Cognitive apprenticeship in the anatomical sciences: A study of the relationship between the anatomical expertise and clinical expertise of medical students as demonstrated on standardized assessments

Knowledge of gross anatomy and embryology continues to be important for medical student training. However, the relevance of anatomical knowledge during the preclinical years remains underexplored considering recent revisions to the scoring of the United States Medical Licensing Examination (USMLE). Guided by the framework of cognitive apprenticeship, which conceptualizes the anatomy laboratory as a learning environment that leads to medical student expertise, the focus of this study was on the relationship between the anatomical expertise and clinical expertise of medical students as measured by scores on standardized assessments. Data from 108 medical students who graduated as part of the Class of 2024 at a Southeastern institution were included in the analysis. A multiple linear regression model was created with the predictor variables of Gross Anatomy and Embryology Sub-score on the National Board of Medical Examiners (NBME) Comprehensive Basic Science Examination and MCAT Score for each of the following outcome variables: USMLE Step 2 Score; NBME Clinical Science Subject Examination (CSSE) Scores for Medicine, Surgery, Pediatrics, Obstetrics and Gynecology, Psychiatry, Family Medicine, and Clinical Neurology; and NBME Advanced CSSE Score for Emergency Medicine. In the resulting models, Gross Anatomy and Embryology Sub-score was a statistically significant predictor of USMLE Step 2 Score as well as for all NBME CSSE Scores and NBME Advanced CSSE Scores. The findings of this study support cognitive apprenticeship as a theoretical perspective for anatomical sciences education by providing evidence for a relationship between medical students' anatomical expertise and clinical expertise.