Do they know too little? An inter-institutional study on the anatomical knowledge of upper-year medical students based on multiple choice questions of a progress test

The depth of medical students’ knowledge of human anatomy is often controversially discussed. In particular, members of surgical disciplines raise concerns regarding deficits in the factual anatomical and topographical knowledge of upper-year students. The question often raised is whether or not medical students have sufficient anatomical and topographical knowledge when they graduate from medical school. Indeed, this question is highly relevant for curricular planners. Therefore, we have addressed it by evaluating the performance of students in the 5th and 6th years of their studies on anatomical multiple choice questions from the Berlin Progress Test Medicine performed at 10 German university medical schools. Results were compared to a reference based on a standard setting (modified Angoff-procedure). The reference was established independently by 5 panels of anatomists at different universities across Germany. As the ratings were independent of university affiliation, teaching-experience or training of the anatomists, an overall cut off score could be calculated which corresponded to 60.4% correct answers for the question set used in this study. In the progress test, on average only 29.9% of the students’ answers were correct, reflecting that the performance was significantly below the expected standard. On the basis of the test results it remained unclear whether acquisition or retention of anatomical information was insufficient. Further evaluation by item characteristics revealed that the students had major difficulty in applying their theoretical knowledge to practical problems in the context of a clinical setting. Thus, our results reveal deficits in the anatomical knowledge of medical students in their final years. Therefore medical curricula should not only focus on enhancing the acquisition and retention of core anatomical knowledge, but aim at improving skills applying this in a clinical setting