ArticleBMC medical education2026
Academic foundation and postgraduate exam success: the serial mediating roles of psychological state and behavioral engagement.
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
backgroundWith the intensifying competition of postgraduate entrance examinations in China, academic foundation is confirmed as a key predictor of success, yet the serial mediating mechanism of psychological state and behavioral engagement in this relationship remains unexplored.
methodsA cross-sectional study was conducted on 280 participants from Kunming Medical University, comprising 150 admitted and 130 non-admitted candidates. Academic foundation was set as the independent variable, exam outcome as the dependent variable; psychological state and behavioral engagement served as serial mediators, support resources as a covariate, and gender, residence type, and family income as control variables. Utilizing DWLS (Full Information Maximum Likelihood) estimation and 5000 Bootstrap sample size for statistical power, the serial multiple mediation analysis was conducted for the sample.
resultsThe total effect of academic foundations on exam success was determined to be statistically significant (B = 0.265, 95% CI [0.154, 0.391], P < 0.001), with 67.2% of the total effect being accounted for as a direct effect (B = 0.178, 95% CI = [0.082, 0.286], P < 0.001). Two major indirect pathways were found. The first indirect pathway went through psychological states and behavioral engagement. It had a big effect (B = 0.029, 95% CI [0.007-0.067], P = 0.048) and was responsible for 10.8% of the whole effect. There was a significant effect (B = 0.058, 95% CI [0.020, 0.119], P = 0.019) from the second indirect pathway, which was through psychological states alone. It made up 21.9% of the total effect. A total indirect effect was observed to have a significant effect (B = 0.087, 95% CI [0.034, 0.145], P = 0.02), which accounted for 32.8% of the total effect produced.
conclusionsBy validating the dual-path serial mediation model of the Academic Foundation on Postgraduate Exam Success, this research substantiates several existing theories while providing several avenues for the use of these theoretical constructs by postgraduate entrance exam candidates and their respective institutions.
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