Curricular and pedagogical aspects of gross anatomy education for undergraduate physiotherapy students: a scoping review.

Abstract

The objective of this review was to collate and map gross anatomy curricular and pedagogical approaches for physiotherapy students. Knowledge of anatomy is essential for physiotherapy clinical diagnosis, treatment effectiveness and safe practice. The information on this topic is sparse, and what does exist is diverse. This scoping review describes anatomy educational approaches for physiotherapy students and provides needed insight into this topic. No limits were applied on the date of the database search or age of participants. Languages were limited to English, French, German and Spanish. Studies had to include information on gross anatomy curricula or pedagogy for physiotherapy students, or information from qualified physiotherapists or those teaching gross anatomy to physiotherapy students. Included studies were mainly sourced from EBSCOhost (CINAHL, ERIC and MEDLINE), PubMed and Scopus databases. Perusal of reference lists facilitated further retrievals. Studies published from inception up to 21 July 2019 were included. Studies were identified and screened, and the process was reported in a PRISMA flow diagram. JBI methodology for scoping reviews was followed. Selected studies were charted according to a template created and published in a JBI scoping review protocol. Fifty-four studies satisfied the inclusion criteria. Various studies gave calculable length of intervention in weeks (n=14, 26%), hours (n = 7, 13%) or both (n = 21, 39%). The majority of studies (n = 50, 93%) were cross-sectional studies; three were randomized controlled trials (6%). Mean sample sizes varied from 55.3 ± 30.4 (professional behaviors, ethical and humanistic aspects) to 323.2 ± 219.7 participants (multi-modal and blended learning). Overall, 29 studies (54%) included physiotherapy students or personnel in physiotherapy anatomy programs exclusively in the sample. Other disciplines with physiotherapy students included medical students (n = 12, 22%), and occupational therapy students (n = 10, 19%). The interprofessional education category (n = 8) determined that interdisciplinary teamwork led to increased anatomical learning and awareness of future clinical roles. Computer-assisted learning (n = 9) was effective as a stand-alone or adjunct pedagogy, useful for self-study and helped anatomical knowledge retention. Team-based learning (n = 2), peer teaching (n = 6) and clinical input incorporating case-based learning and horizontal and vertical integration (n = 4) resulted in anatomical knowledge retention and were associated with mastery of anatomical understanding, an increase in examination confidence and higher examination grades. Contradictory learning outcomes resulted from the use of online videos in blended and multi-model learning studies (n = 7). Increased student participation in asynchronous online discussion forums benefitted academic learning outcomes. The category of curriculum, pedagogy and materials (n = 15) identified and compared different survey results pertaining to the curricular aspect of the objectives of this review. One study investigated the flipped classroom concept. The use of anatomy content to encourage professional, ethical and humanistic aspects (n = 3) of physiotherapy students' behavior resulted in positive outcomes. This scoping review revealed a multi-faceted topic with many types of interventions and outcomes recorded. It identified variations in pedagogies, curricular content and learning approaches integral to the subject and their impact on gross anatomy education for this population. Beneficial behavioral, anatomical learning, knowledge retention and academic outcomes were identified.