title: The impact of learning environment disruption on medical student performance.
abstract: OBJECTIVE
  This study aimed to quantify the effects of two distinct and separate disruptions caused by earthquakes to a medical school learning environment on two separate cohorts of Year 5 medical students.
  
  
  METHODS
  The first disruption was caused by an earthquake of magnitude 7.1 that occurred near the end of the academic year but caused minimal physical damage. The second disruption, to a different cohort of students, was caused by a magnitude 6.3 aftershock that occurred at the beginning of the academic year, caused loss of life and widespread damage to the city, and resulted in the closure of the medical school building for 2 years. Using students from the same class, who spent their year in different unaffected cities, as control subjects, and students from previous years in the same city as historic controls, we developed models to compare actual and predicted performances on end-of-year examinations in each of the two cohorts with those in the three previous unaffected year groups.
  
  
  RESULTS
  The predictive models fitted the data well with multiple correlations for the written (R range: 0.69-0.79) and clinical (R range: 0.52-0.69) examinations. Students in the first cohort, for whom the disruption occurred close to end-of-year examinations but had a mild effect on the physical environment, performed slightly (-1.5% to -2.0%) but significantly (p < 0.05) worse than predicted for all three outcomes. Students in the second cohort, who experienced major disruption of their physical environment, performed as expected.
  
  
  CONCLUSIONS
  An unexpected disruption that occurred close to examinations, but which had less physical environmental effect, had a greater impact on assessment performance than a more severe disruption and series of disruptions to which students had time to adapt and which they could work around. Two theories are offered to explain the observations.
authors: Department of Medical Education, University of Otago, Christchurch, New Zealand. tim.wilkinson@otago.ac.nz
authors: Tim J
authors: TJ
authors: Wilkinson
authors: Anthony N
authors: AN
authors: Ali
authors: Caroline J
authors: CJ
authors: Bell
authors: Frances A
authors: FA
authors: Carter
authors: Chris M
authors: CM
authors: Frampton
authors: Jan M
authors: JM
authors: McKenzie
mesh_terms: D000223:Adaptation, Psychological; D000328:Adult; D004190:Disasters; D004504:Education, Medical, Undergraduate / Q000458:organization & administration*; D004777:Environment; D005260:Female; D006801:Humans; D008297:Male; D009520:New Zealand; D013337:Students, Medical / Q000523:psychology*