Attendance, engagement and performance in a medical school curriculum: early findings from competency-based progress testing in a new medical school curriculum

Abstract

IntroductionMedical students often do not value attending in-person large group sessions. It is also not clear from prior research whether attendance at large group sessions impact on performance in medical school. The goal of this study was to assess the relationship between voluntary attendance in large group sessions organized as a “flipped classroom” in a new innovative curriculum and students’ mastery of clinical applications of basic science knowledge.MethodologyOur students’ ability to apply basic science knowledge to clinical problems is assessed via progress testing using three methodologies: a locally developed multiple-choice examination, written examination developed through the National Board of Medical Examiners (NBME) Customized Assessment Services Program and post encounter questions included in a clinical skills examination. We analyzed the relationship between voluntary attendance at weekly large group “flipped classroom” sessions and the students’ performance on examinations given at four intervals over the initial 24-week module of the medical school curriculum.ResultsComplete data were available for 167 students. A total of 82 students (49.1%) attended all large group sessions, 65 students (38.9%) missed one or two sessions and 20 students (12.0%) missed three or more sessions. There were no difference between the students in the groups on their medical admission (MCAT) examination scores. The growth in performance from each time point until the next was statistically significant. There was no statistically significant difference in growth between the students who had no absences and those who had one or two absences. Students who missed three or more sessions performed significantly lower than their peers over the 24 week module and were more likely to score one or more standard deviations below the class mean on the assessments.ConclusionsWe found no relationship between attendance and MCAT scores suggesting the differences in performance on the progress tests was not due to initial differences in knowledge or reasoning skills. While the study was not experimental, it suggests large group sessions using a “flipped classroom” approach to provide reinforcement, feedback and practice may be effective for increasing learning and retention in the application of basic science knowledge among first year medical students.

Should attendance for preclinical simulation and clinical education be mandatory?

“…A number of variables have been investigated in isolation or in combination to evaluate their effect on attendance and performance; these include gender, age, student social class, type of course (i.e., passive versus active), class size, discipline, grade point average (GPA), admissions criteria, previous knowledge on the topic, instructor's teaching approach, language, and learning climate. [2][3][4] Conclusions vary, with some studies indicating a positive correlation between attendance and student performance, [5][6][7][8] others indicating no relationship, 9,10 and yet others showing associations only a minimal relationship. 11 The topic of mandatory attendance becomes even more complex when considering its application in a preclinical simulation or clinical dental school environment.…”

The Impact of Educational Resources and Perceived Preparedness on Medical Education Performance

“…With the current rate at which medical knowledge is updated, it is crucial to ensure that future physicians are comfortable synthesizing and applying new evidence as it unfolds. This has been observed in the recent transition to a “competency-based” approach where students are taught to seek out and apply new information readily [ 3 ]. In the same token, the exponential growth in availability of online medical educational resources over the past decade has placed the onus primarily on medical students to ascertain which is the most effective method of knowledge acquisition outside of their formal curriculums [ 2 , 4 ].…”

Learning from failure: how eliminating required attendance sparked the beginning of a medical school transformation

“…Research shows that the relationship between classroom attendance and academic performance in medical school is variable [1]. Some studies report a positive association between student attendance and the United States Medical Licensing Examination (USMLE) Step 1 scores [2] while others report a positive relationship between student attendance and course performance [3,4].…”