Determinants and Strategies for Improving Attendance in Pharmacology: A Mixed-Methods Cross-Sectional Study From a Medical School in Mauritius.

Introduction Absenteeism refers to frequent absence from classes without a valid or justifiable reason. This study aimed to explore medical students' perceptions of the factors associated with absenteeism in pharmacology classes, identify student-perceived strategies to improve attendance, and examine the associations between demographic variables and students' perceptions of absenteeism-related factors at Sir Seewoosagur Ramgoolam Medical College, Belle Rive, Mauritius.  Methods A mixed-method cross-sectional observational study was conducted at Sir Seewoosagur Ramgoolam Medical College, Belle Rive, Mauritius, from October 4 to November 2, 2025. Google Forms (Google Inc., Mountain View, CA, USA) was used to collect the quantitative data. The quantitative data were analyzed using IBM SPSS Statistics for Windows Version 31.0 (IBM Corp., Armonk, NY, USA). The qualitative data were analyzed using NVivo 15 (Windows) software (QSR International, Melbourne, Australia).  Results During the study period, a total of 144 medical students were enrolled in the pharmacology course, of whom 100 respondents participated in the study, yielding a response rate of 69.44%. Among the respondents, 61 (61%) were female, and 39 (39%) were male. A significant association was identified between semester and perceptions regarding long lectures (> 2 hours) as a contributing factor to absenteeism (p = 0.002) and difficulty of attending classes for six consecutive days (p = 0.046) for factors causing absenteeism in pharmacology. For the factors improving attendance, a relationship was observed between gender and the link to the clinical practice (p = 0.02), with a greater proportion of male students (23, 59.0%) strongly agreeing with this approach compared to female students (26, 42.6%). From the thematic analysis, five themes emerged from the generated codes, which were attendance patterns, academic and teaching influence, social and peer influence, institutional and policy factors, and structural and environmental barriers. Conclusion Absenteeism in pharmacology remains a significant and multifactorial issue. This study identifies several contributory factors underlying absenteeism, including long lectures (>1 hour), a preference for self-study, difficulty waking up, six consecutive classes per week, and burnout, which were perceived by students as influencing attendance. The factors that may improve attendance were flexible class schedules, incorporating mixed teaching techniques, providing study breaks before examinations, reducing the duration of lectures, and delaying early morning classes (8.00 am). In addition, making lectures more interactive and linking content to clinical practice are essential and were perceived by students to improve attendance.