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INTRODUCTION
The self-assessment process conducted as part of the certification of the Dental Undergraduate Program at Universidad de Antioquia in 2001(1) showed some lack of knowledge of the factors leading to academic dropout in this school, and led to suggest strategies for improvement, such as studies aimed at determining the causes for dropout, in order to implement adequate solutions. In 2007, an article was published(2) identifying the external causal factors, such as economic factors, work-related factors, academic load, inadequate methodologies, and sexual harassment. The results of the present study seek to provide additional information to the administrative bodies of the University and the School, to establish strategies aimed at reducing the increasing levels of academic dropout in recent years, according to the reports by MARES. (Consulta realizada a MARES, Sistema interno de la Universidad de Antioquoia)
The examination of academic dropout at the School of Dentistry required a series of fundamental concepts to understand and analyze the diverse topics addressed in this study.
In this study, academic dropout is described as the permanent abandonment of classrooms for different reasons, and reentry refers to the abandonment of studies for a certain period, to enroll again in the same academic program once the obstacles that forced the dropout are overcome.(2) The evolution towards dropping out is an entire process, that sometimes grows slowly inside the individuals, who finally express their decision for better or worse of themselves and their environment.(3) This process starts with the entrance exam with early admission cancel, or by passing the exam but not enrolling, followed by early drop-out in the first four semesters, and late dropout in the following terms, especially the fifth and sixth semesters.(4)
Delving into the study of academic dropout requires accuracy, sensitivity, and the ability to detect the emotional dynamics within individuals.(5) Dropping out is a problem commonly discussed, but little is known about its true roots, which are multiple in nature.
Academic dropout is usually preceded by constant repetition of courses, which usually leads to the abandonment of studies.(6,7)
As the University of Talca points out(8)
Repetition is the act of repeatedly take a teaching activity due to poor student performance or for reasons unrelated to academic work. Repetition in higher education can occur in various ways according to the curricular regime. It can refer to all the academic activities of a certain period (year, semester, or quarter), or to each academic subject in the case of a flexible curriculum. The latter is the most frequent in universities of the region. In both cases, repetition results in academic delay, or the extension of studies above the formally established regulations for each academic program.
As students fail or cancel courses or lectures in more than one occasion, they gain a “working capital” which they overcome in some cases, enabling them to face the initial barriers of the first courses and, with effort and persistence, they can compensate the deficiencies in training and instruction from secondary education. Tinto(9) points out that students enter higher education with different patterns and characteristics related to their initial willingness to learn, their intentions during their permanence in the institution, and their goals and personal commitment. But as they advance in their studies, they continuously modify and reformulate these features throughout the academic process by means of the interactions they establish with the academic structure and its members, and by the social system the institution promotes. Prior to the integration of students to the university, Tinto identifies family history, the students’ skills and capabilities, and their interest in learning. Secondly, the author identifies the goals and institutional commitment. Third, the institutional experiences, which are divided into two aspects: the academic system, involving the formal dimension, referred to results and achievements, and the informal dimension, regarding the interactions with professors; the second aspect is linked to the social system, including formal extracurricular activities and, at the informal level, the interactions with peers. The fourth level involves personal integration and the assimilation of policies, as well as academic and social integration. This aspect is followed by a second stage of definition of goals and commitments as well as the external commitments, leading to the final decision to leave.(9)
According to Díaz-Peralta,(10) the variables most frequently found in the literature are grouped into four categories: individual (age, sex, family, and social integration), academic (vocational guidance, intellectual development, academic performance, study methods, admission processes, degrees of satisfaction with the career, and academic load), institutional (academic regulations, financing, university resources, quality of the academic program, and relationships with professors and peers), and socio-economic (socioeconomic level, employment status of students, employment status of parents, and educational level of parents).
Educational institutions, especially higher education centers, are responsible for establishing academic and administrative mechanisms for students to adjust to college life allowing them to overcome the difficulties of the academic programs and to successfully complete the course of studies they have pinned their hopes on.(4)
MATERIALS AND METHODS
This was an educational retrospective descriptive study(11) using quantitative analysis as well as qualitative analysis for some items. The goal was to determine academic dropout at the Universidad de Antioquia School of Dentistry. The study population included 156 students who canceled the academic semester in the undergraduate dental program during the period under study; 64 participants were dropouts and 92 reentered the dental program between the first semester of 2004 and the first semester of 2014 (information taken from semester reports of the Registrar’s Office as secondary sources). Out of the 64 dropouts, only 16 could be contacted (25%), and out of the 92 reentry students, only 18 could be contacted (20%) as primary sources. Information was sent via email, telephone, or personal communication, but the response rate was small.
