RETHINKING ANATOMY IN A COMPRESSED TIME FRAME: CLINICAL SYMPTOMS, NOT CASE STUDIES, AS THE BASIS FOR INTRODUCTORY INSTRUCTION IN GROSS ANATOMY

Abstract

The goal of this study was to develop effective approaches to train first year medical students in Gross Anatomy/Embryology in a compressed time frame. Pedagogical reorganization was based upon a core of clinical conditions taught in second‐year and Step One board review courses. These conditions were not presented as clinical problems (many students had limited prior training in medical terminology) but lectures and discussions focused upon clinical symptoms, allowing for a direct correlation of structure and function. Instruction in anatomy was extended to prepare for laboratory dissections. Overall methodology was multi‐modal, including 'flipped' and traditional lectures, guided study of prosections/radiographs and small group laboratory review sessions. Some content was reduced: knowledge of muscle actions and innervations was required, not origins and insertions. Performance in anatomy was specifically evaluated by computer‐based written examinations that included a set of questions (36) previously asked over a 7 year period (repetitively or with minor modification) and by regional practical exams. Mean scores in all areas were sustained or numerically improved, despite the compression of instruction duration. There were no significant differences in performance based upon question format (Basic science anatomy, Clinical Vignette) or instructional modality ('flipped' vs traditional lectures). Point biserial data indicated that students needing assistance in learning could still be identified. These results suggest that training in Gross Anatomy can be effectively maintained in a compressed duration by instruction in the context of symptomatology of clinical syndromes and conditions, a format that should also facilitate review for USMLE Step One Board examinations.Support or Funding InformationWVCTSI grant U54GM104942