International Journal of Science Annals, Vol. 3, No. 2, 2020 SOCIAL AND BEHAVIORAL SCIENCES. Psychology ORIGINAL RESEARCH Perception of Students on Online Self-Assessment Tool in Anatomy During COVID-19 Crisis AuthorsтАЩ Contribution: Chakrabarti S.1 ABCDEFG, Vidya B. M.1 ABDEF A тАУ Study design; B тАУ Data collection; 1 Saveetha Medical College and Hospital, Chennai, India C тАУ Statistical analysis; D тАУ Data interpretation; E тАУ Manuscript preparation; F тАУ Literature search; G тАУ Funds collection Received: 20.11.2020; Accepted: 16.12.2020; Published: 20.12.2020 Abstract Background and As anatomy subject is the basis of the MBBS curriculum, itтАЩs clear understanding and Aim of Study: knowledge is needed. Syllabus of anatomy is vast and also volatile, to summarise large amounts of facts and train students for acquisition of the skills, we believe that students learn by practice. Due to COVID-19 crisis on educational system online learning and assessment of students has become a preferable replacement of conventional in person teaching and learning. The aim of the study: to determine the perception of first year MBBS students on online self-assessment tool in anatomy, to evaluate their academic achievements during COVID-19 crisis. Material and Methods: The present study included 50 students of first year MBBS of Saveetha Medical College. Steps to conduct the aim for divided in two google forms, one contains challenging questions on the topic Lungs and Heart and other was a questionnaire to know the studentsтАЩ perception on this online assessment tool. Results: It was observed that majority of the students have attempted the first google form and have also performed really well in it. 80% of the students were successful in giving the right answer for the questions given. In the second google form, which was a questionnaire, 85% of the students have found this online self-assessment to be really useful, interesting and easy way of learning. They found the questions to be challenging and help them to remember the topic in a long run. 91% of the students have liked the way of learning. Conclusions: Online self-assessment tool definitely proved to be a student friendly method of learning. This method gave them a way to learn and practice their subject topics as well as helped them in improving their perception and memory. Keywords: education, students, perception, memory, anatomy, COVID-19 Copyright: ┬й 2020 Chakrabarti S. Published by Archives of International Journal of Science Annals DOI and UDC DOI 10.26697/ijsa.2020.2.3; UDC 159.953.5:372.8:614.46 Conflict of interests: The authors declare that there is no conflict of interests Peer review: Double-blind review Source of support: This research did not receive any outside funding or support Information about Chakrabarti Sudakshina тАУ https://orcid.org/0000-0003-1344-8317; the authors: sudhianat@gmail.com; Doctor of Medicine, Associate Professor of Anatomy, Saveetha Medical College and Hospital, Chennai, India. Vidya Bhansali Miss тАУ https://orcid.org/0000-0002-8827-2216; vidyabhansali7@gmail.com; Saveetha Medical College and Hospital, Chennai, India. 16 ╤Аrint ISSN: 2617-2682; online ISSN: 2707-3637; DOI:10.26697/ijsa IJSA Introduction Anatomy is one of the fascinating subject in MBBS faculty to modify their teaching and assessment methods curriculum which involves a lot of understanding of (S. Rafique & H. Rafique, 2013). basics and knowledge of the clinical part. It is the study A systemic process of collecting, analyzing and of the internal structure and structural design of the interpreting data in order to validate or judge students is living things. assessment (Shamkuwar & Mokhasi, 2018). Nowadays In the vast curriculum of MBBS, anatomy is one of the different innovative teaching techniques which bring challenging subjects among the students. As 1st year about an interest in the students are introduced. There MBBS students, anatomy doesnтАЩt prove to be cake walk are many techniques like anatomical books, cadavers, as students are newly exposed to the unfamiliar prosection anatomy 3D views, audio and visual learning. environment of the curriculum. They are exposed to Among all this is online self assessment. Nowadays totally new scenario of teaching and learning process students have become more familiar and expert in (Jaiswal, Sathe, Gajbhiye, & Sathe, 2015). operating the electronic devices like smart phones, The learning characteristics of students have been laptop, etc. The correlation of these devices with extensively studied and numerous theories have been anatomy study can create a better combination in proposed. For example, in the widely read theory of learning and practicing of the subjects (Davis & andragogy, Knowles (1984) described adult students as Dargusch, 2015). Online self assessment is equally self-directed learners whose knowledge acquisition important as online teaching and learning thus without a occurs best when it is exploratory and task-oriented, proper comprehensive online assessment tool the rather than via rote memorization. Learning involves the teaching or learning does not fulfil the purpose and reorganization and transfer of new information from the cannot motivate the students so there was a need of limited confines of working memory to the limitless immediate development of variety of online assessment repository of the long term memory. Working memory, tools, programs with