The low representativeness of this sample due to its small size compared to the population under evaluation requires cautiousness in analyzing the obtained findings. Although research in social sciences allows for a sample equivalent to 22% of the population size,(13) this is true for the number of necessary subjects in studies using quantitative tools and qualitative analysis, as is the case in the present study.
The sampling was intentional and with voluntary participation, trying to reach the highest possible number of dropouts and reentry students, who were requested voluntary participation once contacted. Those who agreed to participate responded to a semi-structured survey.
The sample was divided into two groups: the first group included 16 students who left the program definitely and decided to participate once contacted. These were called dropout students. The second group was formed by 18 students who had abandoned their studies in the same period and reentered the dental program because they decided this was the career they wanted to pursue. They quit temporarily due to diverse situations and returned once the problem was solved; these were called reentry students.
Using the categories detailed by Díaz-Peralta as a reference,(10) some individual and socio-economic variables were selected to compose the questions, and two separate surveys were conducted, one for each group of students. A pilot test was conducted to validate the surveys and the information in them was verified in order to establish the causes for undergraduate students dropping out and to learn about their socio-demographic characteristics.
The data were processed using version 23 of IBM- SPSS. A database was created for the quantitative analysis of the information gathered. Descriptive analysis of the studied variables was also conducted. Qualitative methods were used to analyze the categories found in unstructured or semistructured questions which are shown in table 2. These analyses seek to determine the causes of student dropout.
Table 1 Socio-demographic characteristics of dropouts and reentry students at the Universidad de Antioquia School of Dentistry, 2004-2014
| Students | Sex | Marital status | School where they graduated | Have a job | |||||||
|---|---|---|---|---|---|---|---|---|---|---|---|
| Classification | F | M | Married | Separated | Cohabiting | Single | Widow/er | Public | Private | Yes | No |
| Dropouts | 10 | 6 | 3 | 3 | 7 | 1 | 2 | 10 | 6 | 1 | 10 |
| Reentry | 6 | 12 | 0 | 1 | 15 | 0 | 2 | 12 | 6 | 5 | 13 |
*Absolute numbers
Table 2 Dropouts’ motivations to cancel semesters
| Dropouts’ motivations to cancel semesters | Students | |
| No. | Percentage | |
| Academic difficulties | 6 | 37.5 |
| Program change | 5 | 31.3 |
| Economic or work-related reasons | 3 | 18.8 |
| Relocation to another city | 1 | 6.3 |
| Does not respond | 1 | 6.3 |
The ethical aspects were present throughout the investigative process, understanding them as permanent reflection and respect towards participants, all of whom signed an informed consent. The researchers highlight in special the aspects included in the ethical guidelines for research in health (Resolution 8430 of October 1993), as this is a research project with no risk for the participants, paying special attention to respect for dignity, the protection of participants’ rights, the pursuit of their well-being, and their consent as a starting point for inclusion. The research protocol used for this study was approved by the Committee on Bioethics in Research of the Universidad de Antioquia School of Dentistry (Affidavit 4 of 2014).
RESULTS
In conducting the investigative surveys, two basic categories were established: dropouts and reentry students.
Dropouts
Out of the 16 dropouts who answered the survey, 6 were men (37.5%) and 10 women (62.5%) with ages ranging from 19 to 42 years and an average of 29.4 ± 6.7 years. Three were married, seven were unmarried, three were cohabitating, two were separated, and one was a widow. Most dropouts belonged to socioeconomic stratum 3 and were living in Medellin. Most households had 2 to 5 people, and in most cases, there was only one economic provider. Nine dropouts had no children, five had one child, and one had two daughters. 62.5% came from public schools. 43.8% lived with their parents and 56.3% lived in their own home. The average number of the dropouts’ father’s level of education is 10 years and their mothers have 11 years of education in average. The mothers were the ones who most contributed economically to the household, in 20% of cases (Table 1).
At the time of filling out the survey, 10 dropouts (62.5%) had jobs in various sectors such as construction, teaching, administration, finance, and real estate industry. Six did so to provide support for their families, and the others only contributed to it in part. Seven (43.8%) had a full-time job in different hours and had academic difficulties such as “not being able to devote time to the studies” or “non-flexible schedules.” 81.3% of dropouts who had a job were the household economic providers and 50% worked to pay for their studies. 43.8% thought that housing was their main need.
At the time of dropping out, most (12 students, representing 75%) were not pursuing additional studies, except for one who was studying English and one more who was studying music. Two students quit in the first semester, 3 in the second semester, 3 in the fourth and fifth semesters, 2 in the sixth semester, and 1 in the seventh semester; out of these, 9 students (56.3%) had good academic performance, and only 2 (12,5%) had poor performance.
