Non-attendance correlates with poor performance, but manual recording of attendance is problematic. Online activity reports may be a more efficient method of identifying at-risk students. Summary of work: This research is part of a prospective study examining physical attendance, online activity reports (Moodle), continuous assessments and summative examination performance. Ethical approval was granted by RCSI Ethics Committee. Two modules within the first year of the undergraduate medical program were identified for inclusion. Results: Data from 2 RCSI modules are presented (NM and AS). A single cohort of 365 students undertook both modules, 30 of whom were repeating. Comparison of medians showed significant reductions in all parameters within the repeat student group. In NM, regression analysis showed continuous assessment had the largest effect size on summative examinations for both first-time and repeat student groups (R2 = 0.545; R2 = 0.289). Among repeat students, online access of lecture notes had a larger effect size than physical attendance at small group tutorials, while both these indices were less contributory (R2 < 0.1) for first-time students. In AS, continuous assessment showed the largest effect size for first-time students (R2 = 0.585), while online access of lecture notes was most contributory among repeat students (R2 = 0.35). Conclusions: Effect sizes are most notable for continuous assessment, but online activity correlates with summative performance and is more predictive for outcomes among repeat students than physical attendance. These indices may be useful to screen at-risk students for individual intervention and support.