Presentations

Abstract

Introduction:

Among the many trends of changing medical school curricula, includes a shortening of the pre-clerkship phase timeline from 24 to 18 or 12 months. Shortening of the curriculum is particularly difficult for anatomy teaching faculty as knowledge in anatomy is seen as foundational for medical and health profession students. In response to the dynamic medical education landscape and a novel opportunity to assess the potential of peer-learning in anatomical coursework, collaborative quizzes were introduced in a shortened and condensed anatomy course for first-year medical students at Eastern Virginia Medical School (EVMS) in Norfolk, VA. The aim of this study was to evaluate the benefits and implications of group assessments in a gross anatomy laboratory.

Methods:

In fall 2022, the first-year anatomy course for medical (n = 151) and medical master's students (n = 52) at EVMS consisted of 9.5 weeks and focused on providing students with a comprehensive overview of clinically relevant human anatomy through lecture and laboratory components. Quantitative assessment of students' understanding was composed of two summative examinations of NBME questions (midterm and final), and four graded formative collaborative quizzes in the anatomy laboratory. Collaborative quizzes, consisting of 20 single-best answer multiple choice questions, were taken by students in groups of six. For each question, students were given time to answer before and after group discussion and both answer choices were recorded. Quiz questions were categorized into multiple groups based on their format, the number of tags, and the subject matter indicated. Qualitative data was collected in the form of open-ended questions as part of the course evaluations and analyzed using an open-coding theme by two independent researchers.

Results:

Quantitative analysis of the averaged student collaborative quiz grades before and after group discussion displayed a statistically significant increase in scores after group discussion along with a decrease in standard deviation. Linear regression analysis of the percentage difference between individual and group scores and their respective average examination demonstrated a negative relationship. Question categories "Clinical Vignette," "Muscle," and "Other" exhibited greater changes in answers during the Head and Neck quiz. "Image-based" questions displayed greater answer changes in two quizzes: Upper Limb & Back and Thorax/Abdomen/Pelvis. Notably, "1 Tag", "Multiple Tags", "Blood Supply", and "Nerve" questions each showed greater answer changes across three quizzes. In contrast, "No Tag" questions exhibited consistently low answer changes for all quizzes. The number of positive responses in the course evaluations (n = 42) outweighed the negative responses (n = 8). Most of the positive responses centered around general positivity with notable comments expressing that the quizzes effectively stimulated group discussions, helped identify areas of weakness, allowed for application of knowledge in a low-stakes environment, and highlighted valuable information. Negative responses primarily centered around logistical changes.

Conclusion:

This study advocates for the incorporation of collaborative quizzes in a compact anatomy curriculum. The negative relationship between the percentage difference in individual and group quiz scores and their respective average examinations scores offers a potential method of identifying struggling students before their first examination, enabling timely academic support. Categorization and analysis of the quiz questions revealed certain question types and subject matter that had increased reliance on group discussion, indicating areas of weakness for the students to study and educators to reinforce. Furthermore, student feedback was overwhelmingly positive, expressing both enjoyment of the process and appreciation for the valuable learning benefits it provided. The uniqueness of these quizzes lies in their ability to administer students with opportunities to assess their knowledge in a low-stakes setting while simultaneously benefiting from peer learning. By implementing this assessment tool, anatomy educators may enhance both the efficiency and effectiveness of learning and teaching in an academic environment emphasizing time reduction. Collaborative quizzes prove to be a promising solution for optimizing the learning experience amid the constraints of condensed curricula.