Evaluation of the Effectiveness of a Surface Anatomy Curriculum in Teaching Medical Students the Physical Exam
Authors: Curry Brian , Brown Shilpa , Hryniuk Alexa , Edmondson Anna 
Published: June 2021

Introduction

First year medical students at the Medical College of Georgia learn to conduct the physical exam during Physical Diagnosis (PD). The physical exam is taught head to toe, similar to a clinician's technique for evaluating patients with no specific complaints. Students review online handouts/videos in preparation for PD workshops. However, students struggled with content because the workshops were completed before relevant anatomy was taught in basic science modules. To address this concern, Surface Anatomy sessions were introduced prior to the PD workshops.

Purpose and Hypothesis

The purpose of this study was to assess the effectiveness of Surface Anatomy sessions in teaching students the relevance of surface anatomy in performing the physical exam. We hypothesized that these sessions would improve students' knowledge of surface anatomy relevant to the physical exam.

Methods

Surface Anatomy sessions were integrated into PD addressing Vital Signs, HEENOT (Head, Ears, Eyes, Nose, Oral Cavity, Throat) exam, Cardiopulmonary exam, Abdominal and Genitourinary/Gynecological (GU/GYN) exams, and Neurologic/Musculoskeletal exams. At the beginning of the year, students (n=193) completed a pre‐test with 16 Hotspot questions, where students click an area on an image, to determine prior surface anatomy knowledge. During each session, students answered 3 Audience Response System (ARS) questions assessing knowledge acquisition. Students completed a post‐test with the same Hotspot and ARS questions to assess retention at the conclusion of the curriculum. Students' performance on pre‐ and post‐tests were analyzed using two‐tailed, paired t‐tests to determine the effectiveness of the Surface Anatomy curriculum in understanding and performing the physical exam.

Results

Students performed significantly better on post‐test Hotspot questions after the Surface Anatomy curriculum compared to pre‐test questions (42% ± 16.8% vs. 21.4% ± 11.4%; p<0.05). Despite learning relevant anatomy in basic science modules, students were still unable to correctly answer most questions at the end of the Surface Anatomy curriculum. Scores on post‐test questions related to the Cardiopulmonary exam were surprisingly low (average 19% ± 11.8%), especially since that content was previously taught in a basic science module. Students performed better on post‐test questions addressing the Abdomen and GU/GYN exam (average 70% ± 29.6%), which was just covered in the basic science modules. Students performed significantly worse on ARS questions at the end of the Surface Anatomy curriculum compared to their performance on the same questions during the sessions (53.8% ± 21.7% vs. 88.5% ± 11.8%, p<0.05).

Conclusion

These results suggest a significant lapse in knowledge retention over the course of the curriculum. Overall, students appear to have difficulty recognizing, applying, and retaining their knowledge of surface anatomy relevant to the physical exam despite these sessions. In the future, more opportunities are needed to help students integrate surface anatomy knowledge with physical diagnosis skills.

This abstract is from the Experimental Biology 2019 Meeting. There is no full text article associated with this abstract published in The FASEB Journal.