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ORIGINAL ARTICLE
Year : 2020  |  Volume : 10  |  Issue : 3  |  Page : 215-220

Influence of lecture attendance and prerequisite academic achievement on dental students' performance in a clinical endodontic course: A correlational study


1 Department of Restorative and Prosthetic Dental Sciences, College of Dentistry, King Saud Bin Abdulaziz University for Health Sciences; King Abdullah International Medical Research Center, Ministry of National Guard Health Affairs, Riyadh, Kingdom of Saudi Arabia
2 King Abdullah International Medical Research Center, Ministry of National Guard Health Affairs; Department of Medical Education, College of Medicine, King Saud bin Abdulaziz University for Health Sciences, Riyadh, Kingdom of Saudi Arabia

Date of Submission25-Dec-2019
Date of Decision02-Feb-2020
Date of Acceptance05-Feb-2020
Date of Web Publication27-Aug-2020

Correspondence Address:
Dr. Abdulmohsen Alfadley
Department of Restorative and Prosthetic Dental Sciences, College of Dentistry, King Saud Bin Abdulaziz University for Health Sciences, National Guard Health Affairs, P. O. Box 22490, Riyadh 11426
Kingdom of Saudi Arabia
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Source of Support: None, Conflict of Interest: None


DOI: 10.4103/sej.sej_200_19

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  Abstract 


Introduction: Decreased lecture attendance in undergraduate dental education has been observed worldwide. The limited studies on the influence of lecture attendance on dental students' performance have yielded inconclusive results. Hence, the aim of this study was to evaluate the influence of lecture attendance on dental students' academic performance and determine if the past performance of students in prerequisite courses is predictive of their performance in an endodontic course at College of Dentistry, King Saud Bin Abdulaziz University for Health Sciences, Riyadh, Saudi Arabia.
Materials and Methods: This was a correlational study design in which historical data for students (n = 158) enrolled in Endodontics II (ENDD 512) course were obtained for two consecutive academic years. Data were collected from grade transcripts provided by the assessment unit, and lecture attendance records were taken by the student affairs unit. The data were analyzed statistically. The level of significance (α) was set as 0.05.
Results: The percentage of lectures attended had a weak correlation with ENDD 512 final grades (r = 0.108, P = 0.179). Comparison to previous academic performance showed that endodontic course grades were strongly correlated with all prerequisite course grades (P < 0.01).
Conclusion: The students' performance in the course was most strongly predicted by their performance in certain prerequisite courses, while attendance was not a significant predictor.

Keywords: Dental education, endodontics, lecture attendance, performance, prerequisite courses


How to cite this article:
Alfadley A, Masuadi E, Mohamed TA, Jamleh A. Influence of lecture attendance and prerequisite academic achievement on dental students' performance in a clinical endodontic course: A correlational study. Saudi Endod J 2020;10:215-20

How to cite this URL:
Alfadley A, Masuadi E, Mohamed TA, Jamleh A. Influence of lecture attendance and prerequisite academic achievement on dental students' performance in a clinical endodontic course: A correlational study. Saudi Endod J [serial online] 2020 [cited 2020 Oct 31];10:215-20. Available from: https://www.saudiendodj.com/text.asp?2020/10/3/215/293578




  Introduction Top


Evaluating the performance of students through examinations, and subsequently, course grades is a common tool to assess the effectiveness of teaching and learning. Many variables may affect the performance of students such as students' intellectual ability, study patterns, instructional methods, and learning resources. Moreover, lecture attendance is an increasingly scrutinized parameter in today's era of evolving online education.[1] Massingham and Herrington noted an increasing trend among university students to skip scheduled classes.[2] Some students indicated their ability to learn the class material on their own, rendering class attendance unneeded.[3] In contrast, many educators are in the opinion that classroom attendance is important, mainly for the insight, nature of the material, and critical decisions that cannot be obtained from other sources.[4]

