Retrieval Practice Through an Integrated Anatomy Laboratory Experience in a Doctor of Physical Therapy Curriculum

Gross anatomy is a foundational first-year component of Doctor of Physical Therapy (DPT) curriculum, with limited future vertical integration. Retrieval practice and spaced learning to enhance retention are rarely embedded in second-year DPT coursework. This study evaluated Integrated Anatomy Experiences (IAEs) in a musculoskeletal Patient Management Course (PMC). Sixty-two second-year DPT students participated in two IAEs incorporating: peer-led osteology review, prosected donor exploration, faculty-guided palpation and assessment, and integrated clinical application. A mixed-methods design guided by Kirkpatrick Levels 1 and 2 was used. Knowledge was assessed pre/posttest using identical multiple-choice questions. Item-level performance was analyzed using Wilcoxon signed-rank tests, effect sizes, and item difficulty. Student perceptions of the IAEs were collected through de-identified reflections and analyzed thematically using a structured codebook. Nine of 10 items demonstrated higher proportions of correct answers on the posttest, with significant improvement for most items (p < 0.05). Effect sizes were medium to large (r = 0.31-0.63). Item-difficulty indices increased for most items, and distractor analysis revealed reductions in implausible choices. Qualitative analysis showed predominantly positive reactions; students emphasized improved understanding of anatomical relationships, greater appreciation of clinical relevance, enhanced spatial reasoning, and increased confidence with palpation skills. Only one student expressed discomfort in the donor laboratory. Embedding IAEs within second-year PMCs appears to strengthen knowledge retrieval and promotes vertical integration of anatomy with clinical skills. This approach may be valuable for cohorts with limited prior hands-on anatomy experience and is feasible when faculty collaborate to design multimodal learning activities.