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2016, Cilt 6, Sayı 2, Sayfa(lar) 178-185
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DOI: 10.5961/jhes.2016.154
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
Abstract
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.
  • Top
  • Abstract
  • Introduction
  • Methods
  • Results
  • Disscussion
  • Conclusion
  • References
  • Introduction
    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., 2014).

    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 of Medicine.

    This study aims at examining the opinions and attitudes of freshmen students in Erciyes University Faculty of Medicine towards absenteeism.

  • Top
  • Abstract
  • Introduction
  • Methods
  • Results
  • Disscussion
  • Conclusion
  • References
  • Methods
    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 absenteeism scale.

    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.

  • Top
  • Abstract
  • Introduction
  • Methods
  • Results
  • Disscussion
  • Conclusion
  • References
  • Results
    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 below.


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    Table 1: Distribution of Students' Socio-Demographic Characteristics

    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.


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    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.


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    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 later.

    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.


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    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.

  • Top
  • Abstract
  • Introduction
  • Methods
  • Results
  • Disscussion
  • Conclusion
  • References
  • Discussion
    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.

  • Top
  • Abstract
  • Introduction
  • Methods
  • Results
  • Discussion
  • Conclusion
  • References
  • Conclusion
    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 their motivation.

    ACKNOWLEDGEMENT
    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.

  • Top
  • Abstract
  • Introduction
  • Methods
  • Results
  • Discussion
  • Conclusion
  • References
  • References

    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/ index.php/esj/article/viewFile/5312/5121

    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/ association-between-student-absenteeism-at-a-medicalcollege- and-their-academic-grades/

    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, 3(3), 31-33.

    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 Akademi.

    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/ docview/211287655/fulltextPDF/286C566FEAAE46A8PQ/1?a ccountid=17396

    13) Gump S.E. (2006). Guess who's (not) coming to class: student attitudes as indicators of attendance. Educational Studies, 32(1), 39–46.

    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), 27-30.

    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, 2(10), 324-8.

    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), 251-266.

    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. com/docview/211270191/fulltextPDF/156E8A6C51784DB8P Q/1?accountid=17396

  • Top
  • Abstract
  • Introduction
  • Methods
  • Results
  • Discussion
  • Conclusion
  • References
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