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Journal of Quality in Health Care & Economics Research Article 15 min read

The Effect of Classroom Attendance on Academic Achievement of Management and Leadership Discipline of Nursing Students at Instituto Superior Cristal and Universidade de Dili, Timor-Leste, 2024: A Case Study

Domingos Soares
ISSN: 2642-6250  10.23880/jqhe-16000438  Received: May 16, 2025  Published: June 06, 2025
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Keywords
Effect Classroom-Attendance Academic-Achievement Management-Leadership Nursing Students
Abstract

Background: The participation of students in the classroom during the learning process is an important point that needs to be given attention in nursing education. The previous study indicated that was significant relationship between level ofeducation and academicals achievement is (P,0,05) it is very relevance with the current situation around the world (Fard et al., 2023). Many universities in Timor-Leste are always persuaded by student’s presence in the classroom during the learning process, because the indication of how many students leave the classroom unjustified. Aims was to understand the effect of the classroom attendance to the course achievement index.Material and Method: This case study was conducted on Nursing Students n=230 was registered as an active student in the nursing department at Instituto Superior Cristal (ISC) and Universidade de Dili (UNDIL) Timor-Leste. Who have attendedmanagement and leadership course as 16 sessions during from August 2023 to January 2024. The purposive sample was used in the study. Data was conducted use the following component: 1) Present list, quiz report, 3) Individual work report, 4) Midtest report, 5) Final test report, 6) Group work report, 8) Course Achievement index report (Management and leadership). The data was analysis used the SPSS 23.0.Result: All the nursing students n=230 was become the object of this case study. Was participated by man 64 (27.8%) andfemale 166 (72.2%). Who have complete classroom attendance about 19 (8.3%) only and never come to attendance the classabout 2 (9%). The academic achievement of management and leadership discipline are get academic achievement: goodcategory (B) as 57 (24,8%), sufficient category (C) as 118 (51,3), mediocre category (D) as 32 (13.9%) and insufficient categoryas 23 (10.0%). The use of the regression between the final value and the presence in the classroom and sex is significantly

Abbreviations

ISC: Instituto Superior Cristal; CRA: Classroom Attendance.

Introduction

Management and leadership nursing are considered an essential area by each organization around the world to be improving right now for the own staff. New staff of manager or leaders hoped have ability to manage and lead their work in an organization specially in the healthcare services [1]. Nurse leaders and management action as a principal’s guides for healthcare professional terms, guarantying the quality patient care on each health facilities [2]. The participation of students in the classroom during the learning process is an important point that needs to be given attention in nursing education [3].

The behaviouristic theory in the learning process also contribute more benefit to the academicals achievement of the students. Behavioristic theory provide motivation to the all student to change their knowledge and attitude according classroom attendance actively in the all session. This theory also uses reinforcement approach such as provide the reward or punishment to the students based on their respectfully to the school rules. It is will be improve their frequency in classroom attendance [4]. John Watson concern in the learning attitude improvement and apply in the more various education models in each education institution. Students needs respect to the school role which was introduce to following by all students. It is will be gives benefit for increasing the ability of the students in anywhere and anytime to learn more about management and leadership theory [5].

Gender issues also provide various significant of the learning result by the students at many university and educational institution. Otherwise, a study was conducted at Ghana reported that cumulative record for students’ academic performance man higher compare with female such 29.55% versus 18.97% [6].

The previous study indicated that was declared that significant relationship between level of education and academicals achievement is (P,0,05) it is very relevance with the current situation around the world [7]. Many universities in Timor-Leste are always persuaded by student’s presence in the classroom during the learning process, because the indication of how many students leave the classroom unjustified. Of course, most of university have trying to create a quality of nursing education in the country. In terms of management discipline many universities need to strengthening nursing students is ability or skills on leadership such as delegation, communication, conflict resolution, critical thinking, decision-making, team building, motivation, mentorship, advocacy, time management, interpersonal skills. On the management aspect focused in human resource and facilities allocation, prioritization, task management, budgeting scheduling, quality improvement, delegation, risk management and other relevance aspect [2]. Nurse leaders and manager from both nursing education and healthcare practice is essential to strength the management of risk and will providing a good competence to safe and improve nursing care in the field [8]. Based on the argument was mentioned above it is also need to encourage students to pay attention seriously on the manage their time to participate actively in the class room or practical session. Time management also considered the important skills of the students to organize their learning process at the school [9].

