Battle of the sections: Student outcomes and course feedback support combined prosection and dissection laboratory formats to maximize student success.

Gross anatomy laboratories frequently utilize dissection or prosection formats within medical curricula. Practical examination scores are consistent across the formats, yet these examinations assessed larger anatomical structures. In contrast, a single report noted improved scores when prosection was used in the hand and foot regions, areas that are more difficult to dissect. The incorporation of prosected donors within "Head and Neck" laboratories provided an opportunity to further characterize the impact of prosection in a structurally complex area. Retrospective analysis of 21 Head and Neck practical examination questions was completed to compare scores among cohorts that utilized dissection exclusively or incorporated prosection. Mean scores of practical examination questions were significantly higher in the prosection cohort (84.27% ± 12.69) as compared with the dissection cohort (75.59% ± 12.27) (p < 0.001). Of the 12 questions that performed better in the prosection cohort (88.42% ± 8.21), 10 items mapped to deeper anatomical regions. By comparison, eight of nine questions in the dissection cohort outperformed (88.44% ± 3.34) the prosection cohort (71.74% ± 18.11), and mapped to anatomically superficial regions. Despite the mean score increase with positional location of the questions, this effect was not statically significant across cohorts (p = 1.000), suggesting that structure accessibility in anatomically complex regions impacts performance. Student feedback cited structure preservation (71.5%) and time savings (55.8%) as advantages to prosection; however, dissection was the perceived superior and preferred laboratory format (88.6%). These data support combined prosection and dissection formats for improving student recognition of deeply positioned structures and maximizing student success.

Objective Structured Practical Examination (OSPE) as a Tool for the Formative Assessment of Practical Skills in the Subject of Physiology: A Comparative Cross-Sectional Analysis.

BACKGROUND: Practical assessments hold a critical role in evaluating medical education. However, achieving objectivity, consistency, authenticity, reliability, and practical usefulness in student evaluations can be a formidable challenge. The Objective Structured Practical Examination (OSPE) stands out as a promising technique tailored to assess performance in a realistic educational setting. OSPE offers a unique approach to aligning assessment methods with the educational objectives of a given activity, making it possible to comprehensively gauge the attainment of pedagogical goals. OBJECTIVE: This study aimed to overcome the limitations associated with traditional practical tests and explore the potential advantages of OSPE in improving the objectivity, consistency, authenticity, and reliability of student evaluations in the context of medical education. Through a comparative analysis, this research endeavors to illuminate the practical applicability of OSPE. The primary goal of this research was to introduce and assess the feasibility of employing the OSPE as a formative assessment tool for appraising the practical capabilities of Physiology students. METHODOLOGY:  Fifty students from 1st year MBBS were included in this study after their written consent. They were divided into two groups of 25 students each; two practical procedures, (a) hemoglobin estimation, and (b) performing blood group. Students were assessed at two different sessions. Students of each group assessed by the conventional method in the first session were assessed by OSPE in the second session of the same practical and vice versa. At the completion of the assessment process, both students and teachers were asked to rate the various assessment techniques on a Likert scale. Student test results and instructor and student opinions were statistically examined using the paired t-test. A significance level of 0.05 was used. RESULTS:  When evaluated using the OSPE method, students obtained significantly higher mean marks (12.58±2.74) compared to the conventional assessment method (8.44±2.13). A paired t-test confirmed the statistical significance of the improvement in student performance with OSPE (p<0.0001). Student feedback indicated strong agreement (92%) that OSPE encourages greater focus on practical examinations and is an effective assessment and learning method. Teachers expressed unanimous agreement that OSPE is a more comprehensive evaluation tool (100%) and better at highlighting student strengths and weaknesses (75%). The majority of teachers (75%) believed that OSPE should be incorporated into future examinations. CONCLUSION:  The study demonstrates that OSPE significantly enhances student performance and is well-received by both students and teachers as a more effective and comprehensive assessment method.

A neuroanatomy lab practical exam format in alignment with the universal design for learning framework.