At the university level, the influence of classroom attendance on students' performance has yielded conflicting results. Two studies found a positive correlation between lecture attendance and course grades,[2],[5] while one failed to prove any relationship.[6] Crede et al. conducted a meta-analytic review of college data and noted a positive association between attendance and course grades. The authors have concluded that lecture attendance was the strongest predictor of academic performance.[4] In fact, the assessment of this question in dental education is likely to be influenced by other variables such as variation in educational maturity between undergraduate and dental students.[7] On the other hand, in dental education, the effect of lecture attendance on course grades has not been adequately assessed. One study that evaluated the dental biomaterials course and another that looked at the research methodology course reported a strong relationship between lecture attendance and student performance.[8],[9] On the contrary, Azab et al. evaluated three basic science courses (epidemiology, infectious diseases, and medicine II) and three preclinical courses (oral and maxillofacial radiology, anesthesiology, and fixed prosthodontics) and reported no association between lecture attendance and final grade.[10] More recently, a well-designed study by Shumway et al. has evaluated the effect of lecture attendance and prerequisite academic outcomes on dental students' performance in an oral pathology course.[11] The study found that lecture attendance was weakly correlated with final grades. Students' performance was, however, strongly predicted by their grades in prerequisite basic science courses. None of these studies assessed the relationship between lecture attendance and students' performance in a clinical endodontic course.

Previous local and international studies have assessed different areas related to the teaching and practice of endodontics among undergraduate dental students.[12],[13],[14],[15],[16] Nevertheless, it should be noted that the influence of lecture attendance and prerequisite academic outcomes on the future performance of dental students has not been adequately evaluated among dental students in Saudi Arabia. Therefore, the purpose of this study was to assess the association between lecture attendance and academic performance (final grade) and determine if the past performance of students in prerequisite courses is predictive of their performance in a clinical endodontic course at the College of Dentistry, King Saud Bin Abdulaziz University for Health Sciences (KSAU-HS), Riyadh, Saudi Arabia.


  Materials and Methods Top


Ethical approval for conducting the study was obtained from the Institutional Review Board at King Abdullah International Medical Research Center (IRB# SP19/372/R). This study followed a correlational study design in which historical data for students enrolled in Endodontics II (ENDD 512) course were obtained for the 2017–2018 and 2018–2019 academic years. The professional stage of the dentistry program offered at KSAU-HS consists of 4 years of study (D1–D4). Students who successfully complete this program are awarded a Doctor of Dental Medicine degree. The endodontic curriculum at KSAU-HS consists of three courses: one preclinical course offered in the 2nd year (Endodontics I [ENDD 411]) and two clinical courses, ENDD 512 and Endodontics III (ENDD 613), offered in the 3rd and 4th years, respectively. In the last two academic years, 158 students were enrolled in the ENDD 512 course. Students were excluded from the study if they failed the outcome course or more than one prerequisite course in previous years, dropped from the course prior to the final examination period, or were denied access to the final examination for violating the 75% attendance requirement.

Based on the research question and types of variables, sample size estimation was accomplished following a hypothesis testing statistical procedure. At a 5% level of significance and assuming a coefficient of determination (R-square) of 10% with eight regressors, the expected power of the test is 83.9%. The calculation was performed using Piface (URL: https://homepage.divms.uiowa.edu/~rlenth/Power/). A nonprobabilty sampling technique was used. A consecutive sampling approach that targeted all the study population was adopted. Hence, all eligible male and female dental students who were enrolled in ENDD 512 during the 2017–2018 and 2018–2019 academic years were included in this study.

