Promoting Reflection in the Laboratory

Abstract

The traditional approach to dissection, with students following a set of specific instructions to reveal the structures for studying, does not make maximal use of the small group setting in the gross anatomy laboratory. In problem-oriented dissection (POD), a clinical case is introduced before the students start dissecting the cadavers, which have been prepared to mimic the clinical condition in the case. The students need to reflect on their basic anatomical knowledge in order to devise a clinical procedure which needs to be done on their patients (i.e., the cadavers). They then perform their self-devised procedure on the cadaver, followed by the dissection of the region to look at the results of their procedure. The dissection results prompt the students to reflect on their self-devised procedure and the anatomy. Students then go to the literature to search for the recommended way(s) of performing the clinical procedure, which will stimulate students to further reflect by comparing their self-devised procedure to the recommended one(s). Different groups of students then gather together again in the laboratory to share their self-devised procedures, the results of their procedures on the cadavers, and their reflections. The teacher in the POD should be a facilitator, whose role is to guide the students to reflect and to apply their anatomical knowledge. One method to structure the teacher-student interactions is the one-minute preceptor model, a learner-centered and time-efficient framework which provides rich feedback and promotes reflection. It consists of five microskills: get a commitment from the students; probe for supporting evidence; reinforce what was done right; correct errors and fill in omissions; and teach a general rule.