The traditional format for neuroanatomy lab practical exams involves stations with a time limit for each station and inability to revisit stations. Timed exams have been associated with anxiety, which can lead to poor performance. In alignment with the universal design for learning (UDL), Timed Image Question and Untimed Image Question exam formats were designed to determine which format supports student success, especially for those who performed poorly in the traditional format. Only the Untimed Image Question format allowed students to revisit questions. All three formats were administered in a randomized order within a course for three cohorts of medical students. When all students' scores were analyzed together, the type of format had no effect. However, when analyses were conducted only on students who performed poorly in the traditional format, the type of format had an effect. These students increased their score, on average, by at least one grade level in the Untimed Image Question format compared to the traditional format. Students who performed well in the traditional format maintained their A, on average, in the two new formats. More students indicated Untimed Image Question as their most preferred format after experiencing all three formats. Most students associated the inability to revisit questions with high levels of anxiety. A neuroanatomy lab exam format was therefore identified as consistent with the UDL framework such that all students, regardless of test anxiety levels, can equally demonstrate what they learned. This format allowed for unlimited time per question and ability to revisit questions.

Automated grading of anatomical objective structured practical examinations using decision trees: An artificial intelligence approach.

An Objective Structured Practical Examination (OSPE) is an effective and robust, but resource-intensive, means of evaluating anatomical knowledge. Since most OSPEs employ short answer or fill-in-the-blank style questions, the format requires many people familiar with the content to mark the examinations. However, the increasing prevalence of online delivery for anatomy and physiology courses could result in students losing the OSPE practice that they would receive in face-to-face learning sessions. The purpose of this study was to test the accuracy of Decision Trees (DTs) in marking OSPE questions as a first step to creating an intelligent, online OSPE tutoring system. The study used the results of the winter 2020 semester final OSPE from McMaster University's anatomy and physiology course in the Faculty of Health Sciences (HTHSCI 2FF3/2LL3/1D06) as the data set. Ninety percent of the data set was used in a 10-fold validation algorithm to train a DT for each of the 54 questions. Each DT was comprised of unique words that appeared in correct, student-written answers. The remaining 10% of the data set was marked by the generated DTs. When the answers marked by the DT were compared to the answers marked by staff and faculty, the DT achieved an average accuracy of 94.49% across all 54 questions. This suggests that machine learning algorithms such as DTs are a highly effective option for OSPE grading and are suitable for the development of an intelligent, online OSPE tutoring system.

Virtual Practical Examination for Student Nurse Educators in Health Sciences Education during the COVID-19 Pandemic: A Narrative Review.

(1) Background: There is a gap in the literature that explores challenges and opportunities relating to virtual or e-assessment health science education with particular relevance to the Health Sciences Education practical examination for student nurse educators. Therefore, this review aimed to address this gap and provide recommendations for enhancing identified opportunities and for overcoming identified challenges.; (2) Methods: The review was conducted across Google Scholar, PubMed/MEDLINE, Science Direct, Directory of Open Access Journals, Complementary Index, SCOPUS, and the Cumulative Index to Nursing and Allied Health Literature (CINAHL) with the intention of identifying opportunities and challenges presented by e-assessment in the HSE practical examination for student nurse educators during the COVID-19 pandemic.; (3) Results: The following aspects are discussed: (1) opportunities, including benefits, for both student nurse educators and facilitators and opportunities for Nursing Education; and (2) challenges, including issues with accessibility and connectivity as well as the attitudes of both students and facilitators.; (4) Conclusions: Despite challenges which included connectivity issues that led to frustration and stress, the unpreparedness and attitudes of students and facilitators, there are some opportunities that have emerged from e-assessment that can be beneficial to both the students and the facilitators, as well as the institutions. These include a reduced administrative burden, improved teaching and learning, and immediate feedback from facilitators to students and from students to facilitators.

The Effect of Histology Examination Format on Medical Student Preparation and Performance: Stand-Alone Versus Integrated Examinations.

