Anatomical knowledge retention in third‐year medical students prior to obstetrics and gynecology and surgery rotations

Abstract

Surgical anatomy is taught early in medical school training. The literature shows that many physicians, especially surgical specialists, think that anatomical knowledge of medical students is inadequate and nesting of anatomical sciences later in the clinical curriculum may be necessary. Quantitative data concerning this perception of an anatomical knowledge deficit are lacking, as are specifics as to what content should be reinforced. This study identifies baseline areas of strength and weakness in the surgical anatomy knowledge of medical students entering surgical rotations. Third-year medical students completed a 20-25-question test at the beginning of the General Surgery and Obstetrics and Gynecology rotations. Knowledge of inguinal anatomy (45.3%), orientation in abdominal cavity (38.8%), colon (27.7%), and esophageal varices (12.8%) was poor. The numbers in parentheses are the percentage of questions answered correctly per topic. In comparing those scores to matched test items from this cohort as first-year students in the anatomy course, the drop in retention overall was very significant (P = 0.009) from 86.9 to 51.5%. Students also scored lower in questions relating to pelvic organs (46.7%), urogenital development (54.0%), pulmonary development (17.8%), and pregnancy (17.8%). These data showed that indeed, knowledge of surgical anatomy is poor for medical students entering surgical clerkships. These data collected will be utilized to create interactive learning modules, aimed at improving clinically relevant anatomical knowledge retention. These modules, which will be available to students during their inpatient surgical rotations, connect basic anatomy principles to clinical cases, with the ultimate goal of closing the anatomical knowledge gap.

Anatomical Knowledge Retention in Physiotherapy Students: A Preliminary Assessment

“…Again, similar issues with attrition were noted in other programs. For example, in a comprehensive assessment of the retention rate, the third year medical students at The George Washington Medical School [5] were given anatomy tests covering different regions as they entered general surgery and obstetrics/gynaecology clerkships. The results were compared with the students' performance in their first year anatomy tests.…”

“…The performance and retention varied considerably between different anatomical structures -from 12.8% (59.1% drop in retention rate) correct answers on esophageal varices to 97.2% (1.6% drop) on lymphatic drainage. The results of The George Washington Medical School study highlighted the need to improve students' retention and the necessity for the educational strategies which will facilitate this process to be based on a good assessment of students' current knowledge in various areas of anatomy [5].…”

“…The main features of strategies to improve retention of anatomy in medical education were the need to repeat and revise previously adopted knowledge, integrate this knowledge with that from other pre-clinical and clinical subjects and, perhaps most importantly, apply this knowledge within the clinical context [3,5,14,15]. Indeed, More comprehensive tests which would include a practical component based on cadavers, medical images and living anatomy as well as a battery of clinically oriented questions are needed for the full assessments of anatomy knowledge.…”

“…The regular assessments of the level of basic science knowledge at different stages of study and of its retention rate are therefore a necessity in constantly evolving health curricula. This, however, is a complex process as recent research demonstrates considerable differences between different basic sciences and, indeed, diverse retention rates between various subjects and topics within the same discipline [3][4][5].…”

Curricular response to increase recall and transfer of anatomical knowledge into the obstetrics/gynecology clerkship

“…Students indicated difficulty transferring anatomical knowledge from the classroom to the clinic (Lazarus et al, 2012).This perception of a deficit in knowledge retention has been supported by poor pre-clinical anatomy evaluation scores. This represented a significant decline from the cohort's average score of 87% on matched test items from their first-year anatomy course (Jurjus et al, 2014). This represented a significant decline from the cohort's average score of 87% on matched test items from their first-year anatomy course (Jurjus et al, 2014).…”