Explicit Connections Between Anatomy and Clinical Science are Key to Successful Cognitive Integration.

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Abstract

The importance of integrated basic and clinical science knowledge is well recognized across the health professions; however, supporting the development of learner’s integrated knowledge in day-to-day teaching continues to be an educational challenge. A number of experimental studies show that learners can benefit when instruction is designed to support to support cognitive integration. This type of integration occurs at the individual session-level and can be contrasted with integration efforts that occur within the curriculum. To date, there remains limited research on specific strategies that educators can use to support learners in achieving cognitive integration during individual teaching sessions. In a series of studies, we examine the relative impact of integrating anatomy and clinical science instruction with different learning strategies on novices learning diagnosis of musculoskeletal (MSK) pathologies.In each study, novice learners were taught four MSK upper limb pathologies using different instructional approaches (integrated anatomy and clinical science, segregated anatomy and clinical science, or clinical science only) combined with additional learning strategies (focused self-explanation, feature counting, holistic self-explanation, or worked-examples). Integrated instruction involved explicitly teaching the underlying causal mechanisms for the signs and symptoms associated with each MSK pathology, whereas no explicit linkages were provided in the segregated or clinical science only learning conditions. Immediately after learning and one-week later, learners completed a diagnostic accuracy test.The findings of these studies showed that novices who learned the MSK pathologies using integrated instructional materials developed superior diagnostic abilities compared to those in the segregated or clinical science only learning groups (p < 0.05). Further, learners who also engaged in holistic self-explanation while learning with integrated instructional materials scored higher on the diagnostic accuracy test compared those who simply read through worked-examples that highlighted the underlying anatomical pathology associated with each MSK condition (p < 0.05). Accuracy on the holistic self-explanation task was also positively correlated with learners diagnostic scores one-week after initial learning (r = 0.457).Our findings demonstrate the value of providing explicit connections between anatomy and clinical science in supporting deep learning in novices. This research also highlights the value of designing instruction that supports cognitive integration and demonstrates that one to maximize learning of anatomy is to use it as a tool to help learners more effectively understand and organize clinical concepts. Further, our findings suggest that learning strategies that emphasize the explicit connections between anatomy and clinical science in a holistic way, hold the potential to support the development of learners’ conceptual knowledge.© FASEB.