Most medical schools have transitioned from discipline-based to integrated curricula. Although the adoption of integrated examinations usually accompanies this change, stand-alone practical examinations are often retained for disciplines such as gross anatomy and histology. Due to a variety of internal and external factors, faculty at the University of Cincinnati College of Medicine recently began to phase out stand-alone histology practical examinations in favor of an integrated approach to testing. The purpose of this study was to evaluate this change by (1) comparing examination performance on histology questions administered as part of stand-alone versus integrated examinations and (2) ascertaining whether students alter their approach to learning histology content based on the examination format. Data from two courses over a period ranging from 2018 to 2022 were used to evaluate these questions. Results indicated histology question performance initially dropped after being included on integrated examinations. Stratification of students by class rank revealed this change had a greater impact on lower-performing students. Longitudinal data showed that performance 2 years after the change yielded scores similar to previous standards. Despite the initial performance drop, survey results indicate students overwhelmingly prefer when histology is included on integrated examinations. Additionally, students described alterations in study approaches that align with what is known to promote better long-term retention. The results presented in this study have important implications for those at other institutions who are considering making similar changes in assessment strategies.

Standard-Setting of Multidisciplinary Objective Structured Practical Examination.

Purpose The present work applies the standard-setting in the multidisciplinary Objective Structured Practical Examination (OSPE) of the MusculoSkeletal and Integument systems (MSK) module using Modified Ebel's method to differentiate the competent students from the non-competent ones. Materials and methods One hundred fifty-six students participated in the multidisciplinary OSPE. The MSK-OSPE consists of mid-module and final. According to the blueprint of the OSPE, the mid-module OSPE tested the knowledge and skills of the upper limb, and the final OSPE verified the knowledge and skills of the lower limb. Modified Ebel's method was used to identify the Minimum Pass Level (MPL) in each station and the whole exam accordingly. Results Fifty-seven percent (57%) of the students passed both exams, while 25.6% did not pass the mid-module exam and 31.4% did not pass the final exam, 17.9% did not pass both exams and 25% did not pass one exam. The MPL for most of the stations in both exams using modified Ebel's method of the standard-setting was more than 50% which is the conventional pass mark. However, the MPL for stations 4, and 6 in the mid-module exam (ulna and arteries of the upper limb) and stations 7, 9, and 14 (muscles of the lower limb, anatomy of ankle joint, physiology of nerve) was < 50%. While the total pass mark of the mid-module OSPE was 66% and the pass mark for the final OSPE was 60% Conclusion The minimal pass level (MPL) in mid module and final OSPE were 66% and 60% respectively which are more than the conventional cut off point (50%) that indicating that the standard-setting was effective in identifying poor performers who cannot be identified by the conventional method that led to enhance the quality of OSPE as an assessment tool. Moreover, students developed the skills to deal with standardized patients in clinical stations. However, some defects and areas of improvement were identified in some physiological and anatomical stations. The organizing committee recommended identifying the poor performers and conducting extra-tutorial sessions on the defective topics.

Perceptions of Physical Therapy Students on their Psychomotor Examinations: a Qualitative Study.

Introduction: Practical examinations are necessary to demonstrate learning in the psychomotor, cognitive, and affective domains. Student perceptions of the organization and execution of practical examinations are an important consideration in the development of practical examinations. Review of the Literature: Multiple other health professions have investigated students' perceptions of objective structured clinical examinations (OSCE). There is little in the physical therapy literature with respect to student perception regarding proctor presence during practical examinations or OSCEs. Subjects: The participants were members of the classes of 2019-2021 in a Doctor of Physical Therapy (DPT) program at a New England University. Methods: A qualitative thematic approach was applied to de-identified transcripts of student focus group interviews. Independently coded themes were identified, discussed, and refined iteratively. Results and Discussion: Four themes emerged with multiple subthemes: impact of proctor being present; realistic, patient-focused experience; preparation for the practical; and stress. Students valued preparation that included clear expectations, utilization of formative assessments, and peer feedback prior to the practical. They also noted that a distractive-free testing space, having no proctor present in the room, recording the practical, and the format of OSCE's decreased stress and improved performance. Conclusions: These findings add to the body of knowledge in physical therapy and provide guidance to faculty as they plan and organize practical examinations.

Flipped spotters learning model: An innovative student activity-based strategy. A preparation tool for anatomy practical examinations in medical education.

