Medical Student Preferences on the Anatomy of a Practical Exam

Medical schools traditionally assess anatomy knowledge using individual, cadaver-based assessments during students' first and second years. Recently, some institutions have updated their anatomy curricula to emphasize virtual learning and team-based instruction or assessments. Despite the implications of these changes on student performance and satisfaction, there is limited literature describing medical students' preferences on the structure of anatomy practical exams. Since learners are a key stakeholder in assessment redesign, this quality improvement study sought to illuminate their perspectives on four aspects of anatomy practical exams. Our institution's Class of 2028 (n = 224) experienced four different anatomy practical exams during their first year, varying in anatomy viewing method, question type, and the addition of a group exam. To leverage their unique experience, this cohort was invited to complete a voluntary survey asking their preferences regarding the aforementioned conditions and preferred grading distribution of individual and group exams. They could explain each of their choices in optional free responses. Descriptive statistics and chi-square tests were used to analyze quantitative data, while thematic analysis identified patterns in the comments. All results were statistically significant (p < 0.001) and indicated preferences for specific variations to anatomy assessment. Of the 114 responses, 69.3% favored viewing the anatomy with pinned cadavers over digital images, citing the strengths of the three-dimensional orientation and reflection of anatomic variation. The majority (93.9%) preferred multiple choice over fill-in-the-blank questions for their relative ease and consistency with standardized exams. Most (72.8%) preferred an individual then group exam over an individual-only exam due to collaboration-enhanced learning. The two most favored grading distributions were Individual 90%/Group 10% (42.1%) and Individual 50%/Group 50% (22.8%). Reasons for the former included lesser penalty for disagreeing with group members and individual accountability, while those for the latter emphasized fairness. The most popular combination of answer choices (15.8%) matched the composite of the most favored option for each question. This study revealed our learners' priorities in the assessment process. Ultimately, it serves to guide anatomy curriculum directors in assessing their own students' preferences and designing practical exams with consideration for their viewpoints.