Overcoming Challenges of a Dispersed Anatomy Learning Experience Within an 18‐month Systems‐Based Medical Curriculum
Authors: Nelsen Sylvia 
Published: April 2020

Numerous Undergraduate Medical Education (UME) programs have undergone a curriculum transformation in recent years with the goal of more effectively integrating clinical, systems, and basic sciences throughout the curriculum. In short, the traditional model of two years of didactic instruction in which one year of “normal” function is followed by one year of “abnormal” function has been replaced with one in which “normal” function is presented in direct contrast with “abnormal” to provide an immediate clinical context for the basic science. In 2014, the Oregon Health & Science University (OHSU) UME program implemented a new curriculum (YourMD), which begins with an 18‐month pre‐clinical “Foundations Phase” where most of the basic science is taught in a series of systems‐based courses. This curricular model provides opportunities for meaningful learning but also presents significant challenges in the sequencing and timing of content throughout the curriculum. These changes combined with reduced contact hours necessitate more time‐efficient learning experiences.

Students of anatomy require a specific set of learning skills to master the highly visual and vocabulary‐rich content. They are able to establish these skills and refine them as they move through a traditional course, but this process is much more challenging when the learning experience is dispersed sporadically throughout a systems‐based curriculum that is condensed into 18‐months. To help students develop these learning skills and to improve comprehension of functional and clinical anatomy, we targeted four aspects of the learning experience: sequencing of content, spacing of sessions, faculty contact, and assessments. This presentation focuses specifically on the evolution of these aspects of the learning experience related to musculoskeletal anatomy, primarily during the SBM block, over the course of the six years YourMD has been running, and the results of these changes.

The SBM block is a 5‐week course early in the YourMD curriculum. Initially, this course was the first exposure to anatomy, and all musculoskeletal content (back, neck, face, upper limb, and lower limb) was taught in the first two weeks. Several changes were made to the sequencing and spacing of this content to decompress the learning experience, including postponing some content to later courses, adding a series of introductory lectures during their first course, and distributing the learning experiences during SBM over all five weeks of the block. Additionally, faculty contact hours were expanded via extra‐curricular open labs and faculty‐led small group study sessions, and assessments were revised by increasing the relative importance of anatomy exams for passing the course, adding a practice practical, and replacing the comprehensive practical with a comprehensive written integrated clinical imaging exam. These changes have resulted in modest improvements in assessment scores overall, and students report increased comprehension and feeling well‐prepared for step 1 and clinical rotations.