Faculty and Medical Student Attitudes About Preclinical Classroom Attendance

Background: Technological advances have diminished reliance on classroom attendance for mastering preclinical medical school course content, but nonattendance may have unintended consequence on the learning environment. Perceptions among educators and students regarding the value of attendance and implications of nonattendance have not been systematically studied.

Purposes: The purpose of this study was to investigate differences in medical student and faculty attitudes regarding preclinical classroom attendance and the impact of nonattendance on educators and the learning environment.

Methods: Using Internet-based surveys, we assessed attitudes about preclinical classroom attendance among medical students and teaching faculty at Washington University School of Medicine. Our primary hypothesis was that students would be less likely than faculty to place societal value on attendance and relate it to professionalism.

Results: A total of 382 (79%) of 484 eligible students and 248 (64%) of 387 eligible faculty completed the survey. Both groups recognized a negative impact of poor attendance on faculty enthusiasm for teaching (students 83%, faculty 75%), but faculty were significantly more likely to endorse a negative impact on effectiveness of lectures (75% vs. 42%, p<.0001) and small-groups (92% vs. 76%, p<.0001) and a relationship between attendance and professionalism (88% vs. 68%, p<.0001). Students were significantly more likely to support free choice among learning opportunities (90% vs. 41%, p<.0001) including regularly missing class for research and community service activities (70% vs. 14%, p<.0001) and to consider lecture videos an adequate substitute for attendance (70% vs. 15%, p<.0001). Free-text responses suggested that students tended to view class-going primarily as a tool for learning factual material, whereas many faculty viewed it as serving important functions in the professional socialization process.

Conclusions: In this single-center cohort, medical student and teaching faculty attitudes differed regarding the importance of classroom attendance and its relationship to professionalism, findings that were at least partially explained by differing expectations of the purpose of the preclinical classroom experience.