Structural Relationships between Environmental Factors, Psychological Health, and Academic Performance in Medical Students Engaged in Online Learning during the COVID-19 Pandemic

Int J Environ Res Public Health. 2023 Jan 13;20(2):1494. doi: 10.3390/ijerph20021494.


As a result of the COVID-19 outbreak and the enforced quarantine, universities in Malaysia were required to switch to an online class format. The resulting changes in the environmental factors of students may have had an impact on their psychological health and academic performance. This study aimed to determine the effects of environmental factors and the psychological health of students and examine their structural relationship with academic performance. A cross-sectional design with an online self-reported questionnaire was adopted, and the study was conducted among 207 undergraduate medical students at the Health Campus of Universiti Sains Malaysia. The environmental factors were measured using the lighting-noise-temperature scale and technology scale, while psychological health was assessed using the short version of the General Health Questionnaire and academic performance was determined based on Grade Point Average. Descriptive statistics and structural equation modeling were used for analysis of the data. No significant relationship was found between environmental factors and academic performance, or between environmental factors and psychological health. Nonetheless, the hypothesized structural model provided scientific evidence of an inverse relationship between psychological health and academic performance. These findings could be helpful for academics, health policymakers, and health educators in terms of understanding and promoting psychological wellbeing among university students, as well as improving their academic performance.

Keywords: COVID-19; academic performance; environmental factor; online learning; psychological health.

MeSH terms

  • Academic Performance*
  • COVID-19* / epidemiology
  • Cross-Sectional Studies
  • Education, Distance*
  • Humans
  • Pandemics
  • Students, Medical* / psychology
  • Universities

Grants and funding

This research received no external funding.