Retention of Basic Sciences Knowledge at Clinical Years: A single Institute Study from Sudan

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Khalid, Huda M. Haroon, Hashim Eltom, AbdelAziem A. Ali This is a preprint; it has not been peer reviewed by a journal. https://doi.org/ 10.21203/rs.3.rs-7601399/v1 This work is licensed under a CC BY 4.0 License Status: Published Journal Publication published 14 Jan, 2026 Read the published version in BMC Medical Education → Version 1 posted 12 You are reading this latest preprint version Abstract Background Retention of basic science knowledge is essential for effective clinical reasoning and decision-making in medical education. However, many students face difficulties applying this foundational knowledge during their clinical years. Methodology : Aiming to determine the level of retained basic science knowledge among undergraduate medical students, a cross sectional-single institutional-based study was conducted among two different batches in the University of Kassala, Sudan during the academic period spanning 2021 to 2022. Thirty-six single answer questions were used for data collection. The data were entered and analyzed using SPSS version 25. Results Out of 185 invited students, 164 completed the questionnaire yielding 88.65% response rate. Approximately one-third of the respondents reported complete satisfaction with the basic sciences curriculum. Students' test scores ranged from 19.44% to 88.89%, with an overall average of 57.49 ± 14.60. Notably, 32 students (19.51%) scored ≤ 47%. The average scores between the two student batches were nearly identical (57.67% ± 14.82 and 57.32% ± 14.47), suggesting consistency in performance across batches. Analysis across subject areas revealed that integrated questions consistently produced the highest mean scores in both batches (64.66 ± 19.68 and 62.35 ± 21.07 respectively). Overall, integrated questions had the highest average score at 63.55 ± 20.39, followed by Physiology (60.37 ± 19.31) and Biochemistry (55.22 ± 16.49). Anatomy recorded the lowest average score (50.81 ± 18.46). Conclusion The study revealed good results of integrated questions and dissatisfaction with the basic sciences syllabus, particularly in anatomy. medical education basic sciences medical schools Sudan Figures Figure 1 Background Basic sciences are the backbone of undergraduate medical education as they provide the ground upon which the clinical sciences are built [ 1 ]. Basic science knowledge enhance clinical diagnosis skills [ 2 , 3 ], and integration of such information in clinical decision-making using a rigorous scientific approach [ 4 ]. Continuity and knowledge transformation are key concepts in medical education and the representation of basic science in later clinical training would be a fruitful approach in investigating the knowledge development [ 5 ]. Retention of basic science knowledge is essential for effective clinical reasoning and decision-making in medical education [ 6 ]. However, many students face difficulties applying this foundational knowledge during their clinical years, which can negatively affect their clinical performance [ 7 ]. Therefore, the present study is designed to assess and compare the ability of undergraduate medical students from University of Kassala to retain and transfer their knowledge of basic sciences (Anatomy, physiology and biochemistry) to clinical studies. Methodology Study design and data collection A cross-sectional, Institutional- based study was conducted at Faculty of Medicine and Health Sciences, University of Kassala, Sudan. The University established since 1990, comprises various academic programs, including the Faculty of Medicine and Health Sciences. Initially, the Faculty followed a conventional curriculum in which basic science subjects were taught over the first two academic years. In 2016, the hybrid model had been adopted, restructuring the basic science component to be delivered over five semesters. This study was conducted during the academic period spanning 2021 to 2022. The study targeted all the medical students of Batch 26 (134 students) and Batch 25 (135 students), who had completed their studies of basic science courses (anatomy, physiology, and biochemistry), and shifted to the study of clinical courses. Batch 26 completed the courses of basic sciences according to the reformed curriculum during the first five semesters, while batch 25 learned the basic sciences during completed two years (second and third year). The students who were unwilling to participate or absent during study were excluded. A questionnaire containing personal characteristics and close-ended questions was developed for this study (attached as supplementary file). Four sets of questions were developed to assess the students’ ability to retain the basic science knowledge and transfer it to clinical scenario. Each set comprised nine questions dedicated to each discipline (anatomy, physiology, and biochemistry) and the remainder consisting of integrated questions. Each question required selecting the correct answer and carried equal weight. The test questions were carefully prepared by subject matter experts from the departments of Anatomy, Physiology, and Biochemistry who created the questions in accordance to standard textbooks. Each department developed a sufficient number of questions based on their respective areas of expertise. From these, nine questions were selected from each department, ensuring coverage of essential concepts and learning objectives. Additionally, nine integrated questions were prepared to assess students’ ability to apply knowledge across the three disciplines. A total of thirty-six close-ended questions had been selected for the examination and the order of the questions was random. All selected questions underwent a thorough review and revision process to ensure clarity, relevance, appropriate difficulty level, and alignment with the learning objectives, providing a fair and comprehensive assessment for all students. All the students (185) attended the test, sat in lecture room to answer the questions in 60 minutes. Prior to answer the questions they were instructed to provide general information including identification number, year of study, gender. Statistics Data was analyzed using Statistical Package for Social Sciences (SPSS) for Window version 25 (SPSS Inc., Chicago, IL, USA) and double checked before analysis. Mean standard deviation, frequency, ratio, and percentage, and coupled t -test were used and P < 0.05 was considered significant. Results Out of 185 invited students, 164 completed the questionnaire yielding 88.65% response rate. Seventy-nine students (48.2%) from batch 26 and 85 (51.8%) from batch 25 while male to female ratio was 1: 1.1. Overall Students Performance According to the policy of the Faculty of Medicine and Health Sciences, a score of 50% or above is considered as pass, 48–49% is a borderline while ≤ 47% is a failure. Students’ scores on the test ranged from 19.44% to 88.89%, with a mean score of 