‘We need one more hour solely based on anatomy… Give us anatomy!’: Early-year learner perceptions of anatomy within an integrated & case-based learning osteopathy curriculum

Abstract

BackgroundIntegrated curricula, where the teaching of basic and clinical sciences is combined horizontally and vertically, have received increasing attention in the health professions education literature. This structure is thought to better prepare learners for the clinical learning environment and their future work as a health professional. Our research aimed to explore student perceptions of anatomy within an integrated curriculum underpinned by case-based learning (CBL). MethodsTwo focus groups using semi-structured questions were conducted with year 1 learners. Audio-recorded data was then thematically analysed through a constructivist lens. ResultsThirteen students participated. Participants recognized the value of anatomy for their future work and ascribed it a high priority for their learning, including asking for greater anatomy contact hours. CBL does not assist in learning anatomy per se, rather it provides context, enhances its relevance to future work, and unifies the curriculum. With the exception of anatomy and biomechanics, students had trouble recognizing other components of the integrated biomedical sciences subject (e.g. physiology and pathology). This outward disconnect resulted in confusion. However, participants reported strong links between the basic science and clinical skills units. ConclusionsStudy outcomes suggest learners appreciate the integrated curriculum structure in the early stages of their anatomy learning. Its high value may be related to perceived difficulty of this content, or the 3 hidden curriculum privileging anatomy over subject content. Integrated subjects need to balance content to ensure it is reflective of future practice, and signpost to assist learners to navigate the subject and facilitate their learning.

Professional identity in osteopathy: A scoping review of peer-reviewed primary osteopathic research

“…Further exploration of osteopathic socialisation may reveal impacts, both positive and negative, on students' developing OPI. Moreover, research into student, faculty and institutional perspectives around influences on OPI [91,111] might indicate whether these align, informing ongoing debates about underlying "osteopathic principles", objectives and practices within OEIs.…”

“…OEIs provide environments where students are introduced, through the "curriculum on paper" [107], to behaviours and attitudes which, in theory, represent those the profession wishes to uphold. However, the hidden curriculum may exert both positive and negative influences, particularly given diversity of views within and between OEIs [69,71,78,91]. As role models, educators may contribute to the hidden curriculum by transmitting beliefs, values and behaviours from one generation to next, shaping OPI of individuals as well as profession as a whole.…”

“…Student beliefs may also be generated by unquestioned assumptions and longstanding processes at institutional level, for example about knowledge and skills required for the professional role. It was suggested that science-based entry requirements may perpetuate student perceptions of osteopathy as biomedically-focused manual therapy [90], and this would seem to be supported by reports of student demand for increased anatomy input in early training [91]. Studies described OEIs' curricular overemphasis on "technical rationality" [98] and the biomedical model [78].…”

Frontloading gross anatomy: impacts on medical student performance

“…[24] In addition, integrated curricula often present challenges to providing adequate levels of anatomical knowledge to medical students due to the general trend of reducing contact hours of basic science disciplines including anatomy. [2,25,26] One attractive solution for this challenge could be vertical integration of basic sciences into the clinical curricula; [3] however, this approach often faces the practical challenge of how to blend basic sciences into tightly scheduled clerkship schedules. [27] Alternatively, one might argue that gross anatomy can be better integrated with certain applied clinical coursework than other foundational courses, as this would per-Anatomy • Volume 15 / Issue 3 / December 2021 mit lessons in the clinical relevance of the subject matter and earlier experiences with clinical problem solving.…”

Effectiveness of problem-based learning strategies compared to conventional anatomy teaching approaches

“…Students' learning improved when integrated teaching methods were adopted, as it has a vitality both for the present and future medical years. 2 A study in China mentioned that team-based learning (TBL) is different from CTM. The research documented that learning, collaboration, enthusiasm towards the subject, communication and ability of learning improved significantly in a TBL compared to CTM where students learn individually on their own.…”