Abstract
Introduction
Technology has changed the dynamics of teaching and learning any subject. More emphasis is being laid on e-learning and self-directed learning. In this scenario, there is a rising doubt whether the physical attendance of students in theory lectures and clinical postings is at all important. Various studies have been conducted in different subjects to find a relation between outcome and attendance. However, we could not find any study done in Otorhinolaryngology. Hence, this study was conducted with the aim to know the correlation between attendance and performance for Otorhinolaryngology undergraduate students.
Methodology
This is a retrospective cohort study carried out in the Otorhinolaryngology Department of a tertiary care teaching hospital of western Gujarat. The attendance (theory and clinics, biometrically fetched), internal theory examination marks (out of 40), and internal practical examination marks (out of 40) of a single batch students were obtained from the academic records and analyzed using Microsoft Excel sheet.
Results
Out of 158 students, data of 151 students was analyzed in this study (7 students were absent on the day of examination). 76 students were boys and 75 girls. The combined (theory and clinics) average attendance of girls was 88.37%, as compared to 78.37% for boys (p < 0.0001). Out of 80 (40 for theory and 40 for clinics), girls got an average of 37.12 marks as compared to 30.89 for boys (p < 0.0001). There was a positive and significant correlation between marks obtained and attendance percentage for total students as well as for boys and girls separately.
Conclusion
There is a positive and significant correlation between attendance percentage and marks obtained, both for theory and clinics, for Otorhinolaryngology undergraduate medical students.
Keywords: Assessment, Attendance, Correlation, ENT, Otorhinolaryngology, Practical marks, Theory marks
Introduction
Academic performance of students depends on various factors. Various studies have identified factors such as students’ attitude, family background, interest in the subject and influence of instructor that affect students’ performance [1]. Study of these factors can provide useful information for educational interventions to optimize students’ performance and encourage learning apart from student counseling and making educational policies. In addition to the above factors, regular attendance in class could be an important factor. The premise is that regular attendance of students irrespective of several other factors relates to performance. Positive significant correlation between attendance and performance has been shown in various subjects like computer science, biological sciences, management, and physics [2–5]. As far as medical subjects are concerned, studies in India have been conducted in Microbiology and Pharmacology, that also conclude that attendance is an important factor which affects students’ performance [1, 6].
Access to e-learning resources has augured self-directed learning which is being emphasized as a novel method of gaining knowledge. This has undermined the role of a medical teacher as a facilitator. Dwindling attendance of medical students in theory classes and clinical postings has become an agenda for every academic council meeting. Technology has also played a pivotal role in determining the classroom dynamics. Distance learning modules in medical sciences have gained significant momentum recently. However, teaching and learning of medical science is different from humanities since there is a difference in dealing with a human subject and dealing with a machine. The clinical expertise of a medical teacher takes precedence over the knowledge written in books. Hence, attending classes becomes all the more important in medicine than in other subjects.
Most of the previous studies on this subject have been done for theory classes in non-clinical and para-clinical medical subjects [5, 6] . The objective of this study was to find a correlation between attendance and marks obtained for theory and practical examination in Otorhinolaryngology.
Materials and Methods
The present study was conducted in the Department of Otorhinolaryngology from February 2019 to March 2019. Institutional Ethics Committee approval was obtained before starting this study. At the end of 6th semester, a theory and clinical examinations were held. Assessment was done by two experienced teachers and biases were removed by random allocation of students. The 6th semester attendance (theory and clinics, biometrics fetched), internal theory examination marks (out of 40), and internal practical examination marks (out of 40) of one Batch were obtained from the academic records and analyzed using Microsoft Excel sheet. 7 students who didn’t appear for any examination were excluded.
Statistical Analysis
Pearson correlation coefficient was calculated to know the correlation between two variables and one way ANOVA was used to know the significance of two means. A p-value of < 0.05 was considered to be significant.
Results
Out of 158 students in 6th Semester, 7 students didn’t appear for examination, hence, data of 151 students was analyzed in this study. 76 students were boys and 75 girls.
From Table-1 it is seen that the combined (theory and clinics) average attendance of girls was 88.37%, as compared to 78.37% for boys (p < 0.0001). Similarly, girls had significantly higher attendance than boys in theory and clinics separately as well. The clinics attendance of girls was better than their theory attendance (92.31 v/s 84.43, p < 0.0001). The clinics attendance of boys was also better than their theory attendance (87.44 v/s 69.31, p < 0.0001).
Table 1.
Comparison of attendance percentage of boys and girls
| Boys (n = 76) | Girls (n = 75) | p value | |
|---|---|---|---|
| Overall average attendance percentage | 78.37 | 88.37 | < 0.0001 |
| Clinics average attendance percentage | 87.44 | 92.31 | 0.00491 |
| Theory average attendance percentage | 69.31 | 84.43 | < 0.0001 |
Table-2 compares the marks obtained by boys and girls. Out of 80 (40 for theory and 40 for clinics), girls got an average of 37.12 marks as compared to 30.89 for boys (p < 0.0001). The average marks of girls were also significantly more than boys when calculated separately for theory and clinics. On further analysis it was found that there was a positive and significant correlation between average theory and clinics marks of boys (9.97 v/s 20.92, r = 0.615, p < 0.05) and girls (14.64 v/s 22.48, r = 0.459, p < 0.05).
