National Survey of Narrative Assessment in LCME-accredited Anatomy Laboratories

Abstract

Abstract Narrative assessment is a key component of competency-based medical education, providing qualitative information that supports learner development and professional growth. LCME Element 9.5 requires narrative assessment whenever teacher–student interaction permits, yet its implementation in anatomy laboratories remains poorly characterized. This descriptive, cross-sectional survey examined anatomy instructional modalities, narrative-assessment practices, reviewer structures, feedback characteristics, and faculty perceptions among respondents affiliated with LCME-accredited U.S. medical schools. Faculty from 155 institutions were invited; 58 responses were included in the analytic sample. Among 49 respondents who completed the instructional-modality item, cadaveric dissection was the most common instructional modality ( n = 30), followed by prosection ( n = 12), other approaches ( n = 5), and virtual anatomy ( n = 2). Nine respondents did not answer this item. Narrative assessment was reported by 31 of 58 respondents (53%). Because of small and uneven modality subgroup sizes, instructional-modality comparisons were interpreted descriptively. Among respondents reporting narrative assessment, feedback was typically delivered during the session or within 48 h, and most described their feedback as personalized. Respondents generally rated narrative assessment as beneficial. Reviewer workload was not associated with perceived benefit. Open-text responses highlighted barriers including time constraints, competing instructional demands, difficulty observing individual performance, and uncertainty regarding accreditation expectations. Narrative assessment was valued but implemented inconsistently among respondents, with workload and class size frequently identified as practical constraints. These findings describe current respondent-reported practices and identify practical considerations relevant to developing sustainable feedback strategies that uphold LCME standards in anatomy laboratories.