2016, Cilt 6, Sayı 2, Sayfa(lar) 178-185
The Attitudes of Freshman Students in Erciyes UniversityFaculty of Medicine towards Absenteeism
Zeynep BAYKAN1, Mehmet KILINÇ2, Melis NAÇAR1
1Erciyes Üniversitesi, Tıp Fakültesi, Tıp Eğitimi Anabilim Dalı, Kayseri, Türkiye
2Erciyes Üniversitesi, Tıp Fakültesi, Kayseri, Türkiye
Keywords: Absenteeism, Faculty of medicine, Student, Attitude
The aim of this study was to determine the opinions and attitudes of the freshman students in Erciyes University Faculty of Medicine
towards absenteeism. It was a descriptive and cross sectional study, which was conducted in May 2015. 81% of 310 students were
accessed. A questionnaire including an absenteeism attitude scale was applied to the students. For the analysis of data, Chi square and
Mann Whitney U tests were used. 7.2% of students said that they always attended the theoretical lessons whereas 71.1% of them reported
that they sometimes did not attend these lessons. 21.7%, on the other hand, stated that they mostly did not attend these lessons. 81.1% of
the students indicated that they always attended the practical lessons. Another finding was that foreign students attended the theoretical
lessons more than Turkish students. The most common suggestion made by the students for preventing absenteeism was linking the basic
courses with clinical information to be used later. The mean score obtained from the absenteeism attitude scale was 54.6 ± 15.0. The mean
scores obtained from necessity, responsibility and obligation subscales were 19.6 ± 5.5, 21.4 ± 6.7, and 13.6 ± 6.1, respectively. 73.5% of
the students indicated that attendance should not be controlled in the Faculty of Medicine. At the end of the study it was revealed that
medical students had negative attitudes towards attendance and there was a need to organize activities that would increase their motivation
and prevent absenteeism.
Education is the process through which one makes changes in
his/her behavior in a desired form as a result of his/her experiences
of interacting with the environment. It can be done in a
planned, programmed, organizational and controlled way (as
in formal education) as well as haphazardly in any environment
in which an individual lives (as in informal education) (Koçak,
2011; Eskicumalı, 2011). While informal education equips
the learner with the social skills necessary for adjusting to
the social life, formal education leads to desired behavioral
changes in individual and gains the individual his/her social,
political and economic role in the future. (Eskicumalı, 2011).
Formal education is carried out by experts in formal education
institutions. One of the most important requirements for formal
education activities conducted at schools to be fulfilled is
that students' access and continuation to school is ensured.
Absenteeism is defined as not going to school, not following
the classes regularly and is an undesired student behavior
(Usta, Şimşek, & Uğurlu, 2014). In earlier studies, it was found
that school attendance increased learning, affected achievement
positively, taught students how to take responsibility
and improved their social skills (Kirby & McElroy, 2003; Stanca,
2006; Credé, Roch, & Kieszczynka, 2010). In our country, it is a
legal obligation for students to attend the classes at universities
which are formal educational institutions1. Although there are
different practices regarding attendance at different universities,
attendance is generally viewed as an important behavior
at universities, is included in faculty directives and students'
attendance at theoretical and practical lessons, and laboratory
sessions is tracked.2,3,4 There are similar practices across the
globe; however, despite the strict rules, absenteeism still arises
as a serious problem and an increasing phenomenon in existing
publications (Desalegn, Berhan, & Berhan, 2014; Wadesango &
Machingambi, 2011; Kottasz, 2005).
There can be different reasons affecting students' attendance
or absenteeism. These reasons are generally similar all over the
world; however, the level and magnitude of these reasons can
differ from one country to another. The reasons pertaining to
absenteeism are seen to have six dimensions, which are those
related to administrators, teachers, family, environment, academic
worries or individual reasons (Altınkurt, 2008). Among
these reasons, students' attitudes towards absenteeism are
also found to affect their absenteeism behavior (Usta et al.,
Absenteeism studies are of great significance for developing
plans against absenteeism. In our country, there are very few
studies conducted at university level about student absenteeism
and student opinions regarding this issue. Besides, this topic is found not to be studied with students of the Faculty
This study aims at examining the opinions and attitudes of
freshmen students in Erciyes University Faculty of Medicine
The study was planned as descriptive and cross-sectional. It
was aimed to access 310 students by subtracting 6 students
having absenteeism since the beginning of the semester from
316 students who were freshmen students in Erciyes University
Faculty of Medicine in 2014-2015 academic semesters. 251
of these students (81%) were accessed but 2 of them were not
included into the analysis since they left the majority of the
questions unanswered. The study was conducted in May, 2015.
