Improving Surgical Anatomy Teaching

Background: Medical students in clinical settings may have difficulty to recall and apply anatomical knowledge in diagnostic reasoning and problemsolving. In this double blind prospective randomized trial we aimed to assess A) the learning effect of anatomy teaching in the Surgery Clerkship Preparation Course (SCPC) and B) whether offering an anatomical pretest has an additional learning effect. Methods: In a 10 months period, 10 SCPC groups were randomly assigned in 2 study arms. The intervention arm (5 groups, n=128) received an anatomical pretest at day 1. The control arm (5 groups, n=135) received a sham pretest. All students participated in anatomy classes at day 2-4 and underwent an anatomical posttest at day 15. Pre- and posttest scores were corrected for item difficulty (Modified-Angoff method). Pre- and posttest scores of the intervention group were compared to assess the learning effect of anatomy teaching in the SCPC (Random Effects Model) and posttest scores of both groups were compared to assess the effect of pretesting. Results: A significant improvement on posttest performance was seen in the intervention arm (p=<0.0005). No significant differences in posttest scores were seen (p=0.857) between the intervention and control group. Discussion: This study demonstrates a significant learning effect of anatomy teaching in SCPC. However, no adjuvant effect of pretesting on directing students to subsequent learning was seen. These findings underscore the positive value of anatomy teaching in a SCPC and suggest that the pretest offered does not add to the learning effect in the current study design.