Characterization of High and Low Achievers for Early Identification of Students- A single-centre Qualitative Study in the Indian Context

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Monica Varshini, B. Gayathri, Anto Livin, A.H. Sruthi Anil Kumar This is a preprint; it has not been peer reviewed by a journal. https://doi.org/ 10.21203/rs.3.rs-8342116/v1 This work is licensed under a CC BY 4.0 License Status: Under Review Version 1 posted 10 You are reading this latest preprint version Abstract Background: Academic performance is a crucial indicator of learning efficacy in medical and allied health science education. Teachers provide valuable insights into students learning behaviours, motivation, and challenges through continuous observation. This study examines faculty insights into the differences between high- and low-achieving students to identify key learning characteristics and develop strategies for preliminary intervention. Methods: A qualitative study involving 127 faculty members from the Allied Health Sciences departments at SRM Medical College Hospital and Research Centre was carried out between August and October 2025. Ethical approval was acquired before data collection. Semi-structured interviews were designed and verified utilising the AMEE Guide No. 185 framework, and data were analysed using Braun and Clarke's (2006) six-step theme analysis. The data were coded independently by two researchers, with variations rectified through consensus. Results: Faculty characterised high-achieving students as disciplined, self-motivated, and actively engaged, with constant attendance and efficient time management. In contrast, low achievers showed irregular study patterns, lower motivation, poor time management, and limited participation. Further, faculty described that academic achievement was positively impacted by family support, constructive criticism, and mentoring. Conclusion: High achievers demonstrated strong self-regulation and engagement, whereas low achievers showed reduced consistency and focus. Strengthened mentoring and structured academic support may enhance motivation, behavioural regulation, and performance among low achievers, fostering their overall academic performance. Trial registration: The study was prospectively registered with the Clinical Trials Registry India (CTRI), registration number CTRI/2025/03/083587 . Academic Performance Faculty Behaviour Motivation Qualitative research Figures Figure 1 Figure 2 Background Academic performance is an important part of medical and allied health science education. It not only shapes a student’s career but also affects the quality of future healthcare delivery.( 1 ) Over the years, teachers and institutions have introduced many strategies such as strict admission processes, revised curricula, and academic support programs to help students perform better.( 2 ) Yet, poor academic outcomes and student failures continue to be major concerns. International reviews have shown that medical school dropout rates can range from 2.4% to 26.2%. Such underperformance not only causes financial loss to the institutions but also increases stress, anxiety, and depression among students.( 3 )( 4 ) In most institutions, students are classified according to their academic grades: scores of 80% and above are considered exceptional, 70–79% very good, 60–69% good, 50–59% fair, 40–49% average, and below 39% as poor or fail. Students who consistently score in the exceptional or very good range are called high achievers, while those who remain in the average or below-average range are low achievers.( 5 ) Teachers play a crucial role in understanding their students’ learning and behaviour. Through consistent teaching, observation, and interaction, they develop a deep insight of each student’s learning style, motivation, attitude, and level of engagement.( 6 ) Their close contact enables them to identify patterns that may not be apparent through examinations or numerical scores alone. Understanding why some students perform well while others do not is essential for identifying students who need help early and improving learning outcomes.( 7 )( 8 ) Thus, teachers’ perceptions offer valuable perspectives on the learning experiences, challenges, and overall development of students in Allied Health Science education. The present study aims to explore the differences between high- and low-achieving students in Allied Health Sciences through faculty interviews. By identifying the characteristics and learning behaviours of each group, the study seeks to develop better strategies for early intervention and academic improvement. Methodolgy Study Design: This research employed a descriptive qualitative design using semi-structured faculty interviews to explore and distinguish the characteristics of high- and low-achieving students in Allied Health Science education. The design was guided by best practices in qualitative inquiry and aligned with AMEE Guide No. 185 on the use of interviews in medical education research (9).The study received approval from the Institutional Ethics Committee of SRM Medical College Hospital and Research Centre (IEC No: ECR/8966/INST/TN/2013/RR-19) and was registered under the Clinical Trials Registry of India (CTRI/2025/03/083587). All procedures adhered to the ethical principles of the Declaration of Helsinki (2013) (10). Study Setting: The study was conducted at a large private tertiary teaching institution in South India. The study setting included multiple programs within Allied Health Sciences, such as Operation Theatre and Anaesthesia Technology, Medical Laboratory Technology, Radiology, and related disciplines. These programs represent a diverse range of teaching contexts and student interactions that informed the perspectives of participating faculty. Reporting Framework: In accordance with the Consolidated Criteria for Reporting Qualitative Research (COREQ), the development of the interview guide and subsequent methodological procedures were systematically documented to enhance credibility and methodological clarity. Sampling Strategy and Participants: Total population sampling, a non-probability sampling approach, was adopted for this study. All Allied Health Sciences teaching faculty were included to maximize data completeness and enhance the representativeness of perspectives across programs. Faculty holding BSc, MSc, or PhD qualifications were eligible for inclusion, while those unwilling to participate were excluded. Invitation was extended to 127 eligible faculty members, and participation was voluntary. Written informed consent was obtained prior to the interviews. Development of the Interview Guide: A semi-structured interview guide was developed following an extensive review of the literature on student achievement, motivation, and academic behaviour. In addition, input was obtained from subject experts in medical education and allied health instruction to ensure relevance and content validity. The guide included open-ended questions that explored faculty perceptions of student learning characteristics, study habits, motivation, attendance, behavioural patterns, and engagement in classroom and clinical settings ANNEXURE 1. The initial version of the guide underwent face and content validation by a panel of ten experts. These experts included senior faculty with advanced qualifications and extensive experience in allied health teaching, curriculum development, and qualitative research. Each item was reviewed for clarity, relevance, and comprehensiveness, and the Content Validity Index (CVI) was calculated to determine inter-rater agreement.(11) Modifications were made based on expert suggestions to improve phrasing, sequencing, and thematic coverage. Interview questions are mentioned in Table 1. Data Collection: Each interview lasted approximately 30–45 minutes and was audio-recorded using the Fireflies® application to ensure clear and complete data capture. The recordings were transcribed verbatim and cross-checked for accuracy. Each transcript was read two to three times to gain an overall understanding of the data. To further immerse in the content, the transcripts were reviewed carefully, and reflective notes were made to document initial impressions and recurring concepts. The verified transcripts were organised in Microsoft Word and subsequently uploaded into ATLAS.ti (version 25.0.1, Lumivero LLC) for systematic data coding and analysis. Data Analysis: Data analysis followed Braun and Clarke’s six-phase reflexive thematic analysis framework.(12) The process began with data familiarization, after which meaningful segments were identified and coded inductively to ensure that each code accurately reflected participants’ expressed experiences. The codes were then organized into broader themes, which were iteratively reviewed and refined by checking their coherence against the data. The specific features of each theme were examined in depth, and the final themes were clearly defined and named to ensure they captured the essence of the participants’ experiences. Researcher Reflexivity and Quality Control: To ensure rigour and trustworthiness, multiple strategies were implemented. Reflexive memos were maintained during coding to document emerging thoughts, decision pathways, and potential influences of positionality. Regular team discussions ensured transparency in analytic judgments and consistency in the application of codes. Quality control was maintained through cross-checking transcripts, iterative verification of theme development, and systematic use of ATLAS.ti to organise, track, and audit analytic decisions. These measures strengthened the overall rigor, coherence, and trustworthiness of the findings. Results The analysis generated multiple initial codes that were iteratively refined and clustered, resulting in seven interrelated themes influencing students’ academic performance: academic strategies, behavioural differences, classroom engagement, external factors, improvement strategies, motivation, and student–faculty relationships. Themes and subthemes were further defined in Figure 1. Theme 1: Academic Strategies Faculty observed that students with stronger academic records begin preparing early and follow a structured revision pattern, whereas poorly performing students tend to delay their preparation and study only when examinations approach. Across all interviews, the consensus that the faculties had is that the high achievers display more structured study routines, a more organized preparation and a success-oriented mindset. Additionally, the high achievers were quick to review the study material soon after lectures and levered on group discussions and self-testing to strengthen their grasp over the content. On the contrary, the students with poor performance demonstrated an unstructured study routine and procrastination over preparations. Another key highlight shared by the faculty is on how the high-achieving students had a distinct success strategy. They were more practical with the learned theoretical concepts and did not rely on rote memorization alone. One of the participants highlighted, “Theoretical integration gives students better insight. They understand