Clinical vignettes improve performance in anatomy practical assessment.

Area of Science:

• Medical Education
• Anatomy Assessment

Background:

• Medical curricula increasingly use integrated teaching approaches.
• Anatomy knowledge and skills assessment often lags behind these pedagogical shifts.

Purpose of the Study:

• To investigate the impact of incorporating clinical vignettes into anatomy practical examination items.
• To evaluate how clinical stems affect student performance and item psychometric properties.

Main Methods:

• A crossover design study involving 129 undergraduate medical students at Durham University.
• A 30-item anatomy practical test with and without clinical stems.
• Analysis using classical test theory, including item difficulty, discrimination index, point biserial, and reliability.

Main Results:

• Year 2 students showed significantly improved performance and better item discrimination with clinical stems.
• No significant differences in performance or discrimination were observed for Year 1 students.
• Over 65% of items demonstrated good quality (point biserial > 0.2) in both cohorts.
• Year 1 non-clinical items had better reliability than clinical items.

Conclusions:

• Clinical vignettes may enhance anatomy practical assessments for some undergraduate cohorts but not all.
• The effectiveness of clinical stems varies by student year and may require further investigation.
• Findings suggest a need to align anatomy practical assessments with evolving integrated medical curricula.