Based on above condition our study to find out the information related with the students is commitment and strong participation in the learning process during a semester to know what progress of we found. Base on this point, we hope that will be take contribution in the increasing or improving the quality of nursing education in Timor-Leste.

Using behavioristic theory effectively in nursing education process in Timor-Leste condition, it will be contributing to setup a qualified national standard education system in nursing education specifically and other education programs. So that, this study was Aimed to identified and understand the effect of the classroom attendance to the course achievement index or academically performance of the students.

Method

Design

This study was used case study method on 2023. Case study is a methodological in the research approach, it uses to take attention to generating an in-depth understanding, of the contemporary issue and also on phenomenon in the any system evidence providing [10]. Subject was involved nurse’s students who has in semester six at ISC and UNDIL Timor-Leste. The relevance variables were considered such as classroom attendance and the academic achievement for Management and Leadership discipline in a semester.

Instrument

The data collection instrument in the he study was used the report value discipline Management and Leadership in Nursing, University of Dili on 2023. It is being related the relevance information such as 1) Present list, quiz report, 3) Individual work report, 4) Mid-test report, 5) Final test report, 6) Group work report, 8) Course Achievement index report.

Data Analysis

This case study was conducted on Nursing Students n=230 was registered as an active student in the nursing department at Instituto Superior Cristal (ISC) or Higher Institute of Cristal and University of Dili or Universidade de Dili (UNDIL) Timor-Leste. Who have attended management and leadership course as 16 sessions during from August 2023 to January 2024. The purposive sampling was used in the study. Data was conducted use following component: 1) Present list, quiz report, 3) Individual work report, 4) Mid-test report, 5) Final test report, 6) Group work report, 8) Course Achievement index report (Management and leadership). The data was analysis used the SPSS 23.0 with descriptive and inferential analysis methods.

Ethical Approach

During conducting this study, the team was receipt an invitation letter from university to the lecturer (Principal Investigator) to taking responsibility or lead management and leadership discipline to teaching nursing students in two universities. Model of the evaluation and examination will be depending on the lecturer is method including writing final report and publication. Other side we were inform to all the participants (students) as targeted the objective of the study. All the students agree to participate in the study to agree their examination values can be continuing on the article writing process and including publication on the any journal.

Result

General Information

Instituto Superior Cristal (ISC) is a private university was funded in the beginning Timor-Leste Independent restoration time. ISC located at Balide, Dili, Timor-Leste (Timor-Leste Country City). Have conducting health education program (nursing and midwifery) and education focused on teacher producing. The university was having a lot of the experiences organizing education program until now. The founder all is Timores peoples, which have committeemen to contribute in the country human resource development since beginning process until now. Now is led by a Rector with 3 vice Rector and 2 deans (health and education program). Teacher majority is Timores peoples who have graduated in health sector in the country or outside the country. Universidade de Dili (UNDIL) is a private University located in center of Dili city and funded since beginning of independent of Republic Democratic of Timor-Leste. were organized many education program in health sector (nursing, public health and technic of dentist) and other program. Nursing education program on bachelor degree program. The most of the teacher are Timores peoples by bachelor until doctor degree.

Descriptive Analysis

Demography: Instituto Superior Cristal (ISC) or Higher Institute of Cristal a private university located at the Balide, Dili was found in the beginning Timor-Leste restoration moment. This university who have conducting two faculties in health sector and education sector. In the health area was provided specific education in the nurses and midwifery programs since 2010. Other university is name Universidade de Dili (UNDIL) is a private university who have founded since beginning after Timor-Leste independent restoration time. This university also organize many education program and specific in Nursing public health and dentist program.

