Journal of Clinical and Diagnostic Research, ISSN - 0973 - 709X

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Dr Mohan Z Mani

"Thank you very much for having published my article in record time.I would like to compliment you and your entire staff for your promptness, courtesy, and willingness to be customer friendly, which is quite unusual.I was given your reference by a colleague in pathology,and was able to directly phone your editorial office for clarifications.I would particularly like to thank the publication managers and the Assistant Editor who were following up my article. I would also like to thank you for adjusting the money I paid initially into payment for my modified article,and refunding the balance.
I wish all success to your journal and look forward to sending you any suitable similar article in future"



Dr Mohan Z Mani,
Professor & Head,
Department of Dermatolgy,
Believers Church Medical College,
Thiruvalla, Kerala
On Sep 2018




Prof. Somashekhar Nimbalkar

"Over the last few years, we have published our research regularly in Journal of Clinical and Diagnostic Research. Having published in more than 20 high impact journals over the last five years including several high impact ones and reviewing articles for even more journals across my fields of interest, we value our published work in JCDR for their high standards in publishing scientific articles. The ease of submission, the rapid reviews in under a month, the high quality of their reviewers and keen attention to the final process of proofs and publication, ensure that there are no mistakes in the final article. We have been asked clarifications on several occasions and have been happy to provide them and it exemplifies the commitment to quality of the team at JCDR."



Prof. Somashekhar Nimbalkar
Head, Department of Pediatrics, Pramukhswami Medical College, Karamsad
Chairman, Research Group, Charutar Arogya Mandal, Karamsad
National Joint Coordinator - Advanced IAP NNF NRP Program
Ex-Member, Governing Body, National Neonatology Forum, New Delhi
Ex-President - National Neonatology Forum Gujarat State Chapter
Department of Pediatrics, Pramukhswami Medical College, Karamsad, Anand, Gujarat.
On Sep 2018




Dr. Kalyani R

"Journal of Clinical and Diagnostic Research is at present a well-known Indian originated scientific journal which started with a humble beginning. I have been associated with this journal since many years. I appreciate the Editor, Dr. Hemant Jain, for his constant effort in bringing up this journal to the present status right from the scratch. The journal is multidisciplinary. It encourages in publishing the scientific articles from postgraduates and also the beginners who start their career. At the same time the journal also caters for the high quality articles from specialty and super-specialty researchers. Hence it provides a platform for the scientist and researchers to publish. The other aspect of it is, the readers get the information regarding the most recent developments in science which can be used for teaching, research, treating patients and to some extent take preventive measures against certain diseases. The journal is contributing immensely to the society at national and international level."



Dr Kalyani R
Professor and Head
Department of Pathology
Sri Devaraj Urs Medical College
Sri Devaraj Urs Academy of Higher Education and Research , Kolar, Karnataka
On Sep 2018




Dr. Saumya Navit

"As a peer-reviewed journal, the Journal of Clinical and Diagnostic Research provides an opportunity to researchers, scientists and budding professionals to explore the developments in the field of medicine and dentistry and their varied specialities, thus extending our view on biological diversities of living species in relation to medicine.
‘Knowledge is treasure of a wise man.’ The free access of this journal provides an immense scope of learning for the both the old and the young in field of medicine and dentistry as well. The multidisciplinary nature of the journal makes it a better platform to absorb all that is being researched and developed. The publication process is systematic and professional. Online submission, publication and peer reviewing makes it a user-friendly journal.
As an experienced dentist and an academician, I proudly recommend this journal to the dental fraternity as a good quality open access platform for rapid communication of their cutting-edge research progress and discovery.
I wish JCDR a great success and I hope that journal will soar higher with the passing time."



Dr Saumya Navit
Professor and Head
Department of Pediatric Dentistry
Saraswati Dental College
Lucknow
On Sep 2018




Dr. Arunava Biswas

"My sincere attachment with JCDR as an author as well as reviewer is a learning experience . Their systematic approach in publication of article in various categories is really praiseworthy.
Their prompt and timely response to review's query and the manner in which they have set the reviewing process helps in extracting the best possible scientific writings for publication.
It's a honour and pride to be a part of the JCDR team. My very best wishes to JCDR and hope it will sparkle up above the sky as a high indexed journal in near future."



