Perils of Preaching to the Choir

By: Mackenzie Betancur, Student Pharmacist; Kelli Rourke, Student Pharmacist; and Jennifer Trujillo, PharmD, FCCP, BCPS, CDE, BC-ADM

Have you ever walked into a classroom and been instantly disappointed because attendance is less than optimal? The hours of preparation time and the new strategies you incorporated to improve active learning flash before your eyes. What’s your knee-jerk reaction? For many faculty, including this faculty author, it’s hard not to verbally express frustration about the number of empty seats. But what are the implications of complaining about attendance to those students who are in attendance? Are there perils to preaching to the choir? After several discussions on an academic rotation, we’ve come to believe there are.

Tackling the deterioration in classroom attendance:

The emphasis and focus on classroom attendance is driven, at least partly, by an abundance of research investigating the link between attendance and performance. For example, researchers in the UK looked at this relationship specifically in pharmacy students.1 Their findings showed a positive and statistically significant association between the two. When looking at one individual course, a total of twelve students failed the final examination.1 Out of those twelve, nine had attendance below 80%.1

These findings validate faculty concerns, showing it is reasonable to be troubled when attendance is subpar. But, how do faculty respond to the deterioration of classroom attendance, and is it working? ACPE accreditation standards emphasize active learning and engagement.2 From the student authors’ perspectives, this is where we’ve seen faculty focus, with the addition of in-class activities, small group discussions, and extra assignments. When attendance for these activities doesn’t meet faculty expectations, the tension can be palpable. On occasion, this leads to the expression of disappointment and dissatisfaction to those actually attending.

While this response is very natural, it doesn’t come without consequences. Sitting in class, feeling reprimanded for the actions of your peers is defeating. This also distracts from the learning experience and sets a negative tone for the rest of the session. These implications erase the positive intention of even the most creative teaching methods. We’ve seen firsthand the deterioration of student-faculty relationships as a result.

One study looking at medical student and faculty attitudes about classroom attendance showed that both students and faculty agreed that lecturer enthusiasm toward teaching diminished when classroom attendance was poor.3 However, many attitudes between students and faculty differed. Faculty felt more strongly that poor attendance negatively impacted the effectiveness of lectures.3 Students felt they should have the freedom to decide what learning opportunities they attended and didn’t feel that they were disadvantaged by watching lecture videos outside of class time.3

Though it may feel personal to faculty, often the reason students are not attending classroom sessions has little to do with lack of effort or commitment on the students’ end. A study completed at Auburn University assessed reasons pharmacy students were not attending class.4 Two of the top five reasons that students did not attend class were related to studying or completing work for other courses.4 Many students attributed their absenteeism to feeling tired and oversleeping because of studying the night before.4 A similar number of students stated that they were working on other assignments or actively studying for a different course.4 Another factor that influenced attendance was the availability of course content outside of the lecture setting.4 Many of you have likely seen this in your respective schools with the integration of recorded lectures. Because of the heavy workload, students find themselves faced with a choice between studying for examinations or attending lectures that they can access outside of class. In doing this, students are actually demonstrating the ability to prioritize and organize their time, two high priority skills for residency training.

Next Steps:

We recognize that this is a complicated issue and many individuals have different ideas about how best to handle the decline in classroom attendance. While plenty of literature shows a link between attendance and performance, there is also plenty of literature that contradicts this. Educators should consider if attendance is truly essential in every situation and take pause before taking offense. Remember that the students who are there have chosen to show up and put other responsibilities aside to engage in your lecture. All too often these students are getting the brunt of your frustration. We encourage you to be present with the students in front of you and know that your efforts are not futile. Even those watching lecture videos outside of class still reap the benefits of your hard work and creativity.

Ultimately, preaching to the choir doesn’t solve the problem of decreased attendance and classroom engagement. Expectations likely need to change. Educators should focus less time dwelling on the empty seats in the room and continue to foster an engaging classroom environment for those who are there.


  1. Irwin N, Burnett KM, McCarron PA. Association between attendance and overall academic performance on a module within a professional pharmacy degree. Curr Pharm Teach Learn. 2018;10(3):396-401.
  2. Accreditation Council for Pharmacy Education. Accreditation Standards and Key Elements for the Professional Program in Pharmacy Leading to the Doctor of Pharmacy Degree. 2016; 5-7.
  3. Zazulia AR, Goldhoff P. Faculty and medical student attitudes about preclinical classroom attendance. Teach Learn Med. 2014;26(4):327-34.
  4. Westrick SC, Helms KL, McDonough SK, Breland ML. Factors influencing pharmacy students’ attendance decisions in large lectures. Am J Pharm Educ. 2009;73(5):83.

Mackenzie Betancur is a fourth-year student pharmacist at the University of Colorado, Skaggs School of Pharmacy and Pharmaceutical Sciences in Aurora, Colorado. Her interests include geriatrics and ambulatory care. In her free time, Mackenzie enjoys spending time with her one-year old labradoodle and gardening.

Kelli Rourke is a fourth-year student pharmacist at the University of Colorado, Skaggs School of Pharmacy and Pharmaceutical Sciences in Aurora, Colorado. Her educational interests are broad, including primary care and internal medicine. In her free time, Kelli enjoys exploring the nearby Rocky Mountains and hosting game nights with family and friends.

Jennifer Trujillo is a Professor in the Department of Clinical Pharmacy at the University of Colorado Skaggs School of Pharmacy and Pharmaceutical Sciences in Aurora, Colorado. Her educational scholarship interests include curricular innovation, instructional design, and teaching and learning assessment. In her free time she enjoys the beautiful hiking and biking trails of Colorado, traveling, and spending time with her family.

Pulses is a scholarly blog supported by Currents in Pharmacy Teaching & Learning

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