57.49% ± 14.60. The failure rate was 19.51%, while 80.5% of students passed the examination. Notably, no borderline scores was recorded in this assessment. Figures (1) illustrates the average scores for individual test questions, categorized by basic science disciplines (Anatomy, Physiology, and Biochemistry) and integrated questions, providing insight into subject-specific and interdisciplinary performance trends. Analysis of the pass rate across different sets of questions revealed varying level of performance. The pass rate for Anatomy was recorded at 51.8%, representing the lowest performance among the assessed subjects. In contrast, Physiology demonstrated a considerably higher pass rate of 72.0%, followed by Biochemistry at 62.8%. Notably, the Integrated Questions achieved the highest pass rate of 79.3%, indicating stronger student performance in questions that required the application of knowledge across multiple disciplines. Student Performance on Test Questions by Batch As illustrated in table 1, students' scores across disciplines showed a similar distribution between the two batches, with no borderline scores recorded in either group. Anatomy consistently exhibited poor performance, with nearly half of the students in both batches failing to reach the passing threshold. Although a slight improvement was noted in the performance of Batch 26 on integrated questions, the difference was not statistically significant. Physiology maintained consistently high pass rates in both batches (approximately 72–74%). In contrast, Biochemistry showed notably stronger performance in Batch 25, with a higher pass rate (67.1%) compared to 59.2% in Batch 26. Comparative analysis of mean scores across Basic Science Discipline The analysis of mean scores across basic science disciplines revealed that students performed highest in integrated questions with an average score of 63.55% ± 20.39, followed by physiology at 60.37% ± 19.31. Biochemistry had a lower mean score of 55.22% ± 16.49, with 61 students (37.2%) scoring below the passing threshold of 47%. The lowest mean score was observed in anatomy, at 50.81% ± 18.46, where 79 students (48.2%) failed to meet the minimum passing criteria. Comparative analysis of mean test scores between Batches The overall mean test scores were remarkably similar between the two batches, with Batch 26 achieving a mean score of 57.67% ± 14.82 and Batch 25 scoring 57.32% ± 14.47. When examining performance across individual disciplines—Anatomy, Physiology, and Biochemistry—as well as Integrated Questions, both batches demonstrated their highest mean scores in the integrated questions. Batch 26 achieved an average of 64.66% ± 19.68, while Batch 25 followed closely with 62.35% ± 21.07. Independent-sample t -test was conducted to compare the mean scores of Batch 26 and Batch 25, as well as to examine differences based on gender. The analysis revealed no significant difference in the scores between Batch 26 (M = 57.67, SD = 14.82) and Batch 25 (M = 57.32, SD = 14.47); t(0.15), p = 0.88. The mean difference was 0.35, with a 95% confidence interval (CI) ranging from − 4.17 to 4.86, Table (2). However, a statistically significant difference was found when comparing question results (anatomy, physiology, integrated, and total questions) based on gender ( p < 0.01, 95% CI: -11.37 to -2.61). Comparison of the Mean Test Scores: Subject vs. Integrated Questions A paired sample t -test was conducted to compare the mean scores of three individual subject-based questions (biochemistry, physiology, and anatomy) with the mean scores of integrated questions. The analysis revealed that biochemistry and physiology questions had significantly higher mean scores compared to anatomy. However, when the overall mean score of the three subject-based questions was compared with the mean score of the integrated questions, the integrated questions demonstrated a significantly higher mean score. This difference was statistically significant ( p < 0.05), suggesting that students performed better on integrated questions, which may reflect a better retention and application of basic medical sciences knowledge in a clinically oriented context (table 3). Discussion Our study showed that biochemistry and physiology questions had significantly higher mean scores compared to anatomy and the integrated questions demonstrated a significantly higher mean score in comparison with the three investigated subjects (Anatomy, Physiology and Biochemistry). This difference suggesting that students performed better on integrated questions, which may reflect a better retention and application of basic medical sciences knowledge in a clinically oriented context. This finding aligns with the evidence suggesting that integrated assessments, which combine knowledge from multiple disciplines, can enhance student understanding and retention [ 8 , 9 ]. The relatively strong performance in integrated questions may indicate that students are better able to synthesize and apply knowledge across disciplines than to recall information from isolated subjects [ 10 – 12 ]. The current results necessitate an urgent need for improvement, particularly in anatomy subject which showed lower average scores and a higher proportion of failures. These findings reflect a broader trend of limited retention of basic science knowledge during clinical years, as documented in many previous studies [ 13 , 14 ]. Our results highlight that clinical knowledge can be well understood after complete understanding of applied basic science background. A gain the finding of the results support the fact that basic knowledge has a direct influence on the clinical practice and leads to successful answering to clinical questions. By achieving good correlation between basic and clinical knowledge the score will be acceptable and we will obtain better results. Basic science are more memorable when ever it is correlated to clinical knowledge [ 13 ]. The students become more eager when they become engaged in the clinical sciences and this might explain their high score in integrated questions. Many factors had been documented as having impact on the relationship between basic and clinical medical sciences such as variation in curricula, learning methods, and student's attention. To enhance the retention of basic science knowledge during clinical training, it is essential to cultivate engaging and interactive learning environments. Fostering positive student–teacher interactions, employing diverse teaching strategies, and incorporating continuous, multifaceted assessment methods can significantly reinforce learning. Additionally, lectures designed with low information density that focus on key concepts have been shown to be more effective learning tools [ 15 ]. In the current study and among the basic science subjects, physiology emerged as the strongest area of student performance. Its close connection to clinical practice likely fosters greater student engagement and facilitates comprehension, which may explain the higher average scores. In