not only what is being done but why it matters in real clinical practice.” , highlighting how integrating theoretical knowledge with practical approaches helped in deeper understanding of the concepts. Proactive learning was another key differentiator, wherein the high-achieving students referred to additional resources and sought clarity for comprehending the topics well. As one of the faculty members highlighted , “I’ve seen high achievers create concept maps or diagrams to visualize content.” Theme 2: Behavioural Differences Personality traits and classroom demeanour were identified as influential factors affecting academic performance. The teachers reiterated that the high-achieving students possessed a calmer, focused and self-motivated attitude and maintained their composure even in challenging situations. A participant noted that “They have a sense of discipline; even when they face setbacks, they stay calm and consistent.” Several faculty members highlighted concerns related to lack of discipline, absenteeism, and engagement in maladaptive behaviours. One faculty participant pointed out a growing concern, stating, “Some of our students get involved in smoking or even drugs, and once that starts, their attendance drops and their performance follows the same path.” Faculty noted that low-achieving students were more easily distracted during classes and study sessions. They often struggled to maintain focus and were influenced by external factors such as peer conversations, mobile phone use, or lack of interest. In contrast, high-achieving students displayed better concentration and were able to remain attentive for longer periods. Theme 3: Student-Faculty Relationship Faculty perceptions offered valuable insights into how teachers understand students’ learning behaviours, challenges, and support needs across different levels of achievement. Many faculty members emphasized that recognising individual differences among students is essential for effective teaching, mentoring, and academic support. Faculty viewed students who are high-achievers’ as self-motivated and goal-oriented. They also required minimal supervision, whereas low-achieving students often needed closer guidance and structured feedback to stay on track. A participant remarked, “ Students who perform well tend to engage with faculty more actively and seek guidance when they face difficulties.” reflecting the recognition that not all students respond equally to uniform teaching methods. Faculty also highlighted that low-achieving students often hesitated to approach teachers or communicate their difficulties. Many appeared less confident, avoided asking questions, and tended to withdraw from academic interactions. Teachers noted that this limited communication made it challenging to identify their struggles early and provide timely support. As one participant shared, “ The low performers usually stay silent even when they are struggling, and they come to us only when the problem has already become serious. ” This reluctance to seek help was viewed as a major barrier to their academic progress. Theme 4: Improvement Strategies Teachers emphasized that improvement was achievable when students received consistent guidance, mentoring, and opportunities to reflect on their learning habits. Peer support emerged as one of the most effective strategies. Faculty observed that collaborative learning environments encouraged students to clarify doubts, exchange perspectives, and reinforce understanding through peer explanations. High-achieving students often played a mentoring role, helping their peers in both theoretical and clinical components. One participant mentioned, “When students are encouraged to help one another, it creates a culture of academic empathy and shared success.” indicating that structured peer learning promoted not only academic improvement but also interpersonal confidence and teamwork. Faculty also noted that low-achieving students required a more structured form of academic support to make meaningful progress. Teachers observed that these students often struggled with planning, time management, and sustaining consistent study routines, making targeted assistance essential. Regular follow-up, simplified learning goals, and stepwise guidance were found to help them stay organised and motivated. As one faculty member explained, “The weaker students improve only when we guide them regularly and break tasks into smaller, manageable steps,” highlighting the importance of personalised and continuous support. Theme 5: Motivation Faculty consistently emphasized motivation as a key factor influencing students’ academic engagement, learning consistency, and overall performance. Motivation was described as the internal drive that determines how students approach their studies and sustain effort across academic tasks. Faculty observed that high-achieving students exhibited strong self-motivation and an intrinsic desire to learn, often setting clear academic and professional goals. One faculty member expressed, “Motivation drives consistency. Even if the student is tired or discouraged, motivated ones still manage to revise or complete tasks,” highlighting students who were motivated to learn from within without having the need for an external push. In contrast, low-achieving students were often characterized by fluctuating or extrinsic motivation, studying primarily to meet minimum requirements or pass examinations. Faculty observed that such students lacked sustained interest in theoretical understanding or clinical application, which negatively impacted their performance and confidence. As one faculty commented, “Without self-motivation, even bright students can underperform. It’s the push that makes students revise, seek help, and aim higher,” indicating that motivation levels directly influenced the quality of engagement and learning outcomes. Faculty also mentioned that encouragement and acknowledgment from teachers significantly enhanced student motivation. They emphasized that simple gestures, such as appreciation or constructive feedback, often helped restore learners’ interest and sustained their academic effort. Theme 6: External Factors Faculty noted that a variety of external influences play a significant role in shaping students’ academic performance and learning behaviour. Though motivation and study habits are considered as important aspects, teachers emphasized that there are factors beyond the classroom that can determine how effectively students engage with their studies. It was seen that influences of the family especially in terms of support, socio-economic background and work commitments had a significant impact on students’ overall learning environment. Faculty observed that students who were strongly encouraged by their families, and a supportive home environment tended to have a better focus and perseverance. One participant remarked, “When parents communicate positively and support the student’s goals, performance tends to improve. It gives the student a sense of accountability without pressure.” On the other hand, lack of family understanding or personal stress was frequently linked to absenteeism, anxiety, and poor concentration. Additionally, socio-economic factors were another significant external influence. Faculty observed that students from financially challenged backgrounds often faced challenges in managing both their academic responsibilities as well as part-time work commitments. Financial instability sometimes resulted in reduced access to study materials, time constraints, and mental fatigue. As one faculty member explained, “Financial burdens and lack of family support affect attendance and output,” highlighting how economic challenges can impact academic performance and attendance. Theme 7: Classroom Engagement Classroom participation and engagement in activities were identified as major indicators of students’ commitment to learning and overall academic achievement. Faculties highlighted that high-achieving students often displayed curiosity, attentiveness, and a readiness to contribute to class discussions. One participant stated, “Students who excel usually show consistency. They attend classes regularly, take notes meticulously, ask questions, and take ownership of their learning” highlighting that engagement during classes often translated into improved comprehension and confidence during assessments. In contrast, low-achieving students were often perceived as passive learners, reluctant to ask questions or participate in collaborative learning activities. Faculty observed that such students frequently avoided interaction due to fear of making mistakes, lack of preparation, or diminished self-confidence. As one teacher remarked, “Skipping classes breaks this continuity, and catching up later takes twice the effort and rarely yields the same depth.” indicating that hesitation and disengagement often stemmed from anxiety rather than lack of ability. In summary, this thematic analysis identified seven core themes along with their corresponding themes and subthemes. Together, these elements provide a comprehensive understanding of the patterns that distinguish high- and low-achieving students Table 2. Discussion The findings of this qualitative study illuminate the complex interplay of motivational, behavioural, emotional, and contextual factors that differentiate high- and low-achieving students within allied health education. These differences are best explained through established psychological theories that describe how learners develop, sustain, or struggle with academic engagement. High achievers demonstrated structured study behaviours, intrinsic motivation, early preparation, and proactive help-seeking, whereas low achievers were characterized by inconsistent routines, emotional disengagement, and significant external stressors. Integrating these results with Achievement Goal Theory, Self-Determination Theory (SDT), Pekrun’s Control-Value Theory (CVT), Eccles’ Expectancy-Value Theory (EVT), and Social Cognitive Theory offers a deeper mechanistic understanding of why such disparities persist Fig. 2 . Achievement Goal Theory clarifies the strategic learning differences observed among students. High achievers’ structured revision, early preparation, and deep-learning behaviours align with a mastery-goal orientation that fosters conceptual understanding and long-term achievement ( 13 )( 14 ). Such mastery orientation is supported by evidence that deep learning and metacognitive strategies enhance academic performance in health-professions education ( 15 ). In contrast, low achievers’ reliance on rote memorization, last-minute studying, and procrastination is consistent with performance-avoidance tendencies, which have been associated with anxiety, cognitive overload, and shallow processing ( 16 ). Their low persistence echoes findings that avoidance oriented learners often lack the emotional and cognitive resources needed to sustain engagement in demanding academic environments ( 17 ). Motivational differences map strongly onto Self-Determination Theory. High achievers’ intrinsic motivation, active help-seeking, and reflective engagement indicate satisfaction