Dr. Arunava Biswas
MD, DM (Clinical Pharmacology)
Assistant Professor
Department of Pharmacology
Calcutta National Medical College & Hospital , Kolkata




Dr. C.S. Ramesh Babu
" Journal of Clinical and Diagnostic Research (JCDR) is a multi-specialty medical and dental journal publishing high quality research articles in almost all branches of medicine. The quality of printing of figures and tables is excellent and comparable to any International journal. An added advantage is nominal publication charges and monthly issue of the journal and more chances of an article being accepted for publication. Moreover being a multi-specialty journal an article concerning a particular specialty has a wider reach of readers of other related specialties also. As an author and reviewer for several years I find this Journal most suitable and highly recommend this Journal."
Best regards,
C.S. Ramesh Babu,
Associate Professor of Anatomy,
Muzaffarnagar Medical College,
Muzaffarnagar.
On Aug 2018




Dr. Arundhathi. S
"Journal of Clinical and Diagnostic Research (JCDR) is a reputed peer reviewed journal and is constantly involved in publishing high quality research articles related to medicine. Its been a great pleasure to be associated with this esteemed journal as a reviewer and as an author for a couple of years. The editorial board consists of many dedicated and reputed experts as its members and they are doing an appreciable work in guiding budding researchers. JCDR is doing a commendable job in scientific research by promoting excellent quality research & review articles and case reports & series. The reviewers provide appropriate suggestions that improve the quality of articles. I strongly recommend my fraternity to encourage JCDR by contributing their valuable research work in this widely accepted, user friendly journal. I hope my collaboration with JCDR will continue for a long time".



Dr. Arundhathi. S
MBBS, MD (Pathology),
Sanjay Gandhi institute of trauma and orthopedics,
Bengaluru.
On Aug 2018




Dr. Mamta Gupta,
"It gives me great pleasure to be associated with JCDR, since last 2-3 years. Since then I have authored, co-authored and reviewed about 25 articles in JCDR. I thank JCDR for giving me an opportunity to improve my own skills as an author and a reviewer.
It 's a multispecialty journal, publishing high quality articles. It gives a platform to the authors to publish their research work which can be available for everyone across the globe to read. The best thing about JCDR is that the full articles of all medical specialties are available as pdf/html for reading free of cost or without institutional subscription, which is not there for other journals. For those who have problem in writing manuscript or do statistical work, JCDR comes for their rescue.
The journal has a monthly publication and the articles are published quite fast. In time compared to other journals. The on-line first publication is also a great advantage and facility to review one's own articles before going to print. The response to any query and permission if required, is quite fast; this is quite commendable. I have a very good experience about seeking quick permission for quoting a photograph (Fig.) from a JCDR article for my chapter authored in an E book. I never thought it would be so easy. No hassles.
Reviewing articles is no less a pain staking process and requires in depth perception, knowledge about the topic for review. It requires time and concentration, yet I enjoy doing it. The JCDR website especially for the reviewers is quite user friendly. My suggestions for improving the journal is, more strict review process, so that only high quality articles are published. I find a a good number of articles in Obst. Gynae, hence, a new journal for this specialty titled JCDR-OG can be started. May be a bimonthly or quarterly publication to begin with. Only selected articles should find a place in it.
An yearly reward for the best article authored can also incentivize the authors. Though the process of finding the best article will be not be very easy. I do not know how reviewing process can be improved. If an article is being reviewed by two reviewers, then opinion of one can be communicated to the other or the final opinion of the editor can be communicated to the reviewer if requested for. This will help one’s reviewing skills.
My best wishes to Dr. Hemant Jain and all the editorial staff of JCDR for their untiring efforts to bring out this journal. I strongly recommend medical fraternity to publish their valuable research work in this esteemed journal, JCDR".



Dr. Mamta Gupta
Consultant
(Ex HOD Obs &Gynae, Hindu Rao Hospital and associated NDMC Medical College, Delhi)
Aug 2018




Dr. Rajendra Kumar Ghritlaharey

"I wish to thank Dr. Hemant Jain, Editor-in-Chief Journal of Clinical and Diagnostic Research (JCDR), for asking me to write up few words.
Writing is the representation of language in a textual medium i e; into the words and sentences on paper. Quality medical manuscript writing in particular, demands not only a high-quality research, but also requires accurate and concise communication of findings and conclusions, with adherence to particular journal guidelines. In medical field whether working in teaching, private, or in corporate institution, everyone wants to excel in his / her own field and get recognised by making manuscripts publication.


