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Students' perceptions of anatomy across the undergraduate problem-based learning medical curriculum: a phenomenographical study.

Bergman EM, de Bruin AB, Herrler A, Verheijen IW, Scherpbier AJ, van der Vleuten CP - BMC Med Educ (2013)

Bottom Line: Results indicated that a PBL approach in itself was not enough to ensure adequate learning of anatomy, and support the hypothesis that educational principles like time-on-task and repetition, have a stronger impact on students' perceived and actual anatomical knowledge than the educational approach underpinning a curriculum.For example, students state that repetitive studying of the subject increases retention of knowledge to a greater extent than stricter assessment, and teaching in context enhances motivation and transfer.Innovations in teaching and assessment, like spiral curriculum, teaching in context, teaching for transfer and assessment for learning (rewarding understanding and higher order cognitive skills), are required to improve anatomy education.

View Article: PubMed Central - HTML - PubMed

Affiliation: Department of Educational Development and Research, Maastricht University, Maastricht, The Netherlands. e.bergman@maastrichtuniversity.nl.

ABSTRACT

Background: To get insight in how theoretical knowledge is transformed into clinical skills, important information may arise from mapping the development of anatomical knowledge during the undergraduate medical curriculum. If we want to gain a better understanding of teaching and learning in anatomy, it may be pertinent to move beyond the question of how and consider also the what, why and when of anatomy education.

Methods: A purposive sample of 78 medical students from the 2nd, 3rd, 4th and 6th year of a PBL curriculum participated in 4 focus groups. Each group came together twice, and all meetings were recorded and transcribed verbatim. Data were analysed with template analysis using a phenomenographical approach.

Results: Five major topics emerged and are described covering the students' perceptions on their anatomy education and anatomical knowledge: 1) motivation to study anatomy, 2) the relevance of anatomical knowledge, 3) assessment of anatomical knowledge, 4) students' (in)security about their anatomical knowledge and 5) the use of anatomical knowledge in clinical practice.

Conclusions: Results indicated that a PBL approach in itself was not enough to ensure adequate learning of anatomy, and support the hypothesis that educational principles like time-on-task and repetition, have a stronger impact on students' perceived and actual anatomical knowledge than the educational approach underpinning a curriculum. For example, students state that repetitive studying of the subject increases retention of knowledge to a greater extent than stricter assessment, and teaching in context enhances motivation and transfer. Innovations in teaching and assessment, like spiral curriculum, teaching in context, teaching for transfer and assessment for learning (rewarding understanding and higher order cognitive skills), are required to improve anatomy education.

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Curriculum map of the PBL curriculum of Maastricht University at time of this study. The first and second year are each divided in six thematic units, the third year is divided in four clusters. The fourth and fifth year are devoted to twelve different clerkships. Half of the sixth year is dedicated to participation in a research project the other half is dedicated to in patient care (extensive clerkship).
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Figure 1: Curriculum map of the PBL curriculum of Maastricht University at time of this study. The first and second year are each divided in six thematic units, the third year is divided in four clusters. The fourth and fifth year are devoted to twelve different clerkships. Half of the sixth year is dedicated to participation in a research project the other half is dedicated to in patient care (extensive clerkship).

Mentions: The study was conducted in the PBL curriculum of Maastricht University, the Netherlands (see Figure 1). At the time of this study, years 1 and 2 consist of six thematic units of approximately six weeks, with few real patient encounters. Paper cases are the starting point for learning in groups of around ten students and a tutor, and knowledge is assessed by 80–120 multiple choice questions in end-of-block tests. In the four systems-based clusters of year 3, the paper cases are replaced by patient contacts in outpatient clinics [28], and knowledge is assessed in oral exams and written essay questions. The anatomy of the thorax, abdomen, pelvis, musculoskeletal system and nervous system is taught in years 1 and 2, and revisited in year 3. In the first three years, anatomy is taught in tutorial groups, during lectures and in the dissection room with models, prosected cadavers and – for the musculoskeletal system - surface anatomy. Years 4 and 5 are devoted to clinical clerkships in twelve disciplines, with formal anatomy instruction being included in only the ophthalmology clerkship and ENT clerkship. In year 6 students undertake an eighteen-week research clerkship and an eighteen-week clinical clerkship with more independence and responsibility for patient care than in the preceding years. Throughout the curriculum, anatomy is also assessed in OSCE’s in years 1, 2, 3 and 5 and four progress tests each year. For a detailed description of the curriculum see Van Berkel et al. [29].


Students' perceptions of anatomy across the undergraduate problem-based learning medical curriculum: a phenomenographical study.