of psychological needs for autonomy, competence, and relatedness ( 18 ). This aligns with our study demonstrating that intrinsic motivation and deep-learning strategies significantly predict high academic achievement in higher education ( 19 ). Conversely, low achievers exhibited externally regulated or unstable motivation, consistent with SDT’s prediction that controlled motivation undermines sustained self-regulation and long-term performance ( 20 ). Faculty observations that structured guidance and consistent encouragement improve motivation correspond with SDT’s emphasis on competence and relatedness supportive environments ( 21 ). Emotional processes reflected in the findings correspond with Pekrun’s CVT. High achievers’ calm, focused, and disciplined demeanour suggests positive activating emotions such as interest, hope, and satisfaction emotions arising when students perceive control and value in academic tasks. Emotional regulation is an important determinant of performance and has been empirically associated with improved learning outcomes ( 16 ). In contrast, low achievers’ distractibility, lack of engagement, and high absenteeism suggest negative deactivating emotions, including boredom and anxiety, which emerge when learners perceive low control or low value in their academic tasks ( 17 ). Such emotional patterns reduce cognitive resources, diminish persistence, and reinforce maladaptive behaviours. Student faculty interactions reveal additional motivational and emotional distinctions. High achievers’ proactive engagement is consistent with EVT, reflecting high expectancy for success and high task value. Positive teacher student relationships have been shown to enhance motivation, academic resilience, and self-efficacy ( 22 ). Conversely, low achievers’ reluctance to seek help reflects low expectancy beliefs and high perceived cost two critical constructs in EVT. This withdrawal aligns with Social Cognitive Theory, which emphasizes that learners with low self-efficacy anticipate failure and avoid supportive interactions ( 21 ). Such avoidance delays early identification of academic struggles and contributes to cycles of learned helplessness. External contextual factors in particular financial strain, limited family support, and personal stress further explain the observed performance differences. These align with EVT’s cost component, wherein elevated emotional or logistical burdens reduce the perceived value of academic effort. Socio environmental stressors are known to negatively influence academic persistence and motivation ( 23 ). Findings that high achievers benefited from stable family support resonate with SDT’s emphasis on relatedness as a key source of emotional resilience. Additionally, these patterns align with literature demonstrating that contextual constraints reduce opportunities for active learning, collaboration, and critical thinking all essential for academic success ( 24 )( 25 ). Collectively, these findings emphasize that academic performance emerges from a dynamic and reciprocal system of motivation, emotion regulation, self-efficacy, and contextual support. Taken together, these theoretical perspectives highlight that high achievement results from the convergence of mastery-goal orientation, intrinsic motivation, positive academic emotions, strong self-efficacy, and supportive relational and contextual environments. In contrast, low achievement is reinforced by controlled or unstable motivation, performance-avoidance goals, negative emotions, low expectancy, and high cognitive or environmental cost. Thus, interventions must target multiple layers of this ecosystem by strengthening competence beliefs, enhancing relatedness and emotional support, reducing perceived cost, and promoting mastery oriented learning climates. Limitations This study has several limitations that should be acknowledged. As a single-centre qualitative study, the findings reflect the perspectives of faculty from one allied health institution and may not generalize across varied cultural or institutional contexts. Although total population sampling improved data completeness, voluntary participation may have introduced response bias, as faculty with stronger views or greater engagement in academic issues may have been more likely to participate. Additionally, the study relied exclusively on faculty perceptions, which may not capture students’ internal motivations, emotional experiences, or personal challenges. Incorporating student interviews or observational data in future studies would strengthen triangulation and enhance interpretive depth. The use of reflexive thematic analysis, while methodologically appropriate, is influenced by researchers’ backgrounds and interpretive positions, which may shape theme development. Moreover, contextual stressors such as financial strain were reported indirectly through faculty rather than measured directly. Future research should incorporate multi-institutional, mixed-methods, and longitudinal designs to better understand how motivational, emotional, and behavioural patterns evolve over time. Despite these limitations, the study offers theoretically grounded insights into early identification of struggling learners and provides direction for targeted academic and emotional support interventions. Conclusion The study highlights that academic success among allied health science students is influenced by structured learning habits, motivation, and active engagement. High achievers exhibit discipline, consistency, and self-driven learning, while low achievers often lack these qualities. Strengthening teacher–student relationships, providing timely mentoring, and fostering intrinsic motivation are essential to improving outcomes. Additionally, implementing targeted academic support interventions such as regular counselling, study skills training, time management guidance, and structured feedback mechanisms can effectively promote both personal and professional development. Abbreviations CVI Content Validity Index SDT Self-Determination Theory CVT Perkin’s Control-Value Theory EVT Eccles’ Expectancy-Value Theory Declarations Acknowledgements: This study was conducted in the Department of Allied Health Sciences, a large private tertiary teaching institution in South India. We extend our sincere gratitude to all faculty members who participated in the interviews and contributed their valuable perspectives. We also thank the experts who assisted in validating the interview guide and supported the qualitative analysis process. AI tools (ChatGPT for language refinement and NotebookLM for literature organization) were used responsibly for writing clarity, while all interpretations and conclusions remain solely those of the authors. Author Contributions: The conception and design of the study were led by U.M. and B.G., who also oversaw the overall direction of the research. Data collection was carried out by U.M. and A.L, who were responsible for gathering and organizing the interview materials. A.S. and U.M contributed to the analysis and interpretation of data, supporting the development of themes and refinement of findings. The manuscript was jointly written by B.G. and U.M., with both contributing to the drafting and integration of key sections. B.G. provided critical revision of the manuscript, ensuring intellectual coherence and clarity. All authors reviewed and approved the final version of the manuscript. Ethical approval and consent to participate: Ethical approval for this study was obtained from the Institutional Ethics Committee of SRM Institute of Science and Technology (IEC No: ECR/8966/INST/TN/2013/RR-19), and informed consent was obtained from all participants. Funding: No funding was received for conducting this study. Competing Interests: The authors declare no competing interests. Consent for Publication: Not applicable. Data Availability: The interview transcripts and datasets generated during this study are available from the corresponding author on reasonable request. Authors details: Department of Anaesthesia, SRM Medical College Hospital and Research Centre, Faculty of Medicine and Health Sciences, SRM Institute of Science and Technology, Kattankulathur, Chengalpattu, Tamil Nadu, India Division of Medical Research, Faculty of Medicine and Health Sciences, SRM Institute of Science & Technology, Kattankulathur, Chengalpattu, Tamil Nadu, India References Abdolalipour S, Namdar-Areshtanab H, Ghaffarifar S, Ghaffari R, Mirghafourvand M. Exploring the experiences of medical students regarding the factors affecting academic achievement: a qualitative study. BMC Med Educ [Internet]. 2024 Nov 12;24(1):1292. Available from: https://bmcmededuc.biomedcentral.com/articles/10.1186/s12909-024-06294-1 Harackiewicz JM, Priniski SJ. Improving Student Outcomes in Higher Education: The Science of Targeted Intervention. Annu Rev Psychol [Internet]. 2018 Jan 4;69(1):409–35. 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Available from: https://www.scirp.org/journal/doi.aspx?doi=10.4236/ce.2024.153023 Blyznyuk T, Kachak T. Benefits of Interactive Learning for Students’ Critical Thinking Skills Improvement. J Vasyl Stefanyk Precarpathian Natl Univ [Internet]. 2024 Mar 31;11(1):94–102. Available from: https://journals.pnu.edu.ua/index.php/jpnu/article/view/7840 Tables Table 1. SEMI-STRUCTURED INTERVIEW QUESTIONS FOR FACULTY PARTICIPANTS S.NO INTERVIEW QUESTION 1. What common behaviours do you see in students who do well in their studies? 2. How do good study habits help students succeed? What habits do struggling students usually lack? 3. How do students who perform well prepare for assessments and exams compared to those who struggle? 4. How does student participation in both theory and practical sessions affect their performance? 5. How does regular class attendance affect student performance? 6. How does the classroom atmosphere, student interactions, and teacher-student relationships affect learning? 7. What early signs show that a student might struggle academically? How do you help such students? 8. How important is self-motivation for academic success? 9. What effect does parental participation have on a student's academic achievement? 