Anatomical Knowledge Retention in Changing Curricula

Abstract

Traditionally anatomy is one of the first subjects taught in medical school. Practicing physicians have commented on medical students' poor anatomical knowledge in surgically oriented clerkships. Literature also shows that correlating clinical and anatomical sciences throughout early medical education may improve anatomical knowledge retention. With major medical school curricular changes happening across the nation, more quantitative data confirming this correlation is needed.The medical curriculum at the George Washington University School of Medicine recently underwent reorganization, transforming an earlier discipline‐based curriculum to that of an integrated system‐based one. In order to determine whether reorganization has an effect on anatomical knowledge retention, comparisons of anatomical knowledge between classes in the different curricula were made. Students from the last class of the discipline‐based curriculum and students from the first class of the new, integrated curriculum completed the same 27question test before beginning their general surgery and obstetrics and gynecology (OB/Gyn) rotations. Scores for specific anatomy categories related to general surgery and OB/Gyn were then analyzed and compared between classes.Comparing the scores from the 2013 and 2016 cohorts, there was an overall decrease in retention from 65.69% to 63.64% (Table 1). Item analysis per topic revealed a mean decrease in surgical anatomy and OB/Gyn anatomy retention of 2.53% and 1.58%, respectively. There was a 21.6% increase in inguinal canal anatomy retention and a 17.33% increase in appendix related questions. There was also a 12.02% decrease in fallopian tube anatomy retention.In conclusion, when comparing the 2013 to the 2016 data there were overall decreases in retention for the anatomy as it relates to general surgery and OB/Gyn; however improvements were noted for specific topic areas. These results suggest that the change in retention is apparent and multifactorial. The differences between surgical anatomy retention and OB/Gyn anatomy retention scores may be related to the way the subject matter was organized and presented, or how the anatomic foundational knowledge was integrated with its clinical relevance. Although integrative learning has been associated with better retention, more studies will have to be conducted to validate this statement. Finally, analyzing the subject matter, curriculum structure, clinical focus, and objectives should be evaluated moving forward.Support or Funding InformationThe George Washington School of Medicine and Health Sciences Complication by Broad Category Number of test items 2013 Correct (%) 2016 Correct (%) Change in Retention from 2013 to 2016 (%) Surgery Inguinal Canal 2 MCQs 45.28 66.87 21.5922 Vasculature 3 MCQs 30.74 35.74 5.0026 Abdomen 3 MCQs 47.63 48.19 0.5671 Appendix 4 MCQs 71.53 88.86 17.3297 MEAN TEST SCORE 13 MCQs 66.98 64.45 −2.53 OB/Gyn Uterine 2 MCQs 45.69 55.73 10.0353 Vasculature 4 MCQs 49.14 64.31 15.1671 Peritoneal Cavity 1 MCQ 82.76 92.17 9.4114 Fallopian tube 1 MCQ 63.22 51.20 −12.0184 Embryology 3 MCQs 47.92 48.79 0.877 Placenta 1 MCQ 80.14 78.92 −1.217 MEAN TEST SCORE 14 MCQ 64.40 62.82 −1.58 Overall Retention for Both Disciplines 2013: 65.69 2016: 63.64 −2.05