comparison, biochemistry and anatomy showed weaker results, with mean scores of 55.22% ± 16.49 and 50.81% ± 18.46, respectively. Poor retention of anatomy was documented in other study [ 16 ]. These disparities may be attributed to the inherently challenging nature of biochemistry and anatomy, both of which demand extensive memorization and grasp of intricate concepts. Furthermore, the lower performance in these areas highlights the need for revised instructional approaches. Implementing effective teaching strategies as concept-based learning, visual aids, active learning sessions, and clinically relevant case discussions, may help students better understand and retain complex material. An interesting observation was that the overall performance across both batches (Batch 26 and Batch 25) was remarkably similar, with very small differences in mean scores (57.67% ± 14.82 for Batch 26 vs. 57.32% ± 14.47 for Batch 25). This suggests consistency in the student's performance regardless of batch assignment. There should be a system in the faculties of medicine aiming to evaluate the extent to which their educational objectives are well applied and achieved. Conclusion The present findings demonstrated that clinical year students achieved high scores on integrated questions, but they did not perform as well on basic sciences questions. This study acts as a base for understanding the validity of the faculty curriculum; it could also be used as a basis for discussion about the methods, and programs of learning medicine. Limitation and Recommendation There are limitations to this study: it is a single institute study and not covered whole medical schools in Sudan thus more research is needed in this area to determine whether all Sudanese medical students are actively engaged and able to retain key concepts or not. Furthermore, collaboration between basic science departments and clinical departments to help create a unified teaching approach is needed. Declarations Ethics approval and consent to participate Ethical approval Permission to carry the study was obtained from the Research Ethics Committee of Faculty of Medicine & Health Sciences, University of Kassala, Sudan. Research methods involving human data were performed in accordance with the Declaration of Helsinki and its later amendments. Participation was voluntary, and written informed consent was obtained from all students who agreed to participate. Students had the right to withdraw at any stage without facing any negative consequences. Consent for publication Not applicable Competing interests The authors declare that they have no competing interests Funding None Author Contribution KFA carried out the study and participated in the statistical analysis and procedures. AAA, HHM and E H coordinated and participated in the study design, statistical analysis and the drafting of the manuscript. All the authors read and approved the final version. Acknowledgement The authors would like to express their heartfelt gratitude to the Faculty of Medicine and Health Sciences and all the study participants for their cooperation and invaluable contributions to the success of this research. Data Availability Relevant data generated or analyzed during this study are available fromthe corresponding author on reasonable request. References Chakkarapani A, Sheng ML. Assessment of Long-Term Retention of Human Anatomy Knowledge and Skills among Modern-Day Health Science Students. Int J Sci Technol Res. 2021;10:153–7. Fernando S, Ellawala A, Wijayasiri A. Comparing traditional and integrated curricula on physiology knowledge retention and application. South-East Asian J Med Educ 2020, Jan 30;13(2). Norris ME, Cachia MA, Johnson MI, Rogers KA, Martin CM. Expectations and Perceptions of Students' Basic Science Knowledge: Through the Lens of Clerkship Directors. Med Sci Educ. 2020. 21;30(1):355–365. 10.1007/s40670-019-00913-z . PMID: 34457678; PMCID: PMC8368669. Slavin S, D'Eon MF. Overcrowded curriculum is an impediment to change (Part A). Can Med Educ J. 2021;12(4):1–6. 10.36834/cmej.73532 . PMID: 34567300; PMCID: PMC8463236. Sobieraj DM, Chen AMH, Luciano JL, Bechtol RA, Kelsch MP. Exploring tools to manage curricular content and overload within the professional PharmD program. Am J Pharm Educ. 2024;88(10):101276. Zafar I, Chilton J, Edwards J, Watson H, Zahra D. Exploring basic science knowledge retention within a cohort of undergraduate medical students in the United Kingdom: A longitudinal study. Clin Teach. 2023;20(5):e13633. Quintero GA, Vergel J, Arredondo M, Ariza MC, G_omez P, Pinzon-Barrios AM. Integrated medical curriculum: advantages and disadvantages. J Med Educ Curric Dev. 2016;3(1):133–7. https://doi.org/10.4137/JMECD.S18920 . Bahiru Tenaw Goshu. Basic Medical Sciences Knowledge Retention for Clinical Practice.Advances in Medical Education and Practice 2022:13: 475–482. Malau-Aduli BS, Alele FO, Heggarty P, Teague PA, Gupta TS, Hays R. Perceived clinical relevance and retention of basic sciences across the medical education continuum. Adv Physiol Educ. 2019;43(3):293–9. https://doi.org/10.1152/advan.00012.2019 . El-Bab MF, Sheikh B, Shalaby S, El-Awady M, Allam A. Evaluation of basic medical sciences knowledge retention among medical students. Ibnosina J Med Biomed Sci. 2011;3(1):45–52. https://doi.org/10.4103/1947-489X.210870 . Gupta S, Gupta AK, Verma M, Kaur H, Kaur A, Singh K. The attitudes and perceptions of medical students towards basic science subjects during their clinical years: a cross-sectional survey. Int J Appl Basic Med Res. 2014;4(1):16–9. https://doi.org/10.4103/2229-516X. 125675 . Schneid SD, Pashler H, Armour C. How much basic science content do second-year medical students remember from their first year? Med Teach. 2019;41(2):231–3. https://doi.org/10.1080/0142159X . 2018.1426845. Malau-Aduli BS, Alele FO, Heggarty P, Teague PA, Gupta TS, Hays R. Perceived clinical relevance and retention of basic sciences across the medical education continuum. Adv Physiol Educ. 2019;43(3):293–9. https://doi.org/10.1152/advan.00012.2019 . Doomernik DE, van Goor H, Kooloos JG, Ten Broek RP. Longitudinal retention of anatomical knowledge in second-year medical students. Anat Sci Educ. 2017;10(3):242–8. Ghosh A. Continuous professional development for physicians. Med UNAB. 2013;16(2):71–6. Holmbukt T. Interdisciplinary approaches for deep learning. Nordic J Lang Teach Learn 2018, Aug 15;6(1). Tables Table (1): Students Performance on Test questions by Batch Subject questions Pass rate (%)Batch 26 (n=79) Pass rate (%)Batch 25 (n=85) Anatomy 54.2 50.6 Physiology 71.9 73.9 Biochemistry 59.2 67.1 Integrated questions 84.8 74.1 Table (2): Comparison the mean Test score by students’ Batch Questions Mean difference t- value P value 95% CI Anatomy 2.91 1.01 0.32 -2.79- 8.61 Physiology -3.04 -1.01 0.32 -8.99 – 2.92 Biochemistry -0.98 -0.38 0.71 -6.07-4.13 Integrated 2.49 0.78 0.44 -3.82- 8.79 Total questions 0.35 0.15 0.88 -4.17- 4.86 Table (3): comparison the mean test score: Subject vs Integrated questions Pair compared Mean difference