Impact of Gross Anatomy Lab and Its Instructional Format on Undergraduate Anatomy Knowledge

Abstract Body : INTRODUCTION. Cadaver-based gross anatomy labs are an effective form of active learning, as they require hands-on engagement and enhance student understanding of 3D relationships among anatomical structures. Despite the known efficacy of cadaver-based education, recent trends in anatomy education driven in part by the COVID-19 pandemic have shifted towards incorporating non-cadaveric active learning modalities such as virtual or augmented reality. What is unclear is how anatomy laboratory and its instructional format (in-person vs. online) impacts student mastery of anatomy. OBJECTIVE. The purpose of this study was to compare the performance of undergraduate students taking anatomy lecture only to those students enrolled in anatomy lecture and lab in both in-person (2019 and 2022) and remote teaching (2021) formats. MATERIALS AND METHODS. Human subjects research exemption was granted by the UC Davis Institutional Review Board (IRB ID: 1944066-1). Student lecture multiple-choice exam scores from six quarters (Winter 2019 (n = 411), Spring 2019 (n = 191), Winter 2021 (n = 425), Spring 2021 (n = 298), Winter 2022 (n = 442), and Spring 2022 (n = 289)) were analyzed. Identifiers were removed to protect students’ confidentiality. In 2019 and 2022, anatomy lab was taught in-person using prosections, while in 2021, the lab was taught remotely on Zoom, with live-streaming of prosections using document cameras. Exam scores were compared between two cohorts of students: those enrolled in lecture only and those enrolled in both lecture and lab concurrently. Exam scores of two midterms and one comprehensive final exam were compared between the two cohorts. Normality of exam score distribution was assessed using the Shapiro-Wilk test, and based on the findings, the Mann-Whitney U test was subsequently used to compare exam scores of the lecture only vs. lecture and lab cohorts within each quarter. Descriptive statistics and effect size (r and Cohen’s d) were calculated for each exam. Statistical significance was set at p < 0.05. RESULTS. Across eighteen lecture exams in six different quarters, students enrolled in both lecture and lab had significantly higher scores when compared to those students enrolled in lecture only. When all exam scores were combined (MT1+MT2+final; 140-point total), students enrolled in both lecture and lab outperformed their lecture-only peers by an average of 14 points, which amounted to a 10% difference in their final grade. To assess whether in-person and remote online anatomy labs are equally effective in improving the lecture exam scores, effect sizes for exam score improvement of the two cohorts (lecture only vs. lecture/laboratory) were compared between in-person vs. online teaching quarters. It was found that in-person anatomy lab instruction had greater effect on students’ lecture scores (Cohen’s d = 0.51) as compared to remote anatomy lab instruction (Cohen’s d = 0.40). CONCLUSION. Taking both anatomy lecture and lab concurrently, whether in-person or online, enhances student mastery of anatomical knowledge as assessed by lecture course exam performance. In-person anatomy lab, however, improved students’ lecture exam performance more as compared to remote gross anatomy lab. SIGNIFICANCE/IMPLICATION. This research provides additional evidence that anatomy lab enhances student comprehension of anatomical structures and relationships, as indicated by the significantly higher exam scores of the cohort of students who enrolled in both courses.