The aim of the study was explicitly stated to the students, and
they were given a questionnaire subsequent to their verbal
approval of participation into the study. The questionnaire form
used in the study consisted of two sections. In the first section,
there were 13 questions which aimed to determine students'
socio-demographic characteristics, their opinions and suggestions
about attendance and the extent of their attendance.
Some of the questions were multiple choices while some were
open-ended. In the second section, there was attitude towards
Attitude towards absenteeism scale (AAS) was developed by
Usta et al. (2014) in order to determine the attitudes of college
students towards absenteeism. The scale was composed of
three subdimensions and 19 statements. It was prepared as a 5
point Likert scale and scored as “Strongly Agree=5”, “Agree=4”,
“Undecided=3”, “Disagree=2”, “Strongly Disagree=1 Negative
statements were reverse-coded (statements 5, 14, 16-19).
The first to sixth statements of the scale showed the necessity
component while the seventh to thirteenth statements were
concerned with responsibility component and the fourteenth
to nineteenth statements were about obligation component.
After reverse-coding was done, total points were obtained.
From the sum of all statements, students' attitudes toward
absenteeism were determined. The total point to be obtained
was 19-95 while necessity point was 6-30, responsibility point
was 7-35 and obligation point was 6-30. High points demonstrated
positive attitude towards attendance whereas low
points showed negative attitude.
The Cronbach alpha values were calculated as 0.91 for the
overall scale, as 0.81 for necessity subdimension, as 0.84 for
obligation subdimension and as 0.81 for responsibility subdimension.
The data obtained from the study were entered into the
computer and given in numbers and percentages. In order to check for the normality of the distribution in the analysis, Kolmogorov-
Smirnov test was used. For the analysis of categorical
variables between groups, Chi square was used whereas the
comparison of scale points were done with Mann Whitney U
test since they did not have normal distribution.
249 students participating in the study had an average age
of 19.1± 1.1 (min: 17- max: 24). The distribution of students'
socio-demographic characteristics is shown in Table 1
When the students were asked the question of “What percent
of the lessons can be allowed for absenteeism according to the
Academic Studies and Exam Directives of Erciyes University
Faculty of Medicine?”, 16.9% stated that they did not know.
79.2% (164 students) of those who reported to know said that
this percentage was 20% at most. With regard to absenteeism
in theoretical lessons, 15.7% of the students indicated
that they did not know the percentage. 71.4% of the students
who said they knew the percentage, on the other hand, knew
it as 25% at most. 67.1% of the Turkish students and 46.7%
of the foreign students had a right estimate regarding their
attendance rates in practical lessons. Having a right estimate
of attendance rates in theoretical lessons was 61.5% among Turkish students while it was 40.0% among foreign students.
No statistical difference was found between students' nationality
and the accuracy of their estimates of attendance rates in
theoretical and practical lessons. (Fisher Chi Square p=0.157;
Fisher Chi Square p=0.110).
71.1% of the students reported to have absenteeism in theoretical
lessons sometimes whereas 21.7% stated that they had
absenteeism in these lessons usually or always. 7.2% of the
students indicated that they always attended the theoretical
lessons. Besides, 81.1% always attended the practical lessons
while 18.9% had some absenteeism. The distribution of absenteeism
rates in theoretical and practical lessons according to
students' sociodemographic characteristics is shown in Table 2.
Click Here to Zoom
|Table 2: Student Absenteeism Rates in Theoretical and Practical Lessons according to Students’ Socio-Demographic Characteristics
When the students' attendance rates in theoretical and practical
lessons were examined according to their sociodemographic
characteristics, a statistical difference was found only between
nationality and students' attendance rates in theoretical lessons.