In Nursing program specification this two universities were have commitment to how manage and improve the nursing program start in the bachelor degree program until strata degree program. Current case study was make analysis in term of the achievement of the students on the final examination of the management and leadership discipline. Focus analysis related with the two core component such as academicals achievement and attendance frequency of the students in the class room learning process during a semester.

VariablesSub-groupf%
GenderMaleISC3515
UNDIL2913
FemaleISC8939
UNDIL7733
Total230100
ProfessionNursing students230100
Education levelBachelor degree programs230100

Table 1: Character of participants (n=230).

Participants included in the study was 15% male from ISC and 13% male from UNDIL, 39% female from ISC and 33% female from UNDIL, two universities in the Bachelor degree program education on semester six each university (Table 1).

Classroom attendance (CRA)f%Mean
0 CRA20.914
2 CRA10.4
4 CRA10.4
5 CRA10.4
6 CRA52.2
7 CRA73
8 CRA73
9 CRA135.7
10 CRA229.6
11 CRA229.6
12 CRA2812
13 CRA3515
14 CRA3214
15 CRA3515
16 CRA198.3
Total230100

Table 2: Classroom attendance report (n=230).

Based Table 2 mentioned above that 8% only was full attended activity classroom learning. With mean 14 only.

Who is attended until 13 and 15 are 15.2% and rest is lower by this achievement.

Classroom
attendance
UniversityGenderAcademic Performance Achievement
Insufficient
(E): < 45
points
Mediocre
(D): 45-59
points
Sufficient
(C): 60-74
points
Good (B):
75-84
points
Excellent
(A): 85-
100 points
Total
n%n%n%n%n%n%
0 to 5ISCMale521020.910.40093.9
Female312141.720.900114.8
UNDILMale211020.920.90073
Female422131.331.310135.7
6 to 10ISCMale101010.441.70073
Female212141.741.700125.2
UNDILMale1010104.331.310167
Female1010231052.2103114
11 to 14ISCMale210083.593.921219.1
Female1000502293.9426428
UNDILMale000020.931.31062.6
Female101093.9125.21043314
Total
Male
Female
n /%2310125118515725209230100
115422511229.6426629
125849340351516716471

Table 3: Detailed Academic Performance Report.

Based on the above Table 3 indicated that 27,8% female students from ISC who have complete present classroom attendance gate excellent academicals performance in the management and leadership discipline. Majority 51.3% even male and female they gate sufficient academic performance achievement. In terms of the gender issues, female achieve 7.0% compare with male 1.7% they got excellent academic performance. About 10% students gate academic performance Insufficient (E) or < 45 points where majority by students was attendance classroom between 0 to 5 times during hold total targeted based on the curriculum.

Academic Achievement CategoryMaleFemaleTotal
n%n%n%
Insufficient (E): < 45124.8125.32310
Mediocre (D): 45-5941.783.5125
Sufficient (C): 60-74 points2511934011851
Good (B): 75-84 points229.635155725
Excellent (A): 85-100 points41.7167209
Total672916471230100

Table 4: General Academic Performance report (n=230).

Academicals performance progress on Management and leadership discipline examination achievement by Nursing students at ISC and UNDIL based on the above table indicated as below: insufficient about 10%, sufficient 51%, good 25%, and excellent 9% only (Table 4).

Model Sum of Squares df Mean Square F Sig. 1 Regression 53.444 2 26.722 48.28 .000b Residual 125.638 227 0.553 Total 179.083 229 a. Dependent variable: Academic Achievement b. Predictors: (Constant), Classroom attendance and Sex 2 Regression 65.924 1 65.924 7.885 .005b Residual 1906.341 228 8.361 Total 1972.265 229

Inferential Analysis

Compare academic achievement, classroom attendance and sex of the participants such as below detail context.

Use the Regression Analysis on ANOVA Test.

  • a. Dependent variable: Classroom attendance
  • b. Predictors: (Constant), sex

Table 5: Compare Academic achievement with classroom attendance and sex with ANOVA Test (n=230).

