Enhancing Female Pelvic Anatomy Education with Clinical Vignettes and Problem‐Based Learning (PBL)
Authors: He Yingxin , Ravikumaran Nair Rakesh 
Published: May 2022

Introduction

Female pelvic anatomy poses challenges for learners due to complexity of the spatial relationships between pelvic floor structures. As anatomy education continue to implement novel approaches such as use of 3D and interactive models to enhance student learning,1 strategies to improve the medical school curriculum remain vast. Problem‐based learning (PBL) is often recognized as a successful teaching method in which learners are encouraged to apply their own knowledge and investigative skills in solving defined problems.2 This study will analyze the effects of using clinical scenarios and PBL in combination with prosected cadavers on student recall ability and knowledge base improvement.

Objectives

Incorporation of clinical vignettes and PBL with prosected cadavers will facilitate improved understanding of female pelvic anatomy compared with using only prosected cadavers.

Methods

First‐year medical students at Florida International University HWCOM class of 2025 were put into 16 groups of approximately 7 to 10 students (n=137) and rotated through four 25‐minutes stations. One station was facilitated by a 4th year medical student teaching assistant (TA), who used clinical vignettes and PBL combined with a prosected female cadaver that exposed pelvic floor structures. Students also rotated at three other 25‐minute stations (before or after) containing radiologic imaging of relevant anatomy, self‐study, and a procedural station (ureteral catheterization). Prior to the TA station, the students were provided a pre‐session examination containing 2 questions to assess their knowledge of common female pelvic anatomy concepts. Students were then provided the same questions after completing the station to assess for enhanced recall. Both the pre‐ and post‐session examinations used clinical vignettes with multiple choice answers (A through D). Students received 1 point if they answered correctly and 0 points if they answered incorrectly.

Results

For the first question assessing proximity of the uterine artery to the ureter, 91% of students answered correctly in the post‐test, compared with 67% in the pre‐test. For the second question assessing ovarian torsion, 72% answered correctly in both the pre‐ and post‐tests.

Conclusion/ Significance and Implication

The results of the first question supports that the use of clinical vignettes and PBL in addition to cadaver prosection can improve the student knowledge base. However, the results of the second question did not support the hypothesis. Possible contributors could be due to lack of standardization in teaching styles among different instructors on the female cadaver or that addition of PBL may be insufficient to generate better outcomes in learning for questions that are of higher complexity. Potential follow up to this study could include assessing for alternative confounders to explore discrepancies in the results.

1. Hampton BS, Sung VW. Improving medical student knowledge of female pelvic floor dysfunction and anatomy: a randomized trial. Am J Obstet Gynecol. 2010 Jun;202(6):601.e1‐8. doi: 10.1016/j.ajog.2009.08.038. Epub 2010 Apr 28.

2. Savery JR. Overview of problem‐based learning: definitions and distinctions. Interdiscip J Probl Based Learn. 2006;1(1):9–20.