10. From your experience, how do socio-economic factors such as financial stability, family support, or work commitments affect students' ability to succeed in their education? Table 2. FACULTY-DERIVED CHARACTERISTICS OF HIGH- AND LOW-ACHIEVING STUDENTS Theme Category High-Achieving Students Low-Achieving Students Academic Strategies Structured; early preparation; organized; concept maps; self-testing; revision; higher-order thinking; extra resources Procrastination; last-minute study; unstructured; rote memorization; minimal revision; limited resources Behaviour & Demeanour Calm; disciplined; focused; self-regulated; consistent attendance Distracted; irregular attendance; passive; peer-influenced; maladaptive behaviours Student–Faculty Interaction Proactive; help-seeking; clear communication; confident; independent Hesitant; poor communication; delayed help-seeking; dependent; withdrawn Motivation Intrinsic; goal-oriented; persistent; self-driven Extrinsic; fluctuating; low interest; minimal initiative External Factors Family support; stable environment; fewer financial constraints Financial stress; low family support; personal pressures; work burdens Classroom Engagement Regular attendance; active participation; questioning; collaborative; note-taking Passive; reluctant; disengaged; fear of mistakes; absenteeism Improvement Strategies Peer mentoring; reflective; supportive Needs structure; stepwise guidance; continuous monitoring Additional Declarations No competing interests reported. Supplementary Files AMEEANEXXURE2.docx Cite Share Download PDF Status: Under Review Version 1 posted Reviews received at journal 26 Jan, 2026 Reviews received at journal 26 Jan, 2026 Reviewers agreed at journal 18 Jan, 2026 Reviewers agreed at journal 14 Jan, 2026 Reviewers agreed at journal 09 Jan, 2026 Reviewers invited by journal 09 Jan, 2026 Editor invited by journal 16 Dec, 2025 Editor assigned by journal 12 Dec, 2025 Submission checks completed at journal 12 Dec, 2025 First submitted to journal 12 Dec, 2025 You are reading this latest preprint version Research Square lets you share your work early, gain feedback from the community, and start making changes to your manuscript prior to peer review in a journal. As a division of Research Square Company, we’re committed to making research communication faster, fairer, and more useful. We do this by developing innovative software and high quality services for the global research community. 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1","display":"","copyAsset":false,"role":"figure","size":169895,"visible":true,"origin":"","legend":"\u003cp\u003e\u003cstrong\u003eThematic framework illustrating differences between high- and low-achieving students\u003c/strong\u003e\u003c/p\u003e","description":"","filename":"1.png","url":"https://assets-eu.researchsquare.com/files/rs-8342116/v1/21783098b47f5dce640d3132.png"},{"id":100141580,"identity":"86d73ff6-ac88-4780-816b-d9114372e7f4","added_by":"auto","created_at":"2026-01-13 11:42:47","extension":"png","order_by":2,"title":"Figure 2","display":"","copyAsset":false,"role":"figure","size":424999,"visible":true,"origin":"","legend":"\u003cp\u003e\u003cstrong\u003eKey Theories and Contextual Factors Explaining Variations in Student Achievement\u003c/strong\u003e\u003c/p\u003e","description":"","filename":"2.png","url":"https://assets-eu.researchsquare.com/files/rs-8342116/v1/9c872a3f13ed3241fdac1ea3.png"},{"id":100382613,"identity":"1125a11f-bd6d-4278-b252-534d2e0f1838","added_by":"auto","created_at":"2026-01-16 10:43:25","extension":"pdf","order_by":0,"title":"","display":"","copyAsset":false,"role":"manuscript-pdf","size":1410903,"visible":true,"origin":"","legend":"","description":"","filename":"manuscript.pdf","url":"https://assets-eu.researchsquare.com/files/rs-8342116/v1/f750d8e8-a7d7-4f86-b65e-36e7de1d1009.pdf"},{"id":100141581,"identity":"8be7c7da-1f1c-489b-96fd-e6b0571fd1b2","added_by":"auto","created_at":"2026-01-13 11:42:47","extension":"docx","order_by":1,"title":"","display":"","copyAsset":false,"role":"supplement","size":22370,"visible":true,"origin":"","legend":"","description":"","filename":"AMEEANEXXURE2.docx","url":"https://assets-eu.researchsquare.com/files/rs-8342116/v1/4ebe66eef42a08631b43da55.docx"}],"financialInterests":"No competing interests reported.","formattedTitle":"Characterization of High and Low Achievers for Early Identification of Students- A single-centre Qualitative Study in the Indian Context","fulltext":[{"header":"Background","content":"\u003cp\u003eAcademic performance is an important part of medical and allied health science education. It not only shapes a student\u0026rsquo;s career but also affects the quality of future healthcare delivery.(\u003cspan citationid=\"CR1\" class=\"CitationRef\"\u003e1\u003c/span\u003e) Over the years, teachers and institutions have introduced many strategies such as strict admission processes, revised curricula, and academic support programs to help students perform better.(\u003cspan citationid=\"CR2\" class=\"CitationRef\"\u003e2\u003c/span\u003e) Yet, poor academic outcomes and student failures continue to be major concerns. International reviews have shown that medical school dropout rates can range from 2.4% to 26.2%. Such underperformance not only causes financial loss to the institutions but also increases stress, anxiety, and depression among students.(\u003cspan citationid=\"CR3\" class=\"CitationRef\"\u003e3\u003c/span\u003e)(\u003cspan citationid=\"CR4\" class=\"CitationRef\"\u003e4\u003c/span\u003e)\u003c/p\u003e \u003cp\u003eIn most institutions, students are classified according to their academic grades: scores of 80% and above are considered exceptional, 70\u0026ndash;79% very good, 60\u0026ndash;69% good, 50\u0026ndash;59% fair, 40\u0026ndash;49% average, and below 39% as poor or fail. Students who consistently score in the exceptional or very good range are called high achievers, while those who remain in the average or below-average range are low achievers.(\u003cspan citationid=\"CR5\" class=\"CitationRef\"\u003e5\u003c/span\u003e)\u003c/p\u003e \u003cp\u003eTeachers play a crucial role in understanding their students\u0026rsquo; learning and behaviour. Through consistent teaching, observation, and interaction, they develop a deep insight of each student\u0026rsquo;s learning style, motivation, attitude, and level of engagement.(\u003cspan citationid=\"CR6\" class=\"CitationRef\"\u003e6\u003c/span\u003e) Their close contact enables them to identify patterns that may not be apparent through examinations or numerical scores alone. Understanding why some students perform well while others do not is essential for identifying students who need help early and improving learning outcomes.(\u003cspan citationid=\"CR7\" class=\"CitationRef\"\u003e7\u003c/span\u003e)(\u003cspan citationid=\"CR8\" class=\"CitationRef\"\u003e8\u003c/span\u003e) Thus, teachers\u0026rsquo; perceptions offer valuable perspectives on the learning experiences, challenges, and overall development of students in Allied Health Science education.\u003c/p\u003e \u003cp\u003eThe present study aims to explore the differences between high- and low-achieving students in Allied Health Sciences through faculty interviews. By identifying the characteristics and learning behaviours of each group, the study seeks to develop better strategies for early intervention and academic improvement.\u003c/p\u003e"},{"header":"Methodolgy","content":"\u003cp\u003e\u003cstrong\u003eStudy Design:\u003c/strong\u003e\u003c/p\u003e\n\u003cp\u003eThis research employed a descriptive qualitative design using semi-structured faculty interviews to explore and distinguish the characteristics of high- and low-achieving students in Allied Health Science education. The design was guided by best practices in qualitative inquiry and aligned with AMEE Guide No. 185 on the use of interviews in medical education research (9).The study received approval from the Institutional Ethics Committee of SRM Medical College Hospital and Research Centre (IEC No: ECR/8966/INST/TN/2013/RR-19) and was registered under the Clinical Trials Registry of India (CTRI/2025/03/083587). All procedures adhered to the ethical principles of the Declaration of Helsinki (2013) (10).\u003c/p\u003e\n\u003cp\u003e\u003cstrong\u003eStudy Setting: \u003c/strong\u003e\u003c/p\u003e\n\u003cp\u003eThe study was conducted at a large private tertiary teaching institution in South India. The study setting included multiple programs within Allied Health Sciences, such as Operation Theatre and Anaesthesia Technology, Medical Laboratory Technology, Radiology, and related disciplines. These programs represent a diverse range of teaching contexts and student interactions that informed the perspectives of participating faculty. \u003c/p\u003e\n\u003cp\u003e\u003cstrong\u003eReporting Framework: \u003c/strong\u003e\u003c/p\u003e\n\u003cp\u003eIn accordance with the Consolidated Criteria for Reporting Qualitative Research (COREQ), the development of the interview guide and subsequent methodological procedures were systematically documented to enhance credibility and methodological clarity.\u003c/p\u003e\n\u003cp\u003e\u003cstrong\u003eSampling Strategy and Participants:\u003c/strong\u003e\u003c/p\u003e\n\u003cp\u003eTotal population sampling, a non-probability sampling approach, was adopted for this study. All Allied Health Sciences teaching faculty were included to maximize data completeness and enhance the representativeness of perspectives across programs. Faculty holding BSc, MSc, or PhD qualifications were eligible for inclusion, while those unwilling to participate were excluded. Invitation was extended to 127 eligible faculty members, and participation was voluntary. Written informed consent was obtained prior to the interviews.\u003c/p\u003e\n\u003cp\u003e\u003cstrong\u003eDevelopment of the Interview Guide: \u003c/strong\u003e\u003c/p\u003e\n\u003cp\u003eA semi-structured interview guide was developed following an extensive review of the literature on student achievement, motivation, and academic behaviour.\u003cbr\u003e In addition, input was obtained from subject experts in medical education and allied health instruction to ensure relevance and content validity. The guide included open-ended questions that explored faculty perceptions of student learning characteristics, study habits, motivation, attendance, behavioural patterns, and engagement in classroom and clinical settings ANNEXURE 1. The initial version of the guide underwent face and content validation by a panel of ten experts. These experts included senior faculty with advanced qualifications and extensive experience in allied health teaching, curriculum development, and qualitative research. Each item was reviewed for clarity, relevance, and comprehensiveness, and the Content Validity Index (CVI) was calculated to determine inter-rater agreement.(11) Modifications were made based on expert suggestions to improve phrasing, sequencing, and thematic coverage. Interview questions are mentioned in \u003cstrong\u003eTable 1.\u003c/strong\u003e\u003c/p\u003e\n\u003cp\u003e\u003cstrong\u003eData Collection:\u003c/strong\u003e\u003c/p\u003e\n\u003cp\u003eEach interview lasted approximately 30–45 minutes and was audio-recorded using the Fireflies® application to ensure clear and complete data capture. The recordings were transcribed verbatim and cross-checked for accuracy. Each transcript was read two to three times to gain an overall understanding of the data. To further immerse in the content, the transcripts were reviewed carefully, and reflective notes were made to document initial impressions and recurring concepts. The verified transcripts were organised in Microsoft Word and subsequently uploaded into ATLAS.ti (version 25.0.1, Lumivero LLC) for systematic data coding and analysis.\u003c/p\u003e\n\u003cp\u003e\u003cstrong\u003eData Analysis:\u003c/strong\u003e\u003c/p\u003e\n\u003cp\u003eData analysis followed Braun and Clarke’s six-phase reflexive thematic analysis framework.