Student attendance and academic performance in undergraduate obstetrics/gynecology clinical rotations

Deane, R. P. and Murphy, D. J. (2013) Student attendance and academic performance in undergraduate obstetrics/gynecology clinical rotations. pp. 2282-2288. ISSN 00987484 (ISSN)

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IMPORTANCE: Student attendance is thought to be an important factor in the academic performance of medical students, in addition to having important regulatory, policy, and financial implications for medical educators. However, this relationship has not been well evaluated within clinical learning environments. OBJECTIVE: To evaluate the relationship between student attendance and academic performance in a medical student obstetrics/gynecology clinical rotation. DESIGN, SETTING, AND PARTICIPANTS: A prospective cohort study of student attendance at clinical and tutorial-based activities during a full academic year (September 2011 to June 2012) within a publicly funded university teaching hospital in Dublin, Ireland. Students were expected to attend 64 activities (26 clinical activities and 38 tutorial-based activities) but attendance was not mandatory. All 147 fourth-year medical students who completed an 8-week obstetrics/gynecology rotation were included. EXPOSURES: Student attendance at clinical and tutorial-based activities, recorded using a paper-based logbook. MAIN OUTCOMES AND MEASURES: The overall examination score (out of a possible 200 points) was obtained using an 11-station objective structured clinical examination (40 points), an end-of-year written examination comprising 50 multiple-choice questions (40 points) and 6 short-answer questions (40 points), and an end-of-year long-case clinical/oral examination (80 points). Students were required to have an overall score of 100 points (50%) and a minimum of 40 points in the long-case clinical/oral examination (50%) to pass. RESULTS: The mean attendance rate was 89% (range, 39%-100% [SD, 11%], n = 57/64 activities). Male students (84% attendance, P = .001) and students who failed an end-of-year examination previously (84% attendance, P = .04) had significantly lower rates. There was a positive correlation between attendance and overall examination score (r = 0.59 [95% CI, 0.44-0.70]; P < .001). Both clinical attendance (r = 0.50 [95% CI, 0.32-0.64]; P < .001) and tutorial-based attendance (r = 0.57 [95% CI, 0.40-0.70]; P < .001) were positively correlated with overall examination score. The associations persisted after controlling for confounding factors of student sex, age, country of origin, previous failure in an end-of-year examination, and the timing of the rotation during the academic year. Distinction grades (overall score of ≥60%) were present only among students with attendance rates of 80% or higher. The odds of a distinction grade increased with each 10% increase in attendance (adjusted odds ratio, 5.52; 95% CI, 2.17-14.00). The majority of failure grades (6/10 students; 60%) occurred in students with attendance rates lower than 80%. The adjusted odds ratio for failure with attendance rates of 80% or higher was 0.11 (95% CI, 0.02-0.72). CONCLUSIONS AND RELEVANCE: Among fourth-year medical students completing an 8-week obstetrics/gynecology clinical rotation, attendance at clinical and tutorial-based activities was positively correlated with overall examination scores. Further research is needed to understand whether the relationship is causal, and whether improving attendance rates can improve academic performance. Copyright 2013 American Medical Association. All rights reserved.