t-value 95% CI P-value Biochemistry- integrated -8.33 -5.24 -11.47- (-5.20) 0.000 Physiology- integrated -3.18 -2.15 -6.10- (-0.24) 0.033 Anatomy- integrated -12.73 -9.27 -15.45- (-10.02 0.000 Additional Declarations No competing interests reported. Supplementary Files Questionnaire2.docx Cite Share Download PDF Status: Published Journal Publication published 14 Jan, 2026 Read the published version in BMC Medical Education → Version 1 posted Editorial decision: Revision requested 28 Oct, 2025 Reviews received at journal 23 Oct, 2025 Reviews received at journal 20 Oct, 2025 Reviewers agreed at journal 20 Oct, 2025 Reviewers agreed at journal 17 Oct, 2025 Reviewers agreed at journal 14 Oct, 2025 Reviewers agreed at journal 13 Oct, 2025 Reviewers invited by journal 13 Oct, 2025 Editor assigned by journal 13 Oct, 2025 Editor invited by journal 22 Sep, 2025 Submission checks completed at journal 19 Sep, 2025 First submitted to journal 19 Sep, 2025 You are reading this latest preprint version Research Square lets you share your work early, gain feedback from the community, and start making changes to your manuscript prior to peer review in a journal. As a division of Research Square Company, we’re committed to making research communication faster, fairer, and more useful. We do this by developing innovative software and high quality services for the global research community. Our growing team is made up of researchers and industry professionals working together to solve the most critical problems facing scientific publishing. Also discoverable on Platform About Our Team In Review Editorial Policies Advisory Board Help Center Resources Author Services Accessibility API Access RSS feed Manage Cookie Preferences © Research Square 2026 | ISSN 2693-5015 (online) Privacy Policy Terms of Service Do Not Sell My Personal Information {"props":{"pageProps":{"initialData":{"identity":"rs-7601399","acceptedTermsAndConditions":true,"allowDirectSubmit":false,"archivedVersions":[],"articleType":"Research Article","associatedPublications":[],"authors":[{"id":534063255,"identity":"95707772-0d37-42ef-b015-23cbc0be7814","order_by":0,"name":"Fatima A. 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medical education as they provide the ground upon which the clinical sciences are built [\u003cspan citationid=\"CR1\" class=\"CitationRef\"\u003e1\u003c/span\u003e]. Basic science knowledge enhance clinical diagnosis skills [\u003cspan citationid=\"CR2\" class=\"CitationRef\"\u003e2\u003c/span\u003e, \u003cspan citationid=\"CR3\" class=\"CitationRef\"\u003e3\u003c/span\u003e], and integration of such information in clinical decision-making using a rigorous scientific approach [\u003cspan citationid=\"CR4\" class=\"CitationRef\"\u003e4\u003c/span\u003e]. Continuity and knowledge transformation are key concepts in medical education and the representation of basic science in later clinical training would be a fruitful approach in investigating the knowledge development [\u003cspan citationid=\"CR5\" class=\"CitationRef\"\u003e5\u003c/span\u003e]. Retention of basic science knowledge is essential for effective clinical reasoning and decision-making in medical education [\u003cspan citationid=\"CR6\" class=\"CitationRef\"\u003e6\u003c/span\u003e]. However, many students face difficulties applying this foundational knowledge during their clinical years, which can negatively affect their clinical performance [\u003cspan citationid=\"CR7\" class=\"CitationRef\"\u003e7\u003c/span\u003e]. Therefore, the present study is designed to assess and compare the ability of undergraduate medical students from University of Kassala to retain and transfer their knowledge of basic sciences (Anatomy, physiology and biochemistry) to clinical studies.\u003c/p\u003e"},{"header":"Methodology","content":"\u003cdiv id=\"Sec3\" class=\"Section2\"\u003e\u003ch2\u003eStudy design and data collection\u003c/h2\u003e\u003cp\u003eA cross-sectional, Institutional- based study was conducted at Faculty of Medicine and Health Sciences, University of Kassala, Sudan. The University established since 1990, comprises various academic programs, including the Faculty of Medicine and Health Sciences. Initially, the Faculty followed a conventional curriculum in which basic science subjects were taught over the first two academic years. In 2016, the hybrid model had been adopted, restructuring the basic science component to be delivered over five semesters. This study was conducted during the academic period spanning 2021 to 2022. The study targeted all the medical students of Batch 26 (134 students) and Batch 25 (135 students), who had completed their studies of basic science courses (anatomy, physiology, and biochemistry), and shifted to the study of clinical courses. Batch 26 completed the courses of basic sciences according to the reformed curriculum during the first five semesters, while batch 25 learned the basic sciences during completed two years (second and third year). The students who were unwilling to participate or absent during study were excluded. A questionnaire containing personal characteristics and close-ended questions was developed for this study (attached as supplementary file). Four sets of questions were developed to assess the students\u0026rsquo; ability to retain the basic science knowledge and transfer it to clinical scenario. Each set comprised nine questions dedicated to each discipline (anatomy, physiology, and biochemistry) and the remainder consisting of integrated questions. Each question required selecting the correct answer and carried equal weight. The test questions were carefully prepared by subject matter experts from the departments of Anatomy, Physiology, and Biochemistry who created the questions in accordance to standard textbooks. Each department developed a sufficient number of questions based on their respective areas of expertise. From these, nine questions were selected from each department, ensuring coverage of essential concepts and learning objectives. Additionally, nine integrated questions were prepared to assess students\u0026rsquo; ability to apply knowledge across the three disciplines. A total of thirty-six close-ended questions had been selected for the examination and the order of the questions was random. All selected questions underwent a thorough review and revision process to ensure clarity, relevance, appropriate difficulty level, and alignment with the learning objectives, providing a fair and comprehensive assessment for all students. All the students (185) attended the test, sat in lecture room to answer the questions in 60 minutes. Prior to answer the questions they were instructed to provide general information including identification number, year of study, gender.\u003c/p\u003e\u003c/div\u003e\n\u003ch3\u003eStatistics\u003c/h3\u003e\n\u003cp\u003eData was analyzed using Statistical Package for Social Sciences (SPSS) for Window version 25 (SPSS Inc., Chicago, IL, USA) and double checked before analysis. Mean standard deviation, frequency, ratio, and percentage, and coupled \u003cem\u003et\u003c/em\u003e-test were used and \u003cem\u003eP\u003c/em\u003e\u0026thinsp;\u0026lt;\u0026thinsp;0.05 was considered significant.