(12) The process began with data familiarization, after which meaningful segments were identified and coded inductively to ensure that each code accurately reflected participants’ expressed experiences. The codes were then organized into broader themes, which were iteratively reviewed and refined by checking their coherence against the data. The specific features of each theme were examined in depth, and the final themes were clearly defined and named to ensure they captured the essence of the participants’ experiences.\u003c/p\u003e\n\u003cp\u003e\u003cstrong\u003eResearcher Reflexivity and Quality Control:\u003c/strong\u003e\u003c/p\u003e\n\u003cp\u003eTo ensure rigour and trustworthiness, multiple strategies were implemented. Reflexive memos were maintained during coding to document emerging thoughts, decision pathways, and potential influences of positionality. Regular team discussions ensured transparency in analytic judgments and consistency in the application of codes. Quality control was maintained through cross-checking transcripts, iterative verification of theme development, and systematic use of ATLAS.ti to organise, track, and audit analytic decisions. These measures strengthened the overall rigor, coherence, and trustworthiness of the findings.\u003c/p\u003e"},{"header":"Results","content":"\u003cp\u003eThe analysis generated multiple initial codes that were iteratively refined and clustered, resulting in seven interrelated themes influencing students’ academic performance: academic strategies, behavioural differences, classroom engagement, external factors, improvement strategies, motivation, and student–faculty relationships. Themes and subthemes were further defined in \u003cstrong\u003eFigure 1.\u003c/strong\u003e\u003c/p\u003e\n\u003cp\u003e\u003cstrong\u003eTheme 1: Academic Strategies\u003c/strong\u003e\u003c/p\u003e\n\u003cp\u003eFaculty observed that students with stronger academic records begin preparing early and follow a structured revision pattern, whereas poorly performing students tend to delay their preparation and study only when examinations approach. Across all interviews, the consensus that the faculties had is that the high achievers display more structured study routines, a more organized preparation and a success-oriented mindset. Additionally, the high achievers were quick to review the study material soon after lectures and levered on group discussions and self-testing to strengthen their grasp over the content. On the contrary, the students with poor performance demonstrated an unstructured study routine and procrastination over preparations. Another key highlight shared by the faculty is on how the high-achieving students had a distinct success strategy. They were more practical with the learned theoretical concepts and did not rely on rote memorization alone. One of the participants highlighted, \u003cem\u003e“Theoretical integration gives students better insight. They understand not only what is being done but why it matters in real clinical practice.”\u003c/em\u003e, highlighting how integrating theoretical knowledge with practical approaches helped in deeper understanding of the concepts.\u003c/p\u003e\n\u003cp\u003eProactive learning was another key differentiator, wherein the high-achieving students referred to additional resources and sought clarity for comprehending the topics well. As one of the faculty members highlighted\u003cem\u003e, “I’ve seen high achievers create concept maps or diagrams to visualize content.”\u003c/em\u003e\u0026nbsp;\u003c/p\u003e\n\u003cp\u003e\u003cstrong\u003eTheme 2: Behavioural Differences\u003c/strong\u003e\u003c/p\u003e\n\u003cp\u003ePersonality traits and classroom demeanour were identified as influential factors affecting academic performance. The teachers reiterated that the high-achieving students possessed a calmer, focused and self-motivated attitude and maintained their composure even in challenging situations. A participant noted that \u003cem\u003e“They have a sense of discipline; even when they face setbacks, they stay calm and consistent.” \u0026nbsp;\u0026nbsp;\u003c/em\u003e\u003c/p\u003e\n\u003cp\u003eSeveral faculty members highlighted concerns related to lack of discipline, absenteeism, and engagement in maladaptive behaviours. One faculty participant pointed out a growing concern, stating, \u003cem\u003e“Some of our students get involved in smoking or even drugs, and once that starts, their attendance drops and their performance follows the same path.”\u003c/em\u003e\u0026nbsp;\u003c/p\u003e\n\u003cp\u003eFaculty noted that low-achieving students were more easily distracted during classes and study sessions. They often struggled to maintain focus and were influenced by external factors such as peer conversations, mobile phone use, or lack of interest. In contrast, high-achieving students displayed better concentration and were able to remain attentive for longer periods.\u003c/p\u003e\n\u003cp\u003e\u003cstrong\u003eTheme 3: Student-Faculty Relationship\u003c/strong\u003e\u003c/p\u003e\n\u003cp\u003eFaculty perceptions offered valuable insights into how teachers understand students’ learning behaviours, challenges, and support needs across different levels of achievement. Many faculty members emphasized that recognising individual differences among students is essential for effective teaching, mentoring, and academic support. Faculty viewed students who are high-achievers’ as self-motivated and goal-oriented. They also required minimal supervision, whereas low-achieving students often needed closer guidance and structured feedback to stay on track. A participant remarked, \u003cem\u003e“\u003c/em\u003e\u003cem\u003eStudents who perform well tend to engage with faculty more actively and seek guidance when they face difficulties.”\u0026nbsp;\u003c/em\u003ereflecting the recognition that not all students respond equally to uniform teaching methods.\u003c/p\u003e\n\u003cp\u003eFaculty also highlighted that low-achieving students often hesitated to approach teachers or communicate their difficulties. Many appeared less confident, avoided asking questions, and tended to withdraw from academic interactions. Teachers noted that this limited communication made it challenging to identify their struggles early and provide timely support. As one participant shared, \u003cstrong\u003e\u003cem\u003e“\u003c/em\u003e\u003c/strong\u003e\u003cem\u003eThe low performers usually stay silent even when they are struggling, and they come to us only when the problem has already become serious.\u003cstrong\u003e”\u003c/strong\u003e\u003c/em\u003e This reluctance to seek help was viewed as a major barrier to their academic progress.\u003c/p\u003e\n\u003cp\u003e\u003cstrong\u003eTheme 4: Improvement Strategies\u003c/strong\u003e\u003c/p\u003e\n\u003cp\u003eTeachers emphasized that improvement was achievable when students received consistent guidance, mentoring, and opportunities to reflect on their learning habits. Peer support emerged as one of the most effective strategies. Faculty observed that collaborative learning environments encouraged students to clarify doubts, exchange perspectives, and reinforce understanding through peer explanations. High-achieving students often played a mentoring role, helping their peers in both theoretical and clinical components. One participant mentioned, \u003cem\u003e“When students are encouraged to help one another, it creates a culture of academic empathy and shared success.”\u003c/em\u003e indicating that structured peer learning promoted not only academic improvement but also interpersonal confidence and teamwork.\u003c/p\u003e\n\u003cp\u003eFaculty also noted that low-achieving students required a more structured form of academic support to make meaningful progress. Teachers observed that these students often struggled with planning, time management, and sustaining consistent study routines, making targeted assistance essential. Regular follow-up, simplified learning goals, and stepwise guidance were found to help them stay organised and motivated. As one faculty member explained, \u003cem\u003e“The weaker students improve only when we guide them regularly and break tasks into smaller, manageable steps,”\u003c/em\u003e highlighting the importance of personalised and continuous support.\u003c/p\u003e\n\u003cp\u003e\u003cstrong\u003eTheme 5: Motivation\u0026nbsp;\u003c/strong\u003e\u003c/p\u003e\n\u003cp\u003eFaculty consistently emphasized motivation as a key factor influencing students’ academic engagement, learning consistency, and overall performance. Motivation was described as the internal drive that determines how students approach their studies and sustain effort across academic tasks.\u0026nbsp; Faculty observed that high-achieving students exhibited strong self-motivation and an intrinsic desire to learn, often setting clear academic and professional goals. One faculty member expressed, \u003cem\u003e“Motivation drives consistency. Even if the student is tired or discouraged, motivated ones still manage to revise or complete tasks,”\u003c/em\u003e highlighting students who were motivated to learn from within without having the need for an external push.\u003c/p\u003e\n\u003cp\u003e\u0026nbsp;In contrast, low-achieving students were often characterized by fluctuating or extrinsic motivation, studying primarily to meet minimum requirements or pass examinations. Faculty observed that such students lacked sustained interest in theoretical understanding or clinical application, which negatively impacted their performance and confidence. As one faculty commented, \u003cem\u003e“Without self-motivation, even bright students can underperform. It’s the push that makes students revise, seek help, and aim higher,”\u003c/em\u003e indicating that motivation levels directly influenced the quality of engagement and learning outcomes. Faculty also mentioned that encouragement and acknowledgment from teachers significantly enhanced student motivation. They emphasized that simple gestures, such as appreciation or constructive feedback, often helped restore learners’ interest and sustained their academic effort.\u003c/p\u003e\n\u003cp\u003e\u003cstrong\u003eTheme 6: External Factors\u003c/strong\u003e\u003c/p\u003e\n\u003cp\u003eFaculty noted that a variety of external influences play a significant role in shaping students’ academic performance and learning behaviour. Though motivation and study habits are considered as important aspects, teachers emphasized that there are factors beyond the classroom that can determine how effectively students engage with their studies. It was seen that influences of the family especially in terms of support, socio-economic background and work commitments had a significant impact on students’ overall learning environment. Faculty observed that students who were strongly encouraged by their families, and a supportive home environment tended to have a better focus and perseverance. One participant remarked, \u003cem\u003e“When parents communicate positively and support the student’s goals, performance tends to improve. It gives the student a sense of accountability without pressure.”\u003c/em\u003e On the other hand, lack of family understanding or personal stress was frequently linked to absenteeism, anxiety, and poor concentration.