Objectives: 
Gross anatomy lays the foundation for subsequent understanding of
clinical teaching so teaching gross anatomy to undergraduate students has
always been challenging. Students are the most important stakeholders in this
process of teaching and learning. Constant feedback and its evaluation is a
requisite to prepare an appropriate and effective clinical based, integrated
gross anatomy curriculum. Feedback obtained from students is an essential tool
in the process of evaluation of teaching and learning in any institution.
Analysis of feedback from students and reflections of teachers can help to make
new improvements and modifications in the course content and teaching methods.

 Method: This study was conducted in the form of an anonymous survey.
150 medical students of the first year MBBS class participated in this study. A
questionnaire was circulated amongst them during college hours. There were 17
questions in the questionnaire which were based on the course content, methods
of teaching, quality of teaching, teaching tools, mode of assessment of
students, and suggestions to improve the quality of the curriculum in relation
to gross anatomy.

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 Results: Majority (76%) of the students was willing to
participate in the survey and gave their honest opinion. Though majority (77%)
of the students liked the subject, the course content, methods and tools of
teaching. A number of students suggested that audiovisual tools should be used
more and more over, they wanted to have more CBL sessions and clinical visits.   

 Conclusion: Feedback by students can play an
important role in modification, reconstruction and delivery of an effective,
integrated gross anatomy course. Student’s feedback in gross anatomy teaching
suggests that learning process can be improved if better teaching methods are
adopted; latest teaching tools are used along with more interactive teaching
sessions between students and faculty.

 Keywords: gross anatomy teaching; student’s feedback; evaluation

 

 

 

 

INTRODUCTION:

 Student’s opinion or feedback on the teaching,
learning and assessment has been an important tool in assessing and reviewing
effectiveness of instructional and assessment methods in medical education. 1,
2

Some authors
in the past have opinionated that students’ judgments are not reliable and
valid as they are inconsistent in making opinions and are always looking for an
easy way out that suits them (3-7), however this opinion has not been supported
by later research.(4)

Median and
average correlation of students’ rating with self-rating by instructors have
been reported by some investigators. (8) There is a moderate correlation of
students rating with that of administrators.(9)and also moderate relationship
has been shown between the feedback of faculty and students.(10) Moreover it
has been found that student age, gender or level of study does not affect their
feedback about the teaching/learning process.(11)

Therefore,
it can be concluded from these findings that reliability and credibility of student’s
feedback is pretty high. Analysis of student feedback is imperative to apprise
the faculty and administration of the requirements of students, weakness and
strength of teaching and learning process, besides helping to evaluate the
effectiveness of teaching and learning methods.12–16 Thus, effectiveness of  student feedback to the improvement and
modification of curriculum of any subject cannot be undermined.

The present
study was undertaken to analyze students’ feedback in gross anatomy teaching in
CMH Medical College Lahore.

 Aims and objectives were to find out student’s response to;

• Coverage of course content in lectures,

 • Appropriateness of
teaching methods used in gross anatomy,

 • Quality of teaching
in lectures of gross anatomy with regards understanding of subject,

 • Use of innovative
and latest available teaching tools in lectures, demonstrations and dissection
hall, and

 • The mode of
assessments used.

 

 

Materials and Methods: This study was conducted in the form
of an anonymous survey in the Anatomy department of CMHLMC & IOD Lahore.
One hundred and fifty medical students belonging to the first year MBBS class
participated in this study. A questionnaire based on Likert’s five points scale
was circulated amongst them during college hours after obtaining consent from
students. Questionnaire is attached as Table-1.

The
questions in the questionnaire were based on the coverage of course content,
methods of teaching, quality of teaching, teaching tools used, mode of
assessment of students and suggestions to improve the quality of the curriculum
in relation to gross anatomy teaching.

The
responses obtained from questionnaire were analyzed in regard to following
attributes:

• Coverage
of course content (Question number 1, 2 and 3)

• Quality of
teaching (Question number 4, 5, 6 and 16)

• Methodology of teaching (Question
number (7, 8)

• Use of
innovative tools (Question number 9, 10, 11, 12 and 13)

 • Mode of assessment of students (Question
number 14 and 15)

The feedback
for each attribute was analyzed with the help of responses of predetermined
three questions except quality of teaching where 4 questions were included.
Response 1 and 2 of each question were clubbed together and considered as
inadequate or dissatisfactory. Response 3, 4 and 5 were clubbed together and
considered as adequate or satisfactory. Suggestions by the students to improve
gross anatomy teaching in response to question 17 were included in Discussion.

Results: 115 out of 150 students returned back the
questionnaire after voluntarily responding to the questions. Student’s responses
to the questionnaire are given in Table-2.

Student’s Response for the Coverage of course content and
Quality of teaching are shown in Figures
1 and 2.

Student’s response for Methodology of teaching, use of
innovative tools and mode of assessment for students are shown in Figures 3-5.

However, responses to question number 17 were analyzed
separately and discussed in discussion section.

 

 

TABLE-1: STUDENT
FEEDBACK ABOUT GROSS ANATOMY TEACHING AND ASSESSMENT:

STUDENT’S FEEDBACK
QUESTIONNAIRE

Please grade the following as;
1-Poor,   2-
Fair,   3-Good, 
4-Very good,  5-excellent.

S. No.

Questions

1

2

3

4

5

1

Coverage of important and
relevant content of the topics
taught in lectures.

 

 

 

 

 

2

 Teaching of clinical correlation wherever
relevant in lectures.
 

 

 

 

 

 

3

Flow of lectures clearly
explained the content which helped you to understand the topic well.

 

 

 

 

 

4

Highlighting of important
points during lectures that helped you for further study in each topic.

