Developing Clinical Reasoning Skills in the Anatomy Lab with Dr. Cara Sandholdt
Posted on 11/5/21 by Sarah Boudreau
Students don’t always want to pay attention to their anatomy and physiology coursework—sometimes they would rather focus on medicine and clinical applications rather than the basic sciences. In order to engage her students and make the best of her resources, Dr. Cara Sandholdt integrates Visible Body’s Anatomy & Physiology into her students’ pre-lab work.
Dr. Sandholdt is a faculty member at Betty Irene Moore School of Nursing at the University of California, Davis. She has over thirteen years of experience teaching at various institutions, and she currently teaches first-year physician assistant and nurse practitioner students. She recently delivered a webinar for Visible Body in which she explained how she structures labs to encourage clinical reasoning skills.
This blog post will summarize the webinar, which you can find below. The full webinar includes a Q&A portion:
Classes of 75-85 students were a barrier to having a cadaver lab. With a limited budget and limited time for a full cadaver lab, Dr. Sandholdt sought out a different approach.
"Instead of trying to get this program to develop a full, new anatomy lab dissection program, my solution was to use a combination of virtual anatomy and small-group lab sessions,” Dr. Sandholdt explained.
Dr. Sandholdt prepares pre-recorded lectures and activities for students to study before their labs. Some students have recently taken their prerequisite courses and are more familiar with anatomy and physiology terms, while other students require more time to brush up. This asynchronous approach helps students work at their own pace.
Integrated into this pre-lab work are modules within the Anatomy & Physiology app. Students “read them like an interactive textbook,” and indeed, Dr. Sandholdt’s program replaced one of their old textbooks with Visible Body’s Anatomy & Physiology.
Using graphics from Visible Body, Dr. Sandholdt also prepares laboratory guides that highlight clinical applications so her students can better connect what they learn in the lab with what they see in practice.
"We can have shorter periods of time in the lab, knowing that students were prepared for the lab with all the resources and the Visible Body modules we gave them before the lab,” said Dr. Sandholdt.
Inside the Lab
In the lab, Dr. Sandholdt’s students spend an hour in small groups around the cadaver table. The groups rotate through the lab, and Dr. Sandholdt runs the sessions in a Q&A format.
Every part of the lab connects to one big question: Why are these structures clinically relevant?
It’s Dr. Sandholdt’s goal for students to talk at least half the time during a lab, so she asks them about what they see, what they have learned, and what clinical applications they see. Because her students often have a lot of clinical experience, Dr. Sandholdt directly asks them about their experiences.
Dr. Sandholdt used a pulmonary lab as an example.
She starts with bony landmarks and the region of the thorax. She asks her students questions about which bony landmarks they use on their patients and which ribs they would find to listen to the middle lobe of the lung. These discussions of surface anatomy connect to what the students are learning in their physical assessment course.
GIF from Anatomy & Physiology
Next, Dr. Sandholdt looks at the chest wall and examines the muscles. Her students discuss situations like what the diaphragm might look like when a patient has COPD and other patient conditions they have encountered, and in this stage, they can feel the diaphragm.
The pre-lab work prepares students for this hands-on learning experience so that they can make more connections between their labs and their clinical experience.
What Students Have to Say
Dr. Sandholdt has used this approach for four years, and in addition to course evaluations, she has developed a survey to assess student perception of the course. The survey also collects qualitative assessments of the curriculum.
Student responses are overwhelmingly positive. Dr. Sandholdt says that her classes range from 75-80 students, and in one survey, 50 students answered. 96% strongly agreed with the statement "I would recommend this type of anatomy lab (interactive discussion with prosection) to other students," and 94% strongly agreed with "My experience in the anatomy lab was worthwhile.” Students reported that this curriculum was engaging, relevant, and easily applied to their other coursework.
Qualitative student responses also reflected a positive experience, as they agreed that the lab work was their favorite part of the course.
Students reported that their pre-lab work was important to their understanding of the labs, that their hands-on learning was valuable, and that it was crucial to apply the class’s content to clinical experience.
"I think this is where both the lab handouts and the Visible Body modules really came together to help the students really get engaged in the lab and make the best use of their time,” said Dr. Sandholdt.
Dr. Sandholdt uses thorough preparation through Anatomy & Physiology modules and other materials so that students have the knowledge they need to optimize their time in the cadaver labs.