The impact of a competitive learning environment on hormonal and emotional stress responses and skill acquisition and expression in a medical student domain

The concept of competition has implications for educational contexts, as hormonal and emotional changes under competitive stress can modulate learning and memory processes. This study examined the impact of a competitive learning environment and associated hormonal and emotional responses on skill acquisition and expression in a medical domain. Using a cross-over design, sixteen male medical students participated in a competitive (in pairs facing each other) and non-competitive (alone) learning situation. In each treatment, an instructional video was followed by a timed straight-line suture evaluation with anxiety and competitiveness recorded. Salivary testosterone (T) and cortisol (C) were assessed at rest, before and after evaluation to quantify changes in T (ΔT) and C (ΔC). These procedures were followed by two sessions of self-directed training before retesting. Paired learning produced a larger positive ΔT (5.9–7.8% vs. 2.0–5.3%) and ΔC (7.6% vs. 3.3%), which was accompanied by more anxiety and elevated competitiveness (p <.01). Anxiety declined and suturing abilities improved over time (p <.001), irrespective of the learning approach, with resting C concentrations decreasing when learning alone (p <.05). Some ΔT and ΔC measures correlated (r = 0.40 to 0.65) with anxiety and competitive desire with paired learning only, whereas the ΔC was linked to suturing performance (r = −0.35) when learning alone. In summary, a tacit competition in a natural learning situation promoted more pronounced hormonal and emotional responses. However, skill acquisition and its expression improved to a similar extent in both situations of competitive and non-competitive assessment. Different adaptive pathways for skill expression and development emerged from this work.