Abstract
BACKGROUND: Introverted medical students often encounter distinct challenges in collaborative learning (CL) environments that can impact their performance. Understanding both introverted and extroverted perspectives is essential for developing supportive strategies. This study investigates the barriers faced by introverts in CL settings and compares these with the perspectives of extroverted peers. METHODS: The study utilized an exploratory mixed-methods design targeting pre-clinical medical students. The qualitative phase involved in-depth semi-structured interviews with 12 students to identify obstacles faced by introverts in CL. The quantitative phase utilized an 18-item questionnaire developed from the qualitative findings, administered to 162 students to quantify perceived barriers. Perceived barriers between different personality groups were compared. Maudsley Personality Inventory (MPI) was utilized to assess introverted personality. RESULTS: Thematic analysis revealed seven major themes: (1) fear of responsibility, (2) shyness, (3) low communication due to a lack of intimacy, (4) contextual self-doubt in group learning, (5) a need for stimuli to express opinions, (6) diminished roles due to others' dominance, and (7) high energy required for participation. Introverts often avoid leadership roles, hesitate to voice their opinions, and require more intimate group settings for effective communication. The average MPI score is 23.6 ± 6.4, and 50% are introverts by the cutoff point of 24. Exploratory Factor Analysis extracted a questionnaire with four domains: (1) insecurities, (2) aloofness, (3) attention anxiousness, which hampers leadership, and (4) pacing challenges, which need additional assistance. The overall Cronbach's alpha was 0.87. The average scores for these domains are 3.28 ± 1.00, 3.60 ± 0.72, 3.42 ± 0.77, and 3.56 ± 0.86, respectively (F(3, 644) = 4.88, p = 0.002). Introverts rated attention anxiousness hampering leadership significantly higher than extroverts (Introverts = 3.60 ± 0.70, Extroverts = 3.24 ± 0.81, t(160) = 3.603, p = 0.001, Cohen's d = 0.48). However, both groups rated similarly for other domains. CONCLUSION: CL can challenge introverted medical students, especially during fast-paced clinical reasoning or when team leadership is required in unstructured settings. Medical schools should offer structured social engagement, adapt group-based assessments, and accommodate diverse learning styles. Importantly, strategies should be co-developed with both introverted and extroverted students to address performance anxiety, communication, and leadership in CL environments.