In 37.5% of dropouts, cancellations were due to academic difficulties, while 31.3% (5) canceled for a change in academic program, 18,8% (3) for economic or work-related reasons, 6.3% (1) for relocation to another city, and 6.3% did not respond. 25% (4) of dropouts consider the possibility of reentering (Table 2).
Of the 16 dropouts, 14 would recommend the School of Dentistry to others, and the remaining 2 did not respond to this question. The reasons for recommending include: “Because it is an excellent university,” “It’s certified,” “Its graduates are outstanding” and “Faculty members are excellent.”
The opinion on the education received during their time in the School was excellent for 50%, good for 43.8% and poor for 6.3%. The reasons for these answers include: “It offers quality education with comprehensive training,” “It is demanding and has good professors”; another participant thinks that “professors are mediocre; there are many adjunct professors.” They suggest that “the university should somehow help working students.”
Regarding the facilities offered by the School of Dentistry for recreational or leisure activities, 31.3% think that such facilities are adequate, 25.0% consider them fairly adequate, 25.0% consider them inadequate, and 18.8% very good.
Regarding academic atmosphere, 68.8% believe that the academic atmosphere at the School was very nice and pleasant, and for 31.3% that variable was indifferent. Dropouts usually devote their free time to reading, practicing sports and spending time with family.
Reentry students
Out of the 18 reentry students, 12 were men (66.7%) and 6 women (33.3%), with ages ranging from 20 to 37 years, and an average age of 25.6 ± 3.8 years. Fifteen (83.3%) were unmarried, one was cohabitating, and two were separated. Most (77.8%) reentry students belonged to socio-economic strata 2 and 3 and were living in the metropolitan area, and 66.7% of these graduated from public high schools. Most households have 3 to 5 people, and one or two are the economic providers. 83.3% of reentry students did not have children, two students had a child, and one student had three children. Most (44.4%) lived with their parents in their own home. The average number of reentry student’s father’s level of education is 10 years, and their mothers have 11 years of education in average. In most cases, the parents were the main household economic providers (Table 1).
When they first quit, 66.7% were not pursuing additional studies, 27.8% were working in sectors such as industry, commerce, food, and hotel industry, 22.2% were working by the hour and 16.7% during weekends. 27.8% had work-related academic difficulties, and 22.2% were earning less than a minimum monthly wage. At the time of responding the survey, they considered having a job and leisure time as their main needs. Most of them devote their free time to practicing sports.
Concerning repetition, 27.8% repeated one course more than twice; these courses include “Form and function” and “Biology and chemistry.” Among the main reasons for which 77.8% of them failed courses are “lack of commitment” and “lack of motivation in the studies.” Among the reasons for repeating courses are “academic difficulties” (38.9%), “work-related reasons” (27.8%), and to a lesser extent “physical and mental health” -lack of self-esteem- (Table 3).
Table 3 Reasons for repeating courses among reentry students
| Reasons for repeating courses among reentry students | Students | |
|---|---|---|
| No. | Percentage | |
| Academic difficulties | 7 | 38.9 |
| Physical and mental health | 6 | 33.33 |
| Economic or work-related reasons | 5 | 27.8 |
Some of the implications of repeating courses are: the emotional impacts for 38.9% of participants, work-related implications for 22.2%, lack of interest for 16.7%, and a bad perception of oneself for 11%. 16.7% were pursuing additional studies at the time of repeating the course.
Regarding academic performance at the time of dropping out, 38.9% considered it was good and 27.8% considered it was poor. The opinion on the education received while they were in the school was good for 77.8%, and poor for 11.1% due to “lack of flexibility,” “lack of support,” and because there were “many adjunct professors with no good pedagogy,” among other reasons.
Regarding the facilities offered by the School of Dentistry for recreational or leisure activities, 44,4% consider them fairly adequate. 38.9% reentry students thought that the academic environment was nice, and 33.3% considered that it was stressful.
DISCUSSION
The main findings of the present study agree with several studies on academic dropout in higher education in that this is a complex phenomenon, as Tinto points out, (9) due to the interaction of multiple variables, including not only economical situations that make it difficult to keep enrolled in college but also work-related issues and difficulties related to family and social responsibilities, just to name a few. According to the conceptual model suggested for the analysis of academic dropout in Chile,(10) “students are subjected to a continuous tension between these factors, trying to maintain a balance in the intention of remaining enrolled in their courses; when this balance is broken, students abandon their studies, the university, or even tertiary education”.
