examinations.


Almost half the students who failed to complete the basic administrative task of providing a recent photograph failed the end of year examinations; this highlights the importance of organisation and attitude in determining an individual's success. More sophisticated tools, such as a diagnostic inventory to investigate learning styles, support the view that disorganised learning is one of the most important predictors of examination failure.1

Three principal factors influence students' learning: the teaching, the learning environment or institution, and the individual student's learning style.2 Our findings suggest that the individual's approach and attitude are particularly important.

Attitude has an important influence on clinical competence and future clinical performance.3 It is beneficial to identify students whose learning style and approach are inappropriate, before they fail. Additional targeted help may be provided for these students.


Contributors: NW had the original idea for the study. Both authors wrote the paper. NW is guarantor.


  • Funding No additional funding.

  • Competing interests None declared.


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