School absenteeism remains a longstanding issue; however, its significant surge, particularly in districts serving lower socioeconomic populations, became increasingly evident as the world emerged from the COVID-19 pandemic. Chronic absenteeism—defined as students missing at least 10% of the academic year—is systematically tracked and reported in public schools from pre-kindergarten through 12th grade. In 2023, according to Malkus, approximately 26% of students were classified as chronically absent.

Although we lack comparable data on absenteeism in higher education, anecdotal evidence from nursing faculty suggests a growing trend of student absenteeism across lectures, simulations, clinical rotations, and extracurricular activities. Current literature on absenteeism in nursing education primarily focuses on attendance policies for clinical practicum, with limited attention to absences from lectures. Attendance patterns also appear to vary, with absenteeism being more prevalent in nonclinical courses, such as nursing research and professional nursing, compared to clinical subjects, like medical-surgical nursing. No data exist correlating absenteeism with attrition from nursing school.

Nursing schools must educate students who experienced pandemic-related learning loss in high school, particularly in foundational areas such as math and reading. Given the reading-intensive nature of nursing curricula and the fundamental competency of medication calculation, persistent absenteeism amplifies this cohort of students’ challenges to redress pre-existing gaps in knowledge, social skills, and study ethic.

The pandemic, lack of academic stamina, advances in remote learning technology, the rise of large language model platforms, higher prevalence of mental health challenges, and shifting societal perspectives on in-person education influence the value of what it means to show up in class and be truly present. The ongoing trend of grade inflation can negatively impact class attendance by reducing students’ perceived need to engage in coursework. When students can obtain higher grades with minimal effort, they may feel less compelled to attend lectures, participate in discussions, or complete assignments.

More than just a seat in the classroom

Although students may review lecture slides or watch recorded simulations and presentations, these passive activities fail to replicate the engagement, critical thinking, and hands-on practice that occurs in real time. Absenteeism also raises concerns about professionalism and work ethic. In clinical practice, showing up is a basic expectation, and the habits students form during their education frequently translate into their professional behaviors. Chronic absenteeism may reflect deeper challenges, such as financial hardship, childcare obligations, burnout, anxiety, or lack of motivation—issues that require intervention from nursing educators and institutions of learning.

As both learning and learning deficits are cumulative, significant absences place students in a Sisyphean cycle of perpetual catching up, hindering their academic progression and overall competency. Failing to attend class without a valid excuse can be viewed as a form of self-sabotage, as it deprives students of valuable learning opportunities, peer interactions, and faculty engagement, which are essential for academic success.

Beyond missing critical content, habitual absenteeism hinders the development of discipline, accountability, and the ability to synthesize complex concepts—skills essential to both academic and professional growth. There is no doubt that chronic absenteeism exacerbates a new graduate nurse’s lack of readiness for practice, making absenteeism not just an academic but also a patient safety issue.

Reviving classroom engagement

To address this issue, we propose that nursing educators must critically examine their own teaching practices and expectations to understand why students disengage. Traditional lecture-heavy courses may not inspire attendance if students believe they can pass by simply reading the material or watching a recording of the lecture. Simulations, frequently designed to mimic high-pressure clinical scenarios, may increase anxiety, leading some students to avoid participation altogether.

If students aren’t adequately prepared or supported in their program, lectures and clinical experiences can feel less like valuable learning opportunities and more like overwhelming obstacles. Without the necessary foundation and guidance, students may perceive attendance in lectures as a burden, a source of anxiety, or even a roadblock to their academic success, especially when they’re balancing demanding coursework and non-academic obligations.

Educators must recognize the importance of fostering an inclusive and engaging classroom culture—one where students feel valued, challenged, and personally connected to their instructors. Given post-pandemic trends, student mental health has emerged as a significant factor influencing absenteeism. The rise in anxiety, depression, and stress-related disorders means that punitive attendance policies alone are unlikely to prove effective. Instead, educators should focus on building relationships with their students, demonstrating empathy, and designing learning experiences that spark curiosity rather than ennui.

An intellectually stimulating, welcoming, and fun classroom can make all the difference in attendance and engagement. Learning thrives in an environment where students trust their educators and genuinely want to learn from them. When faculty cultivate a sense of community in the classroom, students will more likely feel invested in their education. This requires going beyond rigid course structures and embracing a more engaging approach—one that integrates meaningful collaboration, interactive discussions, and real-world problem-solving.

Simple yet intentional strategies—such as knowing students by name, incorporating humor, sharing real-world nursing stories, and inviting collegial conversations—can transform a passive classroom into a thriving learning space. When students feel a personal connection to their instructors, they’ll more likely seek guidance, push through challenges, and take ownership of their education. By prioritizing both rigorous learning and human connection, faculty can create an environment where students not only show up but are fully present and engaged in their journey to becoming competent and compassionate healthcare professionals.

A deeper understanding of how students learn also can support engagement. Not all students thrive under the same instructional methods. Diverse teaching strategies—such as flipped classroom, gamification, evidence-based classroom assessment techniques, and case-based discussions—can create an intellectually stimulating environment that meets a range of learning needs. In addition, AI-powered chatbots and virtual simulations can enhance classroom engagement by providing instant feedback, answering student questions, and facilitating case-based learning.

When students find the classroom experience engaging and relevant, it reinforces the idea that learning is a shared experience that can’t be replicated through independent study alone. These efforts also should align with competency-based education (CBE), which prioritizes skill mastery rather than simply logging hours. However, CBE doesn’t eliminate the need for presence; rather, it stresses the importance of hands-on learning and active participation. Students can develop competencies in isolation; they must engage in real-time learning experiences in the classroom to fully prepare for their roles as future nurses.

Reimagine teaching

Ultimately, addressing absenteeism in nursing education requires a multifaceted approach that goes beyond enforcing attendance policies. Educators must curate learning environments that yield higher return on time investment and create spaces where students feel supported, challenged, and motivated to show up not out of obligation, but because they see the value in their participation.

By reimagining traditional teaching methods, fostering personal connections, and integrating thoughtful competency-based education, faculty can cultivate a culture where presence is recognized as essential to professional growth. Nursing is a profession built on teamwork, communication, and hands-on practice; ensuring that students develop these skills through active participation in their education isn’t just beneficial—it’s imperative. If we want to graduate competent, confident nurses, we must first ensure that they’re present, both physically and mentally, in the learning process.

Anthony Carney DNP, APRN, FNP-C and Fidelindo Lim DNP, CCRN, FAAN are Clinical Associate Professors at New York University Rory Meyers College of Nursing.

References

Dee TS. Higher chronic absenteeism threatens academic recovery from the COVID-19 pandemic. Proc Natl Acad Sci. 2024;121(3):e2312249121. doi:10.1073/pnas.2312249121

Lewis LS, Rebeschi LM, Hunt E. Nursing education practice update 2022: Competency-based education in nursing. SAGE Open Nurs. 2022;8:23779608221140774. doi:10.1177/23779608221140774

Malkus N. Long COVID for public schools: Chronic absenteeism before and after the pandemic. American Enterprise Institute. January 31, 2024. aei.org/research-products/report/long-covid-for-public-schools-chronic-absenteeism-before-and-after-the-pandemic/