Authors are the souls of any journal, and deserve much respect. To publish a journal manuscripts are needed from authors. Authors have a great responsibility for producing facts of their work in terms of number and results truthfully and an individual honesty is expected from authors in this regards. Both ways its true "No authors-No manuscripts-No journals" and "No journals–No manuscripts–No authors". Reviewing a manuscript is also a very responsible and important task of any peer-reviewed journal and to be taken seriously. It needs knowledge on the subject, sincerity, honesty and determination. Although the process of reviewing a manuscript is a time consuming task butit is expected to give one's best remarks within the time frame of the journal.
Salient features of the JCDR: It is a biomedical, multidisciplinary (including all medical and dental specialities), e-journal, with wide scope and extensive author support. At the same time, a free text of manuscript is available in HTML and PDF format. There is fast growing authorship and readership with JCDR as this can be judged by the number of articles published in it i e; in Feb 2007 of its first issue, it contained 5 articles only, and now in its recent volume published in April 2011, it contained 67 manuscripts. This e-journal is fulfilling the commitments and objectives sincerely, (as stated by Editor-in-chief in his preface to first edition) i e; to encourage physicians through the internet, especially from the developing countries who witness a spectrum of disease and acquire a wealth of knowledge to publish their experiences to benefit the medical community in patients care. I also feel that many of us have work of substance, newer ideas, adequate clinical materials but poor in medical writing and hesitation to submit the work and need help. JCDR provides authors help in this regards.
Timely publication of journal: Publication of manuscripts and bringing out the issue in time is one of the positive aspects of JCDR and is possible with strong support team in terms of peer reviewers, proof reading, language check, computer operators, etc. This is one of the great reasons for authors to submit their work with JCDR. Another best part of JCDR is "Online first Publications" facilities available for the authors. This facility not only provides the prompt publications of the manuscripts but at the same time also early availability of the manuscripts for the readers.
Indexation and online availability: Indexation transforms the journal in some sense from its local ownership to the worldwide professional community and to the public.JCDR is indexed with Embase & EMbiology, Google Scholar, Index Copernicus, Chemical Abstracts Service, Journal seek Database, Indian Science Abstracts, to name few of them. Manuscriptspublished in JCDR are available on major search engines ie; google, yahoo, msn.
In the era of fast growing newer technologies, and in computer and internet friendly environment the manuscripts preparation, submission, review, revision, etc and all can be done and checked with a click from all corer of the world, at any time. Of course there is always a scope for improvement in every field and none is perfect. To progress, one needs to identify the areas of one's weakness and to strengthen them.
It is well said that "happy beginning is half done" and it fits perfectly with JCDR. It has grown considerably and I feel it has already grown up from its infancy to adolescence, achieving the status of standard online e-journal form Indian continent since its inception in Feb 2007. This had been made possible due to the efforts and the hard work put in it. The way the JCDR is improving with every new volume, with good quality original manuscripts, makes it a quality journal for readers. I must thank and congratulate Dr Hemant Jain, Editor-in-Chief JCDR and his team for their sincere efforts, dedication, and determination for making JCDR a fast growing journal.
Every one of us: authors, reviewers, editors, and publisher are responsible for enhancing the stature of the journal. I wish for a great success for JCDR."



Thanking you
With sincere regards
Dr. Rajendra Kumar Ghritlaharey, M.S., M. Ch., FAIS
Associate Professor,
Department of Paediatric Surgery, Gandhi Medical College & Associated
Kamla Nehru & Hamidia Hospitals Bhopal, Madhya Pradesh 462 001 (India)
E-mail: drrajendrak1@rediffmail.com
On May 11,2011




Dr. Shankar P.R.