The flipped spotters learning model is a modern student activity-based and learner-centered method in medical education. The aim of the study was to determine if the flipped spotters learning model improves students' learning. Participants were 1214 medical students of Polish (PD) and English (ED) divisions between 2013 and 2019 academic years at the University of Warmia and Mazury in Olsztyn, Poland. They were divided into a traditional group (control group) and a flipped spotters learning group (treatment group). Each flipped spotters learning group was asked to label anatomical structures on various specimens according to the structures name list prepared by the teacher on the multiple stations. The flipped spotters learning group leaders were instructed to take pictures with the appropriately marked structures on each of the human body prosections. After completion of the class, each flipped spotters team received photos for evaluation. In the flipped spotters learning model, the students strengthened their skills and knowledge by matching specimens independently as a form of practical laboratory activities. Students' performance in gross anatomy practical examinations between the group utilizing the flipped spotters learning model, and the group with the traditional teaching model was compared. Students participating in the treatment group achieved, on average 9.9 percentage points higher among PD students, and 13.0 percentage points higher among ED students than the control group in all nine practical examinations (the effect size ranging from 0.47 to 0.95). The results suggest the positive impact of flipped spotters model on improving student's performance in the practical examinations.

Perception of Medical Undergraduate Students about an Electronic Practical Examination In Orthopaedics During the COVID-19 Pandemic.

Background/purpose of study: No study has evaluated the perception of medical undergraduate students to the electronic objective structured practical examination (e-OSPE) in orthopaedics. The aim of the present study is to evaluate the feasibility and perception of the medical undergraduate students to e-OSPE conducted by the department of Orthopaedics to assess problem-solving and clinical decision-making skills of medical undergraduate students. Methods: Medical undergraduate students of second and third year at our medical college who completed the orthopaedic clinical posting and appeared for the orthopaedic practical examination during the second wave of the COVID-19 pandemic were included in this prospective observational study. Students appearing for the exams from 20th March 2021 to 26th June 2021 were invited to complete the questionnaire immediately after the e-OSPE. Internal consistency of the survey questions was assessed using Cronbach's alpha. Results: 272 out of 312 eligible students completed the survey and the survey response rate was 87.2%. Nine groups of medical undergraduate students gave the orthopaedic practical exams from 20th March 2021 to 26th June 2021. 91.2% students felt that the e-OSPE represented a valid modality of evaluation of essential orthopaedic practical knowledge during the COVID-19 pandemic. The overall reliability of the 19 questions included in our survey was very high (Internal consistency: Cronbach's alpha = 0.88). Conclusion: The e-OSPE was well received by the medical undergraduate students at our institute and the students had a positive perception about the new examination technique used in orthopaedics during the COVID-19 pandemic.

Tablet-assisted objective structured spotter practical examination (TOSSPE): Advantages of an innovative anatomy spotter examination method for medical student assessment.

The affordances of technology-based assessments, like the objectively structured practical examination, have become an integral part of gross anatomy courses. The Department of Anatomy Faculty of Medicine at the University of Warmia and Mazury developed and introduced an application for tablet devices which has been implemented in student examinations and assessments, called the tablet-assisted objective structured spotter practical examination. It was created to simplify the educational process and to build a rich learning environment, facilitating deep learning for students through examination and feedback data. The method consists of cadaver stations with traditional corresponding pin spotters in an expanded tablet application. It not only provides instant feedback on various observations of teaching-learning skills but has also positively affected the entire process of education. The method provides an unbiased evaluation of knowledge and understanding of the anatomy course, ensuring objectivity and standardization. The current study was performed on a total of 608 first-year medical students in Polish and English divisions and focused on the observed advantages since the new method was introduced. Outcomes indicate that after the implementation of the method for both the Polish and English divisions' first-year medical students, the mean score of examinations significantly increased compared to other teaching-learning methods. The study highlights that students were excited about the implementation of the new method and identified its many benefits. It is recognized that technological development and the digital environment offer a range of opportunities and added value versus traditional assessment activities, methods, and processes.

Design for assessment of dissection in anatomy laboratory based on group identification of structures and peer evaluation.

