Teaching anatomy with digital self-learning modules

Abstract

The teaching of anatomy in India is highly compartmentalised, discipline-based and delivered in the first year of the 5.5-year MBBS course. The medical student thus does not know how much anatomy of a particular region is clinically relevant. Existing conventional teaching methods do not enable the student to correlate gross anatomy with applied anatomy. Using creativity, an anatomist can help the student understand clinical anatomy in a better way and in context. Once the student realises the purpose of learning the subject in terms of what, how and why he or she needs to study, the process of learning becomes more interesting and effective. Ethical principles were adhered to during the project. To help the students understand clinical anatomy, videos of surgeries of the thyroid and a laryngoscopy were made in collaboration with the surgical faculty. Digital self-learning modules (DSLMs) of the surgical anatomy of the thyroid and larynx were also prepared, including multiple-choice questions with interpretations. Students were randomly assigned to one of two groups (A and B) of 40 students per group. Group A was shown the video of the larynx in the presence of a surgeon-facilitator, who explained the relevance of applied anatomy of the larynx at each stage. After the video presentation, the students were exposed to the DSLM to reinforce the information received. Group B was not exposed to this programme. Group B went through an equivalent process for the thyroid, to which Group A was not exposed. After these sessions, a test consisting of short essays, short-answer questions and multiple-choice questions was administered to both groups on both topics. Perceptions of the programme were obtained from both the students and the faculty staff involved in the study using a 16-item questionnaire. Responses were given on a Likert scale of 0–4. Test scores were analysed using spss (SPSS, Inc., Chicago, IL, USA). T-tests were used to compare mean test scores between the exposed and unexposed groups. The mean test scores were 18.59 and 13.37 (P < 0.001) for the thyroid-related test and 19.46 and 15.47 (P < 0.003) for the larynx-related test in the exposed and unexposed groups, respectively. This indicates that surgical videos combined with the input of a surgeon-facilitator and a corresponding DSLM are effective tools for teaching clinical anatomy in the MBBS course. The reliability of the test questionnaire was good (Cronbach’s alpha 0.768). Responses to the questionnaire items indicated that the module and the surgeon’s point of view were highly appreciated by the students (mean = 3.49, standard deviation [SD] = 0.56). This intervention increased the interest of students in studying the subject in greater depth (mean = 3.46, SD = 0.69). The surgeon also appreciated the concept of exposing the students to surgery at an early stage. The integration of surgical sciences with basic sciences enables students to learn anatomy from the surgeon’s point of view. The students expressed their desire to undertake similar modules on different topics (mean = 3.80, SD = 0.43). The reinforcement of learning using DSLMs proved effective in terms of improving student performance (mean = 3.33, SD = 0.66).