Toward an Intelligent Textbook for Human Gross Anatomy Curricula
Authors: Kluga Ben , Freedman Reva , Naples Virginia 
Published: April 2020

Hundreds of publications have been written on methods for teaching human gross anatomy and closely related human physiology topics. As students find both the breadth and depth of the material challenging, various new approaches have arisen over the decades to complement or supplant the traditional methods of teaching. Concurrently, the time‐honored method of students dissecting cadavers in groups has been criticized as extremely time‐consuming, with cadavers and gross anatomy laboratories increasingly expensive to maintain and difficult to staff. Recent publications have suggested replacing cadaver dissection with the study of models and plastinated specimens. Nevertheless, this approach shows some of the same limitations as traditional dissection as students must still master diverse topics that are difficult to integrate into a coherent body of knowledge.

In the present study we propose the use of a new model, an intelligent textbook underpinned by a hierarchical causal concept map based intelligent tutoring system (ITS) platform. Intelligent tutoring systems are a form of artificial intelligence (AI) that provides sophisticated one‐on‐one tutoring by modeling human knowledge. Our platform takes as input causal concept maps: diagrams of human knowledge where the components are causally linked. The hierarchical nature of these concept maps allows entire concept maps to be linked to one another, i.e., each component could be considered as a process which contains its own lower‐level concept map. This particular architecture allows our platform to address a number of the difficulties faced by students of human gross anatomy: connecting facts and concepts learned separately, building hierarchies among those concepts, and understanding that the causal relations between these concepts happen simultaneously.

For example, a student studying the interaction of the cardiovascular and respiratory systems might be asked to explain shortness of breath in cases of both physical exercise and altitude change. A causal concept map on the topic explains part of this phenomena via the interaction of three components: a ratio between oxygen demand and oxygen supply, respiratory volume, and the process of respiration itself. Causally, the increase in the ratio of oxygen demand to oxygen supply causes an increase in respiratory volume, contributing to an increase in respiration, which permits an increase in the original oxygen demand to oxygen supply ratio, completing the homeostatic loop. If a student wished to explore one of these components more deeply, the hierarchically connected concept map allows for that. For example, respiratory volume could be explained as follows: an increase in diaphragmatic muscle contraction amount causes an increase in the intercostal muscle contraction amount, leading to an increase in thoracic volume, which allows for an increase in both volume of air inhaled and exhaled. Explicitly detailing the concepts as well as their relationships through an intelligent textbook supplement allows students the opportunity to interact with these topics at individually appropriate levels.

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