Neuroanatomy lab creation based on principal coordinate analyses of student confidence

Medical students often demonstrate low confidence in topics related to neuroanatomy. This study examined this phenomenon by analyzing the effect of either dissection-based or model-based laboratory experiences on the qualitative levels of student confidence self-reported by first-year osteopathic medical students (OMS) studying medical neuroanatomy. Anonymous online surveys gauged each student's self-reported confidence in correctly answering written exam questions pertaining to each listed lecture objective for a first-year osteopathic medical school Medical Neuroanatomy course. Survey items asked respondents to qualitatively evaluate their confidence in correctly answering neuroanatomy questions for each learning objective. These surveys were deployed for two consecutive OMS cohorts, before and after the deployment of "hands-on" extracurricular neuroanatomy laboratory activities. A principal coordinate analysis (PCoA), based on the pairwise Jaccard distances between survey respondents, indicated that the more "unconfident" neuroanatomy students could be better categorized into those that felt either more insecure about content related to central nervous system (CNS) long tracts (the corticospinal, DC-ML, and spinothalamic tracts) and those that were more insecure about content related to the primary visual pathway. The use of this novel method for curricular assessment allowed the 113 Likert-scale item responses collected from both cohorts to be summarized with a small number of continuous quantitative "principal coordinates" which identified related groups of problematic topics within the medical neuroanatomy course, such as CNS long tracts and ophthalmological content. Finally, we provide recommendations for the future use of PCoA in determining broader themes in curricular content that contribute most directly to the phenomenon of "neurophobia" and student confidence.