Coming to Class Will Improve Your Grade: An Examination of Lecture Attendance and Lecture Exam Scores in an Undergraduate Human Anatomy Class
Authors: Nichols Richard A. , O'Loughlin Valerie D. 
Published: May 2022

At the onset of the COVID‐19 pandemic, many traditional in‐person courses were converted to synchronous, asynchronous, or hybrid online formats. Instructors of a large undergraduate Basic Human Anatomy course at Indiana University ‐ Bloomington leveraged these changes to convert the lecture portion of the course to a flipped‐classroom model with two components: asynchronous online course content delivery, and live in‐person interactive learning sessions. The in‐person interactive learning sessions introduced students to active learning strategies and techniques (drawing, memory matrices, flow charts, diagrams, etc.), and the students actively participated in these sessions through the use of an online interactive learning platform ‐ TopHat. Here we sought to assess the efficacy and outcomes of the active learning sessions on student performance in the course.

Basic Human Anatomy (ANAT‐A215) is a 5 credit hour undergraduate (baccalaureate) course that has an enrollment of 480 students with 1 large lecture section and 12 smaller lab sections. In Fall 2021, the instructors modified the lecture component of the course into a flipped classroom format. Lecture content was delivered via asynchronous online lectures, and the F2F class time was listed as optional (but strongly encouraged) for attendance. To facilitate greater student‐instructor interaction, one half of the class attended on Mondays and the other half attended on Fridays, and participated in similar interactive sessions. Wednesday F2F interactive lecture sessions were open to the entire class. To encourage attendance and participation in the optional F2F interactive lecture sessions, extra credit points could be earned through participation in TopHat anatomy questions. Points were earned for participation only (.5 points per question). TopHat questions were created by the instructors and consisted of both lower order and higher order questions that tested lecture and lab anatomical content. At the end of each lecture exam block of material, the instructors selected multiple TopHat questions at random for extra credit, with a range of 2‐4 extra credit points that could be earned per exam block.

We found a statistically significant positive correlation between the number of points accumulated for participating in the F2F active learning lecture session questions and lecture exam scores. Using the number of points accumulated via the TopHat questions as a proxy for lecture attendance, we found that more TopHat points accumulated by students resulted in higher mean lecture exam scores – the greatest benefits occurring if students participated in multiple (>3) F2F lecture sessions per block. Students who regularly attended F2F interactive sessions saw the greatest gains in their lecture exam scores. These findings indicate that active learning strategies could be efficacious in supplementing an asynchronous lecture content delivery format. We shared our findings with the class to encourage them to attend the active learning sessions, but encouraging some student populations to attend these sessions remains a challenge. Future research should be conducted on methods to encourage student involvement and participation in the course.