Increasing mental health issues, such as emotional problems, pose a threat for the academic performance of undergraduate students. We propose a route connecting emotional problems and academic performance through executive functioning skills (EFS). Despite the abundance of research on the topic of EFS, there is a significant gap in understanding this route, specifically among a population of undergraduate students. The aim of this study was to examine whether EFS mediated the association between emotional problems and academic performance among undergraduate students. Cross-sectional data (n = 2,531) was used from a survey among Dutch undergraduate students from a large variety of faculties at a university of applied sciences. We assessed emotional problems using the Depression Anxiety Stress Scale-21, five EFS (cognitive inhibition, task initiation, sustained attention, planning, time management), and academic performance (study delay; yes/no). Mediation analyses were performed, using the Hayes PROCESS macro, adjusted for gender. We found that cognitive inhibition, task initiation, sustained attention, planning, and time management mediated the association between emotional problems and academic performance. Regarding separate EFS, no large differences were found. The data suggests that improving all EFS in undergraduates experiencing emotional problems could be a fruitful strategy for preventing academic delays.
To identify ethical issues that interns encounter in their clinical education and thus build a more empirical basis for the required contents of the clinical ethics curriculum. The authors analyzed a total of 522 required case reports on ethical dilemmas experienced by interns from September 1995 to May 1999 at the medical school of Vrije Universiteit in Amsterdam. They identified four regularly described and numerous less frequently described topics. The interns addressed a wide range of ethical themes. In 45% of the cases, they mentioned disclosure or non-disclosure of information and informed consent; in 37%, medical decisions at the end of life; in 16%, medical failures; and in 9%, problems transferring patients from one caregiver to another. The interns also identified 27 themes linked to their unique position as interns and 19 themes related to specific types of patients. Based on self-reported experiences, the authors conclude that clinical ethics teachers should reflect on a multitude of dilemmas. Special expertise is required with respect to end-of-life decisions, truth telling, medical failures, and transferring patients from one caregiver to another. The clinical ethics curriculum should encourage students to voice their opinions and deal with values, responsibilities, and the uncertainty and failings of medical interventions.
