Punnose Kattil¹
Helga Olson², Nirusha Lachman¹, Uma Pandalai¹ and Wojciech Pawlina¹
1 Department of Clinical Anatomy, Mayo Clinic College of Medicine and Science, Rochester, MN
2 Department of Surgical Services, Mayo Clinic College of Medicine and Science, Rochester, MN

Attaining competency in an anatomy course may require a second attempt at taking the examination. In Mayo Clinic, a 6-week hybrid clinical anatomy course for Surgical First Assistants (SFA) provided both online components (lectures and daily audience response formative assessment) and laboratory experience with prosected specimens. Knowledge competency was assessed using multiple choice-based and image-based practical examinations. Students who were unable to meet the grade requirement were offered to remediate anatomy oral examinations using online platform that integrated critical thinking, structure identification and relational concept driven understanding of surgically oriented anatomy. The exam was conducted by a faculty panel over a videoconferencing platform using specific rubric. Students had access to a bank of anatomy images that were relevant to students’ encounters in their surgical training and experiences in the operating room. 

The purpose of this study was to assess student perception of the remedial examination approach in helping them to attain minimum required competency. Cohort of students who underwent remediation were invited to take part in structured interviews utilizing pre-designed questions. Qualitative approach based on grounded theory was used in analyzing data. Study obtained ethical approval by the institutional ethical review board. 

In general students were supportive of the examination format. Three major themes emerged from the study related to study strategy, uncertainty related to examination format, and reflections on the oral examination. 

Analysis of themes revealed that the provided format was effective, and students valued clear communication of expectations for the examination. The unexpected finding was that students with learning disabilities found the oral examination format to be more beneficial in demonstrating their level of acquired knowledge and more conducive to overcome some aspects of their learning disabilities. 

Structured cadaveric image-based online oral examinations offer an effective tool for assessment of core competency especially for students with learning disabilities. 

References (maximum three) 

1. Pawlina W, Drake RL. 2016. Authentic learning in anatomy: A primer on pragmatism. Anat Sci Educ. 9(1):5-7. 

2. Frellsen SL, Baker EA, Papp KK, Durning SJ. 2008. Medical school policies regarding struggling medical students during the internal medicine clerkships: Results of a national survey. Acad Med. 83(9):876-81. 

3. Nixon LJ, Gladding SP, Duffy BL. 2016. Describing failure in a clinical clerkship: Implications for identification, assessment and remediation for struggling learners. J Gen Intern Med 31(10):1172-9.