Introduction
Narrative assessment, descriptions of learners’ non-academic performance,
is vital in medical training globally. The “feedback as coaching” theoretical
framework emphasizes that quality feedback must be timely, personalized, and
improvement?oriented. Narrative assessment is emphasized by the Liaison
Committee on Medical Education (LCME) (Accreditation body in US and Canada)
element 9.5, requiring medical schools to narratively assess students
whenever teacher-student interaction permits. While narrative feedback has
been widely studied in clinical settings, its application in anatomy
laboratories remains underexplored, particularly with large student?faculty
ratios. This descriptive study investigates how LCME?accredited medical
schools implement narrative assessment in anatomy labs, focusing on
timeliness, personalization, and perceived benefit.
 
Methods
A survey was designed and administered via Qualtrics to Anatomy faculty at
155 LCME?accredited institutions. The instrument included 18 items with
quantitative and qualitative elements. Anatomy laboratory landscapes were
analyzed descriptively, and perceived benefit was compared to
Evaluator-student ratios, timeliness, personalization. Qualitative responses
were thematically coded.
 
Results
Cadaveric instruction was most used (N=30), followed by prosection (N=27)
and virtual tools (N=26). 58 Survey responses revealed that approximately
half (27) of surveyed schools provide narrative feedback in anatomy labs.
Faculty reported narrative assessment as beneficial regardless of timeliness,
personalization, or ratios (ns in all comparisons). However qualitative
comments highlighted large student?faculty ratios, time and staffing
constraints as limiting factors to personalization and meaningful engagement.
 
Conclusions
Narrative assessment in anatomy laboratory is valued but inconsistently
implemented. Findings reinforce the “feedback as coaching” framework,
emphasizing quality feedback must be timely, personalized, and improvement?oriented.
Institutional realities, particularly workload and class size, challenge
consistent adoption. Future work should develop scalable resources to help
anatomy faculty meet LCME standards and enhance learning. By identifying
barriers and benefits to narrative assessment, this study provides insights
applicable across medical schools globally.