What the head and neck? A study of integrated gross anatomy with embryology and its effect on learning and retention

Abstract

Mastery in anatomical sciences is critical for medical professionals for competent practice and patient safety. However, widespread curricular changes focused on integration of subjects and clinical content resulted in minimal contact hours for anatomical sciences and increasing reliance on adjunct online resources. The COVID-19 pandemic further highlighted the need for quality online teaching materials. Despite the central role online resources play in anatomical sciences, most remain subject-specific with minimal integration of other disciplines; thus, the educational effect of integrated online resources is unclear. To that end, two versions of a head and neck gross anatomy tutorial were created; although the gross anatomy content was identical, the experimental tutorial also integrated embryology of the head and neck. In a Colorado Multiple Institutional Review Board (COMIRB) exempt #20-2175 randomized single blind study, the first (DS1) and the second year (DS2) dental students enrolled in a gross anatomy course were recruited. The DS1s had never been exposed to the content of the tutorial while the DS2s had learned the content in the prior year. All participants completed a pre-test. Then the participants were randomly assigned to access either the control or the experimental tutorial before completing a post-test and a survey. DS1s also completed a retention test one week after completing the post-test. Seventy-one DS1s, and 71 DS2s completed the study. Both cohorts scored statistically higher in the post-test compared to the pre-test (Tukey HSD, all p's < 0.001). The post-test performance increase for DS2s was significantly higher than for DS1s (main cohort effect: F(1,2) = 4.88, p < 0.05, partial h2 = 0.06, Tukey HSD, p < 0.05). A two-way repeated-measures ANOVA revealed a significantly higher retention test score compared to the pre-test scores for DS1 (Tukey HSD: p < 0.01). Thematic analytics of the survey comments were mostly positive and similar across the experimental conditions. Notably, the experimental group indicated a positive perception of integrated embryology content attributed to providing context for gross anatomy. These findings suggest that a digital tutorial on head and neck anatomy leads to significant learning and short-term retention, regardless of integrated embryology content presentation, but based on thematic analysis students perceive the integrated content to be contextually valuable. The post-test increase difference between DS1 andDS2 indicate that the digital tutorials yield better outcomes as a review resource as opposed to an introductory resource.