Dissection is a unique multisensory educational experience and is essential to learning the anatomical construction of the human and animal bodies. This study aims to introduce a specialized design for the assessment of dissection and to discuss the assessment's attributes. The design was a product of the "assessment drives learning" concept and was developed to motivate students to dissect. Students were awarded "dissection points" based on prior group dissection and identification of structures. Students' perception of the design was examined, and content analysis was performed. The assessment consisted of two parts: the first assigning each student group structures to "pin" on their previously dissected cadavers; the second was a group peer evaluation. The most critical factor for the assessment's success was careful selection of structures assigned to students to pin. The assessment was fit for the purpose, valid, reliable, and had a significant educational impact. Eighty-three percent of students (n = 116) recommended maintaining the assessment design, as they felt it promoted a deep approach to learning as well as teamwork while reducing stress to a minimum. A strong correlation (Spearman's rho = 0.46, P < 0.0001) was present between the high rating of the design and the number of structures learned, as well as, high rating and lower stress level (Spearman's rho = 0.40, P < 0.0001). There was no apparent influence of grades on student perception of the effectiveness of the assessment. This specific design of evaluation could be used as part of anatomy education in veterinary and medical schools.

Assessment of cognitive and psychomotor domains regarding biomedical waste management and hand hygiene among various categories of health-care professionals at a tertiary care center in Northern India.

BACKGROUND: Health care-associated infections (HAIs) are associated with high morbidity, mortality, and costs in the health-care sector. Large proportions of HAIs are preventable by following infection prevention activities such as hand hygiene (HH) and biomedical waste management (BMWM). AIM: The aim was to evaluate the effectiveness of a structured teaching session on the cognitive and psychomotor domains of BMWM and HH practices in a tertiary health-care institute. MATERIALS AND METHODS: Every participant was evaluated for pretest knowledge assessment using a prestructured format along with skill demonstration. The training included interactive sessions, open discussion, and demonstration of various skills with the active participation of various participants by trained faculty and infection control nursing officers. On completion, every participant underwent posttest evaluation. RESULTS: During 11-month study period, 450 health-care professionals (HCPs) participated in the training program. Cognitive domain score increased from 16.3 ± 2.4 to 21.3 ± 2.0 from pre- to post-test, respectively. In psychomotor domain, pre- and post-test scores for HH were 8.3 ± 3.5 and 14.3 ± 1.4, for BMWM, the corresponding values were 8.6 ± 2.1 and 9.8 ± 0.7, respectively. Overall change in the mean (± standard deviation) score between pre- and post-test for various domains of assessment was 5.0 (±2.7), 6.0 (±3.5), 1.1 (±1.8), and 12.2 (±5.3) for knowledge, HH skill demonstration, BMW segregation skill, and cumulative assessment, respectively. CONCLUSION: The initiation of a structured training program can result in a significant increase in participants' cognitive and psychomotor domains of learning, which may have an indirect impact on the prevention of HAIs.

Team-Based Ultrasound Objective Structured Practice Examination (OSPE) in the Anatomy Course.

The clinical use of ultrasound has dramatically increased, necessitating early ultrasound education and the development of new tools in ultrasound training and assessment. The goal of this study was to devise a novel low-resource examination that tested the anatomical knowledge and technical skill of early undergraduate medical students in a gross anatomy course. The team-based ultrasound objective structured practice examination (OSPE) was created as a method for assessing practical ultrasound competencies, anatomical knowledge, and non-technical skills such as teamwork and professionalism. The examination utilized a rotation of students through four team roles as they scanned different areas of the body. This station-based examination required four models and four instructors, and tested ultrasound skills in the heart, abdominal vessels, abdominal organs, and neck regions. A Likert scale survey assessed student attitudes toward the examination. Survey data from participants (n = 46) were examined along with OSPE examination grades (n = 52). Mean and standard deviations were calculated for examination items and survey responses. Student grades were high in both technical (96.5%). and professional (96.5%) competencies with structure identification scoring the lowest (93.8%). There were no statistical differences between performances in each of the body regions being scanned. The survey showed that students deemed the examination to be fair and effective. In addition, students agreed that the examination motivated them to practice ultrasound. The team-based OSPE was found to be an efficient and student-favored method for evaluating integrated ultrasound competencies, anatomical knowledge, team-work, and professional attributes.

The practical examination types (spot test and slide test) of gross anatomy course in faculty of medicine: a simultaneous evaluation of the aspect of student success.