Based on the above Table 5 showed that the variable classroom attendance and sex was related significant with Academic achievement at semester six in two universities in Timor-Leste. There is very relevance or impacted between active attendance of students in the classroom activities with

Coefficients Test

the academic achievement. Its show in the significant value as 0.00 < p value 0,05, it is mean that have positive correlation between independent variable (Academic Achievement) with dependent variable (Classroom attendance).

Coefficientsa
ModelUnstandardized CoefficientsStandardized CoefficientstSig.
BStd. ErrorBeta
1(Constant)-0.180.26-0.70.48
Sex0.0690.1110.0350.6220.54
Present in the classroom0.1620.0170.5399.5280
a. Dependent Variable: Value of Final test discipline

Table 6: : Compare Classroom attendance and sex with the Academic Achievement (n=230).

The students who have actively present in the classroom have positive impact with the academicals achievement it with sig. value 0,00 < P 0,05, it is mean significant correlation on this study (Table 6).

Coefficientsa
ModelUnstandardized CoefficientsStandardized CoefficientstSig.
BStd. ErrorBeta
1(Constant)10.090.75713.330
Sexu1.1950.4250.1832.8080.01
a. Dependent Variable: Present in classroom

Table 7: Compare sex with classroom attendance (n=230).

The use of the regression between the final value and the presence in the classroom and sex is significantly shown by the significant value of ANOVA as 0,000, Coefficients value as 0,005. Relationship between sex a presence of ANOVA as 0,005 and Coefficients value as 0,005 (Table 7).

Discussion

Character of Participants

The study was participated by Nursing students from ISC and UNDIL on six semesters on 2024, majority are female compared then male. The result corresponding last result study were reported that 25% men only in nursing education in Italia compare with the female are lest then this number [11]. The enrolment number of nursing students at United State (US) about indicated that 14% were male and 14,4% were female [12]. In reality showed in the classroom female more than male students in Timor-Leste, including ISC and UNDIL until now. Female more interesting to choose nursing education based on their consent compare with male. Estimated that female students will be dominated in the graduated candidate in two universities in Timor-Leste. This is current situation done in the country and it is real phenomenological right now.

Classroom Attendance

Current study was identified that 8,3% only students at two universities was attended 16-time classroom learning or 100% present at the classroom learning with teacher during semester six in 2024. This result According with last study were mentioned that increased participation the students in classroom learning it was associated with an increasing proportion of more students passing the exam and also this manner was make chance that passing the exam increased by 13% for every additional learning activities was attended by students [3].

Other research showed that the effectiveness of human patient simulator during learning activities towards the improvement of knowledge, motivation and clinical competence of nursing students in quality guarantying [13]. The nurses who have become a managers or leaders in executive positions should have a strong basis, mean that that during in study period must be learning deeply to achieve this point [14]. However, the classroom attendance is determinant factor for academic achievement of the nursing students. Because this point will provide the basis of the management and leadership competencies for leader or manager in the future. Who have actively taken part or presenting in the classroom during learning process on management and leadership discipline it will be determine score of the final exam in the semester. So, hope that leaders or managers of the two university need to pay attention for the classroom attendance of student in the future. Because it will find more benefit for the students in the future.

Academic Achievement

Result of this study was showed that, majority of nursing students gated sufficient category their point on the final exam of management and leadership discipline in semester six at ISC and UNDIL. This result accordance with the Academic performance of nursing students at Aswan University was influenced by many factors, one is related with the classroom discomfort, socioeconomic status, parental education and student’s factors [15].

The highest achievement of any exam in the health sector learning process especially in the area of nursing is always strongly linked to active presence during the learning process in the classroom. During classroom activities, students usually have the opportunity to focus on listening and seeking to understand the explanations given by the lectures in the classroom. If some of the opportunities are completed by conversing with the lecturer by asking and responding, students will understand more about the subject they are receiving than those who are not attending the classroom actively.

