Integrating Clinical Reasoning Skills in an Undergraduate Human Anatomy Course

Abstract

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.