Medical Undergraduates' Assessment Status Regarding Clinical Neuroanatomy.

The study of Anatomy is essential to the learning of different subjects of medicine. Neuroanatomy is a fundamental part of the Anatomy portion of the undergraduate medical (MBBS) curriculum of different universities of Bangladesh. The clinical relevance of Neuroanatomy is beyond doubt in the context of increasing numbers of cases like stroke, head injury and meningitis in Bangladesh. Contemporary Neuroanatomy books are inclined to a clinically-oriented approach in their presentation. However, there is no organized attempt to analyze these recent trends of highlighting the significance of clinically-oriented approach reflected in the learning pattern or student-assessment in the medical undergraduate courses of Bangladesh. Such analyses can offer an insight into the situation and facilitate teachers and curriculum planners to make necessary modifications. The present study was planned- i) to analyze the Neuroanatomy portion of the recent undergraduate Anatomy written question papers of four public universities of Bangladesh for understanding how clinically relevant knowledge has been assessed in the questions ii) to determine the ability of the medical undergraduates to answer clinically-oriented written questions as compared to their ability to answer non-clinically-oriented questions in Neuroanatomy. It was a comparative study with some descriptive components. For Part-A of the study, all the 'Question-segment's of question (SAQ and MCQ) dealing with Neuroanatomy in all the available First Professional MBBS Exams' Anatomy written question papers of four public universities of Bangladesh of the last five years (2005 to 2009) were identified. The frequency of 'Question-segment's those assessing the ability of the clinically relevant knowledge were determined. It was a descriptive study. For Part-B of the study, total 136 New 3rd year medical undergraduates of one Bangladeshi governmental medical college and one private medical college were taken as participants. The medical undergraduates of each medical college were divided into two equal groups by randomization. One group was given 100 clinically-oriented questions and the other was given 100 non-clinically-oriented questions based on the content of Snell. The scores (frequencies of correct responses) of the two groups were compared using an unpaired 't' test. The frequencies of 'Question-segment's assessing clinically relevant knowledge was 6.14%. The performance of the undergraduates answering clinically-oriented questions was significantly poorer (p=0.01) than answering non-clinically-oriented questions (the mean score being 38.49±10.50 and 45.04±8.48 respectively). Teaching and assessment of Neuroanatomy should be designed in a way to orient medical undergraduates towards more clinically-oriented understanding and performance in Neuroanatomy. The clinically relevant knowledge dealing with Neuroanatomy needs to be addressed with appropriate weighting in the First Professional MBBS written questions of Bangladesh. Necessary changes in the curriculum are also suggested in meeting the above expectations.