Flipping the Anatomy Classroom with Clinical Cases and Teamwork at a Large Medical School

Abstract

Students participating in active and collaborative learning understand concepts better, perform better in coursework, and have better attitudes toward teamwork. But, the rise of the digital age has had a negative effect on classroom engagement—a topic of international concern. At UT Southwestern Medical School, voluntary attendance at didactic anatomy sessions is at an all‐time low. Because we believe contact time with students is a valuable commodity, our objective is to develop an anatomy teaching approach that will improve student engagement and teamwork. As content hours are limited, time‐efficiency is essential to the approach we seek to develop. In a pilot study, we developed two face‐to‐face case‐based active learning sessions that were conducted within the time slots formerly scheduled for two face‐to‐face anatomy lecture sessions. Content formerly covered in these didactic sessions was converted into video format and offered on‐demand through our institution’s learning management system. Students were given instructions for pre‐session preparation (i.e., review of the videos and other course materials) several days prior to each session. Due to computer technology limitations in our cadaver lab, a virtual cadaver model (Complete Anatomy, 3D4Medical from Elsevier) was used in place of human cadavers for the two case‐based sessions. During the sessions, each laboratory dissection team of 6‐7 students worked at a table outfitted with a 42‐inch monitor capable of wireless connection to student laptops. The exercises focused on the anatomical basis for several clinical cases involving cranial nerve lesions (Session 1) and abdominal hernias (Session 2). Students were allotted 45 minutes for each mandatory session at the end of which teams were required to electronically submit a completed worksheet for credit. Following each session, students were invited to participate in a brief survey with two open‐ended questions that asked them to name one thing about the exercise they would change and one thing they would keep the same. Results of the surveys revealed that the two most commonly perceived benefits of the exercises were 1) application of anatomy to real cases (41 of 131 responses) and 2) opportunity to work in teams with other students (28 of 131 responses). The most commonly perceived challenge was insufficient time to work through the exercises as a team (95 of 131 responses). Student performance on exam questions directly related to the content of the pilot sessions was higher than in years prior to the pilot; however, this difference was not statistically significant in this high‐performing group of students. The survey results demonstrate that our students perceive value in teamwork and the opportunity to practice applying their theoretical knowledge to real‐world problems. The results also highlight the importance of carving out adequate time in the curriculum for these experiences. In the future, we aim to increase opportunities, outside of dissection and didactic sessions, for our students to practice these important, career‐relevant skills.