According to González-Fiegehen,(8) academic dropout has social consequences in terms of the expectations of students and their families. It also has emotional consequences due to the conflict between the students’ aspirations and their achievements, as well as significant economic consequences for both the individuals and the system as a whole. Also, those who do not complete their studies have fewer job opportunities compared to those who get their degree.
Some semesters in the School of Dentistry have long been diagnosed with academic overload, (13) and this, along with the various extracurricular activities and the students’ work and family obligations, may prevent them from remaining enrolled in their classes, especially for those who have a full-time job and want to pursue a career at the same time and with the same intensity. The evidence points to overall negative student results because the semesters are designed to be completed on a full-time basis. As students advance in their studies, the situation becomes more complicated because attendance is not negotiable anymore so they must find a solution or else see how their longawaited grades start to lower or, even worse, their courses failed or cancelled, causing not only the repetition of courses but also delays compared to their classmates, as well as emotional reactions like the ones discussed above.
The National Association of Universities and Higher Education Institutions (Asociación Nacional de Universidades e Instituciones de Educación Superior, ANUIES)14 points out that academic delay is defined as students’ deferral in registering the courses specified in the sequence of the plan of studies. The progress of students in their plan of studies is therefore irregular: “Delayed students are those who for some reason do not keep the regular pace of the plan of studies and graduate much later than what is specified in the plan of studies”.(14) Temporary dropout is a decision not always taken with the expectation of reentering on the first opportunity.(15) Over time, the possibilities of reentering gradually decrease, and when students do return are less likely to remain due to the commitments made while they were away and because of the psychological pressure of having new classmates they had not met before.
This study agrees with the one by Benítez et al.,(16) who showed that the greater the number of pending courses the lower the academic performance. In higher education, specifically at the Universidad de Antioquia School of Dentistry, students can make decisions concerning the number of courses they will enroll in each semester. Unfortunately, students always risk not completing courses, even though they are enrolled. This produces an accumulation of “pending courses” which, together with those that were not taken, gradually add an extra burden to their work and family responsibilities, creating an imbalance that forces students to drop out.
Some activities during the first semesters are designed to be completed in groups, and some students cannot get together with their classmates due to their work-related duties, increasing the amount of stress, breaking the balance among the different factors, and prompting them to abandon their studies in order to respond to their work and personal obligations. In addition, the clinical activities are strictly face-to-face lessons. We agree with the Microbiology students,(17) who point out that “overloads can cause chronic fatigue because even though everyone should be properly trained to fulfill their responsibilities, they should also rest appropriately to accomplish their tasks for the next day. If this situation is not properly understood, that excess of work will affect academic performance”.
The answers provided by the participants suggest that some students drop out the dental program but do not leave their university education-they usually transfer to another academic program, either within Universidad de Antioquia itself or to another higher education institution-. This suggests that they made a bad career choice, as Tinto points out:(9)
A surprisingly large number of students who enroll in college lack clarity about the reasons why they are there and have not seriously thought about the choice of institution. For many highschool graduates, the process of choosing a higher education institution is noticeably fortuitous, often based on insufficient information. It is not surprising then that so many students wonder early in their academic journey for the reasons why they are enrolled in higher education. The process of clarifying the goal invariably leads some students to finally drop out of school or to transfer to other institutions or programs, and this may probably occur if institutions do not invest enough resources in the academic counseling of students.
Several studies, especially the one conducted by the Universidad Nacional de Colombia,(18) show that certain careers and areas of knowledge tend to have higher dropout levels than others, but the healthcare field has the lowest dropout rate in the country. This is exactly the situation at Universidad de Antioquia, where dropout at the School of Dentistry is very low (lower than 6%), compared to other areas, as University President Mauricio Alviar points out(19) “The average number of student dropout is 46%, and that number is below the national average (55%). There are twenty academic programs whose dropout rate exceeds the average in Colombia, including Mathematics 89%, Materials Engineering 74%, Economics 61%, Biology 58%, and Natural Sciences 72%”. The President says that “improving the student selection process will also improve academic performance and will reduce the number of classes canceled each semester at the University.”
According to the National System of Statistical Information (Sistema de Información Estadística del Ministerio de Educación Nacional, SNIES),(20) 15% of students enrolled in higher education institutions drop out in the first semester. El Colombiano spoke with the President of Universidad de Antioquia, Mauricio Alviar, about the situation of the University:(21)
On average, drop-out rates in regional headquarters are higher than in Medellín (the province’s capital). Last year, the drop-out figure was close to 60%, while in Medellín it is close to 48%, in relation to coverage and quality as one of its determinants, and we should work harder to increase quality [...] Early dropout in the first two semesters is 25% [...]. Towards the end of the 1990s, early dropout, or the one occurring in the first and second semesters, was 11.5%, while currently, the drop-out rate is 23%. And there is yet another striking fact: 20,000 students left the University between 2005 and 2015 due to poor academic performance. The University cannot just sit down and do nothing about it.