Foreign students attended the theoretical lessons more
than the Turkish students.
No difference was found between students' attendance
rates and their knowledge of the faculty directives regarding
attendance in theoretical and practical lessons (Pearson Chi Square=0.231, p= 0.891; Chi Square =1.024, p= 0.599). 59.3%
of the students who never or usually did not attend the theoretical
lessons had a right estimate of their attendance rates.
The distribution of suggestions made by the students for preventing
the absenteeism rates in Erciyes University Faculty of
Medicine is shown in Table 3 below.
Click Here to Zoom
|Table 3: Suggestions for Preventing the Absenteeism Rates in Erciyes University Faculty of Medicine
The most common suggestion made by the students was that
basic courses are linked with the clinical information to be used
The point average obtained from the scale, which aimed to
examine the students' attitudes towards absenteeism was 54.6
± 15.0; the point average for the subscales of necessity, responsibility and obligation was 19.6 ± 5.5, 21.4 ± 6.7 and 13.6 ± 6.1,
respectively. The distribution of students' points according to
their sociodemographic characteristics is shown in Table 4.
Click Here to Zoom
|Table 4: Distribution of Absenteeism Attitude Scale and Subscale Points According to Students' Socio-Demographic Characteristics
73.5'% of the students stated that attendance should not be
controlled at the Faculty of Medicine.
Since students' attending the lessons and having high rates
of attendance lead to meaningful learning, attendance is
also accepted to be an important part of college education.
(Stanca, 2006; Saban, 2002). However, absenteeism at higher
education is a widespread problem that is faced by educators
all over the world. Similarly, it is a source of worry in medical
education (Dashputra, Kulkarni, Chari, & Date, 2015). In this
study, it was revealed that one fifth of the students did not
usually attend the theoretical lessons or never attended these
lessons. Another important finding was that 59% of those
students were informed about the absenteeism limit for theoretical
lessons according to the Faculty of Medicine directives,
which leads us to think that they did not care about this limit
and had absenteeism. Taken into account that the study was
conducted in May in spring semester, it was considered to be
an important result to find that students did not know what
percent absenteeism they were allowed to have for practical
and theoretical lessons (%16.9 and %15.7) or those who said to
know these knew them wrong (%20.8 and %28.6). Additionally,
no difference was found between Turkish and foreigner students.
Normally, when students started their undergraduate
education at the Faculty of Medicine, they were given information
about regulations and directives in the first lesson meeting
titled “introduction to the program”, also they were provided
access to all of the related documents in the webpage of the
Faculty; however it turned out that these practices were not
enough. Hence, it is important that precautions are taken for
those absent students and they are informed about the issue.
While only 7.2% of the students stated to attend the theoretical
lessons all the time, this percentage was 81.1% for practical
lessons. When absenteeism rates were scrutinized in a study,
which was conducted in three chosen higher education institutions
in South Africa, it was seen that all of the students had absenteeism in the following semester (Wadesango & Machingambi,
2011). In Ogunkola and Fayombo's (2012) study which
was conducted in 2 faculties, it was realized that all of the students
did not attend the lessons at least once in the following
semester. In another study done with students studying at the
Faculty of Medicine, despite the harsh precautions taken for
preventing absenteeism done without any excuse, most of the
students occasionally had absenteeism for different reasons
(Merghani, Haroun, & Elmubarak, 2013). In BinSaeed et al.'s
(BinSaeed, al-Otaibi, al-Ziyadi, Babsail, & Shaik, 2009) study,
junior students of Medical School had absenteeism rates of
88% in the preceding year. In another study conducted with
students of Medical School and Health Sciences, it was found
that 75% of the students had absenteeism at least once in
the preceding year (Desalegn et al., 2014). Absenteeism is a
situation which disrupts the dynamics of teaching-learning
environment and affects the welfare of the class negatively.
