ArticleBMC medical education2026
Sociodemographic, lifestyle, and educational environment factors associated with academic performance among Tunisian medical students: a cross-sectional study.
Article in BMC medical education, 2026. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Not yet cited in PubMed.
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Abstract
backgroundAcademic performance strongly influences medical students' professional development. It results from the interaction of multiple factors, including sociodemographic characteristics, lifestyle habits, and academic conditions. Although these determinants have been explored in various contexts, evidence from North African medical schools remains limited, despite their distinct educational structures and resource constraints. Identifying context-specific and modifiable factors is essential to improve educational outcomes. Therefore, this study aimed to identify sociodemographic, lifestyle and academic factors associated with academic performance among medical students at the Faculty of Medicine of Sousse (FMSo), Tunisia.
methodsA cross-sectional study was conducted among FMSo students during the academic year 2023-2024. An exhaustive online survey was distributed through the university's virtual platform to all eligible students. Data were collected using a questionnaire assessing sociodemographic characteristics, lifestyle habits, academic factors, and students' perceptions of educational environment, measured using the validated French version of Dundee Ready Education Environment Measure (DREEM). Academic performance was measured using self-reported overall grade averages categorized into five levels. Ordinal logistic regression was used to identify factors independently associated with higher academic performance.
resultsAmong 1,329 eligible students, 701 participated (52.8% response rate). Most students (47.4%) achieved fairly good performance (12-13.99/20). The median DREEM score was 115 [IQR: 101-130], indicating a generally positive educational environment. In multivariate analysis, significant predictors of higher academic performance included: Tunisian nationality (OR = 4.99, 95% CI:3.01-8.29, p < 0.001), no psychoactive substance use (OR = 2.60, 95% CI:1.64-4.13, p < 0.001), and increased daily revision hours (OR = 1.08, 95% CI:1.03-1.13, p = 0.003). Satisfaction with the educational environment was a significant protective factor, with satisfied students achieving significantly better academic performance (OR = 0.60, 95% CI: 0.44-0.82, p = 0.001).
conclusionsThe academic performance of Tunisian medical students is associated with multiple modifiable factors. Targeted interventions that address modifiable factors such as substance use, study habits, and educational satisfaction may enhance academic performance and student well-being. These findings can inform evidence-based strategies to optimize medical education in Tunisia and similar contexts.
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