Presented By: Brook Hubner, University of Alabama at Birmingham Marnix E. Heersink School of Medicine
Co-Authors: James Baños, University of Alabama at Birmingham Marnix E. Heersink School of Medicine

Purpose 
Locus of Control (LoC) refers to perceptions of whether internal or external factors influence life outcomes. Internal LoC is associated with a sense of control over life's outcomes. External LoC attributes outcomes to outside factors. Although LoC is associated with well-being, academic, and job-related outcomes, there is limited medical education research into LoC. This study is a preliminary examination of LoC in relation to demographic factors and wellness outcomes. 

Methods
In 2023, the Levenson Multidimensional Locus of Control IPC Scales (IPC) were included in an annual M1-M4 wellness survey. The IPC scales assess internal LoC (I), external LoC related to chance (C), and external LoC related to powerful others (P). Analyses include intercorrelations of IPC subscales, demographic correlates, and relationships to other outcome measures (stress, well-being, affect, and burnout). 

Results
The analysis included 470 completed surveys. We found a high correlation between the P and C subscales. The I subscale was consistently the highest and most stable across the four years. The P and C scales were highest for M3s and dropped for M4s. Women scored slightly lower on the I subscale. No URiM effect was observed. There was a modest correlation between LoC and overall well-being. All LoC scales were related to stress and affect to some degree. External LoC related to exhaustion and cynicism.

Conclusions 
Despite consistently high ratings of internal LoC, fluctuations in external LoC across the years suggest that control perceptions may be shaped by the learning environment. Consistent with other studies, LoC appears to be related to psychological wellness and appears to be environmentally malleable, opening avenues for potential intervention. Although our findings are interpreted cautiously given the correlational nature of the analyses, the findings support the idea that LoC warrants further investigation as a potentially relevant factor in student wellness.