Assessment of spatial anatomical knowledge with a 'three-dimensional multiple choice test' (3D-MC)

Background: Text only multiple choice questions (MCQs) are often inadequate to assess anatomical and histological knowledge and may encourage students to memorize abstract textbook knowledge. An alternative are the spotters or tag tests well-known in North American and British anatomy. However, the psychometric properties of this assessment have only been reported in one study for a format using short answer questions. Aims: To describe the implementation and feasibility of a multiple choice tag test (3D-MC) using prosected specimens, histological slides, models and radiographs; to report the psychometric properties and students' acceptance of the 3D-MC; to compare it with a traditional multiple choice format. Results: The administration of the 3D-MC did not pose any major problems. The 3D-MC was significantly easier (mean scores 75% vs. 64%) than traditional MCQs. The estimated correlation (corrected for attenuation) between the two MCQ formats was r = 0.814. Reliability for the 3D-MC was. 665 for 30 items. Student acceptance was very high. Conclusions: The 3D-MC is a feasible, reliable and well-accepted test of anatomical knowledge. Further research should investigate if the higher cost as compared to MCQs using photographs is justified by the assessment of different knowledge and abilities as compared to MCQs using photographs.