A Comparison of Fourth-Year Health Sciences Students' Knowledge of Gross Lower and Upper Limb Anatomy: A Cross-Sectional Study

The Level of Anatomical Knowledge, Hard to Establish: a Systematic Narrative Review

OBJECTIVE

This literature review aimed to gain more insight into the level of anatomical knowledge based on published measurements among medical students, residents, fellows, and specialists.

METHODS

We performed an extensive literature search in three online databases: Medline (using PubMed), Web of Science, and Education Resources Information Centre (ERIC).

RESULTS

A total of 30 relevant studies were found. In these studies, participants took different anatomy tests, and their mean/median scaled scores range from 22.5 to 82.4% on a 0 to 100% scale.

CONCLUSION

This review provides an overview of what is known about measured anatomical knowledge. After critically reviewing the literature, we have to conclude that the existing literature confirms that anatomical knowledge is hard to establish, mainly due to the lack of standardisation.Further research should focus on ways to define and assess 'desired anatomical knowledge' in different contexts. In a next phase, we can discuss if anatomical knowledge is lacking and if interventions are needed.

Curricular and pedagogical aspects of gross anatomy education for undergraduate physiotherapy students: a scoping review

OBJECTIVE

The objective of this review was to collate and map gross anatomy curricular and pedagogical approaches for physiotherapy students.

INTRODUCTION

Knowledge of anatomy is essential for physiotherapy clinical diagnosis, treatment effectiveness and safe practice. The information on this topic is sparse, and what does exist is diverse. This scoping review describes anatomy educational approaches for physiotherapy students and provides needed insight into this topic.

INCLUSION CRITERIA

No limits were applied on the date of the database search or age of participants. Languages were limited to English, French, German and Spanish. Studies had to include information on gross anatomy curricula or pedagogy for physiotherapy students, or information from qualified physiotherapists or those teaching gross anatomy to physiotherapy students.

METHODS

Included studies were mainly sourced from EBSCOhost (CINAHL, ERIC and MEDLINE), PubMed and Scopus databases. Perusal of reference lists facilitated further retrievals. Studies published from inception up to 21 July 2019 were included. Studies were identified and screened, and the process was reported in a PRISMA flow diagram. JBI methodology for scoping reviews was followed. Selected studies were charted according to a template created and published in a JBI scoping review protocol.

RESULTS

Fifty-four studies satisfied the inclusion criteria. Various studies gave calculable length of intervention in weeks (n=14, 26%), hours (n = 7, 13%) or both (n = 21, 39%). The majority of studies (n = 50, 93%) were cross-sectional studies; three were randomized controlled trials (6%). Mean sample sizes varied from 55.3 ± 30.4 (professional behaviors, ethical and humanistic aspects) to 323.2 ± 219.7 participants (multi-modal and blended learning). Overall, 29 studies (54%) included physiotherapy students or personnel in physiotherapy anatomy programs exclusively in the sample. Other disciplines with physiotherapy students included medical students (n = 12, 22%), and occupational therapy students (n = 10, 19%). The interprofessional education category (n = 8) determined that interdisciplinary teamwork led to increased anatomical learning and awareness of future clinical roles. Computer-assisted learning (n = 9) was effective as a stand-alone or adjunct pedagogy, useful for self-study and helped anatomical knowledge retention. Team-based learning (n = 2), peer teaching (n = 6) and clinical input incorporating case-based learning and horizontal and vertical integration (n = 4) resulted in anatomical knowledge retention and were associated with mastery of anatomical understanding, an increase in examination confidence and higher examination grades. Contradictory learning outcomes resulted from the use of online videos in blended and multi-model learning studies (n = 7). Increased student participation in asynchronous online discussion forums benefitted academic learning outcomes. The category of curriculum, pedagogy and materials (n = 15) identified and compared different survey results pertaining to the curricular aspect of the objectives of this review. One study investigated the flipped classroom concept. The use of anatomy content to encourage professional, ethical and humanistic aspects (n = 3) of physiotherapy students' behavior resulted in positive outcomes.

CONCLUSIONS

This scoping review revealed a multi-faceted topic with many types of interventions and outcomes recorded. It identified variations in pedagogies, curricular content and learning approaches integral to the subject and their impact on gross anatomy education for this population. Beneficial behavioral, anatomical learning, knowledge retention and academic outcomes were identified.

Second-Year Nursing Students' Retention of Gross Anatomical Knowledge

Human anatomy is a foundational course in nursing education, however, there is growing concern that students do not retain enough anatomical knowledge to successfully apply it in clinical settings. The aim of this study was to determine retention level of anatomy knowledge among second-year nursing students from their first-year anatomy class, and to determine if there is a difference in level of retention based on organ system. For each system, second-year students were asked to answer 9 to 11 multiple-choice questions (MCQs), and the scores from these quizzes were compared to matched test items from their first-year anatomy examinations. There was a significant decrease in the overall mean score from 83.05 ± 8.34 (±SD) in first year to 54.36 ±12.9 in second year (P = 0.0001). Retention levels were system specific. System-specific knowledge retention was highest for the gastrointestinal system (89.7%), respiratory system (88.5%), and genitourinary system (83.6%). This was followed by the integumentary system (80.1%), special senses (79.4%), nervous system (74.9%), and musculoskeletal system (69.3%). Retention was lowest for the lymphatic system (64.3%), cranial nerves (58.8%), vascular system (53.9%), and head and neck (42.6%). The present study shows that nursing students' anatomy knowledge retention was comparatively higher than rates reported by others in medical and allied-health students. The researchers are now investigating knowledge retention in third- and fourth-year nursing students. Further investigation into why retention is higher for specific systems and intervention strategies to improve knowledge acquisition and retention in nursing students is recommended.

Musculoskeletal Anatomy Knowledge Retention in the Macquarie University Chiropractic Program: A Cross-Sectional Study

Attrition of anatomy knowledge has been an area of concern in health professions curricula. To ensure safe and effective clinical practice, the study of chiropractic requires a good knowledge of musculoskeletal anatomy. In this study, musculoskeletal limb knowledge retention was investigated among students in the 5-year chiropractic program at Macquarie University, Australia. A test of 20 multiple-choice questions, categorized into low-order (LO) and high-order (HO) cognitive ability according to Bloom's Taxonomy, was developed. Students enrolled in the program were invited to participate with 257 of the 387 choosing to participate, (response rate ranging 56%-72% per year level). No attrition of knowledge across the years was observed, instead, a significant increase in knowledge, measured by total LO and HO scores (P < 0.0005), throughout the program. There were significant increases in both low and high cognitive scores which were not uniform, with high-order scores increasing significantly in the last two year levels. The increase of knowledge, may be explained, at least partially, by the vertical and horizontal integrated curriculum. Retrieval of knowledge, especially in clinically applied formats, may have led to an enhanced ability to apply anatomy knowledge and account for the increased scores in the high-order knowledge seen in the later clinical years. Evaluating anatomy knowledge retention at different cognitive levels seems to provide a better assessment and is worth considering in future anatomy educational research.