Additionally, many studies show that those students attending
the lessons are more successful than those having absenteeism
(Credé et al., 2010; Bin Saeed et al., 2009; Bowen, 2005;
Özkanal & Arıkan, 2011; Hamdi, 2006; Deane & Murphy, 2013;
AbuRuz, 2015; Chilwant & Hundekari, 2013). Therefore, lecturers
should plan and conduct the lessons in ways that will foster
high rates of attendance. The most efficient way for doing this
in the learning process is that students are made active and
responsible for their own learning (Saban, 2002). Likewise, this
study also showed that the students had less absenteeism in
practical lessons in which they participated actively.
When the effect of such sociodemographic characteristics of
the students as gender, nationality, place of residence and
chronic disease on the absenteeism rates in theoretical and
practical lessons were examined, it was only seen that foreign
students had less absenteeism in theoretical lessons compared
to Turkish students. This was considered to be due to the fact
that since the lessons were held in Turkish and foreign students
did not have a high command of Turkish, they thought
that they could not be successful in the lessons just by reading
the notes. In Wadesango and Machingambi's (2011) study,
however, the opposite of these findings was found. Those
students who reported to have more absenteeism were those being foreigner, male, having low economic status and having
divorced parents. In BinSaeed et al.'s (2009) study, which was
conducted with junior students of Medical School, male students
were found to have higher amount of absenteeism at all
times of the academic year.
Attitude is one of the important factors which shape human
behavior. In this study, which aimed to examine the attitudes
of the students studying at the Faculty of Medicine towards
attendance through the use of Attitude towards absenteeism
scale, it was seen that they had a positive attitude towards
attendance. While the highest possible point that could be
gained from the total scale was 95, the point average obtained
from the study was only medium (54.6 ± 15.0). The points
obtained in the subdimensions were also medium and not high
enough to demonstrate positive attitude. Moreover, most of
the students (73.5%) believed that attendance should not be
controlled. Personal attitude and motivation for learning are
key factors for student absenteeism (Wadesango & Machingambi,
2011; Kottasz, 2005; Gump, 2006). College educators,
therefore, should encourage the importance of having positive
attitudes toward attendance and should organize activities
that will increase their motivation (Gump, 2006). In also earlier
studies, it was stated that educators should develop methods
that would increase the students' motivation to attend the
lessons. (Moore, Armstrong, & Pearson, 2008; Fjortoft, 2005;
Westrick, Helms, McDonough, & Breland, 2009). When the
suggestions of the students for the prevention of absenteeism
were examined, the most common suggestion was found to
be the linking of preclinical lessons with the information to
be used later. The second most common suggestion was that
attending the lessons gained the students more different benefits
than earning grades. Both of the suggestions showed that
students desired motivation boosting activities.
The freshmen students studying at the Faculty of Medicine at
Erciyes University had problems related to attending classes
and the attitudes of most of the students were negative. The
feedback of the students regarding attendance should be taken
into consideration and activities should be planned to increase
We owe our most sincere thanks to the freshmen students in
Erciyes University Faculty of Medicine, who contributed to the
collection and entering of data as part of the “Evidence-based
Medicine course in 2014-2015 spring semester. These students
are Şevval Eylül Özmen, Oğuzhan Durukal, Aslı Sevimli, Emin
Genç, Zeynep Hasözhan, Tuğba İzem Öztürk, Kader Akpunar,
Servet İbrahim Biçer, Mhd. Belal Sawaf, Belal Munir Asad
Ahmad, Waheeb A.I Damery and Derviş Haluk Öztürk.
1) AbuRuz M.E. (2015). Doed excessive absence from class lead to
lower levels of academic achievement? European Scientific
Journal, 11(7), 146-153. Retriewed from http://eujournal.org/
2) Altınkurt Y. (2008). Öğrenci Devamsızlıklarının Nedenleri ve
devamsızlığın akademik başarıya olan etkisi. Dumlupınar
Üniversitesi Sosyal Bilimler Dergisi, 20, 129-142.
3) BinSaeed A. A., al-Otaibi M. S., al-Ziyadi H. G., Babsail A. A., &
Shaik S. A. (2009). Association Between Student Absenteeism
at a Medical College and their Academic Grades JIAMSE, 19(4),
155-159. Retriewed from http://www.iamse.org/mse-article/
4) Bowen C. (2005). Improving the quality and quantity of attendance
data to enhance student retention. Journal of Further and
Higher Education, 31, 1-39.
