The Effect of Curricular Reform on Gross Anatomy Laboratory Examination Performance: A Retrospective Analysis

Abstract

IntroductionMedical education in the United States has changed dramatically in the last few decades. Medical schools have moved away from a traditional, didactic, and discipline‐based curriculum to a more integrative, active, and student‐centered curriculum. Another common change has been the shift from a graded curriculum to a pass‐fail curriculum. While much research has documented overall performance, especially on high stakes examinations, little research has been conducted on gross anatomy laboratory performance.AimThis study examines the effects of curricular change, including decreased contact hours and shift to a pass‐fail curriculum, on gross anatomy laboratory performance.MethodologyGross anatomy laboratory examinations were reviewed retrospectively in two cohorts: one cohort that was in the previous, nonintegrated curriculum with a graded (i.e., A, B, F) curriculum; and a second cohort that was part of the first integrated class with a pass‐fail curriculum. For the pass‐fail curriculum in particular, the standard for passing was notably lower than that for the graded curriculum. Each of the students’ examinations were de‐identified. Only identification questions (i.e., ones that asked “Identify the tagged structure”) were reviewed. Questions that were common between the two cohorts were used for analysis. An independent samples t‐test was performed on the data, and Cohen’s d effect size was calculated. Significance was ascribed for p<0.05.ResultsThere were 69 questions that were similar between all the laboratory examinations from the pre‐curricular reform and post‐curricular reform cohorts. There was an approximately even number of questions from muscles, nerves, vessels, and additional structures on the cadaveric specimens and plastic models used on the examinations. It was found that the post‐curricular reform cohort scored significantly lower (mean = 67.05 ± 22.35) than the pre‐curricular reform cohort (mean = 79.89 ± 19.56) p<0.001, d = 0.61.Discussion and ConclusionThe results of the study demonstrate that students within the new curriculum, with reduced contact hours and a pass‐fail curriculum, performed significantly poorer than students in the non‐integrated curriculum. Students may have felt that the gross anatomy laboratory experience was lower stakes compared to their other coursework, especially since the passing standard for the post‐curricular reform cohort was markedly lower than the that of the pre‐curricular reform cohort.