the prevailing COVID-19 crisis. or what we can consider at conscious memory, is MCQ are reliable, valid and most easily assessable form. characterized by storage durations as well as content Online assessment method can be accessible anywhere capacities that both are very limited. Long term memory without any obstruction. Nevertheless, online encompasses our repository of accumulated knowledge assessment tool can be of utmost help to the students and therefore has a capacity that is theoretically (Obad et al., 2016). Keeping this technique in mind, the boundless. The challenge facing each learner is to present study is conducted on perception of 1st year organize new information, as it is added to this MBBS students towards an online assessment tool repository, so that it can be successively retrieved and especially in the year when the world had to face the applied in a timely fashion when needed. With that in COVID-19 crisis of the century. mind a challenge facing anatomy educators is to The aim of the study. To determine the perception of first effectively guide learning so as to maximize the year MBBS students on online self-assessment tool in efficiency with the new knowledge is encoded in long anatomy, to evaluate their academic achievements term memory (Kirschner, Sweller, & Clark, 2006). during COVID-19 crisis. With the recent crisis and disruption of education system due to COVID-19 crisis itтАЩs the need of the hour to Materials and Methods develop and strengthen the online mode of teaching and A cross-sectional, descriptive study was conducted on learning and online assessment of students through 50 students of first year MBBS who are currently into development of technology. The paper (OтАЩByrne, Patry, the course of first year in Saveetha Medical College and & Carnegie, 2008) describes the development and Research Institute Chennai after receiving Institutional implementation of program based online anatomy Review Board clearance. Two online Google forms learning and self-directed tools for undergraduate were prepared which gives a brief description and faculty of health science students enrolled in first year response about the study. combined anatomy and physiology courses at the Google form 1: This Google form contains challenging university of Ottawa. and interest provoking questions on the topics of Generally, students find it difficult in understanding of anatomy of heart and lungs. There are 20 questions concepts and learning of the subject. Eventually students framed for the students to answer. The students were get frustrated and lose their hopes over the subject as a asked to respond to the questions after the topics were result, there is a loss of self-confidence among the completed. As this was a first hand experience for the students. Among this confusion in the students, anatomy students the questions were kept simple and straight professors play an important role (Nagar et al., 2012). forward. This form even consists of students details like They act as helping hands for the students struggling name and email-id so that we can assess each particular with the subject. The role of the faculty members in the studentтАЩs knowledge about the topic though medical education is to influence the learning process. confidentiality was maintained throughout the study. The introduction of multiple techniques of learning is The performance of students was analysed in detail. necessary to create an easy learning among the students. Google form 2: This anonymous Google form consists Students feedback is a useful basis for modifying and of questions about the studentsтАЩ perception on the online improving medical education (Bandyopadhyay & assessment tool in anatomy, basically a questionnaire Biswas, 2017). Therefore, in developing the teaching about the studentsтАЩ experience with the online and assessment method it is necessary to get the assessment tool. This questionnaire involved questions feedback from students that will later be useful for the like whether the students found it easy, whether it was a 17 International Journal of Science Annals, Vol. 3, No. 2, 2020 preferable mode of learning, whether it was interesting, Results challenging and thought provoking and other related Responses were taken from the first year MBBS questions. Students were informed that the information students at Saveetha Medical College and Research provided by them is for the research and evaluation Centre on the first Google form which contains purpose only and will be kept confidential. The analysis questions on heart and lungs (Table 1). Responses were of the perception of students were done. collected for each and every question. Table 1. Questions asked on the topic heart and lungs. Answer options No. Questions A B C D The base of the lung separates the left Left lobe of Fundus of the Inferior vena 1. Oesophagus lung from the liver stomach cava (IVC) Suprapleural Mediastinal 2. The apex of the lung is covered by Parietal pleura Costal surface membrane pleura 3. Right lung is divided into 3 lobes 2 lobes 1 lobe 4 lobes The projection of the left lung below 4. Middle lobe Lingula Alveoli Bronchus the cardiac notch is 5. Which lung is shorter and broader Right Left Blood supply to the lungs Bronchial Internal 6. Musculophrenic Intercostal artery predominantly from artery thoracic 2-5 Sympathetic 7. Sympathetic supply of lungs is from T6-T10 C3-C5 T2-T5 ganglia 8. Trachea divides