The weak relationship between anatomy competence and clinical skills in junior medical students.

In modern curricula, the early integration of anatomy and clinical skills education at undergraduate level is seen as important. However, the direct relationship between medical students' competence in anatomy, and their clinical proficiency during early undergraduate years, has scarcely been studied. In this study, the marks for anatomy and clinical skills of three consecutive cohorts of medical students (n = 538 in total) during their first two years were correlated. The anatomy competence was measured using a new marker, the Anatomy Competence Score (ACS) which was calculated with equal contributions from theory knowledge and its practical and clinical application. Proficiency in clinical skills was determined by OSCE performance marks for stations which examined physical examination and practical procedural skills. The possible compounding effect of students' general academic ability was investigated by using the overall performance mark for each student based on their performance in all subjects over the first two years of the medical curriculum. We found that the correlation between anatomy and clinical skills marks was weak to moderate. However, this correlation was virtually nullified once the effect of academic ability was accounted for. Although these findings suggest that anatomy education does not compliment early clinical education, the lack of complexity of clinical problems used in clinical skills assessments (OSCEs) during the early stages may well be the primary contributing factor to this finding.

The anatomy competence score: a new marker for anatomical ability.

The assessment of students' ability in gross anatomy is a complex process as it involves the measurement of multiple facets. In this work, the authors developed and introduced the Anatomy Competence Score (ACS), which incorporates the three domains of anatomy teaching and assessment namely: theoretical knowledge, practical 3D application of the knowledge, and clinical or bedside application of knowledge on patients. Equal contributions from these tripartite domains were used to synthesize the ACS. The theory knowledge was assessed using MCQs and short answer questions while the knowledge of practical 3D application was assessed using an Objective Structured Practical Examination (OSPE). The clinical or bedside application of anatomy knowledge was assessed by an Objective Structured Clinical Examination (OSCE). In this correlation study, the authors examined the interdomain correlations of the summative marks for the three contributing domains of the ACS, in order to examine the rationality of this new marker. Three cohorts of medical students (n = 538) at St. George's, University of London (SGUL) Medical School in the United Kingdom were included and analyzed. The results demonstrated that the correlations between the three domains were significantly low or moderate. The three domains probably represent unique knowledge and abilities. Therefore, it would appear that the average of the domains scores (the ACS) provide a comprehensive picture of a student's ability in anatomy.

Assessment drives learning: an unavoidable truth?

The debate around which factors drive medical students' learning is ongoing and controversial. What is the influence of an assessment's weighting on the motivation of students to study the particular subject? One medical school in London is in a unique position to investigate this question. At our institution, the weighting of Anatomy within the overall scheme of assessment has changed twice in recent years, a trend of increased weighting. This enabled a comparative investigation into the effect these changes have had on the students' motivation to learn Anatomy. A five-point Likert-scale questionnaire survey was used to evaluate students. A section within a broad survey of Anatomy teaching and learning at our institution was dedicated to the evaluation of the amount of weighting Anatomy received within the assessment structure and the effect this had on students' motivation toward learning the subject. Increasing Anatomy's weighting within the scheme of assessment produced a dramatic increasing trend toward students' motivation to learn Anatomy. The weighting of Anatomy has a profound effect on students' motivation to learn it. Although multifactorial and complex in nature, medical students' self-reported drive to study a subject is directly influenced by the weighting of the subject in the overall scheme of assessment.

Venepuncture technique training vs practice: a survey of foundation year 1 doctors.

This survey investigated potential disparity between foundation year 1 doctors' formal undergraduate venepuncture training and their actual clinical practice. Is there still a high prevalence of needle and syringe use?