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Anat Sci Educ. 2017 Sep 22. doi: 10.1002/ase.1741. [Epub ahead of print]

Evaluating a bedside tool for neuroanatomical localization with extended-matching questions.

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Office of Neurological Education, Department of Neurology, National Neuroscience Institute, Singapore Health Services, Singapore, Singapore.
Duke-NUS Medical School, Singapore, Singapore.
Department of Endocrinology, Tan Tock Seng Hospital, Singapore, Singapore.
Singapore National Eye Centre, Singapore Health Services, Singapore, Singapore.
Department of Medicine, National University Health System, Singapore, Singapore.
Centre for Medical Education, Yong Loo Lin School of Medicine, National University of Singapore, Singapore, Singapore.
Department of Medical Education, Faculty of Medicine, University of Colombo, Colombo, Sri Lanka.


Neuroanatomical localization (NL) is a key skill in neurology, but learners often have difficulty with it. This study aims to evaluate a concise NL tool (NLT) developed to help teach and learn NL. To evaluate the NLT, an extended-matching questions (EMQ) test to assess NL was designed and validated. The EMQ was validated with fourth-year medical students and internal medicine and neurology residents. The NLT's usability was evaluated with third- and fourth-year students, and the effectiveness was evaluated with an experimental study of second-year students, using the EMQ as the outcome measure. Students were taught how to use both the NLT and textbook algorithms (control) to perform NL, then randomized into either group, and only allowed to use their assigned tool to complete the EMQ. Primary outcome was the difference in mean EMQ scores expressed as a percentage of total score. For EMQ validation, students (n = 56) scored lower than residents (n = 50) (76.7% ± 1.7 vs. 83.0% ± 1.6; mean ± standard error of mean, P < 0.009). The EMQ demonstrated good reliability (Cronbach's α 0.85) and generalizability (G-coefficient 0.85). Third- (n = 77) and fourth-year (n = 42) students found the NLT user-friendly and helpful in their learning of NL. In the experimental study, scores were significantly higher for NLT group (n = 94) than for controls (n = 101) (42.5 vs. 37.0%, P = 0.014); the effect size (Cohen's d) was 0.36. The EMQ is validated to reliably assess NL and is generalizable, feasible, practical, and of low cost. The concise and user-friendly NLT for NL was effective in aiding medical student performance of NL. Anat Sci Educ. © 2017 American Association of Anatomists.


bedside tool; evaluation; extended-matching questions; medical education; neuroanatomical localization; neuroanatomy education; neurology; neuroscience education

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