at the level of T1 T5 T4 T3 Inhaled particles of foreign body tend to Right principal Left principal 9. Right lung Left lung pass more frequently bronchus bronchus Bronchopulmo- 10. Which are the surgical sector of lungs Root of lungs Hilum of lungs Bronchus nary segment Visceral 11. The area where the trachea bifurcates Carina Hilum Lingula pleura 12. The pericardium is a Fibrous sac Fibroserous sac Muscular sac Serous sac Breakdown of dorsal mesogastrium Costodiaphrag- Costomediastinal Transverse 13. Oblique sinus forms matic resess recess sinus Cardiac 14. Nerve supply to pericardium Phrenic Vagus Intercostal nerve plexus 15. Apex of the heart is formed by Left ventricle Left atrium Right ventricle Left auricle The inferior border of the heart extends Apex to left Apex to right 16. SVC to IVC Apex to IVC from auricle atrium The opening of coronary sinus is Eustachian Tricuspid 17. Thebesian valve Mitral valve guarded by valve valve Narrowing of valve orifice due to 18. Stenosis Pericarditis Fistula Block fusion of cusps is Internal Coronary Musculophrenic Descending 19. Blood supply to heart is by carotid artery vessels artery aorta Sympathetic nerves of the heart are Superficial Deep cardiac 20. T4-T5 T5-T6 derived from cardiac plexus plexus Figure 1 shows about the percent of correct responses obtained from the students on the online self-assessment 100,0 Students correct responses, % tool. This figure gives us an idea that most of the 90,0 students have found it really easy and helpful way of 80,0 learning. Most of the students have given the right 70,0 answers for all the questions. A very few students have 60,0 answered the incorrect one and this proves that most of 50,0 the students have found it to be a very easy way of 40,0 learning. 30,0 Responses were collected from the students about the 20,0 overall positive perception of them on this online self- 10,0 assessment tool. Majority of students agreed on using 0,0 this method of online assessment. Table 2 shows the overall response of the students Number of question towards the online assessment tool in form of MCQтАЩs in Figure 1. The percent of correct responses of the Google form. students on each question. 18 ╤Аrint ISSN: 2617-2682; online ISSN: 2707-3637; DOI:10.26697/ijsa IJSA Table 2. The overall response of the students towards the online assessment tool. Questions on perception of students on Number of studentsтАЩ answers according to the scale, % online assessment tool Strongly Disagree Neutral Agree Strongly Total disagree agree Did this assessment tool help in 0.0 17.6 11.8 47.1 23.5 100.0 improving your memory? Was this assessment interesting? 0.0 0.0 17.6 29.4 53.0 100.0 Did this assessment kindle your interest 6.0 0.0 6.4 32.0 55.6 100.0 in anatomy? Was this assessment useful? 0.0 5.9 11.8 47.1 35.2 100.0 Were the questions in the assessment 0.0 16.7 25.0 50.0 8.3 100.0 challenging? Did you like this way of learning? 0.0 8.3 16.7 16.7 58.3 100.0 Were you able to attend the questions? 8.3 0.0 8.3 66.7 16.7 100.0 Was this assessment an easy way of 15.4 0.0 15.4 53.8 15.4 100.0 learning? A total of 23.5% of students has strongly agreed and students were ready for the move (Houlden & 47.1% have agreed that this online assessment has Veletsianos, 2020). proved to really useful to improve their memory. A total Online learning places emphasis on interactions of 53.0% have strongly agreed and 29.4% have agreed between and among different channels and forms of that this online assessment tool is interesting. A total of interaction for students in the online environment to let 55.6% have strongly agreed and 32.0% have agreed that learners be more engaged in the learning process (Riggs, this online assessment was able to kindle their interest in 2020). anatomy. A total of 35.3% have strongly agreed and The COVID-19 pandemic required expansion of 47.1% have agreed that this assessment was useful to existing infrastructure and more demanding forms of them. A total of 8.3% have strongly agreed and 50.0% technology-enhanced learning (Zimmerman, 2020). have agreed that this assessment was challenging to Digitalization of education and the use of information them. A total of 58.3% have strongly agreed and 16.7% technology are crucial for teaching students today have agreed that they liked the method of learning. A (Melnyk & Pypenko, 2020). total of 16.7% have strongly agreed and 66.7% have Features of the perception of educational programs by agreed that they were able to attend the questions given students of medical universities were studied by in the online assessment tool. A total of 15.4% have Melnyk, Yekhalov, and Sedinkin (2020). strongly agreed and 53.8% have agreed that this is an To make things easier for students, assessment easy way of learning for them. methodologies have evolved. Assessment is an essential The overall positive response of the students for online part of medical education. It is the central to the method of assessment in 1st MBBS students which is educational process. It shows how well students have comparatively new provided confidence to the educators learnt the subject (Shamkuwar & Mokhasi, 2018). and teachers at the time of COVID-19 crisis and thus One of the assessment method is online assessment tool opened a new approach which was to be adopted widely which easily accessible anywhere in providence of in the coming months. internet connection. Through feedback about this online