Abstract:

Declining class attendance has become a growing concern in higher education, particularly in health sciences, where in-person learning is closely linked to the acquisition of practical skills, clinical reasoning, and professional competencies. In disciplines such as Pharmacy, regular attendance is especially relevant, as students are expected to integrate theoretical knowledge with practical applications directly related to patient care, medication safety, and professional responsibility. Understanding the relationship between attendance and academic performance is therefore essential to inform teaching strategies and improve student engagement.

The aim of the present study is to analyse if there exists any clear association between class attendance and academic outcomes over two academic years in undergraduate students of Pharmacy. In this sense, a longitudinal observational study was conducted including the students enrolled in the courses 2024-25 and 2025-26 of Physiology and Pathophysiology I, a basic subject scheduled in the first semester of second year of Pharmacy degree. Attendance was recorded daily through signed attendance lists. At the end of each semester, individual attendance rates were calculated and students were anonymously stratified into four groups: high attendance (> 75% to 100%); moderate attendance (≥ 50% to ≤ 75%); low attendance (≥ 25% to < 50%) and very low attendance (< 25%). Then the final qualification grade for each group as representative of academic performance was statistically compared and a post hoc t Student test was performed. Comparative analysis for each academic course alone (2024-25 or 2025-26) or in combination, as well as considering all student enrolled but also with only the new enrolments were performed.

Mean academic performance expressed as mean ± standard deviation for each group of attendance was 5.7 ± 1.7 to 6.4 ± 2.1 for the high attendance students, 5.0 ± 1.9 to 5.2 ± 1.7 for the moderate group, 4.7 ± 1.9 to 4.6 ± 1.9 for the low one and 3.8 ± 1.9 to 4.0 ± 1.8 for the very low group. Statistical differences (p< 0.05) were found among all the groups except for the moderate and low attendance in the course 2025-2026. This relationship became more pronounced when repeat students were excluded and when data from both cohorts were analysed together. Analysis of daily attendance patterns revealed a progressive weekly decline throughout the semester, with only approximately 25% of students consistently attending or actively participating by the end of the term in the course 2025-26.

These findings confirm a strong association between class attendance and academic performance in health sciences education and reveal a concerning pattern of declining student engagement. This study provides empirical evidence supporting attendance as a key factor in academic success and highlights the need to further investigate the causes of absenteeism. Addressing these factors may help inform targeted educational strategies aimed at improving student engagement and enhancing the effectiveness of face-to-face learning in Pharmacy and related health sciences programmes.

Keywords:

Class attendance, Academic performance, Pharmacy education.