A cohort study of the relationship between attendance and academic achievement in undergraduate Obstetrics and Gynaecology – does attendance matter?

Background Student attendance is assumed to be a key factor in academic achievement. The literature shows a positive but weak correlation between medical student attendance at lectures and academic achievement (correlation coefficients ranging from +0.2 to +0.5) (Horton et al. 2012). The aim of this study was to evaluate the relationship between student attendance and academic achievement in a clinical undergraduate programme. A unique feature of the study was that attendance across individual classroom-based and clinical activities were examined. METHODS A prospective cohort study was conducted over a full academic year from September 2011 to June 2012. Each student was required to document attendance at all classroom-based and clinical activities during their eightweek rotation in his/her logbook by obtaining a signature from the tutor. The attendance rate for each student was calculated by comparing the number of activities the student actually attended with the number of activities the student was required to attend. Academic achievement was based on an assessment score that included an OSCE, MCQ examination, a scenario-based written examination, a long case clinical examination and viva voce examination. The relationship between attendance and academic achievement was investigated using correlational analysis. RESULTS There were 147 students in the cohort. There was a moderate positive correlation between overall attendance and total assessment score (r=+0.586, P=0.01). This applied to both classroom and clinical attendance (r=+0.567, P=0.01 and r=+0.503, P=0.01 respectively). Correlation was highest for male students (+0.670) and students from the EU (+0.674). Attendance correlated equally with both knowledge-based and skills-based assessments. The failure rate increased from three percent among students with high attendance (80- 100%) to 63% among students with low attendance (less than 70%). CONCLUSIONS This study confirmed a positive relationship between student attendance and academic achievement. Attendance at both classroom-based and clinical activities were equally important in academic achievement. Attendance was important for achieving a pass grade to such an extent that satisfactory attendance rates (?80%) almost guaranteed a pass grade. For faculties wishing to specify a satisfactory attendance rate ‘threshold’ should consider adopting a threshold of 80% based on the dramatic increase in failure rates below this level.