Assessing the Use of Paper Musculoskeletal Models in Anatomy and Physiology Classes for Undergraduate Students
Authors: Rehorek Susan Joyce , Falso Paul G 
Published: November 2023

Anatomy and Physiology is a popular course taught at many undergraduate institutions. It is a prerequisite for many graduate medical and paramedical programs. Cadavers (be it human or nonhuman) are not always an available and affordable means to teach anatomy to these students. There are many alternate ways to teach the anatomical aspect of this course, including software, physical models, clay models and color‐in illustrations. However, these methods lack the flexibility of the cadaver and thus it is difficult to show the 3D relationships between various structures. There is one alternative method: the construction and use of 3D paper models. To date, there are few such resources available for students, and are generally aimed at students in medical school. The objectives of this study are 1) to use a series of 4 different paper models to highlight the complexity of the musculoskeletal system on 4 different regions, 2) to compare the use of modified paper cutouts from a medical school publication to newly constructed cut outs specific for this course and 3) to show student learning success in musculoskeletal anatomy in a low technology, relatively inexpensive manner. Students were given 4 models to color and assemble: arm and thigh musculature paper models from a published source for medical students and a pair of in house paper models for facial and abdominal musculature over a 4 week period. They were given ample time during class over a four week period to assemble the paper models, examine plastic models and work through specially designed worksheets on that specified topic. Students were assessed with a series of paired questions (5 per model) administered before the exercise and then again the following week. At the end of simester, students were asked specific questions regarding their opinion of these exercises as part of their student evaluation. When all students were pooled together, they performed better in all questions on average, though not all were significantly better. When comparing models, student grades showed a greater improvement in the facial and adbominal muscle model post exercise questions than those of the limbs, and sometimes even exceeding those of the limbs. The greater imporovement could be due to the fact that the students knew relatively little about human facial and abdominal musculature prior to this exercise. The majority of students liked these exercises and claimed to have learned the most from the facial and abdominal musculature models. When examining these questions in terms of category, the highest post exercise test scores were seen, on average, in questions relating to muscle function, placement, depth, and attachments. When comparing the student cohort by major, the same absolute level of improvement was seen between pre and post exercise assessment, irrespective of major. Thus, paper models are a viable pedagogical tool in anatomical education. Future studies aim to streamline the use of these paper models as pedagogical tools between different instructors, thereby reducing instructor bias, and reworking some of the questions, to eliminate potential replications.