Item Type: Article
Additional Information: Cited By :1; Export Date: 23 February 2015; CODEN: JAMAA; Correspondence Address: Deane, R.P.; Department of Obstetrics and Gynecology, Trinity College, Coombe Women and Infants University Hospital, Dublin, Ireland; email:; References: Schieffler Jr., D.A., Azevedo, B.M., Culbertson, R.A., Kahn, M.J., Financial implications of increasing medical school class size: Does tuition cover cost? (2012) Perm J, 16 (2), pp. 10-14; Richards, A.J., Advancing the medical education mission: The bottom line (2013) Acad Med, 88 (4), p. 434; Hamdy, H., Prasad, K., Anderson, M.B., BEME systematic review: Predictive values of measurements obtained in medical schools and future performance in medical practice (2006) Med Teach, 28 (2), pp. 103-116; Smith, L.B., Medical school and on-line learning: Does optional attendance create absentee doctors? (2012) Med Educ, 46 (2), pp. 137-138; TCD Marking Scheme, ,, Office of the Senior Lecturer, Trinity College, University of Dublin Accessed September 27, 2013; Thompson, J.L., Thompson, A.M., McCain Jr., F.E., Effects of optional laboratory and lecture attendance in a medical physiology course (1974) J Med Educ, 49 (10), pp. 963-972; Sade, R.M., Stroud, M.R., Medical student attendance at lectures: Effect on medical school performance (1982) J Med Educ, 57 (3), pp. 191-192; Fogleman, B.S., Cleghorn, G.D., Relationship between class attendance and NBME part I examination (1983) J Med Educ, 58 (11), p. 904; Glanz, K., Fiel, S.B., Effect of attendance at lectures on medical student performance (1984) J Med Educ, 59 (6), pp. 516-518; Flournoy, D.J., Hyde, R.M., The relationship of lecture attendance and course grade for second-year medical students (1984) J Okla State Med Assoc, 77 (1), pp. 20-22; Hammen, C.S., Kelland, J.L., Attendance and grades in a human physiology course (1994) Am J Physiol, 267 (6 PART 3), pp. S105-S108; Riggs, J.W., Blanco, J.D., Is there a relation between student lecture attendance and clinical science subject examination score? (1994) Obstet Gynecol, 84 (2), pp. 311-313; Dhaliwal, U., Absenteeism and under-achievement in final year medical students (2003) Natl Med J India, 16 (1), pp. 34-37; Khan, H.U., Khattak, A.M., Mahsud, I.U., Impact of class attendance upon examination results of students in basic medical sciences (2003) J Ayub Med Coll Abbottabad, 15 (2), pp. 56-58; Hamdi, A., Effects of lecture absenteeism on pharmacology course performance in medical students (2006) J Int Assoc Med Sci Educ, 16, pp. 27-30; Fernandes, L., Maley, M., Cruickshank, C., The impact of online lecture recordings on learning outcomes in pharmacology (2008) J Int Assoc Med Sci Educ, 18, pp. 62-70; BinSaeed, A.A., Al-Otaibi, M.S., Al-Ziyadi, H.G., Babsail, A.M.A., Shaik, S.A., Association between student absenteeism at a medical college and their academic grades (2006) J Int Assoc Med Sci Educ, 19 (4), pp. 155-159; Chan, W.P., Assessment of medical students' knowledge retention in a diagnostic radiology course: Lecture attendees versus absentees (2009) Ann Acad Med Singapore, 38 (3), pp. 237-239; Millis, R.M., Dyson, S., Cannon, D., Association of classroom participation and examination performance in a first-year medical school course (2009) Adv Physiol Educ, 33 (3), pp. 139-143; Cortright, R.N., Lujan, H.L., Cox, J.H., DiCarlo, S.E., Does sex (female versus male) influence the impact of class attendance on examination performance? (2011) Adv Physiol Educ, 35 (4), pp. 416-420; Hidayat, L., Vansal, S., Kim, E., Sullivan, M., Salbu, R., Pharmacy student absenteeism and academic performance (2012) Am J Pharm Educ, 76 (1), p. 8; Horton, D.M., Wiederman, S.D., Saint, D.A., Assessment outcome is weakly correlated with lecture attendance: Influence of learning style and use of alternative materials (2012) Adv Physiol Educ, 36 (2), pp. 108-115; Cohall, D.H., Skeete, D., The impact of an attendance policy on the academic performance of first year medical students taking the fundamental of disease and treatment course (2012) Caribbean Teaching Scholar, 2 (2), pp. 115-123; O'Brien, B., Cooke, M., Irby, D.M., Perceptions and attributions of third-year student struggles in clerkships: Do students and clerkship directors agree? (2007) Acad Med, 82 (10), pp. 970-978
Uncontrolled Keywords: academic achievement; academic failure; adult; article; clinical examination; cohort analysis; controlled study; female; human; male; medical student; priority journal; prospective study; scoring system; student attendance; student attitude; teaching hospital; undergraduate student; Education, Medical, Undergraduate; Educational Status; Gynecology; Hospitals, Teaching; Humans; Ireland; Obstetrics; Prospective Studies; Students, Medical; Young Adult
Depositing User: Colin Lowry
Last Modified: 27 Nov 2015 02:36

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