Claire Smith

  • Learning anatomy: implications for pedagogy

    Claire Smith and H Mathias, University of Southampton

    Research paper

    Themes: teaching methods, assessment methods, course and programme design

    Tuesday 8 September 2009, 09.00 - 10.00 in room G61

    This research study utilised an illuminative case study methodology to comprehend anatomy learning and application in medical education. Principles from phenomenography and grounded theory were adopted to seek perceptions and experiences of students, staff and alumni. The research methods included focus groups, questionnaires, observations, interviews and an approaches to learning inventory (ASSIST).Through progressive focusing on significant themes a model of learning and applying anatomy knowledge is proposed. The learning of anatomy is influenced by an individual's previous experiences and their perceptions of anatomy in context. Individuals adopt a deep, strategic or surface approach to learning, influenced by identified positive or negative factors. Perception that anatomy is relevant and other positive influences result in a deep approach and vice versa for a surface approach. A strategic approach is driven by the desire to perform in assessments. The approach to learning adopted has consequences in that the adoption of a surface or strategic approach hinders the application of knowledge at a later point. A deep approach enables knowledge application through touch-mediated perception in examining human cadaveric specimens and is the preferred approach to learning anatomy as it enables an understanding of the three-dimensional form.

    Anatomy learning occurs in three stages and the approach adopted reflects different levels of engagement in these stages. Application of knowledge occurs through situated learning where anatomical knowledge is restructured and through experience becomes encapsulated, enabling illness scripts to be applied in the clinical context.

    To enable effective learning and application of anatomy the study recommends that:

    • Clinical content and application of knowledge be increased and that anatomy education continues throughout training.
    • Anatomy education includes the use of human cadaveric specimens.
    • Assessment should be appropriate for anatomy education and promote a deep approach.

    More specifically, teachers are often the point of call for students struggling with anatomy learning. They should examine the student’s previous experience and perceptions of anatomy. Frequently this might reveal that a student has difficulty with the teaching environment and/or that they perceive anatomy to be memorisation based. Some students may be disheartened, either because of assessment results or because they have been caught up in a spiral of negative factors. If this is the case it may be useful to discuss why the student was interested in medicine and where they feel anatomy fits into clinical practice.

    Teachers should ask students to describe what learning activities they carry out for anatomy and it may be useful to provide students with some examples of how to go about learning anatomy. Students may like to try more visual or practical ways of working in their own time. Advice on how to learn anatomy should not be confined to the introduction session but should follow students along their journey of anatomy education.

    The end result of implementing such recommendations is hopefully better patient care and a reduction in the number of medico-legal litigations linked to a deficit of understanding anatomy.