\u003c/p\u003e\n\u003cp\u003eAdditionally, socio-economic factors were another significant external influence. Faculty observed that students from financially challenged backgrounds often faced challenges in managing both their academic responsibilities as well as part-time work commitments. Financial instability sometimes resulted in reduced access to study materials, time constraints, and mental fatigue. As one faculty member explained, \u003cem\u003e“Financial burdens and lack of family support affect attendance and output,”\u003c/em\u003e highlighting how economic challenges can impact academic performance and attendance.\u0026nbsp;\u003c/p\u003e\n\u003cp\u003e\u003cstrong\u003eTheme 7: Classroom Engagement\u003c/strong\u003e\u003c/p\u003e\n\u003cp\u003eClassroom participation and engagement in activities were identified as major indicators of students’ commitment to learning and overall academic achievement. Faculties highlighted that high-achieving students often displayed curiosity, attentiveness, and a readiness to contribute to class discussions. One participant stated, \u003cem\u003e“Students who excel usually show consistency. They attend classes regularly, take notes meticulously, ask questions, and take ownership of their learning”\u003c/em\u003e highlighting that engagement during classes often translated into improved comprehension and confidence during assessments.\u003c/p\u003e\n\u003cp\u003eIn contrast, low-achieving students were often perceived as passive learners, reluctant to ask questions or participate in collaborative learning activities. Faculty observed that such students frequently avoided interaction due to fear of making mistakes, lack of preparation, or diminished self-confidence. As one teacher remarked, \u003cem\u003e“Skipping classes breaks this continuity, and catching up later takes twice the effort and rarely yields the same depth.”\u003c/em\u003e indicating that hesitation and disengagement often stemmed from anxiety rather than lack of ability.\u0026nbsp;\u003c/p\u003e\n\u003cp\u003eIn summary, this thematic analysis identified seven core themes along with their corresponding themes and subthemes. Together, these elements provide a comprehensive understanding of the patterns that distinguish high- and low-achieving students \u003cstrong\u003eTable 2.\u003c/strong\u003e\u003c/p\u003e"},{"header":"Discussion","content":"\u003cp\u003eThe findings of this qualitative study illuminate the complex interplay of motivational, behavioural, emotional, and contextual factors that differentiate high- and low-achieving students within allied health education. These differences are best explained through established psychological theories that describe how learners develop, sustain, or struggle with academic engagement. High achievers demonstrated structured study behaviours, intrinsic motivation, early preparation, and proactive help-seeking, whereas low achievers were characterized by inconsistent routines, emotional disengagement, and significant external stressors. Integrating these results with Achievement Goal Theory, Self-Determination Theory (SDT), Pekrun\u0026rsquo;s Control-Value Theory (CVT), Eccles\u0026rsquo; Expectancy-Value Theory (EVT), and Social Cognitive Theory offers a deeper mechanistic understanding of why such disparities persist Fig.\u0026nbsp;\u003cspan refid=\"Fig3\" class=\"InternalRef\"\u003e2\u003c/span\u003e.\u003c/p\u003e \u003cp\u003e \u003c/p\u003e \u003cp\u003eAchievement Goal Theory clarifies the strategic learning differences observed among students. High achievers\u0026rsquo; structured revision, early preparation, and deep-learning behaviours align with a mastery-goal orientation that fosters conceptual understanding and long-term achievement (\u003cspan citationid=\"CR13\" class=\"CitationRef\"\u003e13\u003c/span\u003e)(\u003cspan citationid=\"CR14\" class=\"CitationRef\"\u003e14\u003c/span\u003e). Such mastery orientation is supported by evidence that deep learning and metacognitive strategies enhance academic performance in health-professions education (\u003cspan citationid=\"CR15\" class=\"CitationRef\"\u003e15\u003c/span\u003e). In contrast, low achievers\u0026rsquo; reliance on rote memorization, last-minute studying, and procrastination is consistent with performance-avoidance tendencies, which have been associated with anxiety, cognitive overload, and shallow processing (\u003cspan citationid=\"CR16\" class=\"CitationRef\"\u003e16\u003c/span\u003e). Their low persistence echoes findings that avoidance oriented learners often lack the emotional and cognitive resources needed to sustain engagement in demanding academic environments (\u003cspan citationid=\"CR17\" class=\"CitationRef\"\u003e17\u003c/span\u003e).\u003c/p\u003e \u003cp\u003eMotivational differences map strongly onto Self-Determination Theory. High achievers\u0026rsquo; intrinsic motivation, active help-seeking, and reflective engagement indicate satisfaction of psychological needs for autonomy, competence, and relatedness (\u003cspan citationid=\"CR18\" class=\"CitationRef\"\u003e18\u003c/span\u003e). This aligns with our study demonstrating that intrinsic motivation and deep-learning strategies significantly predict high academic achievement in higher education (\u003cspan citationid=\"CR19\" class=\"CitationRef\"\u003e19\u003c/span\u003e). Conversely, low achievers exhibited externally regulated or unstable motivation, consistent with SDT\u0026rsquo;s prediction that controlled motivation undermines sustained self-regulation and long-term performance (\u003cspan citationid=\"CR20\" class=\"CitationRef\"\u003e20\u003c/span\u003e). Faculty observations that structured guidance and consistent encouragement improve motivation correspond with SDT\u0026rsquo;s emphasis on competence and relatedness supportive environments (\u003cspan citationid=\"CR21\" class=\"CitationRef\"\u003e21\u003c/span\u003e).\u003c/p\u003e \u003cp\u003eEmotional processes reflected in the findings correspond with Pekrun\u0026rsquo;s CVT. High achievers\u0026rsquo; calm, focused, and disciplined demeanour suggests positive activating emotions such as interest, hope, and satisfaction emotions arising when students perceive control and value in academic tasks. Emotional regulation is an important determinant of performance and has been empirically associated with improved learning outcomes (\u003cspan citationid=\"CR16\" class=\"CitationRef\"\u003e16\u003c/span\u003e). In contrast, low achievers\u0026rsquo; distractibility, lack of engagement, and high absenteeism suggest negative deactivating emotions, including boredom and anxiety, which emerge when learners perceive low control or low value in their academic tasks (\u003cspan citationid=\"CR17\" class=\"CitationRef\"\u003e17\u003c/span\u003e). Such emotional patterns reduce cognitive resources, diminish persistence, and reinforce maladaptive behaviours.\u003c/p\u003e \u003cp\u003eStudent faculty interactions reveal additional motivational and emotional distinctions. High achievers\u0026rsquo; proactive engagement is consistent with EVT, reflecting high expectancy for success and high task value. Positive teacher student relationships have been shown to enhance motivation, academic resilience, and self-efficacy (\u003cspan citationid=\"CR22\" class=\"CitationRef\"\u003e22\u003c/span\u003e). Conversely, low achievers\u0026rsquo; reluctance to seek help reflects low expectancy beliefs and high perceived cost two critical constructs in EVT. This withdrawal aligns with Social Cognitive Theory, which emphasizes that learners with low self-efficacy anticipate failure and avoid supportive interactions (\u003cspan citationid=\"CR21\" class=\"CitationRef\"\u003e21\u003c/span\u003e). Such avoidance delays early identification of academic struggles and contributes to cycles of learned helplessness.\u003c/p\u003e \u003cp\u003eExternal contextual factors in particular financial strain, limited family support, and personal stress further explain the observed performance differences. These align with EVT\u0026rsquo;s cost component, wherein elevated emotional or logistical burdens reduce the perceived value of academic effort. Socio environmental stressors are known to negatively influence academic persistence and motivation (\u003cspan citationid=\"CR23\" class=\"CitationRef\"\u003e23\u003c/span\u003e). Findings that high achievers benefited from stable family support resonate with SDT\u0026rsquo;s emphasis on relatedness as a key source of emotional resilience. Additionally, these patterns align with literature demonstrating that contextual constraints reduce opportunities for active learning, collaboration, and critical thinking all essential for academic success (\u003cspan citationid=\"CR24\" class=\"CitationRef\"\u003e24\u003c/span\u003e)(\u003cspan citationid=\"CR25\" class=\"CitationRef\"\u003e25\u003c/span\u003e). Collectively, these findings emphasize that academic performance emerges from a dynamic and reciprocal system of motivation, emotion regulation, self-efficacy, and contextual support.\u003c/p\u003e \u003cp\u003eTaken together, these theoretical perspectives highlight that high achievement results from the convergence of mastery-goal orientation, intrinsic motivation, positive academic emotions, strong self-efficacy, and supportive relational and contextual environments. In contrast, low achievement is reinforced by controlled or unstable motivation, performance-avoidance goals, negative emotions, low expectancy, and high cognitive or environmental cost. Thus, interventions must target multiple layers of this ecosystem by strengthening competence beliefs, enhancing relatedness and emotional support, reducing perceived cost, and promoting mastery oriented learning climates.\u003c/p\u003e \u003cdiv id=\"Sec20\" class=\"Section2\"\u003e \u003ch2\u003eLimitations\u003c/h2\u003e \u003cp\u003eThis study has several limitations that should be acknowledged. As a single-centre qualitative study, the findings reflect the perspectives of faculty from one allied health institution and may not generalize across varied cultural or institutional contexts. Although total population sampling improved data completeness, voluntary participation may have introduced response bias, as faculty with stronger views or greater engagement in academic issues may have been more likely to participate. Additionally, the study relied exclusively on faculty perceptions, which may not capture students\u0026rsquo; internal motivations, emotional experiences, or personal challenges. Incorporating student interviews or observational data in future studies would strengthen triangulation and enhance interpretive depth. The use of reflexive thematic analysis, while methodologically appropriate, is influenced by researchers\u0026rsquo; backgrounds and interpretive positions, which may shape theme development. Moreover, contextual stressors such as financial strain were reported indirectly through faculty rather than measured directly. Future research should incorporate multi-institutional, mixed-methods, and longitudinal designs to better understand how motivational, emotional, and behavioural patterns evolve over time. Despite these limitations, the study offers theoretically grounded insights into early identification of struggling learners and provides direction for targeted academic and emotional support interventions.