"On looking back through my Gmail archives after being requested by the journal to write a short editorial about my experiences of publishing with the Journal of Clinical and Diagnostic Research (JCDR), I came across an e-mail from Dr. Hemant Jain, Editor, in March 2007, which introduced the new electronic journal. The main features of the journal which were outlined in the e-mail were extensive author support, cash rewards, the peer review process, and other salient features of the journal.
Over a span of over four years, we (I and my colleagues) have published around 25 articles in the journal. In this editorial, I plan to briefly discuss my experiences of publishing with JCDR and the strengths of the journal and to finally address the areas for improvement.
My experiences of publishing with JCDR: Overall, my experiences of publishing withJCDR have been positive. The best point about the journal is that it responds to queries from the author. This may seem to be simple and not too much to ask for, but unfortunately, many journals in the subcontinent and from many developing countries do not respond or they respond with a long delay to the queries from the authors 1. The reasons could be many, including lack of optimal secretarial and other support. Another problem with many journals is the slowness of the review process. Editorial processing and peer review can take anywhere between a year to two years with some journals. Also, some journals do not keep the contributors informed about the progress of the review process. Due to the long review process, the articles can lose their relevance and topicality. A major benefit with JCDR is the timeliness and promptness of its response. In Dr Jain's e-mail which was sent to me in 2007, before the introduction of the Pre-publishing system, he had stated that he had received my submission and that he would get back to me within seven days and he did!
Most of the manuscripts are published within 3 to 4 months of their submission if they are found to be suitable after the review process. JCDR is published bimonthly and the accepted articles were usually published in the next issue. Recently, due to the increased volume of the submissions, the review process has become slower and it ?? Section can take from 4 to 6 months for the articles to be reviewed. The journal has an extensive author support system and it has recently introduced a paid expedited review process. The journal also mentions the average time for processing the manuscript under different submission systems - regular submission and expedited review.
Strengths of the journal: The journal has an online first facility in which the accepted manuscripts may be published on the website before being included in a regular issue of the journal. This cuts down the time between their acceptance and the publication. The journal is indexed in many databases, though not in PubMed. The editorial board should now take steps to index the journal in PubMed. The journal has a system of notifying readers through e-mail when a new issue is released. Also, the articles are available in both the HTML and the PDF formats. I especially like the new and colorful page format of the journal. Also, the access statistics of the articles are available. The prepublication and the manuscript tracking system are also helpful for the authors.
Areas for improvement: In certain cases, I felt that the peer review process of the manuscripts was not up to international standards and that it should be strengthened. Also, the number of manuscripts in an issue is high and it may be difficult for readers to go through all of them. The journal can consider tightening of the peer review process and increasing the quality standards for the acceptance of the manuscripts. I faced occasional problems with the online manuscript submission (Pre-publishing) system, which have to be addressed.
Overall, the publishing process with JCDR has been smooth, quick and relatively hassle free and I can recommend other authors to consider the journal as an outlet for their work."



Dr. P. Ravi Shankar
KIST Medical College, P.O. Box 14142, Kathmandu, Nepal.
E-mail: ravi.dr.shankar@gmail.com
On April 2011
Anuradha

Dear team JCDR, I would like to thank you for the very professional and polite service provided by everyone at JCDR. While i have been in the field of writing and editing for sometime, this has been my first attempt in publishing a scientific paper.Thank you for hand-holding me through the process.


Dr. Anuradha
E-mail: anuradha2nittur@gmail.com
On Jan 2020

Important Notice

Original article / research
Year : 2022 | Month : January | Volume : 16 | Issue : 1 | Page : JC05 - JC11 Full Version

Attitude of Undergraduate Medical Students towards Classroom Lecture Absenteeism and its Association with Academic Performance


Published: January 1, 2022 | DOI: https://doi.org/10.7860/JCDR/2022/53163.15869
Parama Sengupta, Sarmishtha Saha, Tania Sur

1. Associate Professor, Department of Pharmacology, Diamond Harbour Government Medical College, Diamond Harbour, West Bengal, India. 2. Associate Professor, Department of Biochemistry, Diamond Harbour Government Medical College, Diamond Harbour, West Bengal, India. 3. Professor and Head, Department of Pharmacology, Diamond Harbour Government Medical College, Diamond Harbour, West Bengal, India.

Correspondence Address :
Dr. Parama Sengupta,
Associate Professor, Department of Pharmacology, Diamond Harbour Government
Medical College, Diamond Harbour-743331, West Bengal, India.
E-mail: paramas82@gmail.com

Abstract

Introduction: Classroom lecture absenteeism is a challenging issue among medical educators. The benefit of attending lecture classes on academic performance has already been documented. Very few studies have explored the attitude of undergraduate medical students towards classroom lecture absenteeism and its association with the students’ academic performance.

Aim: To explore undergraduate medical students’ attitude towards classroom lecture absenteeism, its association (if any) with academic performance (measured by total marks obtained in semester marks) and also to evaluate the attitude of the students towards attending classroom lectures on pre and paraclinical subjects.

Materials and Methods: This anonymous structured questionnaire based observational study was conducted in the Departments of Biochemistry and Pharmacology in the month of September 2021, of a tertiary care government medical college. Phase 1 (n=98) (batch 2021-22) and phase 2 (n=97) (batch 2020-2021) MBBS students of the government medical college were included. Descriptive statistics, Chi-square test and one-way Analysis of Variance (ANOVA) tests were used to analyse the data. The p?0.05 was considered as statistically significant.

