title: Introversion and medical student education: challenges for both students and educators.
abstract: OBJECTIVE
  Introversion is one of the personality factors that has been shown to be associated with performance in medical school. Prior cross-sectional studies highlight performance evaluation differences between introverted and extraverted medical students, though the mechanisms and implications of these differences remain relatively unexplained and understudied. This gap in the literature has become more salient as medical schools are employing more interactive learning strategies into their curricula which may disproportionately challenge introverted learners.
  
  
  METHODS
  In this article, we provide an overview and working definition of introversion as a valid construct occurring on a continuum. We apply a goodness of fit model to explore how various medical training contexts may be more or less challenging for introverted students and the potential consequences of a poor fit. As preliminary support for these hypothesized challenges, we share observations from students self-identified as introverts. Examples include introverted students feeling at times like misfits, questioning a need to change their identity to succeed in medical school, and being judged as underperformers. We offer pragmatic suggestions for improving the fit between introverted students and their training contexts, such as teachers and students pausing between a question being asked and the initial response being offered and teachers differentiating between anxious and introverted behaviors. We conclude with suggested areas for future qualitative and quantitative research to examine how medical school curricula and the teaching environment may be differentially impacting the learning and health of introverted and extraverted students.
  
  
  CONCLUSIONS
  Extraverted behaviors will continue to be an important part of medical training and practice, but the merits of introverted behaviors warrant further consideration as both medical training and practice evolve. Educators who make manageable adjustments to current teaching practices can improve the learning for both introverted and extraverted styles of academic engagement.
authors.affiliation: a Department of Psychiatry and Health Behavior , Georgia Regents University , Augusta , Georgia , USA.
authors.forename: Bernard
authors.initials: B
authors.lastname: Davidson
authors.forename: Ralph A
authors.initials: RA
authors.lastname: Gillies
authors.forename: Allen L
authors.initials: AL
authors.lastname: Pelletier
mesh_terms: D004501:Education, Medical; D006801:Humans; D007439:Introversion, Psychological; D013337:Students, Medical / Q000523:psychology*
keywords: assessment; personality; qualitative; student characteristics; student health