Locus of control and sense of coherence as predictors of academic achievement among medical and nursing students: a cross-sectional study.
BACKGROUND Academic success in medical and nursing education depends not only on cognitive skills but also on psychological factors. Sense of coherence (SOC) and locus of control (LOC) are key predictors of coping and motivation. This study examined the relationship between academic performance, SOC, and LOC among medical and nursing students. METHODS This descriptive-correlational, cross-sectional study was conducted between April and July 2024 at Ahvaz Jundishapur University of Medical Sciences. A sample of 348 medical (65.2%) and nursing (34.8%) students completed a demographic questionnaire, the Sense of Coherence Scale (SOC-13), and Rotter's Locus of Control Scale. Academic performance was measured using cumulative Grade Point Average (GPA). Data were analyzed using Pearson correlation, independent t-tests, ANOVA, and multiple linear regression (Simultaneous and Stepwise methods). RESULTS The mean scores were 54.53 ± 10.85 for SOC, 10.52 ± 2.57 for LOC (41.1% internal, 58.9% external), and 15.28 ± 1.36 for GPA. GPA correlated positively with SOC (r = 0.519, p < 0.001) and negatively with LOC (r = -0.272, p < 0.001). In the simultaneous multiple linear regression model, SOC (β = 0.496, p < 0.001), female gender (β = 0.129, p = 0.005), and nursing major (β = 0.127, p = 0.036) were significant independent predictors of GPA (Adj. R2 = 0.281). In the stepwise regression model, SOC (β = 0.529, p < 0.001) and female gender (β = 0.133, p = 0.004) emerged as the final robust predictors, accounting for 28.3% of the variance in GPA. CONCLUSION SOC and female gender are the most consistent and powerful independent predictors of academic achievement among medical and nursing students. While LOC and academic interest show initial correlations with GPA, their predictive power diminishes when accounting for SOC in multivariate models. Medical education curricula should integrate interventions to strengthen students' SOC to enhance their psychological resilience and academic success.