 

 

 

 

 

5

 Delivery and pace of lectures was suitable to the
level of your understanding in the class.
 

 

 

 

 

 

6

 Encouragement and freedom of students to ask questions
and give answers during lectures.

 

 

 

 

 

7

 Lectures and demonstrations
were taken in a way that stimulated
interest in the subject and encouraged you to study further.
 

 

 

 

 

 

8

 Session of dissection with suitable instructions helped in proper
identification and study of various structures.
 

 

 

 

 

 

9

 Innovative tools like videos, animations that were included in
lectures and demonstrations to help provide understanding of the topic.
 

 

 

 

 

 

10

CBL sessions helped you to
understand and learn the concepts of gross anatomy.

 

 

 

 

 

11

 CBL sessions motivated for self- study and independent learning.

 

 

 

 

 

12

CBL sessions helped
improve your communication and presentation skills.

 

 

 

 

 

13

Clinical visits / skill lab helped
increase your interest and motivation for the subject.

 

 

 

 

 

14

 Assessments conducted in the form of written examinations
(multiple choice questions and short answer questions) served the purpose to
make you aware of your grasp of the subject.
 

 

 

 

 

 

15

 Assessment conducted in the form of viva
voce examination helped you to improve your subject knowledge and application
skills.
 

 

 

 

 

 

16

 Availability of teachers of department of anatomy to solve
subject queries beyond teaching hours.

 

 

 

 

 

17. What suggestions would
you like to give to improve teaching of gross anatomy? Please write in maximum two sentences.
 

TABLE-2

Students’ responses to the
questionnaire as inadequate/dissatisfactory and adequate/satisfactory.

Attribute

Inadequate/
dissatisfactory
% response( 1+2)

Adequate/Satisfactory
%response(3+4+5)

Coverage of content(Fig.1)

20%

77%

Quality of teaching (Fig.2)

23.5%

77%

Teaching Methodology(Fig. 3)

39%

74%

Innovative Tools used (Fig. 4)

25%

74%

Mode of Assessment (Fig.5)

14%

86%

 

FIGURE-1, Students’ response for the content coverage as poor, fair, good, very
good and excellent

 

 

FIGURE-2, Students’ response for quality of teaching as poor, fair, good, very good
and excellent

 

FIGURE-3, Students’ response for teaching methodology as poor, fair, good, very
good and excellent

FIGURE-4, Students’ response for the use of Innovative Tools as poor, fair, good,
very good and excellent

FIGURE-5,  Students’ responses for Mode of
Assessment of students for learning input as poor, fair, good, very good and
excellent

 

Discussion :

Effectiveness
of students’ feedback for assessing teaching-learning process has been shown to
be quite reliable and consistent. (17) Moreover, it is also logistically easy
and inexpensive to obtain feedback.  In
the present study, out of 150 students approached for feedback, 115(76%)
responded with their opinion. Many other such studies have shown more than 90%
response by students. 18–20

       In
the present study, more students (77% in comparison to 20%) were satisfied with
the coverage of content in lectures. This is similar to the observations of
some prior studies. Rafique
and Rafique20 who stated that majority of students were satisfied with
the content, oration, explanation and language used. Another study (Nagar)21
also showed that around 80% students believed that the lectures and tutorials
taken by teachers were adequate. Some investigators have documented (
Studies18,19) have shown that most students found practical demonstrations
and practical work helpful in learning and these helped solve most of their
queries. Rani observed that 71.6% students stated that learning anatomy by
utilizing skills like drawing diagrams improved their understanding.22

In our
study, most of the
students were satisfied (77%) with the methodology of teaching . They rated the
method of explanation and highlighting of important points in lectures and the
demonstrations during dissection sessions as satisfactory. Majority of students
responded that the teaching methods and quality of teaching and use of
innovative teaching tools like use of interactive gross anatomy atlases, CBL sessions,
and Clinical rounds was much appreciated by them ( 74%). This is similar to the
findings of other studies,18,20,21 in which most of the students were in favor
of using multimedia like

LCDs with
power point presentations as teaching tools, instead of traditional methods of
teaching like blackboard or overhead projectors.

Majority of
responders in the present study were satisfied with the mode of assessment in
subject of gross anatomy (86%), and this finding is supported by other
observers 20 who found out that majority of students felt that the
multiple modes of assessments, that is multiple choice questions plus short
essay type questions and viva and objectively structured practical examinations
etc., improve their knowledge and skill. Larvalmawi et al.19 reported that 79% students rated
the assessments in the form of weekly tutorials as most useful form of
assessment which helped prepare for final examinations which is similar to
findings by Nagar et al.21

 In response to Q. No. 17, students responded
with following suggestions:

 • Lectures should be more interactive involving
students

 • More audio visual aids like videos and
animations should be included in lectures.

 • During dissection/prosection the groups
should be small so each student gets the chance.

•Case Based
Learning (CBL) sessions and clinical visits should be increased.

 These responses are similar to various studies
that have included students suggestions in the feedback.18,22,23 The most
important points highlighted by the students in these studies were to make the
lectures more interactive, more and better use of multimedia, ensure friendly
atmosphere, and to hold  more CBL
sessions and frequent clinical visits.

Taking into
consideration the suggestions of students we have tried to incorporate them in
planning next session teaching schedules to have more interactive lectures,
more organized dissection/ prosection groups , weekly CBL sessions and clinical
lectures and clinical visits of relevant wards in order to make gross anatomy
learning more effective, interesting and relevant for students.

Conclusion:

Students are
the main stake holders in the process of teaching/learning so their feedback
should not be ignored rather it should be taken regularly in order to make the
process of teaching and learning more conducive and effective, as their
feedback helps in modification, reconstruction and delivery of an effective,
integrated gross anatomy course.