Results: Out of 195 students, (male: female ratio being 2:1) 94.87% stayed at hostel. Most of them (51.28%) agreed to attend the classroom lectures for pre and paraclinical subjects for getting attendance. It significantly affected the academic performance of the students (p=0.005). A 61.02% students wanted the lecture classes for pre and paraclinical subjects to be optional. Again 76.92% of them thought attending lecture classes have positive impact on their academic performance. The choice of opinion significantly (p<0.001) affected their academic performances. A 56.41% of the students agreed to skip lecture classes 2-3 times per week and cited the most common reason being “not liking the teaching of a particular teacher.” The choice of the students significantly affected the academic performance (p<0.001). A 67.69% of them opined that by reducing the duration of the class, classroom lecture classes on pre and paraclinical subjects can be improved, and there was significant association between the choice and the academic performance of the students (p<0.001).

Conclusion: Although majority of the students understood the positive impact of lecture classes on academic performances and they do not want the lecture classes to become optional, they wanted certain modifications like making the traditional didactic lecture classes more interactive, exam oriented, and concept based. Also some of their attitudes (if not all) affected their academic performances significantly.

Keywords

Didactic lecture, Interactive lectures, Medical education, Pre and paraclinical subjects

In recent years, all over the world poor attendance in lecture classes has been a challenging issue for medical educators (1). Several studies have documented the downward trend of lecture attendance among medical students (1),(2),(3). As per the Association of American Medical College, from 2015 to 2017, the second year undergraduate medical students’ response regarding how frequently (“often” or “most of the time”) they attend classroom lecture classes declined to 47.3% from 52.3% (2).

Poor attendance of lecture classes has negative impact on the medical school experience like damaged faculty morale which can inturn lead to poor quality of teaching in future and also falling faculty retention rate (3). For the students’ point of view, those who do not attend adequate number of lecture classes may lack the professional behaviour and attitude expected of them after graduation (3). Also, there is a chance that poor lecture attendance might impact the academic performance of the students; however, some studies have documented an opposite outcome (4),(5),(6),(7). Several factors have been identified as reasons for poor lecture attendance. These are availability of high quality video recordings of lecture classes on the internet allowing the students to study at their own pace, and availability of number of high quality online up to date resource material (8).

Several studies have documented that students of different age groups and gender prefer online resource material in different ways (9),(10),(11). Wynter L et al., conducted a study on medical students regarding their use of educational resource material (12). The researchers found that although the popularity of e-learning cannot be denied, traditional classroom lectures remain the most trusted source of learning new topic (12). They also noted while there was some age dependent difference regarding choice of learning material, there were no gender based differences (12).

In another study by Gupta A and Saks NS to explore medical students’ choice regarding attending live lecture classes or recorded lecture sessions, the researchers found that female students and first year medical students are more likely to attend lecture classes compared to second year medical students (13). According to faculty members, attending lecture classes are essential for medical students, as it helps the students to develop professional skills, and indepth understanding of the basic medical sciences which help in their growth as professionals in future (7),(13).There are not many available studies (14),(15) which have explored the undergraduate medical students’ attitude towards attending lecture classes of pre and paraclinical subjects. As understanding the students’ views, expectations and feedbacks in this regard might help in bringing them back to lecture classes.

In this study, undergraduate medical students’ attitude towards classroom lecture absenteeism, its association (if any) with academic performance (measured by total marks obtained in semester marks) and also the attitude of the students towards attending classroom lectures on pre and paraclinical subjects were explored.

Material and Methods

This anonymous self-administered structured closed ended questionnaire based observational study was conducted in Diamond Harbour Government Medical College, Diamond Harbour, West Bengal, India during the month of September 2021. Ethics Committee permission (DHGMC/2021/983 dated 21/2/21) was obtained and informed consent from all the students were taken.

Inclusion criteria: All the MBBS students of Phase 1 (2021-22) (anatomy, physiology, and biochemistry) and Phase 2 (2020-21) (pathology, microbiology, pharmacology, and forensic medicine) were included.

Exclusion criteria: Unwilling students were excluded.

Sample size: Minimum sample size estimated with 95% confidence interval and margin of error of 3% was 166. However, authors included all the willing students of the phase 1 (n=98) and phase 2 (n=97) MBBS batches of our college in the study.

The self-administered questionnaire for prevalidation and pretesting was given to the remaining faculty members of the Department of Pharmacology (except, the two researchers involved in the study) (n=4) and to the students (phase 1; n=5 and phase 2; n=5) from same phases of different college under the same university. They were asked to fill in anonymously a 5 point Likert scale (scored 1-5; score 1: strongly disagree, score 2: disagree; score 3: neutral; score 4: agree, and score 5: strongly agree; minimum score was 4, and maximum score was 20). Questionnaire [Annexure 1] on content, clarity, language, and understandability of the study questionnaire. Cronbach’s alpha value for the questionnaire designed to validate the study questionnaire was 0.73 for all the items.

