A 50 Year Review and Meta‐analysis of Anatomy Laboratory Pedagogies

The debate regarding effective anatomy teaching methods is ongoing and highly controversial. Previously, Winkelmann(2007) attempted to address this discussion through a literature review that compared the efficacy of new anatomy laboratory pedagogies to traditional dissection approaches. This review, however, had considerable methodological weaknesses that undermined the significance and generalizability of its findings and raised further questions about the influence of educational interventions on student performance. One question left unanswered was “What impact, if any, does dissection have on learning anatomy within formal, informal, and hidden curricula?” To address this question, a meta‐analysis was undertaken to objectively, and more conclusively, summarize the effectiveness of instructional laboratory approaches used in anatomy education. Studies published between January 1965 and December 2015 were searched through five databases. Titles and abstracts of the retrieved records were screened using eligibility criteria to determine their appropriateness for study inclusion. Both numerical and qualitative data were extracted for analysis. A summary effect size was estimated to determine the effects of laboratory pedagogies on learner performance and a thematic review was performed to understand the perceptions of key stakeholders. Of the 3,045 records screened, 327 underwent full‐text review. Twenty‐six studies, comprising a total of 7,689 participants, were viable to include in the effect size calculations. The meta‐analysis detected no effect (standardized mean difference = −0.02; 95% CI=−0.15–0.11; p=0.43) on learner performance. Across studies, student performance on knowledge examinations was found to be equivalent regardless of being exposed to either dissection or another laboratory instructional strategy. This was true of every comparison investigated (i.e., dissection vs prosection, dissection vs digital media, dissection vs models/modeling, and dissection vs hybrid). The total heterogeneity was moderate (p<0.001; I 2 =82%) indicating sizable variation among the included studies. In the context of assessing only knowledge gains, this meta‐analysis revealed that the instructional approach of dissection is no better, and no worse, than alternative instructional modalities used in laboratory settings. As identified throughout the systematic review, many authors argued that donor dissection teaches essential ancillary skills such as professional identity, clinical communication and leadership, and introduces students to concepts of death and dying. Few studies, however, have evaluated whether similar themes emerge as a consequence of anatomy teaching in general or whether some of these skills are best imparted through active dissection.