Reviving vivas: Using formative team oral examinations to enhance anatomical communication skills

Abstract

Anatomy is foundational to medical practice, with doctors applying anatomy knowledge to patient care and interprofessional communication. Despite this, undergraduate medical anatomy assessment typically uses multiple-choice questions (MCQs), which cannot assess anatomical communication skills. Oral examinations or ‘vivas’ require students to communicate and demonstrate anatomical knowledge but have been largely phased out as summative assessments due to concerns about reliability and feasibility.¹

Summative assessment at our institution consists of MCQ examinations. Although anatomy learning activities aim to foster communication and teamwork skills, misaligned assessments can hinder engagement. Additionally, limited feedback opportunities constrain educators' ability to support transformative learning.

Students were encouraged to touch and move resources to effectively demonstrate knowledge. While students within teams could volunteer to answer any question, marking rubrics awarded points for substantive contributions from all team members. Based on initial responses, assessors tailored further questions to probe students' understanding. The relatively short time frame was intended to ensure effective responses required knowledge synthesis. Following vivas, assessors and students had 5 min feedback dialogues, including strengths, areas for improvement and learning guidance. Complete scoring rubrics, including written feedback, were also provided to students.

Before each viva, assessors participated in a feedback training workshop and completed a standardisation exercise with course coordinators to ensure their understanding of excellent, good, satisfactory and not satisfactory responses aligned with course outcomes.

These pitfalls have potential implications for patient care if unresolved, such as misunderstandings during handovers and structural misidentification during procedures. Therefore, we refined our curriculum to scaffold anatomical communication skill development by implementing weekly viva practice questions and providing mock viva videos that incorporate pitfalls alongside examiner feedback.

Our experiences highlight that vivas can be successfully reintroduced to undergraduate medical education, particularly when paired with feedback for learning.

Georgina C. Stephens: Conceptualisation; investigation; writing—original draft; project administration; writing—review and editing. Yasith Mathangasinghe: Conceptualisation; investigation; writing—review and editing. David Gonsalvez: Conceptualisation; investigation; writing—review and editing.