PURPOSE
Research on the relationship between medical student in-person attendance
in pre-clerkship courses and performance on standardized exams has been
mixed, with some studies suggesting a positive relationship and others
finding little connection (Lamb et al, 2020; Eisen et al, 2015). The COVID-19
pandemic appears to have increased the preference for/acceptance of virtual
learning. We examined our Behavioral Medicine course (a 40-hour preclerkship
course) which had previously required in-person attendance at all sessions.
In 2025, 12 hours of course time was deemed “required” with optional
in-person attendance for other sessions. We analyzed the relationship between
students’ performance on a summative exam and their time spent in calss and
time spent reviewing prework materials and watching recorded class videos via
our online learning management system (LMS).
METHODS
We examined the relationship between final exam score (range:
66.2-95.8/100, mean=83.8) and in-class time (range:12-40 hours;
mean=18.1hours) and time spent on LMS (range:66-1367 minutes; mean=625.6
minutes) for 54 MS2s.
RESULTS
The strongest correlation with the final exam score (r=0.376, p=0.005) was
total time spent learning (time spent in-person and on the LMS). Time spent
attending class in-person was also significantly correlated with exam score
(r=0.319, p=0.019). Time spent on the LMS alone was not significantly
correlated with final exam score.
CONCLUSIONS
Students who spent more time attending class and working via the LMS
performed best on the final exam. This supports the notion that attending
class, on its own, is associated with better final exam performance, though
findings may reflect preexisting differences, as students were not randomly
assigned to attend in-person vs virtually. Future plans include replicating
these finding with our January 2026 course cohort and examining performance
on CBSE and Psychiatry Shelf Exams. These findings could have implications
for other UME institutions and perhaps even GME programs.