\u003c/p\u003e"},{"header":"Results","content":"\u003cp\u003eOut of 185 invited students, 164 completed the questionnaire yielding 88.65% response rate. Seventy-nine students (48.2%) from batch 26 and 85 (51.8%) from batch 25 while male to female ratio was 1: 1.1.\u003c/p\u003e\n\u003ch3\u003eOverall Students Performance\u003c/h3\u003e\n\u003cp\u003eAccording to the policy of the Faculty of Medicine and Health Sciences, a score of 50% or above is considered as pass, 48\u0026ndash;49% is a borderline while\u0026thinsp;\u0026le;\u0026thinsp;47% is a failure. Students\u0026rsquo; scores on the test ranged from 19.44% to 88.89%, with a mean score of 57.49% \u0026plusmn; 14.60. The failure rate was 19.51%, while 80.5% of students passed the examination. Notably, no borderline scores was recorded in this assessment. Figures\u0026nbsp;(1) illustrates the average scores for individual test questions, categorized by basic science disciplines (Anatomy, Physiology, and Biochemistry) and integrated questions, providing insight into subject-specific and interdisciplinary performance trends. Analysis of the pass rate across different sets of questions revealed varying level of performance. The pass rate for Anatomy was recorded at 51.8%, representing the lowest performance among the assessed subjects. In contrast, Physiology demonstrated a considerably higher pass rate of 72.0%, followed by Biochemistry at 62.8%. Notably, the Integrated Questions achieved the highest pass rate of 79.3%, indicating stronger student performance in questions that required the application of knowledge across multiple disciplines.\u003c/p\u003e\n\u003ch3\u003eStudent Performance on Test Questions by Batch\u003c/h3\u003e\n\u003cp\u003eAs illustrated in table 1, students' scores across disciplines showed a similar distribution between the two batches, with no borderline scores recorded in either group. Anatomy consistently exhibited poor performance, with nearly half of the students in both batches failing to reach the passing threshold. Although a slight improvement was noted in the performance of Batch 26 on integrated questions, the difference was not statistically significant. Physiology maintained consistently high pass rates in both batches (approximately 72\u0026ndash;74%). In contrast, Biochemistry showed notably stronger performance in Batch 25, with a higher pass rate (67.1%) compared to 59.2% in Batch 26.\u003c/p\u003e\u003cdiv id=\"Sec8\" class=\"Section2\"\u003e\u003ch2\u003eComparative analysis of mean scores across Basic Science Discipline\u003c/h2\u003e\u003cp\u003eThe analysis of mean scores across basic science disciplines revealed that students performed highest in integrated questions with an average score of 63.55% \u0026plusmn; 20.39, followed by physiology at 60.37% \u0026plusmn; 19.31. Biochemistry had a lower mean score of 55.22% \u0026plusmn; 16.49, with 61 students (37.2%) scoring below the passing threshold of 47%. The lowest mean score was observed in anatomy, at 50.81% \u0026plusmn; 18.46, where 79 students (48.2%) failed to meet the minimum passing criteria.\u003c/p\u003e\u003c/div\u003e\n\u003ch3\u003eComparative analysis of mean test scores between Batches\u003c/h3\u003e\n\u003cp\u003eThe overall mean test scores were remarkably similar between the two batches, with Batch 26 achieving a mean score of 57.67% \u0026plusmn; 14.82 and Batch 25 scoring 57.32% \u0026plusmn; 14.47. When examining performance across individual disciplines\u0026mdash;Anatomy, Physiology, and Biochemistry\u0026mdash;as well as Integrated Questions, both batches demonstrated their highest mean scores in the integrated questions. Batch 26 achieved an average of 64.66% \u0026plusmn; 19.68, while Batch 25 followed closely with 62.35% \u0026plusmn; 21.07. Independent-sample \u003cem\u003et\u003c/em\u003e-test was conducted to compare the mean scores of Batch 26 and Batch 25, as well as to examine differences based on gender. The analysis revealed no significant difference in the scores between Batch 26 (M\u0026thinsp;=\u0026thinsp;57.67, SD\u0026thinsp;=\u0026thinsp;14.82) and Batch 25 (M\u0026thinsp;=\u0026thinsp;57.32, SD\u0026thinsp;=\u0026thinsp;14.47); t(0.15), p\u0026thinsp;=\u0026thinsp;0.88. The mean difference was 0.35, with a 95% confidence interval (CI) ranging from \u0026minus;\u0026thinsp;4.17 to 4.86, Table\u0026nbsp;(2). However, a statistically significant difference was found when comparing question results (anatomy, physiology, integrated, and total questions) based on gender (\u003cem\u003ep\u003c/em\u003e\u0026thinsp;\u0026lt;\u0026thinsp;0.01, 95% CI: -11.37 to -2.61).\u003c/p\u003e\n\u003ch3\u003eComparison of the Mean Test Scores: Subject vs. Integrated Questions\u003c/h3\u003e\n\u003cp\u003eA paired sample \u003cem\u003et\u003c/em\u003e-test was conducted to compare the mean scores of three individual subject-based questions (biochemistry, physiology, and anatomy) with the mean scores of integrated questions. The analysis revealed that biochemistry and physiology questions had significantly higher mean scores compared to anatomy. However, when the overall mean score of the three subject-based questions was compared with the mean score of the integrated questions, the integrated questions demonstrated a significantly higher mean score. This difference was statistically significant (\u003cem\u003ep\u003c/em\u003e\u0026thinsp;\u0026lt;\u0026thinsp;0.05), suggesting that students performed better on integrated questions, which may reflect a better retention and application of basic medical sciences knowledge in a clinically oriented context (table 3).\u003c/p\u003e"},{"header":"Discussion","content":"\u003cp\u003eOur study showed that biochemistry and physiology questions had significantly higher mean scores compared to anatomy and the integrated questions demonstrated a significantly higher mean score in comparison with the three investigated subjects (Anatomy, Physiology and Biochemistry). This difference suggesting that students performed better on integrated questions, which may reflect a better retention and application of basic medical sciences knowledge in a clinically oriented context. This finding aligns with the evidence suggesting that integrated assessments, which combine knowledge from multiple disciplines, can enhance student understanding and retention [\u003cspan citationid=\"CR8\" class=\"CitationRef\"\u003e8\u003c/span\u003e, \u003cspan citationid=\"CR9\" class=\"CitationRef\"\u003e9\u003c/span\u003e]. The relatively strong performance in integrated questions may indicate that students are better able to synthesize and apply knowledge across disciplines than to recall information from isolated subjects [\u003cspan additionalcitationids=\"CR11\" citationid=\"CR10\" class=\"CitationRef\"\u003e10\u003c/span\u003e\u0026ndash;\u003cspan citationid=\"CR12\" class=\"CitationRef\"\u003e12\u003c/span\u003e]. The current results