\u003c/p\u003e \u003c/div\u003e"},{"header":"Conclusion","content":"\u003cp\u003eThe study highlights that academic success among allied health science students is influenced by structured learning habits, motivation, and active engagement. High achievers exhibit discipline, consistency, and self-driven learning, while low achievers often lack these qualities. Strengthening teacher\u0026ndash;student relationships, providing timely mentoring, and fostering intrinsic motivation are essential to improving outcomes. Additionally, implementing targeted academic support interventions such as regular counselling, study skills training, time management guidance, and structured feedback mechanisms can effectively promote both personal and professional development.\u003c/p\u003e"},{"header":"Abbreviations","content":"\u003cdiv class=\"DefinitionList\"\u003e \u003cdiv class=\"DefinitionListEntry\"\u003e \u003cdiv class=\"Term\"\u003eCVI\u003c/div\u003e \u003cdiv class=\"Description\"\u003e \u003cp\u003eContent Validity Index\u003c/p\u003e \u003c/div\u003e \u003c/div\u003e \u003cdiv class=\"DefinitionListEntry\"\u003e \u003cdiv class=\"Term\"\u003eSDT\u003c/div\u003e \u003cdiv class=\"Description\"\u003e \u003cp\u003eSelf-Determination Theory\u003c/p\u003e \u003c/div\u003e \u003c/div\u003e \u003cdiv class=\"DefinitionListEntry\"\u003e \u003cdiv class=\"Term\"\u003eCVT\u003c/div\u003e \u003cdiv class=\"Description\"\u003e \u003cp\u003ePerkin\u0026rsquo;s Control-Value Theory\u003c/p\u003e \u003c/div\u003e \u003c/div\u003e \u003cdiv class=\"DefinitionListEntry\"\u003e \u003cdiv class=\"Term\"\u003eEVT\u003c/div\u003e \u003cdiv class=\"Description\"\u003e \u003cp\u003eEccles\u0026rsquo; Expectancy-Value Theory\u003c/p\u003e \u003c/div\u003e \u003c/div\u003e \u003c/div\u003e"},{"header":"Declarations","content":"\u003cp\u003e\u003cstrong\u003eAcknowledgements:\u0026nbsp;\u003c/strong\u003e\u003c/p\u003e\n\u003cp\u003eThis study was conducted in the Department of Allied Health Sciences, a large private tertiary teaching institution in South India. We extend our sincere gratitude to all faculty members who participated in the interviews and contributed their valuable perspectives. We also thank the experts who assisted in validating the interview guide and supported the qualitative analysis process. AI tools (ChatGPT for language refinement and NotebookLM for literature organization) were used responsibly for writing clarity, while all interpretations and conclusions remain solely those of the authors.\u003c/p\u003e\n\u003cp\u003e\u003cstrong\u003eAuthor Contributions:\u0026nbsp;\u003c/strong\u003e\u003c/p\u003e\n\u003cp\u003eThe conception and design of the study were led by U.M. and B.G., who also oversaw the overall direction of the research. Data collection was carried out by U.M. and A.L, who were responsible for gathering and organizing the interview materials. A.S. and U.M contributed to the analysis and interpretation of data, supporting the development of themes and refinement of findings. The manuscript was jointly written by B.G. and U.M., with both contributing to the drafting and integration of key sections. B.G. provided critical revision of the manuscript, ensuring intellectual coherence and clarity. All authors reviewed and approved the final version of the manuscript.\u003c/p\u003e\n\u003cp\u003e\u003cstrong\u003eEthical approval and consent to participate:\u003c/strong\u003e\u003c/p\u003e\n\u003cp\u003eEthical approval for this study was obtained from the Institutional Ethics Committee of SRM Institute of Science and Technology (IEC No: ECR/8966/INST/TN/2013/RR-19), and informed consent was obtained from all participants.\u003c/p\u003e\n\u003cp\u003e\u003cstrong\u003eFunding:\u003c/strong\u003e\u003cbr\u003e\u0026nbsp;No funding was received for conducting this study.\u003c/p\u003e\n\u003cp\u003e\u003cstrong\u003eCompeting Interests:\u003c/strong\u003e\u0026nbsp;\u003c/p\u003e\n\u003cp\u003eThe authors declare no competing interests.\u003c/p\u003e\n\u003cp\u003e\u003cstrong\u003eConsent for Publication:\u003c/strong\u003e\u003c/p\u003e\n\u003cp\u003eNot applicable.\u003c/p\u003e\n\u003cp\u003e\u003cstrong\u003eData Availability:\u0026nbsp;\u003c/strong\u003e\u003c/p\u003e\n\u003cp\u003eThe interview transcripts and datasets generated during this study are available from the corresponding author on reasonable request.\u003c/p\u003e\n\u003cp\u003e\u003cstrong\u003eAuthors details:\u0026nbsp;\u003c/strong\u003e\u003c/p\u003e\n\u003cp\u003eDepartment of Anaesthesia, SRM Medical College Hospital and Research Centre,\u003c/p\u003e\n\u003cp\u003eFaculty of Medicine and Health Sciences, SRM Institute of Science and Technology, Kattankulathur, Chengalpattu, Tamil Nadu, India\u003c/p\u003e\n\u003cp\u003eDivision of Medical Research, Faculty of Medicine and Health Sciences, SRM Institute of Science \u0026amp; Technology, Kattankulathur, Chengalpattu, Tamil Nadu, India\u003c/p\u003e"},{"header":"References","content":"\u003col\u003e\n\u003cli\u003eAbdolalipour S, Namdar-Areshtanab H, Ghaffarifar S, Ghaffari R, Mirghafourvand M. 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Available from: https://asmepublications.onlinelibrary.wiley.com/doi/10.1111/medu.13074\u003c/li\u003e\n\u003cli\u003eAljaffer MA, Almadani AH, AlDughaither AS, Basfar AA, AlGhadir SM, AlGhamdi YA, et al. The impact of study habits and personal factors on the academic achievement performances of medical students. BMC Med Educ [Internet]. 2024 Aug 19;24(1):888. Available from: https://bmcmededuc.biomedcentral.com/articles/10.1186/s12909-024-05889-y\u003c/li\u003e\n\u003cli\u003eBandhu D, Mohan MM, Nittala NAP, Jadhav P, Bhadauria A, Saxena KK. Theories of motivation: A comprehensive analysis of human behavior drivers. Acta Psychol (Amst) [Internet]. 2024 Apr;244:104177. Available from: https://linkinghub.elsevier.com/retrieve/pii/S0001691824000544\u003c/li\u003e\n\u003cli\u003eSarwar S, Tara AN, Abid MN, Dukhaykh S. Teachers\u0026rsquo; academic motivation and student procrastination behaviour: mediating effects of emotion regulation and study habits. BMC Psychol [Internet]. 2025 Jan 17;13(1):52. Available from: https://bmcpsychology.biomedcentral.com/articles/10.1186/s40359-025-02352-5\u003c/li\u003e\n\u003cli\u003eUrhahne D, Wijnia L. Theories of Motivation in Education: an Integrative Framework. Educ Psychol Rev [Internet]. 2023 Jun 30;35(2):45. Available from: https://link.springer.com/10.1007/s10648-023-09767-9\u003c/li\u003e\n\u003cli\u003eKamberi M. The types of intrinsic motivation as predictors of academic achievement: the mediating role of deep learning strategy. Cogent Educ [Internet]. 2025 Dec 31;12(1). Available from: https://www.tandfonline.com/doi/full/10.1080/2331186X.2025.2482482\u003c/li\u003e\n\u003cli\u003eLi X, Pei X, Zhao J. Intrinsic motivation and self-efficacy as pathways to innovative teaching: a mixed-methods study of faculty in Chinese higher education. BMC Psychol [Internet]. 2025 Aug 3;13(1):859. Available from: https://bmcpsychology.biomedcentral.com/articles/10.1186/s40359-025-03177-y\u003c/li\u003e\n\u003cli\u003eAbraham R, Singaram VS. Self and peer feedback engagement and receptivity among medical students with varied academic performance in the clinical skills laboratory. BMC Med Educ [Internet]. 2024 Sep 28;24(1):1065. Available from: https://bmcmededuc.biomedcentral.com/articles/10.1186/s12909-024-06084-9\u003c/li\u003e\n\u003cli\u003eWang X. Exploring positive teacher-student relationships: the synergy of teacher mindfulness and emotional intelligence. Front Psychol [Internet]. 2023 Nov 29;14. Available from: https://www.frontiersin.org/articles/10.3389/fpsyg.2023.1301786/full\u003c/li\u003e\n\u003cli\u003eFriedline T, Chen Z, Morrow S. Families\u0026rsquo; Financial Stress \u0026amp;amp; Well-Being: The Importance of the Economy and Economic Environments. J Fam Econ Issues [Internet]. 2021 Jul 15;42(S1):34\u0026ndash;51. Available from: https://link.springer.com/10.1007/s10834-020-09694-9\u003c/li\u003e\n\u003cli\u003eYao D, Qiu Y, Guo Y, Cao Y. College Students\u0026rsquo; Classroom Participation and Learning Outcomes under the Outcome-Based Education: A Case Study of International Logistics Course. Creat Educ [Internet]. 2024;15(03):383\u0026ndash;97. Available from: https://www.scirp.org/journal/doi.aspx?doi=10.4236/ce.2024.153023\u003c/li\u003e\n\u003cli\u003eBlyznyuk T, Kachak T. Benefits of Interactive Learning for Students\u0026rsquo; Critical Thinking Skills Improvement. J Vasyl Stefanyk Precarpathian Natl Univ [Internet]. 2024 Mar 31;11(1):94\u0026ndash;102. Available from: https://journals.pnu.edu.ua/index.php/jpnu/article/view/7840\u003c/li\u003e\n\u003c/ol\u003e"},{"header":"Tables","content":"\u003cp\u003e\u003cstrong\u003eTable 1. SEMI-STRUCTURED INTERVIEW QUESTIONS FOR FACULTY PARTICIPANTS\u003c/strong\u003e\u003c/p\u003e\n\u003cdiv align=\"Left\"\u003e\n \u003ctable border=\"1\" cellspacing=\"0\" cellpadding=\"0\"\u003e\n \u003ctbody\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\" style=\"width: 76px;\"\u003e\n \u003cp\u003eS.NO\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 444px;\"\u003e\n \u003cp\u003eINTERVIEW QUESTION\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\" style=\"width: 76px;\"\u003e\n \u003cp\u003e1.\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 444px;\"\u003e\n \u003cp\u003eWhat common behaviours do you see in students who do well in their studies?\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\" style=\"width: 76px;\"\u003e\n \u003cp\u003e2.\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 444px;\"\u003e\n \u003cp\u003eHow do good study habits help students succeed? What habits do struggling students usually lack?\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\" style=\"width: 76px;\"\u003e\n \u003cp\u003e3.\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 444px;\"\u003e\n \u003cp\u003eHow do students who perform well prepare for assessments and exams compared to those who struggle?\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\" style=\"width: 76px;\"\u003e\n \u003cp\u003e4.\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 444px;\"\u003e\n \u003cp\u003eHow does student participation in both theory and practical sessions affect their performance?\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\" style=\"width: 76px;\"\u003e\n \u003cp\u003e5.\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 444px;\"\u003e\n \u003cp\u003eHow does regular class attendance affect student performance?\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\" style=\"width: 76px;\"\u003e\n \u003cp\u003e6.\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 444px;\"\u003e\n \u003cp\u003eHow does the classroom atmosphere, student interactions, and teacher-student relationships affect learning?\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\" style=\"width: 76px;\"\u003e\n \u003cp\u003e7.\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 444px;\"\u003e\n \u003cp\u003eWhat early signs show that a student might struggle academically? How do you help such students?