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Does an Additional Online Anatomy Course Improve Performance of Medical Students on Gross Anatomy Examinations?

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Abstract

Aim

An online learning course in anatomy was added to the regular academic anatomy course in the 2nd year of medicine at UNAN-Leon in Nicaragua, using the MOODLE platform. This study aims to determine the learning effect of this course.

Method

Second-year medical students were randomly allocated to an experimental (N = 25) and control group (N = 50). Only the experimental group had access to the online learning module. We compared the performance of the experimental and the control group on both regular anatomy assessment and an objective structured practical exam (OSPE). Additionally, five focus groups were interviewed to learn about their experiences of the expanded course.

Results

Of students in the experimental group 94.1% and 81.6% of students in the control group took the OSPE. The experimental group significantly outperformed the control group (41.1 ± 19.3 points vs. 32.1 ± 23.1 points) on the OSPE. No differences between the two groups were found on the regular anatomy examination. Focus group interviews revealed students’ opinions about the online course were generally positive.

Conclusion

In general, the addition of an online course to the regular course was beneficial. The results of the qualitative evaluation of this intervention provides us with input about how to teach and evaluate the anatomy course and how to further improve the online course to enhance anatomy learning.

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Change history

  • 25 June 2019

    The original version of this article has been updated to correct the names of authors Custer, van Leeuwen, and Bleys.

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Acknowledgments

The authors wish to thank Dr. Rodolfo Peña, MD, PhD, for his contribution in the educational intervention design; Dr. Daysis Yoe Ling Chang, MD, PhD, for her collaboration in the statistical analysis; and Dr. Ligia Cruz, MD, PhD and Dr. Sonia Acevedo, MD, family doctor specialist, for their collaboration in reviewing and editing the paper.

Author information

Authors and Affiliations

  1. Department of Morphological Sciences, Faculty of Medical Sciences, National Autonomous University of Leon (UNAN-Leon), Leon, Nicaragua

    Ana Yoe-Cheng Chang Chan

  2. Center for Research and Development of Education, University Medical Center Utrecht, Utrecht, The Netherlands

    Eugene J. F. M. Custers & Olle ten Cate

  3. Department of Radiology, University Medical Center Utrecht, Utrecht, The Netherlands

    Maarten Simon van Leeuwen

  4. Department of Anatomy, University Medical Center Utrecht, Utrecht, The Netherlands

    Ronald L. A. W. Bleys

Authors
  1. Ana Yoe-Cheng Chang Chan
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  2. Eugene J. F. M. Custers
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  3. Maarten Simon van Leeuwen
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  4. Ronald L. A. W. Bleys
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  5. Olle ten Cate
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Corresponding author

Correspondence to Ana Yoe-Cheng Chang Chan.

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Conflict of Interest

The authors declare that they have no conflict of interest.

Ethical Approval

Participation in the study was voluntary. The approval from the authorities of the Faculty of Medical Sciences of UNAN-Leon was obtained.

Informed Consent

Oral informed consent was obtained from all individual participants included in the study.

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The original version of this article was revised to correct the names of Custers, van Leeuwen, and Bleys.

Appendices

Appendix 1 Content per week of online modules

Week

Cardiovascular

Digestive

Respiratory

1

Heart: internal and external configuration. Pericardium.

Abdominal walls: muscles of the anterolateral wall, posterior wall muscles, spine (lumbar). Inguinal canal.

Ribcage: diameters, openings, sternum, ribs, spine (thoracic).

2

Mediastinum: classification and content (large vessels). Arteries and veins of the head and neck.

Peritoneum and peritoneal compartments.

Diaphragm muscle and accessory muscles of breathing.

3

Arterial system: arteries of the abdomen and pelvis.

Oral cavity, salivary glands, and pharynx.

Nasal cavity, paranasal sinuses, and pharynx.

4

Arterial system: arteries of the upper limb and lower limb.

Esophagus and stomach.

Larynx, trachea, and bronchi.

5

Venous system: superior vena cava and system of azygos veins.

Small intestine and large intestine.

Lungs, pleura, pleural cavity, and pleural recesses.

6

Venous system: inferior vena cava and portal vein system.

Liver, biliary tract, and pancreas.

Mediastinum: classification and content.

7

Imagenology of the cardiovascular system: X-ray PA and lateral thorax.

Imagenology of the digestive system: abdominal plain X-ray and with oral contrast.

Imagenology of the respiratory system: X-ray PA and lateral chest.

8

Imagenology of the cardiovascular system: thorax CT scan.

Imagenology of the digestive system: abdomen CT scan.

Imagenology respiratory system: thorax CT scan.

9

Evaluation: online test + OSPE

Appendix 2. Focus group discussion guide

Topic

Questions

Online course (only for experimental group)

1. What do you think about the content of the course: activities (forum, chat, wiki, assignment, test) and didactic resources (scientific articles, tutorials, conferences, videos, links)?

2. About the online course, what did you like the most, what do you like the least?

3. What is the usefulness of the online course?

4. Why do you think participation in the course activities was low?

OSPE (for experimental and control group)

1. About the OSPE, what do you like the most, what do you like the least?

2. What is the usefulness of this type of evaluation?

3. Is the OSPE an objective assessment, why?

4. What do you think why is the big difference in the scores between the OSPE and regular anatomy assessment?

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Chang Chan, A.YC., Custers, E.J.F.M., van Leeuwen, M.S. et al. Does an Additional Online Anatomy Course Improve Performance of Medical Students on Gross Anatomy Examinations?. Med.Sci.Educ. 29, 697–707 (2019). https://doi.org/10.1007/s40670-019-00751-z

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