Academic performance is vaguely defined as the success of a person in formal education [1] often assessed by course performance [2], first year examination result [3], final grade point average [4] or standardized test scores [5]. Academic performance at the tertiary level has a strong bearing on one’s quality of life and mental, physical and socio-economic well-being [6]. It affects the job application process and provide valuable information to prospective employers [7]. Mostly, the onus of the students’ performance rest significantly on them [8]. However, the institution’s success is also partially rated by the academic performance of its students [9, 10]. Thus, the students are the most valuable assets to the University [9] hence tertiary institutions put in place measures to enrol the best of students and mentor appropriately to ensure sustained attainment of success.
Allocating first year places to students in the University is always an issue to academic institutions [11]. The decision to admit students into a particular course is based on several factors [12]. Attaining a high grade in high school is a key determinant for gaining admission into high demand courses [12], and The Bachelor of Physiology is no exception. High school grades tend to correlate positively with academic success at the undergraduate level [13], thus it is the most common selective criteria used at entry points [14]. Nevertheless, the utilisation of this criteria results in the over-representation of individuals from socio-economically privileged backgrounds who have attended selective schools in these highly competitive courses [15]. For example, studies show that students from such affluent schools have the advantage of obtaining high scores at high school because of access to study material, requisite equipment, and teachers with high educational backgrounds [16, 15]. However, it has been shown that students from high performing high schools tend to get poorer grades at the tertiary level after controlling for high school grades [15]. Hence, to include students with intellectual ability and/or from less privileged backgrounds, many Universities conduct standardized tests to normalize high school grades from different schools [5]. The use of standardized tests has predictive validity for success in undergraduate programmes. Key determinants of student’s academic performance is not limited to high school grade and high scores on the standardized tests. Once enrolled, other factors also come to play in the academic performance of the students.
The National Benchmark Test (NBT) 2020 report highlighted the need for the higher education sector to offer substantial support in quantitative literacy (QL) and mathematics (MAT) as a large majority of potential students achieved scores within the Basic and Intermediate benchmark ranges [17]. This cohort was admitted during a time when the Faculty of Health Sciences used an admission policy that included the requirement for students to write NBT in addition to the National Senior Certificate [18]. The core domains assessed in the NBT for selection in health sciences programme including the bachelor of Physiotherapy are Mathematics, Academic and Quantitative Literacy [19]. The critical subject’s compulsory in the NSC for admission are Mathematics, English, Physical Sciences, or Life Sciences. The scores in both the NBT and NSC are combined to create a composite index that is essential for classifying applicants based on different admission Categories. It is important to highlight that the top 40% of positions are set aside for students with exceptional academic performance, while the remaining 60% are distributed fairly among high-achieving rural students, those from Quintile 1&3 backgrounds, and individuals of Black and Coloured (BC) ethnicity.
In 1953, the apartheid government introduced the Bantu Education Act (Act No. 47 of 1953) to entrenched and deliver on the promise of separateness among races in South Africa [20–22]. The act included the creation of a Black Education Department, which was responsible for implementing a curriculum aimed at equipping black individuals with basic skills to work for white people [21]. The schools under Bantu Education were established in disadvantaged areas, inspected by the Union of Department of Native Affairs to offer an inferior education, a situation that persists to this day [20, 22]. The Bantu Education system has significantly restricted the ability of black, Indian, and coloured individuals to attend historically white universities. The situation was further exacerbated by the University Education Act of 1959, which made it extremely challenging for certain racial groups to gain entry into historically white universities without obtaining high-level ministerial permission [21].
The democratic South African government introduced the school quintile system, implemented as means to reverse the lasting legacy of Bantu education Act including major curriculum revisions [23]. The quintile system categorizes schools into five quintiles based on the socio-economic status of their surrounding communities, with Quintile 1 representing the most economically disadvantaged and Quintile 5 the most advantaged [24]. While ostensibly designed to address inequality by directing more resources to schools serving impoverished areas, this system has instead entrenched inequalities and marginalized students from lower quintile schools. Schools situated in wealthier areas (Quintiles 4 and 5) typically enjoy better infrastructure, resources, and teaching quality, while those in lower quintiles struggle with inadequate facilities, insufficient staffing, and limited access to educational materials and technologies [24]. Consequently, students attending lower quintile schools are disproportionately disadvantaged in terms of educational opportunities and outcomes, perpetuating a cycle of poverty and marginalization. Moreover, the quintile system has inadvertently created a two-tiered education system, with students from affluent backgrounds accessing higher-quality education and opportunities, while those from disadvantaged backgrounds face systemic barriers to academic achievement and socio-economic mobility 25. Thus, while the intention behind the quintile system may have been to address educational disparities, its implementation has ultimately reinforced inequalities between the rich and the poor, further widening the gap and hindering equitable access to quality education for all South African students [24, 26]. Besides the already existing achievement gap between black and white students [27], white-black teacher to student mismatch also affects academic performance [28, 29].
Though inconclusive, accommodation status of students contributes substantially to academic performance, with off-campus accommodation has been shown to have the advantageous effect on academic performance [30, 31]. This challenges the rational of providing on-campus accommodation by universities to facilitate easy access to study amenities. Additionally, gender differences exist in academic performance; male students require more effort and good teachers, while for female students’ academic performance is influenced by a liking to teachers, luck, and attention [8]. Age, daily study time, extracurricular activities among others are also factors that affect academic performance [32–36].
Aims
The overall aim of this study is to comprehensively investigate the factors influencing academic performance and progression outcomes among medical (MBBCh) and health science (BHSc) students enrolled in the PHSL2004A course, with a particular focus on demographic variables, including living arrangements, race, and admission categories. This study has three objectives. The first seeks to address the influence of demographic factors, including students' living arrangements, race, and admission categories, on academic performance and progression outcomes among MBBCh and BHSc students enrolled in the PHSL2004A course. The second determines the association between students' living arrangements and their progression outcomes in the PHSL2004A course, considering factors such as private residential areas (off-campus) versus university residences (on campus). The third explores the influence of admission categories on academic performance in the PHSL2004A course, specifically examining differences in performance among students admitted under various admission categories.