The effect of curricular reform on gross anatomy laboratory examination performance: An institutional analysis

Abstract

Many medical schools have undergone curricular reform recently. With these reforms, time spent teaching anatomy has been reduced, and there has been a general shift to a pass/fail grading system. At Indiana University School of Medicine (IUSM), a new curriculum was implemented in fall 2016. The year‐long human gross anatomy course taught in 2015 was condensed into an integrated, semester‐long course starting in 2016. Additionally, the grading scale shifted to pass/fail. This study examined first‐year medical student performance on anatomy practical laboratory examinations—specifically, among lower‐order (pure identification) questions and higher‐order (function, innervation) questions. Participants included medical students from a pre‐curricular reform cohort (year 2015, 34 students) and two post‐curricular reform cohorts (years 2016, 30 students and 2017, 33 students). A Kruskal–Wallis ANOVA test was used to determine differences of these questions among the three cohorts. Additionally, 40 of the same lower‐order questions that were asked on gross anatomy laboratory examinations from medical student cohort year 2015 and year 2016 were further analyzed using an independent samples t‐test. Results demonstrated that the pre‐curricular reform cohort scored significantly higher on both lower‐order (median = 81, p < 0.001) and higher‐order questions (median = 82.5, p < 0.05) than both post‐curricular reform cohorts. Additionally, when reviewing the selected 40 similar questions, it was found that the pre‐curricular reform cohort averaged significantly higher (82.1 ± 16.1) than the post‐curricular reform cohort from 2016 (69.3 ± 21.8, p = 0.004). This study provides evidence about the impact of curricular reform on medical student anatomical knowledge.