5) Chilwant K. S., & Hundekari J. C. (2013). Effect of class attendance
on performance in examination in second year medical
students. IOSR Journal of Research & Method in Education,
6) Credé M., Roch S.G., & Kieszczynka U. M. (2010). Class attendance
in college: a meta-analytic review of the relationship of class
attendance with grades and student characteristics. Review of
Educational Research, 80(2), 272–295.
7) Dashputra A., Kulkarni M., Chari S., & Date A. (2015). Medical
students' absenteeism in class: reasons and remedies. Journal
of Educational Research and Studies, 3(1), 24-29.
8) Deane, R. P., & Murphy, D. J. (2013). Student attendance and
academic performance in undergraduate obstetrics/gynecology
clinical rotations. Journal of American Medical Association,
310(21), 2282-2288. doi:10.1001/jama.2013.282228.
9) Desalegn A.A., Berhan A., & Berhan Y. (2014). Absenteeism
among medical and health science undergraduate students at
Hawassa University, Ethiopia. BMC Medical Education, 14:81.
10) Eskicumalı A. (2011). Eğitimin temel kavramları. In Özden Y. &
Turan S. (Eds.), Eğitim bilimine giriş (pp. 2-4). Ankara: Pegem
11) Fayombo G. A., & Ogunkola B. J. (2012). Cross institutional
study of the causes of absenteeism among university
students in Barbados and Nigeria. Journal of Educational and
Developmental Psychology, 2(1), 122-136.
12) Fjortoft N. (2005). Students' motivations for class attendance.
American Journal of Pharmaceutical Education, 69(1),107-
112. Retriewed from http://search.proquest.com/
13) Gump S.E. (2006). Guess who's (not) coming to class: student
attitudes as indicators of attendance. Educational Studies,
14) Hamdi A. (2006). Effects of lecture absenteeism on pharmacology
course performance in medical students. Journal of the
International Association of Medical Science Educators, 16(1),
15) Kirby A., & McElroy B. (2003). The effect of attendance on grade
for first year economics student in university college cork. The
Economic and Social Review, 34(3), 311-326.
16) Koçak R. (2011). Temel kavramlar, öğrenmeyi etkileyen etmenler.
In Behçet O. (Ed.), Öğrenme öğretme kuram ve yaklaşımları
(pp. 3). Ankara: Pegem Akademi.
17) Kottasz R. (2005). Reasons for student non-attendance at lectures
and tutorials: an analysis. Investigations in University Teaching
and Learning, 2(2), 5–16.
18) Merghani T.H., Haroun B. & Elmubarak I. A. (2013). Self-report
of voluntary absenteeism from didactic lectures by medical
students. Universal Journal of Education and General Studies,
19) Moore S., Armstrong C., & Pearson J. (2008). Lecture absenteeism
among students in higher education: a valuable route to
understanding student motivation. Journal of Higher Education
Policy and Management, 30(1),15–24.
20) Özkanal Ü., & Arıkan N. (2011). The relation between success and
absenteeism at Esogu English Preparatory School. Journal of
Language Teaching and Research, 2(1), 68-72.
21) Saban A. (2002). Öğrenme öğretme süreci, Ankara: Anı Yayıncılık.
22) Stanca L. (2006). The effects of attendance on academic
performance: panel data evidence for introductory
microeconomics. The Journal of Economic Education, 37(3),
23) Usta G.H., Şimşek A.S., & Uğurlu C.T. (2014). Üniversite
öğrencilerinde devamsızlık davranışları: Nedenler ve tutum
düzeyleri. Yükseköğretim ve Bilim Dergisi, 4(3), 182-190.
24) Wadesango N., & Machingambi S. (2011). Causes and structural
effects of student absenteeism: a case study of three South
African Universities. Journal of Social Science, 26(2), 89–97.
25) Westrick S.C., Helms K.L., McDonough S.K., & Breland M.L. (2009).
Factors influencing pharmacy students' attendance decisions
in large lectures. American Journal of Pharmaceutical
Education, 73(5), 1-9 Retriewed from http://search.proquest.