assessment we can find whether this method has helped Discussion the students in coping with their learning and practicing Anatomy is one of the challenging and basic subjects process (Bandyopadhyay & Biswas, 2017). essential in the curriculum of MBBS (Gune et al., 2018). Over the past decade, medical schools, postgraduate It involves more of learning and practicing of the topics. training programs, and licensing bodies have made new Extensive changes have taken place all around the world efforts to provide accurate, reliable, and timely to improve the standards of education. assessments of the competence of trainees and Learning and practicing methods are not just restricted practicing physicians (Epstein, 2007). to textbooks and lectures. Such assessments have three main goals: to optimize Nowadays access to internet, electronic gadgets, capabilities of all learners and practitioners by providing journals and educational videos are the newer concepts motivation and direction for future learning, to protect of learning (Jaiswal et al., 2015). the public by identifying incompetent physicians, and to Social distancing during COVID-19 pandemic provide a basis for choosing applicants for advanced accelerated digitalization of education (Melnyk, training (Tabish, 2008). Pypenko, & Maslov, 2020). In this study, we have just taken online assessment as a The COVID-19 pandemic forced almost all global way of learning and practicing. There are many other higher education institutions to rapidly move to online methods and ways which has been used extensively by instruction whether the institution, the faculty or the the students. 19 International Journal of Science Annals, Vol. 3, No. 2, 2020 A study in Bhopal showed that 54.3% students preferred application would be routinely assigned specific multimedia teaching methods as the best anatomy exercises that should be done when they are leaving at teaching methodology and it relies on scientific and does the end of the lecture. not cause lack of attention (Jaiswal et al., 2015). Students can be encouraged by the faculty member to As the teaching methodology majority of students feel complete the given online assessment at the earliest as it that dissection hall teaching is the best method followed shows a great impact when it comes to a long term plan. by slide projector/AV projection/Multimedia, A majority of the students have even found the questions conventional chalk and board methods (Hassanzadeh et in the online assessment to be challenging as it helped al., 2012). them to get a clear knowledge and made them remember A study states that, 82.0% of the students agreed that the the topic on a long run (OтАЩByrne et al., 2008). effectivity and reliability of the multimedia-supported A more important value of these online learning tools anatomy teaching in both the theoretical and practical maybe their ability to appeal to learning styles that are classes was useful was an as there was a notable increase often not addressed very strongly in the lecture room. in the academic performance of the students. In the Undergraduate classrooms are composed of present study, 35.3% have strongly agreed and 47.1% heterogenous populations of learners and these anatomy have agreed that the online assessment tool was really learning tools to address some of this heterogeneity. In helpful to them (Al-Hayani, El-Aziz, Eldeek, & a study, described four types of learning preferences: Hammad, 2008). visual, aural, read/write and kinesthetic and developed a In a study, majority (75.0%) of the students felt that simple online questionnaire that students can use to multiple modes of assessment improve their knowledge recognize their primary learning style (Chapman et al., and skill. 32.7% of the students favoured MCQтАЩs as a 2013; Densen, 2011). mode of assessment. In the present study, we have given What is the value of devoting so much time and energy MCQтАЩs as a self-assessment tool in online mode and to the development of these online self assessment tool 47.1% of students have found that this MCQ based when there already many offline interactive methods online assessment helps them in remembering the topics available to increase the knowledge and practicing way (S. Rafique & H. Rafique, 2013). of the students? In the study conducted, 46.7% of students were aware of The commercially available tools are indeed really the internet as a tool to learning and judge it as an helpful, but they often get difficult for the students to effective source of self learning. In the present study, find such books and get them at an affordable cost. 58.3% of students have agreed that the online self- The other tools might most of the times provide assessment is an easy way of learning (Nagar et al., information that is more than required for the 2012). undergraduate level and makes it difficult for the From the experiences of the researchers in teaching students to read them and have a self assessment undergraduate students, a study was conducted about concerning those difficult topics. collecting feedback on the assessment given to the But this online assessment tool is easily accessible students. anywhere and exactly provides the information and It was recognized that while considerable effort in recent knowledge and assessment which can help them later in years had been focused on improving the quality of final exams too and make it a cake walk for the students. lecturer