Optimising pre-class tests to enhance student engagement in neuroanatomy: a pilot study

BACKGROUND: Neuroanatomy is widely recognised as a challenging discipline in medical education, with student engagement often limited by its complexity. Active learning strategies, such as pre-class tests, have been proposed to improve preparation and confidence, yet evidence on their impact on student behaviours and perceptions remains scarce. METHODS: This pilot study explored the effects of pre-class tests on preparation, confidence, and learning strategies among 144 third-year undergraduate students enrolled in a neuroanatomy course at Afe Babalola University, Nigeria. A mixed-methods survey approach was employed, with quantitative data analysed for reliability (Cronbach alpha = 0.78) and qualitative responses subjected to thematic analysis. RESULTS: Most students (93.1%) reported appropriate test difficulty, and 41.0% rated the content as highly relevant. Pre-class tests prompted thorough preparation in 80.6% of participants, with 50.7% dedicating over two hours to study. Confidence improved for 63.9% of students, and 48.6% adopted new study strategies. However, 63.9% reported increased stress, with qualitative themes highlighting time constraints, inadequate feedback, and content misalignment. CONCLUSION: As a pilot study, these findings suggest that pre-class tests may be associated with enhanced preparation, confidence, and engagement in neuroanatomy, while revealing stress-related challenges requiring design adjustments. Recommendations include extending test duration, improving feedback, and ensuring content alignment. Future multi-institutional studies are warranted.