Table 2.
Comparison of marks obtained by boys and girls
| Boys (n = 76) | Girls (n = 75) | p value | |
|---|---|---|---|
| Overall (theory and clinics) average marks obtained (out of 80) | 30.89 | 37.12 | < 0.0001 |
| Average clinics marks (out of 40) | 20.92 | 22.48 | 0.0022 |
| Average theory marks (out of 40) | 9.97 | 14.64 | < 0.0001 |
From Table-3 it is evident that there was a positive and significant correlation between marks obtained (theory, clinical and combined) and attendance percentage (theory, clinical and combined) for total students as well as for boys and girls separately. The correlation between theory marks and theory attendance of girls was weaker (r = 0.287) as compared to boys (r = 0.599), but significant (p = 0.013).
Table 3.
Correlation between attendance percentage and marks obtained
| Total marks (theory and clinical) v/s total attendance (theory and clinical) | Theory marks v/s Theory attendance | Clinical marks v/s Clinics attendance | |
|---|---|---|---|
| All students (n = 151) | r = 0.663, p < 0.05 | r = 0.563, p < 0.05 | r = 0.503, p < 0.05 |
| Boys (n = 76) | r = 0.668, p < 0.05 | r = 0.599, p < 0.05 | r = 0.548, p < 0.05 |
| Girls (n = 75) | r = 0.504, p < 0.05 | r = 0.287, p = 0.013 | r = 0.375, p = 0.001 |
Discussion
This is a small study addressing the relationship between attendance and performance where other factors, including gender bias, were defactorized by randomization. Conventionally, it is assumed that attending classes improves the performance of the students. This assumption got impetus by evidence emanating from several studies. As early as in 1998, there was a study conducted to correlate lecture attendance and examination performance of first year biological science undergraduates. The authors found a significant correlation between lecture attendance and students’ performance. Further, they found that this correlation was particularly strong for non-Anglophone and UK ethnic minority students, compared to white UK students. [2].
Research on this topic for medical subjects is scarce. In 2014, a study was conducted to find the predictors of academic performance of medical undergraduate students of microbiology class in Kolkata. The authors concluded that, attendance, gender, place of residence and previous academic performance serve as predictors in understanding students’ performance. Among the above mentioned, the attendance of the students is an important factor that has to be monitored and regulated through corrective actions to improve the performance of the class. [5] Similarly, in a study in Pharmacology, performance in theory and practical examinations were significantly affected by attendance in theory and practical classes. [6] The performance was better for girls, as was observed in our study.
In 2010, there was a case study done to know the link between attendance and exam performance at University of the West of England and the authors found that the implementation of an attendance policy increases exam performance: a student can expect to receive an extra 7.7% for each extra seminar they attend. [7] In another study in 2016, various predictors of students’ performance in cardiology examination were studied and it was concluded that lecture attendance was the most significant predictor (P,0.001), that is, 1.0% increase in lecture attendance has predicted a 0.27 increase in students’ final block mark. [8] Hence, lecture attendance is critical for learning even when a problem-based learning medical curriculum is applied.
There are very few studies reported in which there was a weak correlation between attendance and academic performance. [9, 10] In a study in economics, it was reported that attendance did not improve student understanding for classes that uses material covered in reading assignments. [11] Likewise, in 2003, a review in Social Science found that the effect of classroom attendance on student assessment marks is weak. [12].
In our study, besides theory, we also studied the correlation for clinical attendance and clinical examination performance, and found it to be significantly correlated. The clinical marks and theory marks also correlated significantly. The limitation of our study is that it is conducted on a single Batch of students; hence, results may not be generalized. Also, at present we cannot explain the fact that why girls had better attendance and marks than boys in our study. However, more marks to female students can be explained by their greater attendance in class. Our findings do provide a relevant contribution to the existing base of research, and further reinforce the findings of previous researchers that class attendance is, indeed, related to performance.
Attendance is not the only reason student must be present in class. He may be there to experience the unteachable elements of medicine that he will encounter day after day. It is those million indefinable moments in this blessed journey that will shape him to be a humane doctor.
Conclusions
There is a positive and significant correlation between attendance percentage and marks obtained, both for theory and clinics, for ENT undergraduate medical students. The theory marks and clinical examination marks also correlate significantly. Hence, efforts should be made to encourage students to attend regular classes and clinics to improve their academic performance.
Funding
None.
Declarations
Conflict of interest
None.
Informed Consent
Obtained from students.
Footnotes
Publisher’s Note
Springer Nature remains neutral with regard to jurisdictional claims in published maps and institutional affiliations.
Change history
7/27/2023
A Correction to this paper has been published: 10.1007/s12070-023-04107-3
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