AbstractAs part of the curricular change at the University of Rochester School of Medicine and Dentistry, we focused on active learning and greater integration of basic and clinical sciences. With these objectives in mind, this report describes the use of small‐group, case‐based exercises in our gross anatomy course and provides one example of integrating such activities into a traditional course. In addition to formal lectures and laboratory dissection, students meet approximately every fourth class period in small groups to discuss a clinical case which focuses on the relevant anatomy taught at that time. Two first‐year students lead each small group; one fourth‐year student facilitator also attends to provide clinical correlations, answer questions, and reinforce the anatomy. Formative feedback suggests students enthusiastically endorse the self‐directed active learning; they feel these exercises offer both a valuable approach to learning and an opportunity to practice presentation and leadership skills. First‐year students enjoy the interaction with fourth‐year facilitators and the fourth‐year students appreciate the opportunity to review basic science material. Our data suggest that students learn to “think” about the anatomy, and we hope learn to use their understanding and knowledge base in a practical fashion. Moreover, these case‐based exercises can fit nicely into a variety of curricular formats, especially where problem‐based tutorials may not be feasible or desirable. © 1994 Wiley‐Liss, Inc.