Cross‐sectional differences in conceptual versus perceptual anatomy performance among physical therapy students

BACKGROUND: Anatomical knowledge differences after instruction have been widely reported. Conceptual (factual and clinical reasoning) and perceptual-spatial (structural identification) knowledge may differ in retention patterns, but their cross-sectional performance patterns in Doctor of Physical Therapy (DPT) anatomy education are not well defined. This study examined cross-sectional differences in both anatomy knowledge types across body regions and time, and the relationship between confidence and performance. METHODS: In a cross-sectional, multi-cohort design, 53 DPT students from a single programme were assessed at three post-instruction intervals (3, 15 and 27 months after completing a 10-week gross anatomy course). Conceptual knowledge was tested with a 30-item written multiple-choice examination; perceptual-spatial knowledge was evaluated with a 30-station practical examination using prosected specimens and bone models. Pre- and post-assessment confidence surveys were also administered. RESULTS: Performance patterns diverged by assessment type. Written examination scores were lower than original course performance across all cohorts, with no significant differences between cohorts (p = 0.202). In contrast, practical identification scores demonstrated progressively lower performance across cohorts localised to the upper extremity (UE), with first-year students (M = 0.48, SD = 0.19) outperforming third-year students (M = 0.30, SD = 0.14; p = 0.013, d = 1.07). Lower limb and torso performance showed no significant differences across cohorts. CONCLUSIONS: These cross-sectional findings suggest that written conceptual knowledge shows early differences that do not progressively widen, whereas perceptual-spatial identification skills, particularly in the UE, are progressively lower in cohorts further from instruction. This pattern is consistent with a region-specific vulnerability where functional instruction may not substitute for context-matched, hands-on retrieval. Longitudinal replication is needed to confirm these patterns.