PURPOSE: This study aimed to compare the students' scores of the spot (spotter/classical/traditional/tag/ring/bell-ringer) test (3D environment) performed in the laboratory with the slide test (gross anatomy images) (2D environment) in the class. The observation of our department regarding both types for practical examination was reported, in terms of exam marks of the students. Both are preferred as the practical examination types for gross anatomy course our in medical faculty. METHODS: The 29 blocks' scores in 5 years (2013/2014-2017/2018) belonging to first- and second-year medical students' spot tests and slide tests are evaluated retrospectively and statistically compared. Correlations of the spot tests and the slide tests, besides the correlations between theoretical examinations and the practical examination types, are calculated. RESULTS: Spot test scores were significantly higher (p < 0.05) in nine blocks, while slide test scores were higher significantly (p < 0.05) in fourteen. There was no statistically significant difference between the practical examination types (spot/slide) in six blocks. There were correlations between the spot test and the slide test in all blocks (p < 0.001). CONCLUSION: It is considered that the spot test reflects the success/ability in a 3D environment, while the slide test reflects it in the 2D environment. In conclusion, neither of these two types of examinations stands out absolutely. Both types of examinations have their own features in areas, such as assessment power, applicability, and effect on success.

Virtual Reality Bell-Ringer: The Development and Testing of a Stereoscopic Application for Human Gross Anatomy.

As post-secondary education migrates online, developing and evaluating new avenues for assessment in anatomy is paramount. Three-dimensional (3D) visualization technology is one area with the potential to augment or even replace resource-intensive cadaver use in anatomical education. This manuscript details the development of a smartphone application, entitled "Virtual Reality Bell-Ringer (VRBR)," capable of displaying monoscopic two-dimensional (2D) or stereoscopic 3D images with the use of an inexpensive cardboard headset for use in spot examinations. Cadaveric image use, creation, and pinning processes are explained, and the source code is provided. To validate this tool, this paper compares traditional laboratory-based spot examination assessment stations against those administered using the VRBR application to test anatomical knowledge. Participants (undergraduate, n = 38; graduate, n = 13) completed three spot examinations specific to their level of study, one in each of the modalities (2D, 3D, laboratory) as well as a mental rotation test (MRT), Stereo Fly stereotest, and cybersickness survey. Repeated measures ANCOVA suggested participants performed significantly better on laboratory and 3D stations compared to 2D stations. Moderate to severe cybersickness symptoms were reported by 63% of participants in at least one category while using the VRBR application. Highest reported symptoms included: eye strain, general discomfort, difficulty focusing, and difficulty concentrating. Overall, the VRBR application is a promising tool for its portability, affordability, and accessibility. Due to reported cybersickness and other technical limitations, the use of VRBR as an alternative to cadaveric specimens presents several challenges when testing anatomy knowledge that must be addressed before widespread adoption.

Objective Structured Practical Examination in Experimental Physiology Increased Satisfaction of Medical Students.

BACKGROUND: Medical education is a dynamic process, which needs to be improved to meet the new expectations of medical practitioners, health workers, and communities from different countries. An important part of medical students' education is to select an appropriate assessment method. In this regard, the objective structured practical examination (OSPE) can evaluate practical capabilities in a suitable step-wise, scientific, targeted and scheduled manner with direct consideration of student's performance during programmed test stations. The purpose of this study is to investigate the outcomes of the OSPE utilization versus traditional practical examination (TPE) for evaluating students in experimental physiology. METHODS: Totally, 120 medical students were chosen as the participants of this study: 1. TPE group (TPE used as a final exam; n=40); 2. TPE + OSPE group (TPE applied for half of topics and OSPE for another half; n=41); and 3. OSPE group (OSPE performed as a final exam; n=39). In order to evaluate the effect of OSPE, the average final grade of studied groups was compared. In addition, a 5-point Likert scale questionnaire, consisting of 10 questions was used to evaluate the students' attitudes toward using this method. RESULTS: The obtained results showed that the total grade in TPE group was significantly higher in comparison to TPE+OSPE and OSPE groups (respectively, P<0.01 and P<0.05), while according to students' expression, the average score for all of the items in feedback questionnaire was increased significantly in TPE+OSPE and OSPE groups compared with TPE group (P<0.001). CONCLUSION: In summary, feedback from students showed that they were in favor of OSPE compared with the TPE, and according to their statements in a feedback questionnaire, OSPE can improve learning in physiology as well as increasing students' satisfaction.