Next, the students were instructed by two separate teachers from phase 1 and phase 2, by two researchers from two phase 1 and 2, respectively regarding how to fill in the study questionnaire [Annexure 2] and especially about assigning scores based on 5-point Likert scale. Ten minutes were assigned to fill in the questionnaire consisting of 4 sections (a total of 20 questions) namely A (consisting of 4 questions), B (consisting of 5 questions), C (consisting of 4 questions) and D (consisting of 7 questions) under supervision of the teachers (SS and PS) (Table/Fig 1). After 10 minutes, the questionnaires were collected and checked for completeness.

Statistical Analysis

The data were then put on Microsoft spread sheet for analysis. Statistical Package for the Social Sciences (SPSS) version 25.0 was used for statistical analysis. Descriptive statistics, Chi-square test and one-way ANOVA were used for analysis of the data. The p?0.05 was considered as statistically significant.

Results

Demographic profile of the students: In this study, there were a total of 195 participants with 130 male students. There was no significant difference in academic performance between the two phases of students (p=0.638) (Table/Fig 2).

Students’ attitude towards classroom based lectures on pre and para subjects: Majority of the students (n=100; 51.28%) agreed to attend the classroom lectures for pre and paraclinical subjects for getting attendance (Table/Fig 3). There were no significant differences in opinion among male and female students within the same academic phases for both the phases (phase 1 and phase 2); however, the gender based difference in opinion was significant when compared between the two phases (phase 1 and phase 2) (p=0.017). Again choice of answer in this regard (“yes” and “no”) has significantly affected the combined academic performances of both the phases of students (p=0.005) (Table/Fig 3).

Most of the students (n=150; 76.92%) thought attending lecture classes have positive impact on their academic performance. There were no significant differences in opinion among male and female students both within the same phase and between the two phases. However, the choice of opinion significantly (p<0.001) affected their academic performances (Table/Fig 3).

Most of the students (n=110; 56.41%) agreed to skip lecture classes around 2-3 times per week. The differences in the academic performance based on the number of lecture classes usually skipped by the students were significant (p<0.001) (Table/Fig 3). Also, the number of classes skipped by students every week varied significantly (p=0.01) among male and female students from phase 1 but not from phase 2 and also not when all the students from both the phases were considered (Table/Fig 3).

Upon enquiring regarding the reasons behind skipping lecture classes for pre and paraclinical subjects, most of the students (n=166; 85.12%) said they did not like the teaching of a particular teacher (Table/Fig 3).

Students’ input: How to improve classroom lectures on pre and paraclinical subjects: Most of the students (n=173; 88.72%) opined that classroom lectures on pre and paraclinical subjects can be improved by making them more interactive and the choice of opinion showed significant association with academic performance (p=0.009) (Table/Fig 4). Majority of the students agreed (n=132; 67.69%) that by reducing the duration of the class, classroom lecture classes on pre and paraclinical subjects can be improved, and there was significant association between the choice (“yes” or “no”) and the academic performance of the students (p<0.001) (Table/Fig 4). Also, the difference of choice was significant among male and female students of phase 2 (p=0.03) (Table/Fig 4).

Most of the students opted for use of chalk and talk (n=154; 78.97%) and audio visual aids (n=144; 73.84%) during lecture classes. There were significant association between choice of teaching method and students’ academic performance (p<0.001) (Table/Fig 4).

Again majority of the students (n=177; 90.77%) opined that by teaching using clinical correlation and clinical cases and concept building manner, lectures can be improved. Academic performance was significantly associated (p=0.009) with choosing the options “using clinical correlation and clinical cases” (Table/Fig 4). There were no significant differences among male and female students except for those from phase 2 batch (p=0.0008) in “teaching in a concept building manner” (Table/Fig 4).

A 94.87% (n=185) students wanted the teaching in lectures to be exam oriented (Table/Fig 4). Although there were no significant differences in opinion among male and female students within the same batch and between the two batches (Table/Fig 4).

A 63.07% (n=123) students wanted power point presentation slides of the lectures/lecture handsout, 48.71% (n=95) students wanted online resource material (soft copy) and 45.12% (n=88) of them wanted hardcopy of the resource material. Students’ opinion regarding how pre and paraclinical classroom lecture sessions improve preparation for examination.