In terms of data collection, the data were obtained from grade transcripts provided by the assessment unit, and lecture attendance records were taken by the student affairs unit. The assessment unit was contacted to provide the final course grades (out of 100) for the following prerequisite courses: Removable Prosthodontics I (PROD 412), Endodontics I (ENDD 411), Periodontics II (PERD 412), Operative Dentistry II (RESD 413), Orthodontics I (ORTD 411), Pediatric Dentistry I (PEDD 411), and Fixed Prosthodontics I (PROD 411). The instructional methods used in these courses consist mainly of lectures and practical sessions. The assessment methods consist mainly of intra-semester and final written examinations, continuous practical/clinical assessment, objective structured practical examination (OSPE), and practical/clinical examination. Course grades were assigned by adding up the points earned in each assessment component to yield a total score out of 100. In terms of students' attendance, lecture attendance in ENDD 512 course was encouraged. Although students were obliged to attend at least 75% of the sessions to be eligible to take the final examination, there were no marks allocated for course attendance. Students had to sign the attendance sheet at the beginning of each lecture and verification of attendance was performed by the student affairs officer. Assignment of ENDD 512 course grade was performed by the course coordinator without knowledge of course attendance records or students' performance in prerequisite courses. No curve up of course grades was performed.

Data entry and analysis was carried out using the statistical program SPSS version 24 (IBM, Chicago, Illinois, United States). Categorical data such as gender and year of course study were presented as frequencies and percentages, while the numerical data of students' performance in prerequisite courses, students' attendance, and performance in the ENDD 512 course were presented using mean and standard deviation. Furthermore, a scatterplot was used to present the relationship between ENDD 512 grades and grades obtained in prerequisite courses. Independent t-test was used to assess the association between ENDD 512 course grades with baseline characteristics of gender and year of enrollment in the course. Pearson correlation test was used to assess the relationship between the percentage of lectures attended and ENDD 512 final course grades. Furthermore, the bivariate correlation was used to assess the association between prerequisite course grades and ENDD 512 course grades. Stepwise linear regression was used to assess the main variable affecting the final score of ENDD 512. The level of significance (α) was set as 0.05.


  Results Top


Of the 158 students whose records were obtained, 157 students met the criteria for enrollment in the study. One student who failed several prerequisite courses in previous years was excluded from the statistical analysis. Characteristics of participants based on gender and year of enrollment are provided in [Table 1]. Final ENDD 512 course grades were significantly affected by gender (P < 0.001) and year of enrollment in the course (P = 0.011). Female students performed significantly better in the course than male students (P < 0.05) [Table 2]. Generally, students enrolled in the 2017–2018 academic year achieved significantly higher scores than those enrolled in the 2018–2019 academic year (P < 0.05) [Table 3].
Table 1: Distribution of the participants based on the gender and academic year of course enrollment

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Table 2: Summary of course grades by gender

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Table 3: Summary of course grades by the year of enrollment in ENDD 512 class

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Lecture attendance was not influenced by gender (P = 0.185) or year of enrollment in the course (P = 0.077). About 40% of the students missed more than one ENDD 512 lecture. Pairwise comparisons showed that the percentage of lectures attended had a weak correlation with ENDD 512 final grades (r = 0.108, P = 0.179) [Table 4].
Table 4: Pearson correlation coefficients for course grades and enrolled in endodontics 512 attendance

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Comparison to previous academic performance illustrated that ENDD 512 final grades were strongly correlated with all prerequisite course grades (P < 0.01), with a correlation coefficient (r) ranging from 0.484 to 0.653 [Figure 1]. Furthermore, the final grades of prerequisite courses' were generally correlated with students' performance in other prerequisite courses. Stepwise linear regression analysis showed that only PROD 412 (P < 0.001), PEDD 411 (P < 0.001), and PERD 412 (P < 0.05) were significant predictors of ENDD 512 course grades.
Figure 1: Bivariate correlation of students' performance in prerequisite courses and ENDD 512 course

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  Discussion Top


To the best of the authors' knowledge, this is the first study to assess the influence of lecture attendance and prerequisite academic outcomes on dental student performance in a clinical endodontic course. Such information shall educate students and faculty members on the influence of attendance on anticipated student performance and could also help to suggest which students are more likely to require additional support in order to be competent in the endodontic course. The ENDD 512 course was delivered in the same manner over the two academic years with the same course instructors teaching the course for both male and female classes over the past 4 years. Despite that, there were significant differences based on gender and year of course enrollment. This is in agreement with a previous study that reported the superior performance of female dental students over their male counterparts in an undergraduate college setting in Jordan.[17] Such differences may be attributed to factors such as college admission criteria, students' intellectual ability, achievement motivation, and overall quality of assessment plan.

