title: The relationship between academic performance and recreation use among first-year medical students.
abstract: BACKGROUND
  Self-care activities, including exercise, may be neglected by medical students in response to increasing academic demands. Low levels of exercise among medical students may have ripple effects on patient care and counseling. This study investigates the reciprocal role of recreation use and academic performance among first-year medical students.
  
  
  METHODS
  We combined retrospective administrative data from four cohorts of first-year medical students at the University of Illinois at Urbana-Champaign from 2006 to 2010 (n=408). We estimated regression models to clarify the role of changes in recreation use before examinations on changes in academic performance, and vice versa.
  
  
  RESULTS
  The use of recreation facilities by first-year medical students was highly skewed. We found that changes in recreation use before an exam were positively associated with changes in exam performance, and vice versa. Students who make large decreases in their recreation use are likely to decrease their exam scores, rather than increase them.
  
  
  CONCLUSIONS
  Students who make decreases in their recreation, on average, are likely to decrease their exam scores. These findings suggest that medical students may be able to boost their achievement through wellness interventions, even if they are struggling with exams. We find no evidence that decreasing wellness activities will help improve exam performance.
authors.affiliation: Department of Pathology, College of Medicine, University of Illinois at Urbana-Champaign, Urbana, IL, USA; aslade2@illinois.edu.
authors.forename: Alexander N
authors.initials: AN
authors.lastname: Slade
authors.affiliation: Department of Pathology, College of Medicine, University of Illinois at Urbana-Champaign, Urbana, IL, USA.
authors.forename: Susan M
authors.initials: SM
authors.lastname: Kies
mesh_terms: D000328:Adult; D004522:Educational Status; D005260:Female; D006801:Humans; D008297:Male; D044469:Racial Groups; D011998:Recreation; D012189:Retrospective Studies; D013337:Students, Medical / Q000523:psychology*
keywords: academic performance; first-year medical students; longitudinal analysis; wellness interventions
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