Online Assessment of Applied Anatomy Knowledge: The Effect of Images on Medical Students' Performance

Abstract

Anatomical examinations have been designed to assess topographical and/or applied knowledge of anatomy with or without the inclusion of visual resources such as cadaveric specimens or images, radiological images, and/or clinical photographs. Multimedia learning theories have advanced the understanding of how words and images are processed during learning. However, the evidence of the impact of including anatomical and radiological images within written assessments is sparse. This study investigates the impact of including images within clinically oriented single-best-answer questions on students' scores in a tailored online tool. Second-year medical students (n = 174) from six schools in the United Kingdom participated voluntarily in the examination, and 55 students provided free-text comments which were thematically analyzed. All questions were categorized as to whether their stimulus format was purely textual or included an associated image. The type (anatomical and radiological image) and deep structure of images (question referring to a bone or soft tissue on the image) were taken into consideration. Students scored significantly better on questions with images compared to questions without images (P < 0.001), and on questions referring to bones than to soft tissue (P < 0.001), but no difference was found in their performance on anatomical and radiological image questions. The coding highlighted areas of "test applicability" and "challenges faced by the students." In conclusion, images are critical in medical practice for investigating a patient's anatomy, and this study sets out a way to understand the effects of images on students' performance and their views in commonly employed written assessments. Anat Sci Educ 14: 342-351.

Responding to Covid‐19: A thematic analysis of students' perspectives on modified learning activities during an emergency transition to remote human anatomy education

“…However, there were no significant differences in grades on the online laboratory quizzes administered before and after the Covid-19 shutdown (Table 3), and the final examination grades (remote) were markedly higher than the midterm examination grades (in-person) (Table 3). This was not overly surprising, given that previous research has shown that assessment modality does not significantly influence student achievement in anatomy (Attardi & Rogers, 2015), and it is, therefore, unclear if the use of two-dimensional cadaveric images in the learning activities and assessments put students at an actual performance disadvantage (Inuwa et al, 2012;Sagoo et al, 2021). However, it is equally unclear if all of the desired learning outcomes were attained, as the ability to identify anatomical structures on two-dimensional images may not offer reliable evidence of spatial understanding (Gonzales et al, 2020) or other nontraditional discipline-independent skills (Evans & Pawlina, 2021).…”

Motivation and learning methods of anatomy: Associations with mental well‐being

“…Successful outcomes of teaching in terms of establishing a deep understanding of the topic, which will benefit therapists in future practice often depend on the study methods adopted by students when learning anatomy (Criado‐Álvarez et al, 2017). While much of the literature comes from studies on medical program (Abdel Meguid & Khalil, 2017; Ang et al, 2018; Bohl & Gest, 2011; Sagoo et al, 2021; Santos et al, 2021; Smith et al, 2014; Smythe & Hughes, 2008; Wormald et al, 2009), relatively little is known about the favored pedagogical approaches for anatomy used in speech and language therapy program. Notwithstanding, while various pedagogies can be employed during teaching (Schofield, 2018; Skinder‐Meredith, 2010), student motivation is essential to successfully acquire knowledge.…”

Assessing the Wider Outcomes of Anatomy Education

“…Merzougui and colleagues investigate the impact of different question types and format on student perception versus student performance (Merzougui et al, 2021), while the effect of contextual information and images on student performance and the way in which students perceive clinically oriented questions, in particular, is also described (Sagoo et al, 2021). Adaptation of the traditional identification-based "spot-test" assessment to include a multiple-choice format is introduced and shown to be a suitably reliable and challenging alternative to a free-response question approach (Douglas-Morris et al, 2021).…”