Bergman EM, de Bruin AB, Herrler A, Verheijen IW, Scherpbier AJ, van der Vleuten CP - BMC Med Educ (2013)

Curriculum map of the PBL curriculum of Maastricht University at time of this study. The first and second year are each divided in six thematic units, the third year is divided in four clusters. The fourth and fifth year are devoted to twelve different clerkships. Half of the sixth year is dedicated to participation in a research project the other half is dedicated to in patient care (extensive clerkship).
© Copyright Policy - open-access
Related In: Results  -  Collection

License
Show All Figures
getmorefigures.php?uid=PMC4225514&req=5

Figure 1: Curriculum map of the PBL curriculum of Maastricht University at time of this study. The first and second year are each divided in six thematic units, the third year is divided in four clusters. The fourth and fifth year are devoted to twelve different clerkships. Half of the sixth year is dedicated to participation in a research project the other half is dedicated to in patient care (extensive clerkship).
Mentions: The study was conducted in the PBL curriculum of Maastricht University, the Netherlands (see Figure 1). At the time of this study, years 1 and 2 consist of six thematic units of approximately six weeks, with few real patient encounters. Paper cases are the starting point for learning in groups of around ten students and a tutor, and knowledge is assessed by 80–120 multiple choice questions in end-of-block tests. In the four systems-based clusters of year 3, the paper cases are replaced by patient contacts in outpatient clinics [28], and knowledge is assessed in oral exams and written essay questions. The anatomy of the thorax, abdomen, pelvis, musculoskeletal system and nervous system is taught in years 1 and 2, and revisited in year 3. In the first three years, anatomy is taught in tutorial groups, during lectures and in the dissection room with models, prosected cadavers and – for the musculoskeletal system - surface anatomy. Years 4 and 5 are devoted to clinical clerkships in twelve disciplines, with formal anatomy instruction being included in only the ophthalmology clerkship and ENT clerkship. In year 6 students undertake an eighteen-week research clerkship and an eighteen-week clinical clerkship with more independence and responsibility for patient care than in the preceding years. Throughout the curriculum, anatomy is also assessed in OSCE’s in years 1, 2, 3 and 5 and four progress tests each year. For a detailed description of the curriculum see Van Berkel et al. [29].

Bottom Line: Results indicated that a PBL approach in itself was not enough to ensure adequate learning of anatomy, and support the hypothesis that educational principles like time-on-task and repetition, have a stronger impact on students' perceived and actual anatomical knowledge than the educational approach underpinning a curriculum.For example, students state that repetitive studying of the subject increases retention of knowledge to a greater extent than stricter assessment, and teaching in context enhances motivation and transfer.Innovations in teaching and assessment, like spiral curriculum, teaching in context, teaching for transfer and assessment for learning (rewarding understanding and higher order cognitive skills), are required to improve anatomy education.

View Article: PubMed Central - HTML - PubMed

Affiliation: Department of Educational Development and Research, Maastricht University, Maastricht, The Netherlands. e.bergman@maastrichtuniversity.nl.

ABSTRACT

Background: To get insight in how theoretical knowledge is transformed into clinical skills, important information may arise from mapping the development of anatomical knowledge during the undergraduate medical curriculum. If we want to gain a better understanding of teaching and learning in anatomy, it may be pertinent to move beyond the question of how and consider also the what, why and when of anatomy education.

Methods: A purposive sample of 78 medical students from the 2nd, 3rd, 4th and 6th year of a PBL curriculum participated in 4 focus groups. Each group came together twice, and all meetings were recorded and transcribed verbatim. Data were analysed with template analysis using a phenomenographical approach.

Results: Five major topics emerged and are described covering the students' perceptions on their anatomy education and anatomical knowledge: 1) motivation to study anatomy, 2) the relevance of anatomical knowledge, 3) assessment of anatomical knowledge, 4) students' (in)security about their anatomical knowledge and 5) the use of anatomical knowledge in clinical practice.

Conclusions: Results indicated that a PBL approach in itself was not enough to ensure adequate learning of anatomy, and support the hypothesis that educational principles like time-on-task and repetition, have a stronger impact on students' perceived and actual anatomical knowledge than the educational approach underpinning a curriculum. For example, students state that repetitive studying of the subject increases retention of knowledge to a greater extent than stricter assessment, and teaching in context enhances motivation and transfer. Innovations in teaching and assessment, like spiral curriculum, teaching in context, teaching for transfer and assessment for learning (rewarding understanding and higher order cognitive skills), are required to improve anatomy education.

Show MeSH
Related in: MedlinePlus