Influence of the wording of evaluation items on outcome-based evaluation results for large-group teaching in anatomy, biochemistry and legal medicine.

Student learning outcome is an important dimension of teaching quality in undergraduate medical education. Measuring an increase in knowledge during teaching requires repetitive objective testing which is usually not feasible. As an alternative, student learning outcome can be calculated from student self-ratings. Comparative self-assessment (CSA) gain reflects the performance difference before and after teaching, adjusted for initial knowledge. It has been shown to be a valid proxy measure of actual learning outcome derived from objective tests. However, student self-ratings are prone to a number of confounding factors. In the context of outcome-based evaluation, the wording of self-rating items is crucial to the validity of evaluation results. This randomized trial assessed whether including qualifiers in these statements impacts on student ratings and CSA gain. First-year medical students self-rated their initial (then-test) and final (post-test) knowledge for lectures in anatomy, biochemistry and legal medicine, respectively, and 659 questionnaires were retrieved. Six-point scales were used for self-ratings with 1 being the most positive option. Qualifier use did not affect then-test ratings but was associated with slightly less favorable post-test ratings. Consecutively, mean CSA gain was smaller for items containing qualifiers than for items lacking qualifiers (50.6±15.0% vs. 56.3±14.6%, p=0.079). The effect was more pronounced (Cohen's d=0.82) for items related to anatomy. In order to increase fairness of outcome-based evaluation and increase the comparability of CSA gain data across subjects, medical educators should agree on a consistent approach (qualifiers for all items or no qualifiers at all) when drafting self-rating statements for outcome-based evaluation.

Post mortem CT scans as a supplementary teaching method in gross anatomy.

Despite increasing the integration of radiologic imaging teaching in anatomy dissection courses, studies on learning outcome of these interventions are rare or have certain shortcomings in study design. In this study, students were randomly allocated to an intervention group (n=53) receiving five weekly CT-courses of 30min duration during a 6-week gross anatomy course. Students in the control group (n=329) received no additional teaching. Total teaching time did not differ among groups. All students were asked to participate in a pre- and post-course self-assessment (comparative self-assessment; CSA) of learning objectives related to anatomical spatial relationships and a post-course formative assessment on radiologic anatomy. Items of both assessments were matched. Moreover, students of the intervention group were asked to evaluate the CT-courses. Most participants of the intervention group classified the CT-courses as "good" or "very good". Nevertheless, results of the CSA and formative assessment did not differ among study and control groups. These findings indicate that the teaching intervention (CT-courses) did not have an impact on recognition of anatomical structures in radiological images beyond the knowledge acquired in the anatomical dissection course. As a consequence, interventions integrating radiology imaging into dissection courses should be based on psychological considerations of how to best foster student learning. Learning outcome has to be monitored, as results of evaluation surveys can be misleading. Further research on curricular concepts is needed considering both short- and long-term effects.