It is important to note the limitations of the present study in terms of its design and the difficulty of ensuring representativeness with the selected sample, as the results cannot be generalized.
CONCLUSIONS
Academic dropout in higher education is a complex, personal, family, institutional and social phenomenon. According to data of the Ministry of National Education (Ministerio de Educación Nacional, MEN),(22) the dropout rate at the university level in Colombia was 46.1% in March 2016.
Analyzing academic dropout requires both social and statistical studies, since it is a multidimensional problem, as Erika Himmel points out.(23) The academic performance of students is the main cause for dropout at the Universidad de Antioquia School of Dentistry, followed by program transfers and economic reasons. However, we cannot ignore other critical factors that are external to the institution and to the students themselves, such as their prior education, their socio-economic environment, their degree of adaptation to college life, their parents’ level of education, and the student’s expectations regarding their career, just to name a few factors that need to be further studied, as the Ministry of Education has suggested.(22)
Several strategies can in part help regulate dropout rates; some institutions in the country are leading the design of retention strategies from an academic perspective through mentoring sessions, courses, and additional instruction, to name just a few.
But the most important thing for the School of Dentistry and Universidad de Antioquia as a whole is to think of different strategies to ensure students retention.
While entering Universidad de Antioquia is not easy due to the high number of applicants each term (somewhere between 25,000 and 40,000 applicants per semester, of which only 3,000 are accepted), dropping out is even more regrettable, as a large percentage of students come from the lowest socioeconomic levels (strata 1 and 2). Continuing their college studies is not easy for these students, particularly in the School of Dentistry, where since the first semester they need a lot of instruments, white coats, books, and documents, in addition to food and transportation fees. When asking students for their reasons to skip classes, it is not uncommon to get responses like lack of money to eat or to pay for public transportation. In addition, life in some departments of the University, such as ours, is even more expensive, due to the required equipment or the necessary clothing suitable for the clinics. These circumstances require different mechanisms to ensure the presence and permanence of students in the School, especially those from socioeconomic strata 1, 2, and 3.
RECOMMENDATIONS
Perhaps the most important phenomenon to prevent or reduce the dropout rates is not in our hands only. The transition from high school to college is critical and all high schools must have a good system of vocational and professional orientation, as suggested by the Ministry of National Education,(24) to guide students in their academic choices-a decisive step for success in their future lives-.
But the responsibility for permanence in college is not of secondary education alone. Higher education has a tremendous responsibility in orienting and monitoring students in other aspects as fundamental as this, as recommended by the students of Microbiology and Bioanalysis at Universidad de Antioquia:(17)
Adaptation to college life, which should happen at least up to the third academic semester.
Design strategies to improve study habits and to develop critical thinking, reading comprehension, and writing skills.
Mentoring by psychology professionals to help improve failure tolerance and to strengthen their emotions, especially in relation to self-criticism.
In addition, it is critical to ensure the permanence of students from low socio-economic strata in the University, particularly in the School of Dentistry. For these students, remaining in the university after passing the demanding admission exam is a real challenge, due to all the difficulties they should face, not only for economic difficulties but also in terms of work-related, sociological, and psychological situations.
One recommendation is for the Universidad de Antioquia, and for the School of Dentistry in particular, to design a retention plan incorporating the individual needs of students. University administrators should devote some time to permanently monitor and assess the variables that affect the social and academic integration of students in order to implement intervention strategies that help reduce dropout rates. Students maintain a condition of balance (permanence) by combining the academic, social, and institutional factors in constant strengthening. If one of these factors is weakened, it is necessary for the other factors to react adequately to restore the initial balance, while seeking to overcome the factor in crisis.
From the academic point of view, and following the requirements of the Ministry of National Education(25) in line with our School, better actions are needed to achieve flexibility, using the curricular design work that has been done to better adapt to current requirements, considering the needs of the students from the lowest socioeconomic strata, as well as the current labor market needs and the requirements of current teaching-learning systems. We should also take into account the possibility of education by cycles, which enables mobility among levels -technical, technological, and professional- and provides greater opportunities for students, who can enter the labor market by the end of each cycle. Also, new student welfare policies should be established in addition to the ones the University currently has in order to promote permanence and equity, aiming at the academic supervision of students and providing support for the resolution of personal and family conflicts. It is also recommended to involve parents in the monitoring of students.