Conclusion

All nursing students n=230, only a small amount of classroom attendance up to 100%. The students’ classroom attendance has a significant impact on the academic achievement of the management and leadership discipline. Sex factors have a significant impact on student’s attendance in the classroom. In this study was participated majority are female compared with male. In reality showed in the classroom female more than male students in Timor-Leste, including ISC and UNDIL until now. Female more interesting to choose continuous their study in the nursing education. Female students will be dominated in the graduated candidate in two universities in the future Timor-Leste, this is such real phenomenological.

Result of this study indicated that must lower of the behavioural of the students to take part actively or full present (100% present) in the class from two universities only 8,3% achievement. It is very important issues and need intensive pay attention from the university in the future. However, the classroom attendance is determinant factor for academic achievement of the nursing students, this situation still tries to develop in these two universities. Majority of students form this university was positioned on the sufficient category. It is mean that currently already in the central position and hope that will be push up the learning process in the future to apply for the management and leadership in the future. Because this point will provide the basis of the management and leadership competencies for leader or manager in the future.

The result also was detected that have positive correlation between independent variable (Academic Achievement) with dependent variable (Classroom attendance). So, went the student stimulated by teacher to change their behavioral skills to actively take part in the teaching and learning process in the classroom. It will be strengthening their ability to learn more and then will provide positive impact in the academicals performance achievement in the management and leadership science in the future. Of course, leaders or managers of the two university need to maximal pay attention for the classroom attendance of student in the future. Because, according of these ways, it will be achieving the common goal of the university.

Acknowledgment

We are to thank you very much for the all parties were give important feedback for researcher during the process.

Conflict of Interest: In this study no any conflict during the process until this manuscript writing.

Funding: No any funding was accessed.

Reference

1. Hem ZET, Hem A (2017) Management and Leadership in Nursing 6(1): 140-147.

2. Abdul-rahim HZ, Sharbini SH, Ali M, Hashim SH, Abdul- Mumin KH (2025) Leadership and management skills for student nurses: a scoping review. BMC Nursing 24: 111.

3. Rejnö Å, Nordin P, Forsgren S, Sundell Y, Rudolfsson G (2017) Nursing students’ attendance at learning activities in relation to attainment and passing courses: A prospective quantitative study. Nurse Education Today 50: 36-41.

4. Nur S, Mohamed A, Nordin MN, Ehsan SD (2025) BF skinner’s learning theory and teaching strategies. Prademic Press 3(1): 1-14.

5. Rosnawati R, Wahab G (2021) Theories of Learning and Teaching. Repository pp: 1-82.

6. Wrigley C, Charles A, Ackah G, Kusi L (2023) Gender differences in academic performance of students studying Science Technology Engineering and Mathematics (STEM) subjects at the University of Ghana. SN Social Sciences 3(1): 1-22.

7. Fard SB, Vahedian-shahroodi, M, Abbasi MA (2023) The Effect of Class Attendance on Students’ Academic Achievement, Professors’ Motivation, and Student Professionalism: Perspective of Medical Sciences Students. Medical Education Bulletin 4(11): 659-670.

8. Vaismoradi M, Griffiths P, Turunen H, Jordan S (2016) Transformational leadership in nursing and medication safety education: a discussion paper. Journal of Nursing Management 24(7): 970-980.

9. Nayak SG (2018) Special Article Time Management in Nursing-Hour of need. International Journal of Caring Sciences 11(3): 1997.

10. Coombs H (2023) Case Study Research Defined. Southern

Utah University pp:1-3.

11. Moore MF, Xie Y, Davis ASP (2020) Shortage of male nursing students: The experience of a growing nursing program. MRE Press 16(2): 9-17.

12. Practices ME, Experiences S (2019) Men in Nursing

Education.

13. Rumahorbo H, Sofyana H, Ali KM (2018) The Effectiveness

of Human Patient Simulator on Knowledge, Motivation, and Clinical Competence of the Student’s Nursing about Diabetic Ketoacidosis Management. Open Journal of Nursing 8(8): 567-579.

14. Kara B, Senturk S (2019) Leading Nursing for Students

who Want to Become a Manager Nurse. A Qualitative Approach 12(3): 1638-1645.

