106 - Analysis of Student Performance Differences Between In-person and Online Gross Anatomy Practical Examinations

Poster Board Number: 106
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Odd poster #s – first hour
Even poster #s – second hour

Abstract Body : Introduction and Objective: Students training to be healthcare professionals are traditionally taught human anatomy using cadaver-based dissection. A practical examination where students attempt to identify specific structures labeled on a cadaver (in-person) is the most common format for assessment. However, computer-based (online) testing using photographs and digital images is an emerging means of appraisal. Here, we compared scores between in-person and online practical exams to gain insight into the relationship between these assessment modalities and student performance.
Materials and Methods: First year medical students (MS1, n=215 per year) enrolled in academic years 2020 through 2022 and dental students (DS1, n=140 per year) in years 2019 through 2022 at Temple University were provided in-person instruction in Human Structure/Gross Anatomy. Learning exercises consisted of clinical case conferences and cadaver dissection laboratory. Depending on the academic year, students participated in either an in-person or an online practical exam. For the in-person format, students rotated through 50 stations (1 minute per station) and provided a free response to a single structure labeled on either a cadaver, anatomical model, skeletal element, sectional or diagnostic image. Students were given access to each question one time only. The online format consisted of 50 2D-images from Netters Atlas of Human Anatomy, photographs of dissected cadavers, sectional or diagnostic images viewed on individual laptop computers. Students were also given 1 minute to record a free response to a single labeled structure; however, students were able to return to any image within the testing period. Correct answers for each exam were expressed as a percentile and the mean with standard deviation of these percentile scores was tabulated to obtain an overall exam average. Comparisons between assessment types were analyzed using mixed-effects regression modeling with the post-hoc Tukey adjustment for multiple testing. P-value less than 0.05 was considered statistically significant.
Results: Online practical exam scores for MS1 students were 92.06+/-8.98 compared to 87.63+/-10.29 for students assessed in-person (P < 0.0001). Similarly, DS1 students taking the online practical exam outperformed those examined in-person 91.85+/-8.81 vs. 74.47+/-14.15, respectively (P < 0.0001).
Conclusions: Medical and dental students achieve significantly higher scores on online assessments compared to anatomy practical exams conducted in-person using mostly cadavers.
Significance/Implication: Assessment serves to evaluate student comprehension and understanding which informs future strategies for enhancing the learning process. Since online anatomy practical exams are increasingly used as an alternative to traditional in-person practical exams, understanding why students achieve higher scores in this format requires additional analysis. Moreover, the impact of online assessment on long-term memory retention and recognition of 3D spatial relationships between anatomical structures is unclear and warrants further study.