Development and Validation of a Tool to assess the Retention of Clinical Anatomy Knowledge

Introduction: A thorough knowledge in anatomy is essential for the medical student and thereafter for the practicing doctor. Therefore, retention of knowledge acquired during formative years becomes valuable. Knowledge attrition may occur as students move from preclinical years towards clinical training. A tool to measure the level of retention becomes important to assess the level of attrition and apply remedial measures.   
Methodology: AKRA tool, a MCQ based tool was developed aligned to the learning objectives assessed and edited by opinions of clinicians. The AKRA tool was validated using expert opinion and statistical methods. For statistical assessment, it was administered to 100, 3^rd year medical students and 20 recently passed out doctors and the scores calculated. Reliability was assessed using Cronbach alpha, and item discrimination using Pearson correlation. MCQs were graded into poor, marginal, good and excellent based on item discrimination and difficulty indices. Criterion validity was assessed by comparing the AKRA scores with those of an institutional examination. AKRA score was administered to students of two other institutions and scores were compared.  
Results: AKRA tool consisted of 42 MCQs. The reliability was high (Cronbach Alph = 0.81). The average score for AKRA was 61.78 (SD=12.3) %. The AKRA scores of the students correlated well with anatomy test scores achieved at the institutional examination (r=0.76). Scores between the other institutions did not show a significant difference.
Conclusion: AKRA tool is a validated MCQ-based tool to assess the clinical anatomy knowledge in medical students and doctors.