Student performance in anatomy examinations depending on the modes of learning/teaching: onsite or online

Abstract

Introduction: Traditionally, anatomy is a subject that involves a hands-on lab-based component using embalmed cadavers and histology slides. Due to the COVID-19 pandemic there were many changes to Sri Lankan medical education. This study analysed the effect on student performance in anatomy teaching/ learning methods with the start of COVID-19 pandemic in a Sri Lankan medical faculty. Methods: Three student groups with completely onsite (Batch A), transition to online midway through the semester (Batch B), and almost completely online (Batch C) were included. Their second-semester examination performance was analysed in total and component-wise [multiple-choice questions (MCQ), short-answer questions (SAQ) and objective-structured practical exams (OSPE I – Projections, OSPE II – Gross spot]. Descriptive analysis, Kruskal-Wallis and Dwass-Steel-Critchlow-Fligner tests were used for comparison.Results: Allocated proportions for MCQ:SAQ:OSPE Rewere 30:40:30. Mean MCQ marks of batches A, B, C were 14.8,14.9, 16.4 and mean SAQ marks were 24, 25.1, 24 respectively with significant differences in both [MCQ-H(2)=29.1, p=< .001, SAQ- H(2)=11.3, p= .003). With MCQs batch C had the best performance (p=< .001), whereas batch B had better performance than batch A (p< .001) in SAQs. Mean OSPE marks were 24.8, 17.4, 20.7 with a significant difference (H(2)=334.8, p=< .001). Batch B had lower performance than batch A and C (< .001), while batch A had performed better than batch C (< .001) in OSPEs.Conclusion: MCQ performance was better in online learners while OSPE performance, which reflects the understanding of the three dimensional structure was better in onsite learners. This highlights the value of receiving hands-on experience with cadavers and histology practicals.