Majority of the students gave a score of 3 out of 5 on Likert scales for the different ways lecture classes in basic sciences improve preparation for examination namely “by concept clearing” (n=135; 69.2%), “by using the notes taken during lecture sessions” (n=136; 69.74%), “by using the lecture handouts/ppt slides/course materials shared by the teacher” (n=109; 55.89%), and “through interaction with teacher” (n=120; 61.53%) (Table/Fig 5)a. However, comparison of Likert scale scores of students’ input regarding how classroom lectures on pre and paraclinical subjects help students to prepare for exams revealed no significant difference (Table/Fig 5)b.

Discussion

In this study, majority of the participating students (irrespective of gender and educational year) opined that they attended lecture classes of pre and paraclinical subjects for attendance and the choice was significantly associated with the students’ academic performance (p=0.005).

Most of them (from both the phases) thought that lectures for basic sciences (pre and paraclinical subjects) should be made optional; however, the difference in opinion was not significant among male and female students from each of the batch and between students from the two batches. Again, most of them agreed that attending lectures have a positive impact on their academic scores; it was also supported by the significant differences in the scores between students who agreed and who did not agree with the positive impact of attending lecture classes on academic performance (p<0.001). Also, academic scores were significantly better (p<0.001) in students who skipped around 2-3 lecture classes per week compared to students who skipped 3-4 and >4 lecture classes per week. In a similar study like this conducted by Wongtrakul W and Dangprapai Y among dental students regarding the reasons for dental students to skip lecture classes the students strongly believed that lecture classes have positive impacts on their academic score (16). In that study, the researchers also noted that the underachievers were more likely to skip classes compared to students who scored higher marks. Although despite having similarities with present study in the above findings, in their study most of the students unlike this study wanted attending lecture classes to be optional.

Again, probing about the reasons for skipping the lecture classes most of the students cited the reason of “not liking the teaching of a particular teacher” as the most common reason followed by “early morning classes”; however, there were no significant (p=0.27) differences in the academic scores among the students citing different reasons for not attending lecture classes. In the study by Wongtrakul W and Dangprapai Y, the timing of scheduling the lecture class (early morning) was cited as the most common reason for skipping the class and poor presentation skills of the lecturers was cited as the third most common reason for skipping lecture classes (16). In present study “early morning classes” was the second most commonly cited reasons for skipping lecture classes.

Most of the students in present study opined that lecture classes can be improved “by making them more interactive”, “by reducing duration of lecture class”, by using different ways like “power point presentation”, “chalk and talk”, “by showing interesting video”, and “by sharing anecdotes”. Most of them also wanted the lectures to be in exam oriented fashion (94.87%), in concept building (90.77%) and by using clinical correlation and case studies (90.77%).

In another study, Mokhtari S et al., investigated the reasons behind students’ attendance in and absenteeism from lecture classes (17). They noted that like present study “decreased class efficiency” to be the leading reason cited by the students for skipping a lecture class. The researchers also noted that improving teaching prowess of the teachers, better evaluation system, availability of audio visual equipment and taking classes at favourable timings are the different ways that can reduce lecture class absenteeism. In present study, students also pointed out several similar ways to improve lecture classes.

In another study Desalegn AA et al., explored medical students’ absenteeism in Ethiopia (18). They noted that preparing for another examination, lack of interest in the topic, teacher’s teaching methods, and availability of lecture material from other sources are the main reasons behind skipping classes among undergraduate medical students.

Worldwide including India, the selection process for enrolling in medical schools is quite demanding and challenging. In India the National Medical Commission (NMC) regulates the medical education by giving recognition of medical qualifications, giving accreditation to medical schools, granting registration to medical practitioners, monitoring medical practice and by assessing the medical infrastructure in India (19),(20). As per the NMC guidelines (Graduate Medical Education Regulation; GMER) 75% attendance in lecture classes alone is compulsory for eligibility to appear in the final university examinations of that subject (20). However, students in our country like everywhere else have shown an increasing tendency to skip the lecture classes.

Studies have revealed that prestigious institutes like John Hopkins and Harvard Medical Schools have also seen a surprising drop in classroom attendance by 30-40% (4),(21),(22). At this age of smart phone and better internet connectivity, many students prefer to watch recorded online lectures available at various sites at their own pace, which has also contributed to lecture absenteeism. Literature review has shown that lecture absenteeism leads to poorer academic performance. Wongtrakul W and Dangprapai Y, performed a study on preclinical medical students in Thailand to assess the impact of attending live lecture classes on academic performance (16). They found that lecture absenteeism was significantly associated with poorer academic performance among preclinical medical science students. Thus, attending lecture classes is an important measure to improve academic performance of the medical students.