The findings of this study are in agreement with other dental studies that reported a positive correlation between lecture attendance and final course grade. It should be noted, however, that the strength of our correlation (r = 0.108) was weaker than in those studies, which found correlation coefficients of 0.437,[8] 0.280,[9] and 0.173,[11] respectively. Similar to El Tantawi study, lecture attendance was not a significant predictor of the final course grade in regression analyses, although showing a weak positive correlation.[9] This could be explained by the fact the students are more inclined to learn the material on their own and/or have more awareness in determining the consequences of missing classes, so they are more strategic in their absenteeism.[11] Moreover, the use of digital media forms of instruction through video recording of lectures in teaching the dental curriculum at KSAU-HS might be another reason to miss the class. This requires further investigation in future studies. Several methods to record attendance were reported in the literature such as seating chart,[8] electronic clickers,[9] or self-reporting of students.[10] In this study, the attendance was performed using a manual sign-in sheet followed by on-spot verification of actual presence conducted by the student affairs officer.

In this study, prerequisite courses that contain a combination of didactic and practical components were included. While it might be argued that successful completion of these courses requires different attributes to the ones needed for endodontics, it is also worth mentioning that all branches of dentistry are based on common fundamentals such as sound knowledge of dental anatomy, comprehension of oral biological phenomena, and coordinated psychomotor function. ENDD 512 grades were strongly associated with performance in other prerequisite courses. Furthermore, it was interesting to note that performance in each course was strongly correlated to each other. This may be attributed to similarities in course content, instructional method, and assessment design. Considering the strength of the associations reported here, students who struggle in prerequisite preclinical courses should be provided with additional forms of support such as counseling and tutorial sessions to improve their performance prior to their enrollment in clinical dental courses.

This study has its own limitations. The results explicitly relate only to how one endodontic course is being taught at one dental program. Successful completion of this course requires students to excel in various domains such as recall and application of knowledge, analytical ability, patient management skills, and psychomotor skills. The assessment design in this course consists of written tests using multiple-choice questions, OSPE, continuous clinical assessment, and clinical examination. While the role of lecture attendance in fostering the overall performance of students is questionable, it might be argued that classroom attendance may enhance the integration of the information for this purpose.[11] Nevertheless, the influence of classroom attendance on students' performance may be confounded by several variables that were not accounted for in this study, such as lecture quality, instructor effectiveness, engagement by students, nature and length of the content, examination quality, and overall assessment plan of the course. Therefore, extrapolation of our findings to other dental settings should be made with caution.

In light of our findings, we recommend to investigate the factors that may influence student attendance at lectures and lectures effectiveness. Furthermore, the effectiveness of alternatives to lecture-based forms of teaching in promoting the same level of student performance needs to be determined in future studies. Nowadays, however, when digital technology is gaining widespread acceptance in promoting performance in dental education,[1] there seems to be a need for additional studies to determine how to best utilize these modalities in view of their likely effect on attendance.[18],[19] The reason for the observed differences noted between students based on gender warrants a further study in the future to explore potential underlying factors. Further research is recommended to assess the various variables that affect the performance of students in dental education.


  Conclusion Top


Within the limitations of this study, it can be concluded that lecture attendance in an endodontic course was weakly correlated with student performance. Furthermore, performance in prerequisite courses was strongly correlated with students' performance in the clinical endodontic course. Female students performed significantly better than their male counterparts in most courses.

Financial support and sponsorship

Nil.

Conflicts of interest

There are no conflicts of interest.



 
  References Top

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