Getting Active with Musculoskeletal Anatomy Instruction

Educational research has shown that instructional methods utilizing active learning approaches enhance student engagement in the classroom and promote increased learning and content retention. Recent trends in medical education have included the replacement of traditional didactic instruction with a variety of active learning methods. The purpose of this study was to determine the result of replacing didactic instruction in musculoskeletal gross anatomy with one active learning approach, team‐based learning (TBL), in a pre‐clinical Musculoskeletal & Skin course. In the 2014 course gross anatomy of the lower limb was taught through five traditional lectures and six cadaveric dissections. In contrast, upper limb anatomy was taught through a set of independent learning modules, three TBL activities, and six cadaveric dissections. Students' learning was assessed by both practical laboratory examination and written, vignette‐style examination. A comprehensive final examination was administered utilizing test items from the NBME question bank at the course conclusion. We compared student performance on anatomy‐related exam items from the written examinations in the 2014 course and found that mean performance increased by five points after incorporating TBL. We further compared performance on identical upper limb exam items of the 2014 student cohort with that of the 2013 cohort, which was taught by traditional lecture; students taught by TBL scored on average 2 points higher (p=0.15). Mean performance on anatomy‐related items on the NBME final examination was identical between years. We asked students to report their preferred method of anatomy instruction on course evaluations. Forty‐eight percent reported a preference for didactic lecture while 52% preferred self‐study and TBL.