necessitate an urgent need for improvement, particularly in anatomy subject which showed lower average scores and a higher proportion of failures. These findings reflect a broader trend of limited retention of basic science knowledge during clinical years, as documented in many previous studies [\u003cspan citationid=\"CR13\" class=\"CitationRef\"\u003e13\u003c/span\u003e, \u003cspan citationid=\"CR14\" class=\"CitationRef\"\u003e14\u003c/span\u003e]. Our results highlight that clinical knowledge can be well understood after complete understanding of applied basic science background. A gain the finding of the results support the fact that basic knowledge has a direct influence on the clinical practice and leads to successful answering to clinical questions. By achieving good correlation between basic and clinical knowledge the score will be acceptable and we will obtain better results. Basic science are more memorable when ever it is correlated to clinical knowledge [\u003cspan citationid=\"CR13\" class=\"CitationRef\"\u003e13\u003c/span\u003e]. The students become more eager when they become engaged in the clinical sciences and this might explain their high score in integrated questions. Many factors had been documented as having impact on the relationship between basic and clinical medical sciences such as variation in curricula, learning methods, and student's attention. To enhance the retention of basic science knowledge during clinical training, it is essential to cultivate engaging and interactive learning environments. Fostering positive student\u0026ndash;teacher interactions, employing diverse teaching strategies, and incorporating continuous, multifaceted assessment methods can significantly reinforce learning. Additionally, lectures designed with low information density that focus on key concepts have been shown to be more effective learning tools [\u003cspan citationid=\"CR15\" class=\"CitationRef\"\u003e15\u003c/span\u003e]. In the current study and among the basic science subjects, physiology emerged as the strongest area of student performance. Its close connection to clinical practice likely fosters greater student engagement and facilitates comprehension, which may explain the higher average scores. In comparison, biochemistry and anatomy showed weaker results, with mean scores of 55.22% \u0026plusmn; 16.49 and 50.81% \u0026plusmn; 18.46, respectively. Poor retention of anatomy was documented in other study [\u003cspan citationid=\"CR16\" class=\"CitationRef\"\u003e16\u003c/span\u003e]. These disparities may be attributed to the inherently challenging nature of biochemistry and anatomy, both of which demand extensive memorization and grasp of intricate concepts. Furthermore, the lower performance in these areas highlights the need for revised instructional approaches. Implementing effective teaching strategies as concept-based learning, visual aids, active learning sessions, and clinically relevant case discussions, may help students better understand and retain complex material. An interesting observation was that the overall performance across both batches (Batch 26 and Batch 25) was remarkably similar, with very small differences in mean scores (57.67% \u0026plusmn; 14.82 for Batch 26 vs. 57.32% \u0026plusmn; 14.47 for Batch 25). This suggests consistency in the student's performance regardless of batch assignment. There should be a system in the faculties of medicine aiming to evaluate the extent to which their educational objectives are well applied and achieved.\u003c/p\u003e"},{"header":"Conclusion","content":"\u003cp\u003eThe present findings demonstrated that clinical year students achieved high scores on integrated questions, but they did not perform as well on basic sciences questions. This study acts as a base for understanding the validity of the faculty curriculum; it could also be used as a basis for discussion about the methods, and programs of learning medicine.\u003c/p\u003e\u003cdiv id=\"Sec13\" class=\"Section2\"\u003e\u003ch2\u003eLimitation and Recommendation\u003c/h2\u003e\u003cp\u003eThere are limitations to this study: it is a single institute study and not covered whole medical schools in Sudan thus more research is needed in this area to determine whether all Sudanese medical students are actively engaged and able to retain key concepts or not. Furthermore, collaboration between basic science departments and clinical departments to help create a unified teaching approach is needed.\u003c/p\u003e\u003c/div\u003e"},{"header":"Declarations","content":"\u003cp\u003e\u003ch2\u003eEthics approval and consent to participate\u003c/h2\u003e\u003cp\u003eEthical approval Permission to carry the study was obtained from the Research Ethics Committee of Faculty of Medicine \u0026amp; Health Sciences, University of Kassala, Sudan. Research methods involving human data were performed in accordance with the Declaration of Helsinki and its later amendments. Participation was voluntary, and written informed consent was obtained from all students who agreed to participate. Students had the right to withdraw at any stage without facing any negative consequences.\u003c/p\u003e\u003c/p\u003e\u003cp\u003e\u003cstrong\u003eConsent for publication\u003c/strong\u003e\u003cp\u003eNot applicable\u003c/p\u003e\u003c/p\u003e\u003cp\u003e\u003cstrong\u003eCompeting interests\u003c/strong\u003e\u003cp\u003eThe authors declare that they have no competing interests\u003c/p\u003e\u003c/p\u003e\u003ch2\u003eFunding\u003c/h2\u003e\u003cp\u003eNone\u003c/p\u003e\u003ch2\u003eAuthor Contribution\u003c/h2\u003e\u003cp\u003eKFA carried out the study and participated in the statistical analysis and procedures. AAA, HHM and E H coordinated and participated in the study design, statistical analysis and the drafting of the manuscript. All the authors read and approved the final version.\u003c/p\u003e\u003ch2\u003eAcknowledgement\u003c/h2\u003e\u003cp\u003eThe authors would like to express their heartfelt gratitude to the Faculty of Medicine and Health Sciences and all the study participants for their cooperation and invaluable contributions to the success of this research.\u003c/p\u003e\u003ch2\u003eData Availability\u003c/h2\u003e\u003cp\u003eRelevant data generated or analyzed during this study are available fromthe corresponding author on reasonable request.\u003c/p\u003e"},{"header":"References","content":"\u003col\u003e\u003cli\u003e\u003cspan\u003eChakkarapani A, Sheng ML. Assessment of Long-Term Retention of Human Anatomy Knowledge and Skills among Modern-Day Health Science Students. Int J Sci Technol Res. 2021;10:153\u0026ndash;7.\u003c/span\u003e\u003c/li\u003e\u003cli\u003e\u003cspan\u003eFernando S, Ellawala A, Wijayasiri A. 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Nordic J Lang Teach Learn 2018, Aug 15;6(1).