Letter for the article Assessing Medical Students’ Knowledge of Gene
I read Alotaibi and Cordero’s article on medical student knowledge of clinical genetics with interest, especially since it concerns me as a fourth-year medical student.1 The authors assessed that knowledge of clinical genetics is generally insufficient among fourth-year medical students.
Multiple-choice questions (MCQs) are the most commonly used tool to assess knowledge in medical education. However, MCQs have limitations as an assessment tool and can give a false impression of a student’s competence.2 The authors may have benefited from using very short answer (VSA) questions as an alternative to MCQs. Recent evidence suggests that VSAs provide a more authentic assessment of student abilities compared to MCQs because they can identify cognitive errors more easily and potentially better quantify where instruction should be targeted.3 Additionally, after reviewing the examples of genetic MCQs included in the study, it appears that some MCQs primarily test direct and factual recall of knowledge, with less emphasis on more complex clinical reasoning tests and ability. problem solving. It is therefore not surprising that second-year students performed better than fourth-year students in broader knowledge areas, given that they likely reviewed directly relevant resources closer to the assessment. and that they could remember the facts more clearly. The reduced ability of students in later years of medical school to recall factual knowledge has already been demonstrated.4
The fact that 87.8% of second-year students responded that their knowledge of genetics was insufficient for clinical practice is surprising, given that they had recently received all formal genetics instruction in the program. However, the value of asking preclinical students to self-assess their readiness for future clinical practice is questionable, given that they have not yet been exposed to the clinical environment and are unlikely to they are fully aware of the knowledge of clinical genetics required of competent physicians. . A subgroup analysis of the cohort of fourth-year students, including an analysis of the factors that influenced their responses to preparation, would be useful. The COVID-19 pandemic will undoubtedly have affected students’ learning opportunities, so its impact must also be considered in the subgroup analysis.
The small sample size and the limitation to a single medical school make it difficult to generalize the findings to the entire medical student population. However, as discussed by the authors, the results are supported by the existing literature. Clinical genetics is a rapidly evolving field and it is imperative that knowledge gaps are addressed from the undergraduate level. In the United Kingdom (UK), one way to address this issue is the forthcoming UK Medical Licensing Assessment (UKMLA); a summative licensing assessment carried out by all prospective medical students in the UK. In the current UKMLA content map, there is a separate area of professional knowledge called ‘Genetics and Genomics’.5 The high-stakes nature of this exam will therefore hopefully encourage increased representation of genetics in the curriculum and motivate students to maximize their knowledge.
The author reports no conflict of interest in this communication.
1.Alotaibi AA, Cordero MAW. Assessing medical students’ knowledge of genetics: a basis for improving the genetics curriculum for future clinical practice. Adv Med Educ Pract. 2021;12:1521–1530. doi:10.2147/AMEP.S337756
2. Bird JB, Olvet DM, Willey JM, Brenner J. Patients do not have multiple-choice options: trial-based assessment in EMU. Med Educ online. 2019;24(1):1649959. doi:10.1080/10872981.2019.1649959
3. Sam AH, Westacott R, Gurnell M, Wilson R, Meeran K, Brown C. Comparison of single-response and very short-response questions for the assessment of applied medical knowledge at 20 UK medical schools: a cross-sectional study. BMJ open. 2019;9(9):e032550. doi:10.1136/bmjopen-2019-032550
4. D’Eon MF. Loss of knowledge among medical students in first-year basic science courses at the University of Saskatchewan. BMC Med Educ. 2006;6(1):5.
5. MLA content map [Internet]. London: General Medical Council; 2021 [