Several studies have also suggested different measures to improve students’ attendance in lecture classes (16),(17),(18),(23),(24),(25),(26),(27). These are like reinforcing strict roll call policies, giving marks for attending classes or deducing marks if attendance is not upto a specified mark, not allowing them to sit for final exam without attending a specific number of classes, etc., (23),(24),(25),(26),(27). Hence, in authors opinion rather than forcing the students to attend lecture classes (by making attending certain number of lecture classes mandatory or deducting marks for not attending classes), they should be motivated to attend the lecture classes by improving the teachers’ performance (through various faculty development programs, symposiums, workshops, etc.,), by making the lecture class learner centric (interactive and innovative) and outcome oriented. Any forceful attendance of lecture classes most likely will not lead to active participation of the students and thus will not be reflected positively on students’ learning and finally on academic performances.

In this study, it was found that although most of students are in the opinion of making lecture class attendance optional, they do agree on the positive impact of attending lecture classes on their marks. Thus, the students should be motivated to attend the lecture classes through understanding their needs, expectations and consideration of their opinions like by making the lecture sessions more interactive, exam oriented, in a concept building manner, by using various teaching aids like chalk and talk, power point presentations, paper cases/dummy patients. Also, if and whenever possible logistic changes can also be made keeping in mind the students’ opinion, before scheduling lecture classes like avoiding early morning classes or by reducing the duration of lecture sessions or introducing innovative lecture sessions like “flipped classroom sessions” (25) or by planning sessions of content delivery by moderator/facilitators interspersed with active sessions like peer instruction, buzz sessions, think-pair-share sessions, etc., (26).

Adult learning pattern study has established that learner attention span decreases after about 15 to 20 minutes in a typical didactic lecture session; the two most important reasons being working memory and interference (24),(25),(26),(27). As the learner acquires new information, he or she uses the working memory to integrate the new data with existing knowledge to form long term memories. This whole process requires active attention; however, as lecture progresses new information piles up which require more involvement of the working memory which was already active in processing earlier information obtained from the initial parts of the lecture. Hence, the capability of the learner decreases to assimilate new information with existing knowledge, this phenomenon is called interference. Interference thus makes long lectures less fruitful and less enjoyable. Thus, to make lectures fruitful, besides active participation of the learners and improving the teaching quality of the facilitator, one should keep in mind the duration of lecture, as short lectures are more beneficial to students as it respects the learner’s limitations as well.

In another similar study like this study, Ramirez BU have explored the undergraduate medical students’ live lecture attendance, and perceptions and expectations from the said classes (7). The researchers like this study have found that students suggested that improving teaching of the faculty members through faculty development programs, exam oriented teaching and designing active learning sessions might change students’ attitude to regularly attending classroom lecture classes.

Limitation(s)

There are certain limitations of present study. Firstly, the number of study participants was not adequate. Before bringing about definite modifications in the prevailing lecture sessions in pre and paraclinical subjects, similar studies with larger sample size, to the gauge students’ attitude towards attending lecture classes, and also getting feedback from them regarding ways of improving their attendance in lecture classes, are required. Secondly, as the study was conducted in a newly opened government medical college, till now there are only two batches of undergraduate medical students. Hence, to overcome this particular limitation, it has been planned to repeat the study again after two years with two new batches and two of the older batches of students. Although it is not possible to modify the lecture classes for all the topics of all the subjects to be innovative, there are future plans to modify some of the lecture classes in pharmacology by making them more interactive like introducing “flipped classroom sessions” and assess the students’ feedback regarding attending lecture classes and comparing with the present study results to check if there is any positive change in the students’ attitude towards attending lecture classes on basic subjects.

Conclusion

Although majority of the students understood the positive impact of lecture classes on academic performances and they do not want the lecture classes to become optional, they wanted certain modifications like making the traditional didactic lecture classes more interactive, exam oriented, concept based and shortening of the duration of the lecture.

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DOI and Others

DOI: 10.7860/JCDR/2022/53163.15869

Date of Submission: Nov 06, 2021
Date of Peer Review: Nov 23, 2021
Date of Acceptance: Dec 14, 2021
Date of Publishing: Jan 01, 2022

AUTHOR DECLARATION:
• Financial or Other Competing Interests: None
• Was Ethics Committee Approval obtained for this study? Yes
• Was informed consent obtained from the subjects involved in the study? Yes
• For any images presented appropriate consent has been obtained from the subjects. No

PLAGIARISM CHECKING METHODS:
• Plagiarism X-checker: Nov 10, 2021
• Manual Googling: Dec 10, 2021
• iThenticate Software: Dec 21, 2021 (1%)

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