15. Article O, Mahmoud SA (2025) Factors Affecting

Academic Performance among Nursing Students at Aswan University. International Egyptian Journal of Nursing Sciences and Research 6(1).

References

  1. Hem ZET, Hem A (2017) Management and Leadership in Nursing 6(1): 140-147.
  2. Abdul-rahim HZ, Sharbini SH, Ali M, Hashim SH, Abdul- Mumin KH (2025) Leadership and management skills for student nurses: a scoping review. BMC Nursing 24: 111.
  3. Rejnö Å, Nordin P, Forsgren S, Sundell Y, Rudolfsson G (2017) Nursing students’ attendance at learning activities in relation to attainment and passing courses: A prospective quantitative study. Nurse Education Today 50: 36-41.
  4. Nur S, Mohamed A, Nordin MN, Ehsan SD (2025) BF skinner’s learning theory and teaching strategies. Prademic Press 3(1): 1-14.
  5. Rosnawati R, Wahab G (2021) Theories of Learning and Teaching. Repository pp: 1-82.
  6. Wrigley C, Charles A, Ackah G, Kusi L (2023) Gender differences in academic performance of students studying Science Technology Engineering and Mathematics (STEM) subjects at the University of Ghana. SN Social Sciences 3(1): 1-22.
  7. Fard SB, Vahedian-shahroodi, M, Abbasi MA (2023) The Effect of Class Attendance on Students’ Academic Achievement, Professors’ Motivation, and Student Professionalism: Perspective of Medical Sciences Students. Medical Education Bulletin 4(11): 659-670.
  8. Vaismoradi M, Griffiths P, Turunen H, Jordan S (2016) Transformational leadership in nursing and medication safety education: a discussion paper. Journal of Nursing Management 24(7): 970-980.
  9. Nayak SG (2018) Special Article Time Management in Nursing-Hour of need. International Journal of Caring Sciences 11(3): 1997.
  10. Coombs H (2023) Case Study Research Defined. Southern Utah University pp:1-3.
  11. Moore MF, Xie Y, Davis ASP (2020) Shortage of male nursing students: The experience of a growing nursing program. MRE Press 16(2): 9-17.
  12. Practices ME, Experiences S (2019) Men in Nursing Education.
  13. Rumahorbo H, Sofyana H, Ali KM (2018) The Effectiveness of Human Patient Simulator on Knowledge, Motivation, and Clinical Competence of the Student’s Nursing about Diabetic Ketoacidosis Management. Open Journal of Nursing 8(8): 567-579.
  14. Kara B, Senturk S (2019) Leading Nursing for Students who Want to Become a Manager Nurse. A Qualitative Approach 12(3): 1638-1645.
  15. Article O, Mahmoud SA (2025) Factors Affecting Academic Performance among Nursing Students at Aswan University. International Egyptian Journal of Nursing Sciences and Research 6(1).

Cite this article

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@article{domingos2025,
  title   = {The Effect of Classroom Attendance on Academic Achievement of Management and Leadership Discipline of Nursing Students at Instituto Superior Cristal and Universidade de Dili, Timor-Leste, 2024: A Case Study},
  author  = {Domingos Soares},
  journal = {Journal of Quality in Health Care & Economics},
  year    = {2025},
  volume  = {8},
  number  = {3},
  doi     = {10.23880/jqhe-16000438}
}
Domingos Soares (2025). The Effect of Classroom Attendance on Academic Achievement of Management and Leadership Discipline of Nursing Students at Instituto Superior Cristal and Universidade de Dili, Timor-Leste, 2024: A Case Study. Journal of Quality in Health Care & Economics, 8(3). https://doi.org/10.23880/jqhe-16000438
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TI  - The Effect of Classroom Attendance on Academic Achievement of Management and Leadership Discipline of Nursing Students at Instituto Superior Cristal and Universidade de Dili, Timor-Leste, 2024: A Case Study
AU  - Domingos Soares
JO  - Journal of Quality in Health Care & Economics
PY  - 2025
VL  - 8
IS  - 3
DO  - 10.23880/jqhe-16000438
ER  -