Clinically integrated curricula in health science education has been shown to promote the development of problem‐solving schema and positively impact knowledge acquisition. Despite its’ purported benefits, this type of curricula can impose a high cognitive load, which may negatively impact novice learners’ knowledge acquisition and problem‐solving schema development. Introducing explicit clinical reasoning instruction within pre‐professional undergraduate basic science courses may limit factors that increase cognitive load, enhance knowledge acquisition, and foster developing clinical problem‐solving skills. This study, conducted over the Fall and Spring semesters of the 2018–2019 school year, sought to evaluate whether the implementation of a clinical reasoning instructional intervention within a clinically integrated pre‐professional undergraduate general human anatomy course influenced students’ acquisition of anatomical knowledge and development of clinical problem‐solving skills. Results of the study were mixed regarding the acquisition of anatomical knowledge. Both the intervention and comparison groups performed similarly on multiple choice examinations of anatomical knowledge. However, the clinical reasoning intervention positively impacted students’ ability to apply clinical reasoning skills to anatomically based clinical case studies. Results from M\mixed between‐within subjects analysis of variance comparing scores on Written Clinical Reasoning Assessments revealed a significant interaction between time and group affiliation, with the groups receiving the interventions outperforming the comparison groups: Fall, P < 0.001; Spring, P < 0.001. The results of this study may imply that explicit clinical reasoning instruction within a clinically integrated undergraduate Human Anatomy course could hold potential for fostering students’ early clinical reasoning skills.
Contextualized instruction in pre‐baccalaureate undergraduate anatomy courses has the potential to improve knowledge acquisition and retention, and promote the development of problem‐solving schema. However contextualized learning requires a high cognitive load, which may negatively impact novice learners in health science education programs. The first phase of our quasi‐experimental longitudinal study sought to evaluate whether the introduction of explicit clinical reasoning instruction concurrently with contextualized instruction in an undergraduate human anatomy course 1) impacted students’ acquisition of anatomical knowledge 2) promoted the development of clinical reasoning skills. The second phase of this study examined whether that pedagogical approach 3) bolstered students’ retention of anatomical knowledge 4) provided students with transferable foundational clinical reasoning skills. Phase one, conducted over two semesters in an undergraduate human anatomy course, included 462 participants. Each semester, one section of the course was designated the intervention group and received explicit clinical reasoning instruction. The other section was designated the comparison group, and received identical curriculum sans explicit clinical reasoning instruction. Results from independent t‐tests showed that intervention did not change student’s acquisition of anatomical knowledge as measured by four multiple‐choice exams (Fall 2018: p=1.00; Spring 2019: p=.146). However, the intervention positively influenced student’s development of clinical reasoning skills as measured by four Written Assessments. Mixed between‐within subjects ANOVA demonstrated a significant difference between the intervention sections and comparison sections (Fall 2018: p<.001; Spring 2019: p=.010). In the second phase of the study, a cohort of 112 first‐semester students enrolled in a BSN program agreed to be participants. Phase two participants will complete a general anatomy assessment and a written clinical reasoning assessment, similar to the written assessments used in phase one. Mean scores from the assessments will be compared between those who had been in either the intervention or comparison groups during in phase one, as well as against scores of students in the cohort who were not part of phase one. Data collection for phase two is near completion. Results from both phases of the study may guide further research and recommendations regarding pedagogical practices in undergraduate anatomy courses. Our findings will also be of interest to educational professionals concerned with the preparation of students matriculating into professional level health science education programs. We hope to initiate a conversation in regards to the role undergraduate anatomy courses play in the health science education ecosystem. Support or Funding Information The first author for this study was awarded the 2019 American Association of Anatomy Education Research Scholarship. There were no other external funding sources.
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