\u003c/span\u003e\u003c/li\u003e\u003c/ol\u003e"},{"header":"Tables","content":"\u003cp\u003eTable (1): Students Performance on Test questions by Batch\u003c/p\u003e\n\u003ctable border=\"1\" cellspacing=\"0\" cellpadding=\"0\"\u003e\n \u003ctbody\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\" style=\"width: 27.8846%;\"\u003e\n \u003cp\u003eSubject questions\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 37.5%;\"\u003e\n \u003cp\u003ePass rate (%)Batch 26 (n=79)\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 34.6154%;\"\u003e\n \u003cp\u003ePass rate (%)Batch 25 (n=85)\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\" style=\"width: 27.8846%;\"\u003e\n \u003cp\u003eAnatomy\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 37.5%;\"\u003e\n \u003cp\u003e54.2\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 34.6154%;\"\u003e\n \u003cp\u003e50.6\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\" style=\"width: 27.8846%;\"\u003e\n \u003cp\u003ePhysiology\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 37.5%;\"\u003e\n \u003cp\u003e71.9\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 34.6154%;\"\u003e\n \u003cp\u003e73.9\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\" style=\"width: 27.8846%;\"\u003e\n \u003cp\u003eBiochemistry\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 37.5%;\"\u003e\n \u003cp\u003e59.2\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 34.6154%;\"\u003e\n \u003cp\u003e67.1\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\" style=\"width: 27.8846%;\"\u003e\n \u003cp\u003eIntegrated questions\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 37.5%;\"\u003e\n \u003cp\u003e84.8\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 34.6154%;\"\u003e\n \u003cp\u003e74.1\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003c/tbody\u003e\n\u003c/table\u003e\n\u003cp\u003e\u003cbr\u003e\u003c/p\u003e\n\u003cp\u003eTable (2): Comparison the mean Test score by students\u0026rsquo; Batch\u003c/p\u003e\n\u003ctable border=\"1\" cellspacing=\"0\" cellpadding=\"0\"\u003e\n \u003ctbody\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\" style=\"width: 22.4756%;\"\u003e\n \u003cp\u003eQuestions\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 19.8697%;\"\u003e\n \u003cp\u003eMean difference\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 16.6124%;\"\u003e\n \u003cp\u003et- value\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 17.5896%;\"\u003e\n \u003cp\u003eP value\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 23.4528%;\"\u003e\n \u003cp\u003e95% CI\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\" style=\"width: 22.4756%;\"\u003e\n \u003cp\u003eAnatomy\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 19.8697%;\"\u003e\n \u003cp\u003e2.91\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 16.6124%;\"\u003e\n \u003cp\u003e1.01\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 17.5896%;\"\u003e\n \u003cp\u003e0.32\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 23.4528%;\"\u003e\n \u003cp\u003e-2.79- 8.61\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\" style=\"width: 22.4756%;\"\u003e\n \u003cp\u003ePhysiology\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 19.8697%;\"\u003e\n \u003cp\u003e-3.04\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 16.6124%;\"\u003e\n \u003cp\u003e-1.01\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 17.5896%;\"\u003e\n \u003cp\u003e0.32\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 23.4528%;\"\u003e\n \u003cp\u003e-8.99 \u0026ndash; 2.92\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\" style=\"width: 22.4756%;\"\u003e\n \u003cp\u003eBiochemistry\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 19.8697%;\"\u003e\n \u003cp\u003e-0.98\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 16.6124%;\"\u003e\n \u003cp\u003e-0.38\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 17.5896%;\"\u003e\n \u003cp\u003e0.71\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 23.4528%;\"\u003e\n \u003cp\u003e-6.07-4.13\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\" style=\"width: 22.4756%;\"\u003e\n \u003cp\u003eIntegrated\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 19.8697%;\"\u003e\n \u003cp\u003e2.49\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 16.6124%;\"\u003e\n \u003cp\u003e0.78\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 17.5896%;\"\u003e\n \u003cp\u003e0.44\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 23.4528%;\"\u003e\n \u003cp\u003e-3.82- 8.79\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\" style=\"width: 22.4756%;\"\u003e\n \u003cp\u003eTotal questions\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 19.8697%;\"\u003e\n \u003cp\u003e0.35\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 16.6124%;\"\u003e\n \u003cp\u003e0.15\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 17.5896%;\"\u003e\n \u003cp\u003e0.88\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 23.4528%;\"\u003e\n \u003cp\u003e-4.17- 4.86\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003c/tbody\u003e\n\u003c/table\u003e\n\u003cp\u003e\u0026nbsp;\u003c/p\u003e\n\u003cp\u003eTable (3): comparison the mean test score: Subject vs Integrated questions\u003c/p\u003e\n\u003ctable border=\"1\" cellspacing=\"0\" cellpadding=\"0\" width=\"643\"\u003e\n \u003ctbody\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\" style=\"width: 30.0156%;\"\u003e\n \u003cp\u003ePair compared\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 22.084%;\"\u003e\n \u003cp\u003eMean difference\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 14.93%;\"\u003e\n \u003cp\u003et-value\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 19.9067%;\"\u003e\n \u003cp\u003e95% CI\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 13.0638%;\"\u003e\n \u003cp\u003eP-value\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\" style=\"width: 30.0156%;\"\u003e\n \u003cp\u003eBiochemistry- integrated\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 22.084%;\"\u003e\n \u003cp\u003e-8.33\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 14.93%;\"\u003e\n \u003cp\u003e-5.24\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 19.9067%;\"\u003e\n \u003cp\u003e-11.47- (-5.20)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 13.0638%;\"\u003e\n \u003cp\u003e0.000\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\" style=\"width: 30.0156%;\"\u003e\n \u003cp\u003ePhysiology- integrated\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 22.084%;\"\u003e\n \u003cp\u003e-3.18\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 14.93%;\"\u003e\n \u003cp\u003e-2.15\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 19.9067%;\"\u003e\n \u003cp\u003e-6.10- (-0.24)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 13.0638%;\"\u003e\n \u003cp\u003e0.033\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\" style=\"width: 30.0156%;\"\u003e\n \u003cp\u003eAnatomy- integrated\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 22.084%;\"\u003e\n \u003cp\u003e-12.73\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 14.93%;\"\u003e\n \u003cp\u003e-9.27\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 19.9067%;\"\u003e\n \u003cp\u003e-15.45- (-10.02\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 13.0638%;\"\u003e\n \u003cp\u003e0.000\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003c/tbody\u003e\n\u003c/table\u003e"}],"fulltextSource":"","fullText":"","funders":[],"hasAdminPriorityOnWorkflow":false,"hasManuscriptDocX":true,"hasOptedInToPreprint":true,"hasPassedJournalQc":"","hasAnyPriority":false,"hideJournal":false,"highlight":"","institution":"","isAcceptedByJournal":true,"isAuthorSuppliedPdf":false,"isDeskRejected":"","isHiddenFromSearch":false,"isInQc":false,"isInWorkflow":false,"isPdf":false,"isPdfUpToDate":true,"isWithdrawnOrRetracted":false,"journal":{"display":true,"email":"[email protected]","identity":"bmc-medical-education","isNatureJournal":false,"hasQc":true,"allowDirectSubmit":false,"externalIdentity":"meed","sideBox":"Learn more about [BMC Medical Education](http://bmcmededuc.biomedcentral.com/)","snPcode":"","submissionUrl":"https://www.editorialmanager.com/meed/default.aspx","title":"BMC Medical Education","twitterHandle":"BMC_series","acdcEnabled":true,"dfaEnabled":false,"editorialSystem":"em","reportingPortfolio":"BMC Series","inReviewEnabled":true,"inReviewRevisionsEnabled":true},"keywords":"medical education, basic sciences, medical schools, Sudan","lastPublishedDoi":"10.21203/rs.3.rs-7601399/v1","lastPublishedDoiUrl":"https://doi.org/10.21203/rs.3.rs-7601399/v1","license":{"name":"CC BY 4.0","url":"https://creativecommons.org/licenses/by/4.0/"},"manuscriptAbstract":"\u003ch2\u003eBackground\u003c/h2\u003e\u003cp\u003eRetention of basic science knowledge is essential for effective clinical reasoning and decision-making in medical education. However, many students face difficulties applying this foundational knowledge during their clinical years.\u003c/p\u003e\u003ch2\u003eMethodology\u003c/h2\u003e\u003cp\u003e: Aiming to determine the level of retained basic science knowledge among undergraduate medical students, a cross sectional-single institutional-based study was conducted among two different batches in the University of Kassala, Sudan during the academic period spanning 2021 to 2022. Thirty-six single answer questions were used for data collection. The data were entered and analyzed using SPSS version 25.\u003c/p\u003e\u003ch2\u003eResults\u003c/h2\u003e\u003cp\u003eOut of 185 invited students, 164 completed the questionnaire yielding 88.65% response rate. Approximately one-third of the respondents reported complete satisfaction with the basic sciences curriculum. Students' test scores ranged from 19.44% to 88.89%, with an overall average of 57.49\u0026thinsp;\u0026plusmn;\u0026thinsp;14.60. Notably, 32 students (19.51%) scored\u0026thinsp;\u0026le;\u0026thinsp;47%. The average scores between the two student batches were nearly identical (57.67% \u0026plusmn; 14.82 and 57.32% \u0026plusmn; 14.47), suggesting consistency in performance across batches. Analysis across subject areas revealed that integrated questions consistently produced the highest mean scores in both batches (64.66\u0026thinsp;\u0026plusmn;\u0026thinsp;19.68 and 62.35\u0026thinsp;\u0026plusmn;\u0026thinsp;21.07 respectively). Overall, integrated questions had the highest average score at 63.55\u0026thinsp;\u0026plusmn;\u0026thinsp;20.39, followed by Physiology (60.37\u0026thinsp;\u0026plusmn;\u0026thinsp;19.31) and Biochemistry (55.22\u0026thinsp;\u0026plusmn;\u0026thinsp;16.49). Anatomy recorded the lowest average score (50.81\u0026thinsp;\u0026plusmn;\u0026thinsp;18.46).\u003c/p\u003e\u003ch2\u003eConclusion\u003c/h2\u003e\u003cp\u003eThe study revealed good results of integrated questions and dissatisfaction with the basic sciences syllabus, particularly in anatomy.\u003c/p\u003e","manuscriptTitle":"Retention of Basic Sciences Knowledge at Clinical Years: A single Institute Study from Sudan","msid":"","msnumber":"","nonDraftVersions":[{"code":1,"date":"2025-10-27 11:39:41","doi":"10.21203/rs.3.rs-7601399/v1","editorialEvents":[{"type":"communityComments","content":0},{"type":"decision","content":"Revision requested","date":"2025-10-28T13:56:59+00:00","index":"","fulltext":""},{"type":"editorInvitedReview","content":"","date":"2025-10-23T07:50:44+00:00","index":"hide","fulltext":""},{"type":"editorInvitedReview","content":"","date":"2025-10-20T18:20:02+00:00","index":"hide","fulltext":""},{"type":"reviewerAgreed","content":"241659871609366264801619521448344242066","date":"2025-10-20T13:00:53+00:00","index":"hide","fulltext":""},{"type":"reviewerAgreed","content":"275724607592324942923160045892878756641","date":"2025-10-17T09:58:53+00:00","index":"hide","fulltext":""},{"type":"reviewerAgreed","content":"159883074824217815034750914880022727864","date":"2025-10-14T19:23:58+00:00","index":"hide","fulltext":""},{"type":"reviewerAgreed","content":"190571688650171623981670409467260785941","date":"2025-10-13T16:15:51+00:00","index":"hide","fulltext":""},{"type":"reviewersInvited","content":"","date":"2025-10-13T15:33:49+00:00","index":"","fulltext":""},{"type":"editorAssigned","content":"","date":"2025-10-13T11:32:09+00:00","index":"","fulltext":""},{"type":"editorInvited","content":"","date":"2025-09-22T10:17:34+00:00","index":"","fulltext":""},{"type":"checksComplete","content":"","date":"2025-09-19T20:26:56+00:00","index":"","fulltext":""},{"type":"submitted","content":"BMC Medical Education","date":"2025-09-19T20:23:27+00:00","index":"","fulltext":""}],"status":"published","journal":{"display":true,"email":"[email protected]","identity":"bmc-medical-education","isNatureJournal":false,"hasQc":true,"allowDirectSubmit":false,"externalIdentity":"meed","sideBox":"Learn more about [BMC Medical Education](http://bmcmededuc.biomedcentral.com/)","snPcode":"","submissionUrl":"https://www.editorialmanager.com/meed/default.aspx","title":"BMC Medical Education","twitterHandle":"BMC_series","acdcEnabled":true,"dfaEnabled":false,"editorialSystem":"em","reportingPortfolio":"BMC Series","inReviewEnabled":true,"inReviewRevisionsEnabled":true}}],"origin":"","ownerIdentity":"080553ed-b448-4108-bc1b-0af8b049baa3","owner":[],"postedDate":"October 27th, 2025","published":true,"recentEditorialEvents":[],"rejectedJournal":[],"revision":"","amendment":"","status":"published-in-journal","subjectAreas":[],"tags":[],"updatedAt":"2026-01-19T17:08:12+00:00","versionOfRecord":{"articleIdentity":"rs-7601399","link":"https://doi.org/10.1186/s12909-026-08599-9","journal":{"identity":"bmc-medical-education","isVorOnly":false,"title":"BMC Medical Education"},"publishedOn":"2026-01-14 16:30:39","publishedOnDateReadable":"January 14th, 2026"},"versionCreatedAt":"2025-10-27 11:39:41","video":"","vorDoi":"10.1186/s12909-026-08599-9","vorDoiUrl":"https://doi.org/10.1186/s12909-026-08599-9","workflowStages":[]},"version":"v1","identity":"rs-7601399","journalConfig":"researchsquare"},"__N_SSP":true},"page":"/article/[identity]/[[...version]]","query":{"redirect":"/article/rs-7601399","identity":"rs-7601399","version":["v1"]},"buildId":"8U1c8b4HqxoKbykW_rLl7","isFallback":false,"isExperimentalCompile":false,"dynamicIds":[84888],"gssp":true,"scriptLoader":[]}