feedback on student assessment, students This is the need of the hour more due to COVID-19 reported that they were not consistently engaging with crisis development of not only teaching online tools but the feedback provided on assessment items. equally important is the development of assessment In the present study students were given a feedback form tools which are student friendly and easy to operate. on the assessment given to them and majority of them In other studies, scholars have compared knowledge find it challenging and useful (Davis & Dargusch, acquisition by students using an SDL approach versus 2015). other more traditional modes of content delivery When we talk about topic in anatomy, majority of them (Kooloos, de Waal Malefijt, Ruiter, & Vorstenbosch, have found neuroanatomy, pelvis, perineum to be the 2012; Leslie, 2017; Smythe, & Hughes, 2008). difficult topics in a study made. Murad et al. (2010) conducted a systematic review of the In such cases we can help students by creating and effectiveness of SDL in the health professions. They introducing these online assessment tools as it creates found moderate quality evidence that SDL activities confidence among the students when practiced using result in gains in the knowledge domain when compared these online tools (Kramer & Soley, 2002). to traditional teaching methods. As we have taken online assessment as our prime Similarly, in present study too the online assessment can method of assessment to access the students, majority of promote self-directed learning and itтАЩs a motivation for the students have shown interest in it and found the students too for further learning. learning and self-testing tool to be user-friendly, In the present study, 53.0% of students felt the relevant and helpful. assessment tool was interesting, and 50.0% felt it was However, approximately one third of the students did challenging, 58.3% preferred the tool, 53.8% felt itтАЩs an not find the online assessment tool useful. easy way of learning. One strategy that could be used to encourage students to A clear comparison of the objective data of other studies develop a personal schedule of regular practice and of present study are shown in Table 3. 20 ╤Аrint ISSN: 2617-2682; online ISSN: 2707-3637; DOI:10.26697/ijsa IJSA Table 3. A clear comparison of the objective data. Data of other studies Data of present study 54.3% of the students have considered as multimedia to 52.9% of the students have strongly agreed that online be the best method of learning self-assessment tool is an interesting way of learning 82.0% of the students have considered that multimedia 82.4% of the students have found online assessment supported learning is helpful tool to be really helpful in learning 46.7% of the students were aware of internet as easy, 58.3% of the students have found that this online effective and helpful way of studying assessment is an easy way of learning 32.7% of the students found MCQ based online 47.1% have found this MCQ based online assessment assessment to be best mood of assessment to be the helpful in remembering the topics Conclusions Chapman, S. J., Hakeem, A. R., Marangoni, G., & An opinion regarding the online assessment tool in Prasad, K. R. (2013). Anatomy in medical anatomy was taken in Saveetha Medical College education: perceptions of undergraduate medical concluded that majority of the students have found the students. Annals of Anatomy, 195(5), 409тАУ414. online assessment to be really useful as a tool for doi:10.1016/j.aanat.2013.03.005 practice and learning. This method has encouraged Davis, S. E., & Dargusch, J. M. (2015). Feedback, students in learning and practicing their topics in which iterative processing and academic trust тАУ Teacher they arenтАЩt confident and helps them to cope with the Education studentsтАЩ perceptions of assessment vast curriculum. feedback. Australian Journal of Teacher Our study shows that students have found the online Education, 40(1), 10. assessment questions to be challenging and helps them doi:10.14221/ajte.2015v40n1.10 to know their strong and weak topics in the subject. This Densen, P. (2011). Challenges and opportunities facing online tool helps them in improving their perception and medical education. Transactions of the American memory, and place a strong foundation about the topic Clinical and Climatological Association, 122, in the studentsтАЩ mind. The students also found this 48тАУ58. method to be really easy and helpful way of learning. Epstein, R. M. (2007). Assessment in medical As the learning and teaching has changed a lot over the education. The New England Journal of years, both students and teachers can choose the best Medicine, 356(4), 387тАУ396. suited method to enrich and deliver the knowledge. In doi:10.1056/NEJMra054784 the end, the online assessment tool has been proved to Gune, A. R., More, S. S., Satpue, S. P., Wagh, D. T., & be an innovative and student-friendly method of Nikam, V. R. (2018). Perception of first year learning and practice in anatomy. 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It can be found online in the IJSA Archive https://ijsa.culturehealth.org/en/arhiv and in the KRPOCH Publishing Repository https://ekrpoch.culturehealth.org/handle/lib/71 This is an Open Access article distributed under the terms of the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited (http://creativecommons.org/licenses/by/4.0/deed.en). 22