Table 2.

A synthesis of classification systems of underperformance in medical education

Cognitive causes	Insufficient knowledge7,17,18,20,22,34,35,53–56,58	Insufficient investment in studies17–19,34 Learning disorders17,18,22,34,35,54,56 Organization related difficulties19,20,34,51,52,54
	Clinical reasoning7,18,34,71	Insufficient knowledge20,34 Difficulty organizing information34,51,55,56 Clinical reasoning difficulties71
Noncognitive causes	Attitude problems7,18,20,22,35,52,53,57	Ignorance of professional responsibilities20 Different values and beliefs17,18,34,55 Poor insight and self-regulation18,22 Poor social skills7,19,22,52,56 Insufficient motivation22,52–56 Conflicts in the workplace34,35,54,58
	Affective problems7,17,19,34,53	Anxiodepressive mood disorders17,19,20,34,35,51–55 Other mental health issues19,20,22,35,56,58 Substance abuse17,19,20,22,34,35,56,58 Stress (family, personal, relational)34,35,52–54,58