The Effect of Clinical Anatomy Integration on Medical Student Academic Performance and Learning Approach

INTRODUCTION: Integration of clinical procedures have been shown to help motivate medical students to recognize the utility and importance of basic science concepts and develop independent problem-solving skills. To date, no studies have quantified the effects clinical procedure demonstrations have on first-year medical anatomy course performance and retention. The purpose of this study was to facilitate three anatomy learning sessions each with the integration of a clinical procedure. We hypothesized students who observe a clinical procedure demonstration would exhibit better academic performance, retention, and a deeper learning approach. Additionally, we hypothesized that students who perceive the demonstrator to have more clinical experience would exhibit the highest academic performance and deepest learning approach. METHODS: First-year medical students at Lake Erie College of Osteopathic Medicine were recruited (n=63) via email. Over three 30-minute sessions, participants were exposed to the anatomy of the thigh (n= 45), thorax (n= 41), and neck (n= 42). Sessions were structurally similar and contained information regarding surface anatomy, muscles, neurovasculature, and clinical correlates. Each session included discussion of a clinical procedure: Femoral nerve block, thoracentesis, and fine needle aspiration of the thyroid gland, respectively. Participants were semi-randomized into three groups based on learning approach, and each received clinical information using a different method: Physician demonstration, PhD student demonstration, or PowerPoint slide with no demonstration. Learning was assessed using a 15-question multiple choice pre-, post-, and retention test. Learning approach was assessed using the Approach and Study Skills Inventory. Student opinions were collected using two open-response questions. Anatomy course exams were also analyzed to compare differences between study participants and non-participants. RESULTS: All three study groups significantly increased knowledge from pre- to post-test; no difference in post-test scores across groups was detected. Participants displayed no differences in learning approach. Students who experienced a Physician demonstration during the Thorax Session displayed significantly higher retention of material compared to students without a physical demonstration. Thematic analysis of responses revealed participants found integration of clinical demonstrations to be helpful in reinforcing anatomy knowledge. Analysis of participant performance in the Anatomy course exams revealed those in the Physician and PhD student demonstration groups performed significantly higher on session-related items than participants in the "no demonstration" group and non-participants. CONCLUSION: Preliminary results suggest clinical procedure demonstrations in anatomy effectively improve academic performance. Knowledge retention most dramatically improves when physical demonstrations are provided, regardless of the demonstrator's clinical experience level. Lastly, the integration of clinical procedure demonstrations has no measurable relationship to student learning approach. © FASEB.