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Session 3D

Paper 1

How is attendance linked to academic performance in Optometry?

Dr Byki Huntjens - Senior Lecturer | School of Health Sciences

Nuno Esteves - Research Assistant | School of Health Sciences

Dr Tamsin Callaghan - Lecturer | School of Health Sciences

Following the introduction of the Taught Student Attendance and Engagement Policy in 2018, to support improvement in student progression and attainment by monitoring attendance and engagement in all classroom-based activities, we aim to provide evidence for this strategy by analysing longitudinal data collected from the Optometry programme within our School of Health.

Educators are increasingly concerned about poor attendance, a lack of preparation for tutorials or seminars, and disinterest in active learning (Dey 2018; Rogers 2001), particularly during the first year of studies (Strahm and Danaher 2005). It is believed that inconsistent attendance and engagement makes students less likely to succeed (Baron and Corbin 2012; Harper and Quay 2009; Salamonson et al 2009). In September 2018, City University introduced the Taught Student Attendance and Engagement Policy. This Senate policy is an institution-wide initiative to support improvement in student progression and attainment by monitoring attendance and engagement in all classroom-based activities. Within SHS, staff monitors attendance thresholds for all first- and second-year undergraduates and will follow-up with any student attending less than an average of 80% of timetabled activities.

Although there is evidence to suggest that engagement promotes student’s success in a variety of programmes, we aimed to corroborate the need for a strict attendance policy by using longitudinal data collected from a large health care programme within our School of Health. Following a Periodic Programme Review of the Optometry programme in 2016, a mandatory attendance component was introduced as part of each module involving an annual threshold of 80% for attendance and punctuality for all small group (n<30) labs, workshops and tutorial classes. Attendance was recorded through call-out or sign-in sheet, managed by the educators. This has been compared to data prior to the introduction of the attendance component, when attendance was monitored possibly less rigorous and consistent for some of our (non-clinical) modules.

We investigated the relationship between attendance and progression of undergraduate optometry students over a 3-year period (2015-2018). During this session we present the results related to a) correlations between attendance/ punctuality and progression on modular and programme level; and b) variations between cohorts. Furthermore, we will discuss the impact of module type (for example, clinical versus non-clinical), module credits, and module feedback scores on attendance, and explore how these results can be translated to other HE programmes.

Structured like a traditional research presentation, we will provide the attendees with background information and overview of the existing literature (5 min), an outline of our methodology (5 min), visualisation of the results (7 min), and summary of our conclusions (3 min). We will then open the floor for questions and a short discussion (10 min) about (programme specific) attitudes and beliefs towards student attendance versus attainment, and general motivations and potential benefits of City’s attendance policy.

Attendees will gain an understanding of the current evidence with regard to student attendance in relation to progression, and the need for an attendance policy, whether this is appropriate in its current format for their specific programme or not.


Baron, P. and Corbin, L., 2012. Student engagement: rhetoric and reality. Higher Education Research & Development, 31(6), pp.759-772.

Dey, I., 2018. Class attendance and academic performance: A subgroup analysis. International Review of Economics Education, 28, pp.29-40.

Harper, S. R. and Quaye, S. J. 2009. “Beyond sameness with engagement and outcomes for all: An introduction”. In Student engagement in higher education, Edited by: Harper, S. and Quaye, S. 1–15. New York: Routledge.

Rodgers, J. R. 2001. A panel-data study of the effect of student attendance on university performance. Australian Journal of Education, 45(3): 284–295.

Salamonson, Y., Andrew, S. and Everett, B. 2009. Academic engagement and disengagement as predictors of performance in pathophysiology among nursing students. Contemporary Nurse, 32(1–2): 123–132.

Strahm, M. and Danaher, G. 2005. Getting them thinking: The role of the student questionnaire in promoting academic and social integration. Studies in Learning, Evaluation, Innovation and Development, 2(3): 44–54.

Paper 2

Concordance: The impact of experiential learning through simulation

Karen Rawlings-Anderson - Senior Lecturer | School of Health Sciences

Janet Hunter - Senior Lecturer | School of Health Sciences

  • Learning and Teaching approaches:
    The paper describes an innovative approach to engage students in an experiential learning activity to enhance their understanding of the factors that influence medicines adherence.
  • Activities and strategies that support students through their programme.
    This paper addresses the implementation of a unique experience that builds on, and supports the student’s learning experience and professional role development.

It is estimated that only 16% of patients who are prescribed new medication will take it as prescribed, termed as non-adherence. After ten days, almost a third of people are already non-adherent, and of these, 55% are not taking their medicines correctly. The remaining 45% have made the decision not to take their medicines as prescribed. It is calculated that approximately £300 million of medicines are wasted each year in primary care alone due to non-adherence (National Institute for Health and Clinical Excellence, 2009, Royal Pharmaceutical Society, 2013).

Medicines remain the most common therapeutic intervention in healthcare. Nurses are well placed to have conversations with patients related to their medications, and factors that influence their adherence, but it is often hard for them to understand the reasons for non-adherence. If nurses are relatively fit and healthy, they are unlikely to have experienced what it is like to adhere to a medication regime. Experiential learning within healthcare enables students to step into the patient’s world; to appreciate the patient’s perspective and their feelings towards a situation (Beest et al 2018). Therefore, ‘Tic tac medicines’ was designed to provide an experiential approach to enhance student nurses’ understanding of the factors that influence medicines adherence (Stojan et al, 2017).

In ‘tic tac medicines’, students participate in a week-long simulation exercise. They are ‘prescribed’ 3 ‘medications’ that include a variety of frequencies and doses. The medicines are not real, but are tic tacs of different colours. Students pick up their ‘prescription’ from the GP surgery (Student Help Desk) and then collect their prescribed ‘medications’ from the Myddelton Health Centre Pharmacy during opening hours. Students then take their ‘medications’ as prescribed over a 5-day period. During Simulated practice students reflect upon their experiences during a debrief session where they can identify factors that both hinder and enable medicines adherence. Student feedback on this innovation was overwhelmingly positive. It enabled them to discover many reasons for non-adherence, which would not have been identified by discussion alone. This in turn helped them to think about their future practice.

This presentation will discuss how we implemented this innovative idea and transformed the students’ learning experience.

What will I gain from attending the session?

The session will be of interest to any discipline interested in the use of simulation in education.

You will have the opportunity to:

  • Gain an insight into the use of simulation as a learning strategy and the impact this has on student learning.
  • Discuss and assess the benefits and challenges of designing simulation within a programme.
  • Explore how to engage students when the simulation activity occurs outside a simulation environment.
  • Consider how this method of using simulation might be used or adapted to your discipline.


Beest, H, Bemmel, M & Adriaansen, M (2018) Nursing student as patient: experiential learning in a hospital simulation to improve empathy of nursing students. Scandinavian Journal of Caring Sciences. 32: 1390-1397.

National Institute for Health and Care Excellence (2009) Medicines adherence: involving patients in decisions about prescribed medicines and supporting adherence. Clinical guideline (CG76). NICE: London. Available at

Royal Pharmaceutical Society (2013) Medicines Optimisation: helping patients to make the most of medicines. Good practice guidance for healthcare professionals in England. Royal Pharmaceutical Society: London.

Stojan, N,J, Wolff, M, Buckler, S, Kahn, J, Santen, S,A, & Daniel, M (2017) Experiential learning about medication adherence. The Clinical Teacher. 14: 451-453.