Does Absenteeism Affect Academic Performance? An Insight from UK-Based Medical Students [Letter]

Dear editor

Latif Khan et al¹ have highlighted absenteeism as an important issue amongst medical schools. Although the article originates from Pakistan, the authors state that this is a worldwide issue. The study focusses on lecture attendance. However, worldwide several teaching methods are employed including problem-based learning, team-based learning and video-recorded technologies. As UK medical students, we offer an alternative perspective on the conclusions of the study.

We acknowledge several strengths of the study; however, we would like to share a few reflections. Given the range of teaching methods, it would have been appropriate to define the exact parameters of a lecture and therefore disclose the employment of other methods. We feel that this would provide a more holistic overview of student timetables, including total contact hours per week. Consequently, the relative importance of attending lectures compared to attending other teaching sessions for accruing appropriate skills and knowledge is unknown. If teaching occurred outside of lectures, the degree of absenteeism would not be accurate. Conversely, if solely lectures were employed, the conclusions drawn from this study may not be translatable to the rest of the world where other teaching methods are in place.

Furthermore, although the study reaffirms the issue of absenteeism and suggests potential reasons, we feel it would have been more beneficial to determine reasons for absenteeism within the sample. This would be of use to identify student motivations and issues. Additionally, absenteeism may be a confounder for an underlying cause, such as mental health which has been shown to affect both academic performance² and attendance.³ Therefore, enforcing mandatory attendance (as implied by the authors to be beneficial) could have a negative impact on these students. Major causes identified can then be addressed and rectified in order to improve both attendance and academic performance.

The authors raise an important point of an increasing use of video-captured lectures and online self-learning resources. Alongside alternative teaching methods, we would like to further expand upon their impact on our learning experience. We feel the authors exaggerate the value of lectures, stating that students who do not attend lectures do not “foster a positive learning environment”, “[accelerate] teamwork abilities” or increase “self-confidence”. We find these claims to be overstated with a lack of supporting literature or poorly related references. From our experience, team-based learning and interactive group work better developed these skills. Furthermore, several studies show that video-recorded lectures are as effective as live lectures⁴ with added advantages of being able to seamlessly pause, rewind, research and resume the lecture.

To conclude, we acknowledge the correlation between absenteeism and academic performance identified by this study but believe a few alterations would allow for more concrete and valuable conclusions to be drawn. This includes detailing student timetables and exploring alternative teaching methods. We felt it would be of more value to investigate causes for absence and later stratify for these to reduce confounding bias. Future studies could achieve this through student-questionnaires or semi-structured interviews.