Determinants and Outcomes of In-person Lecture Attendance in Medical School.

Introduction: Attendance at in-person lectures in medical schools is declining with nearly 28.8% of all active, second-year medical students who reported "almost never" attending in-person lectures during their preclinical years. The objective of this study was to explore the relationship between medical student attendance and performance and investigate students' goal orientation as factors influencing their decision to attend. Methods: Participants completed a survey at the end of their second year that asked to self-report attendance during each of the three preclinical semesters, factors that influenced attendance, and measured their goal orientation (GO). Student performance outcomes included all courses in the preclinical curriculum and USMLE Step 1 scores. Results: There was a statistically significant reduction in frequency of attendance after each subsequent semester (p < .001). Third semester attendance, but not learning GO, was positively related to M2 course performance. Prove performance GO was positively related and third semester attendance was negatively related to Step 1 score after controlling for M2 course performance. Conclusions: The pattern of declining lecture attendance in medical school with the rapid adoption of virtual learning triggered by the Covid-19 pandemic indicates students have taken more control over where and when they learn. Our results showed that students perceived in-person attendance at lectures was more valuable for balancing keeping up with coursework and maintaining social relationships and less valuable for efficient Step 1 preparation. Students' goal orientation may help identify individuals who are less likely to attend in-person. The full impact of the COVID-19 on student learning is yet to be determined.