\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\" style=\"width: 76px;\"\u003e\n \u003cp\u003e8.\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 444px;\"\u003e\n \u003cp\u003eHow important is self-motivation for academic success?\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\" style=\"width: 76px;\"\u003e\n \u003cp\u003e9.\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 444px;\"\u003e\n \u003cp\u003eWhat effect does parental participation have on a student\u0026apos;s academic achievement?\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\" style=\"width: 76px;\"\u003e\n \u003cp\u003e10.\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 444px;\"\u003e\n \u003cp\u003eFrom your experience, how do socio-economic factors such as financial stability, family support, or work commitments affect students\u0026apos; ability to succeed in their education?\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003c/tbody\u003e\n \u003c/table\u003e\n\u003c/div\u003e\n\u003cp\u003e\u003cstrong\u003eTable 2. FACULTY-DERIVED CHARACTERISTICS OF HIGH- AND LOW-ACHIEVING STUDENTS\u003c/strong\u003e\u003c/p\u003e\n\u003cdiv align=\"Left\"\u003e\n \u003ctable border=\"1\" cellspacing=\"0\" cellpadding=\"0\"\u003e\n \u003ctbody\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\" style=\"width: 192px;\"\u003e\n \u003cp\u003e\u003cstrong\u003eTheme Category\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 192px;\"\u003e\n \u003cp\u003e\u003cstrong\u003eHigh-Achieving Students\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 192px;\"\u003e\n \u003cp\u003e\u003cstrong\u003eLow-Achieving Students\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\" style=\"width: 192px;\"\u003e\n \u003cp\u003eAcademic Strategies\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 192px;\"\u003e\n \u003cp\u003eStructured; early preparation; organized; concept maps; self-testing; revision; higher-order thinking; extra resources\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 192px;\"\u003e\n \u003cp\u003eProcrastination; last-minute study; unstructured; rote memorization; minimal revision; limited resources\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\" style=\"width: 192px;\"\u003e\n \u003cp\u003eBehaviour \u0026amp; Demeanour\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 192px;\"\u003e\n \u003cp\u003eCalm; disciplined; focused; self-regulated; consistent attendance\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 192px;\"\u003e\n \u003cp\u003eDistracted; irregular attendance; passive; peer-influenced; maladaptive behaviours\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\" style=\"width: 192px;\"\u003e\n \u003cp\u003eStudent\u0026ndash;Faculty Interaction\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 192px;\"\u003e\n \u003cp\u003eProactive; help-seeking; clear communication; confident; independent\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 192px;\"\u003e\n \u003cp\u003eHesitant; poor communication; delayed help-seeking; dependent; withdrawn\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\" style=\"width: 192px;\"\u003e\n \u003cp\u003eMotivation\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 192px;\"\u003e\n \u003cp\u003eIntrinsic; goal-oriented; persistent; self-driven\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 192px;\"\u003e\n \u003cp\u003eExtrinsic; fluctuating; low interest; minimal initiative\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\" style=\"width: 192px;\"\u003e\n \u003cp\u003eExternal Factors\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 192px;\"\u003e\n \u003cp\u003eFamily support; stable environment; fewer financial constraints\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 192px;\"\u003e\n \u003cp\u003eFinancial stress; low family support; personal pressures; work burdens\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\" style=\"width: 192px;\"\u003e\n \u003cp\u003eClassroom Engagement\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 192px;\"\u003e\n \u003cp\u003eRegular attendance; active participation; questioning; collaborative; note-taking\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 192px;\"\u003e\n \u003cp\u003ePassive; reluctant; disengaged; fear of mistakes; absenteeism\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\" style=\"width: 192px;\"\u003e\n \u003cp\u003eImprovement Strategies\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 192px;\"\u003e\n \u003cp\u003ePeer mentoring; reflective; supportive\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 192px;\"\u003e\n \u003cp\u003eNeeds structure; stepwise guidance; continuous monitoring\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003c/tbody\u003e\n \u003c/table\u003e\n\u003c/div\u003e"}],"fulltextSource":"","fullText":"","funders":[],"hasAdminPriorityOnWorkflow":false,"hasManuscriptDocX":true,"hasOptedInToPreprint":true,"hasPassedJournalQc":"","hasAnyPriority":false,"hideJournal":false,"highlight":"","institution":"","isAcceptedByJournal":false,"isAuthorSuppliedPdf":false,"isDeskRejected":"","isHiddenFromSearch":false,"isInQc":false,"isInWorkflow":false,"isPdf":false,"isPdfUpToDate":true,"isWithdrawnOrRetracted":false,"journal":{"display":true,"email":"[email protected]","identity":"bmc-medical-education","isNatureJournal":false,"hasQc":true,"allowDirectSubmit":false,"externalIdentity":"meed","sideBox":"Learn more about [BMC Medical Education](http://bmcmededuc.biomedcentral.com/)","snPcode":"","submissionUrl":"https://www.editorialmanager.com/meed/default.aspx","title":"BMC Medical Education","twitterHandle":"BMC_series","acdcEnabled":true,"dfaEnabled":false,"editorialSystem":"em","reportingPortfolio":"BMC Series","inReviewEnabled":true,"inReviewRevisionsEnabled":true},"keywords":"Academic Performance, Faculty, Behaviour, Motivation, Qualitative research","lastPublishedDoi":"10.21203/rs.3.rs-8342116/v1","lastPublishedDoiUrl":"https://doi.org/10.21203/rs.3.rs-8342116/v1","license":{"name":"CC BY 4.0","url":"https://creativecommons.org/licenses/by/4.0/"},"manuscriptAbstract":"\u003cp\u003e\u003cb\u003eBackground:\u003c/b\u003e\u003c/p\u003e \u003cp\u003eAcademic performance is a crucial indicator of learning efficacy in medical and allied health science education. Teachers provide valuable insights into students learning behaviours, motivation, and challenges through continuous observation. This study examines faculty insights into the differences between high- and low-achieving students to identify key learning characteristics and develop strategies for preliminary intervention.\u003c/p\u003e\u003cp\u003e\u003cb\u003eMethods:\u003c/b\u003e\u003c/p\u003e \u003cp\u003eA qualitative study involving 127 faculty members from the Allied Health Sciences departments at SRM Medical College Hospital and Research Centre was carried out between August and October 2025. Ethical approval was acquired before data collection. Semi-structured interviews were designed and verified utilising the AMEE Guide No. 185 framework, and data were analysed using Braun and Clarke's (2006) six-step theme analysis. The data were coded independently by two researchers, with variations rectified through consensus.\u003c/p\u003e\u003cp\u003e\u003cb\u003eResults:\u003c/b\u003e\u003c/p\u003e \u003cp\u003eFaculty characterised high-achieving students as disciplined, self-motivated, and actively engaged, with constant attendance and efficient time management. In contrast, low achievers showed irregular study patterns, lower motivation, poor time management, and limited participation. Further, faculty described that academic achievement was positively impacted by family support, constructive criticism, and mentoring.\u003c/p\u003e\u003cp\u003e\u003cb\u003eConclusion:\u003c/b\u003e\u003c/p\u003e \u003cp\u003eHigh achievers demonstrated strong self-regulation and engagement, whereas low achievers showed reduced consistency and focus. Strengthened mentoring and structured academic support may enhance motivation, behavioural regulation, and performance among low achievers, fostering their overall academic performance.\u003c/p\u003e\u003cp\u003e\u003cb\u003eTrial registration:\u003c/b\u003e\u003c/p\u003e \u003cp\u003eThe study was prospectively registered with the Clinical Trials Registry India (CTRI), registration number \u003cb\u003eCTRI/2025/03/083587\u003c/b\u003e.\u003c/p\u003e","manuscriptTitle":"Characterization of High and Low Achievers for Early Identification of Students- A single-centre Qualitative Study in the Indian Context","msid":"","msnumber":"","nonDraftVersions":[{"code":1,"date":"2026-01-13 11:42:42","doi":"10.21203/rs.3.rs-8342116/v1","editorialEvents":[{"type":"communityComments","content":0},{"type":"editorInvitedReview","content":"","date":"2026-01-26T22:23:03+00:00","index":"hide","fulltext":""},{"type":"editorInvitedReview","content":"","date":"2026-01-26T07:34:06+00:00","index":"hide","fulltext":""},{"type":"reviewerAgreed","content":"248261851640920399975553331616297036648","date":"2026-01-18T22:34:52+00:00","index":"hide","fulltext":""},{"type":"reviewerAgreed","content":"146244053928040804235176833364748986727","date":"2026-01-14T05:05:04+00:00","index":"hide","fulltext":""},{"type":"reviewerAgreed","content":"289441371445745362275604387563507380800","date":"2026-01-09T07:33:23+00:00","index":"hide","fulltext":""},{"type":"reviewersInvited","content":"","date":"2026-01-09T05:00:03+00:00","index":"","fulltext":""},{"type":"editorInvited","content":"","date":"2025-12-16T06:50:56+00:00","index":"","fulltext":""},{"type":"editorAssigned","content":"","date":"2025-12-12T22:06:37+00:00","index":"","fulltext":""},{"type":"checksComplete","content":"","date":"2025-12-12T22:06:05+00:00","index":"","fulltext":""},{"type":"submitted","content":"BMC Medical Education","date":"2025-12-12T05:47:43+00:00","index":"","fulltext":""}],"status":"published","journal":{"display":true,"email":"[email protected]","identity":"bmc-medical-education","isNatureJournal":false,"hasQc":true,"allowDirectSubmit":false,"externalIdentity":"meed","sideBox":"Learn more about [BMC Medical Education](http://bmcmededuc.biomedcentral.com/)","snPcode":"","submissionUrl":"https://www.editorialmanager.com/meed/default.aspx","title":"BMC Medical Education","twitterHandle":"BMC_series","acdcEnabled":true,"dfaEnabled":false,"editorialSystem":"em","reportingPortfolio":"BMC Series","inReviewEnabled":true,"inReviewRevisionsEnabled":true}}],"origin":"","ownerIdentity":"ce735dc8-cb76-45df-9e64-2d37b3fedf85","owner":[],"postedDate":"January 13th, 2026","published":true,"recentEditorialEvents":[],"rejectedJournal":[],"revision":"","amendment":"","status":"under-review","subjectAreas":[],"tags":[],"updatedAt":"2026-01-13T11:42:42+00:00","versionOfRecord":[],"versionCreatedAt":"2026-01-13 11:42:42","video":"","vorDoi":"","vorDoiUrl":"","workflowStages":[]},"version":"v1","identity":"rs-8342116","journalConfig":"researchsquare"},"__N_SSP":true},"page":"/article/[identity]/[[...version]]","query":{"redirect":"/article/rs-8342116","identity":"rs-8342116","version":["v1"]},"buildId":"XKTyCvWXoU3ODBz1xrDgd","isFallback":false,"isExperimentalCompile":false,"dynamicIds":[84888],"gssp":true,"scriptLoader":[]}