Online anatomy assessments for large classes: educational and ethical considerations

The Objectively Structured Practical Exam or OSPE is a commonly used assessment method in anatomy. Traditionally it involves a circuit of timed stations in the Anatomy lab each with one or more questions based on human cadaveric specimens, bones, models, radiological or histological images to which students write very short answers (VSAs). Literature supports the use of VSAs as being superior to the single best answer format where students choose the best of 4–5 options. Recently, student numbers on some degree programmes notably undergraduate Medicine have increased significantly (66% over 7 years in our institution). This inevitably constrains how we conduct OSPEs with the available resources (time, space, cadaveric specimens and staff). The recent pandemic has given us valuable experience of running assessments online effectively. But it is well known that assessment drives learning, and literature does suggest that a move to online OSPEs using images instead of an OSPE done in the lab can lead to changed student learning behaviour with students focussing on learning from atlases rather than from specimens in the lab. We kept our online OSPEs unique by using high-quality professionally obtained cadaveric images of our own cadaveric specimens instead of images from commercial photographic atlases. This format encouraged students to continue to attend Anatomy lab sessions and learn from cadavers as they still remained relevant to assessments. There are however ethical considerations of using cadaveric images and we developed robust processes to remain compliant with our institutions' anatomy licensing regulations. This has resulted in our OSPEs remaining authentic, significantly decreased marking time, ensured consistency and improved quality assurance. Drawbacks include protracted timelines for assessment preparation and increased invigilation burden. We believe that running our anatomy OSPEs on an assessment platform with students on university premises is the future and this honest appraisal of online Anatomy OSPE will help educators implement this in their own institution. Ethics statement: This is a service evaluation and as such no ethical permission was required to change our assessment practice. The Inspector of Anatomy for Scotland was appraised of our processes for use of cadaveric images and has approved.