Conducting orthopaedic practical examination during the Covid-19 pandemic.

BACKGROUND: As the coronavirus disease (COVID-19) pandemic is expected to stay for a longer time, educational activities including residency training have gradually resumed with the aid of virtual tools. In addition to continuing the residency education during COVID-19, it is also important to conduct their examination so that the graduations of final year residents are not delayed. The conventional exam pattern involved clinical case presentations and required resident interaction with a number of patients. However, in view of the COVID-19 pandemic we conducted a "zero-patient contact virtual practical exit examination" for orthopaedic residents. METHODS: In order to replicate the conventional exam case-scenarios, clinical cases were prepared in a digital presentation format. The candidate used N-95 facemasks and gloves, and adequate social distancing was maintained in the examination area. We also designed a 10- item questionnaire aimed at assessing the quality and satisfaction with the exam pattern. RESULTS: The mean score for overall satisfaction with the virtual pattern was 4.5 (out of 5) in examiner group while it was 4.1 in examinee group. Higher scores were also reported for questions related to safety of the exam, relevance and quality of the virtual cases, etc. The mean total feedback score for the examiner and examinee group was 48 and 43.4 respectively (out of 50). CONCLUSION: Orthopaedic residency end-of-training examinations can be successfully conducted during the COVID pandemic, and we hope our experience will be helpful to other residency programs.

Participation in Dissection Affects Student Performance on Gross Anatomy Practical and Written Examinations: Results of a Four-Year Comparative Study.

The role of human dissection in modern medical curricula has been a topic of intense debate. In part, this is because dissection can be time-consuming and curricular hours are being monitored more carefully. This has led some to question the efficacy and importance of dissection as a teaching method. While this topic has received considerable attention in the literature, the question of how dissection impacts learning has been difficult to evaluate in a real-world, high-stakes setting since participation in dissection is often one of many variables. In this study, this challenge was overcome due to a change in the curriculum of a Special Master Program (SMP) that permitted a comparison between two years of students that learned anatomy using prosection only and two years of students that participated in dissection laboratories. Since each class of SMP students took courses in the medical school, and the medical school anatomy curriculum was constant, medical student performance served as a control throughout the study period. Results demonstrate that SMP students who learned through prosection had lower performance on anatomy practical and written examinations compared to medical students. When the SMP program changed and students started participating in dissection, there were measurable improvements in both practical and written examinations. These findings provide evidence of dissection's role in learning and applying anatomy knowledge both within and outside the gross anatomy laboratory.

Summative and Formative Style Anatomy Practical Examinations: Do They Have Impact on Students' Performance and Drive for Learning?

Anatomical knowledge is commonly assessed by practical examinations that are often administered in summative format. The format of anatomy practical examination was changed at the Lee Kong Chian School of Medicine in Singapore from summative (graded; must pass) to formative (ungraded; no pass/fail) in academic year (AY) 2017-2018. Both assessment formats were undertaken online, but the formative mode used a team-based learning activity comprising individual and team assessments. This gave an unique opportunity to investigate: (1) the impact of two different online assessment formats on student performance in practical examination; (2) the impact of new formative practical examination on students' performance in summative examinations; and (3) students' opinions of these two practical examination formats. The class of 2021 perceptions was obtained as they experienced both formats. A retrospective cohort study was also conducted to analyze the Year 2 students' performance in anatomy practical and year-end summative examinations of cohorts AY 2015-2016, AY 2016-2017 (summative format), and AY 2017-2018 (formative format). There were no significant differences in students' performance between two practical examination formats. The cohort who experienced the formative format, performed significantly better in summative examinations (mean ± SD: 82.32 ± 10.22%) compared with the cohort who experienced the summative format (73.77 ± 11.09%) (P < 0.001). Students highlighted positive features of the formative practical examination, including team reinforcement of learning, instant feedback, and enhanced learning. These findings indicate that students continue to study for anatomy practical examination without the need for external drivers. The team-based learning style practical examination enhances students' performance in summative examinations.