Human anatomy and physiology is a content-driven course of study. Is the method of directed case analysis an appropriate means for helping undergraduates to master it? Herreid (2) alludes to two approaches for using case analysis in science classes. In the first, case analysis becomes the primary means of student learning. Can a prominent or even exclusive use of case studies be an effective way to teach human anatomy and physiology, particularly to lower-division nonscience (i.e., allied health, nursing, education) students? Some medical schools have successfully made use of case analyses in their problembased learning approach to teaching, even with students in the initial years of their basic science training (2, 8). In theory, this method could also work with undergraduates. We are not aware, however, of any program that is successfully doing so. Furthermore, we foresee that the intellectual inexperience and academic immaturity of lower-division students could make exclusive or primary reliance on case-based learning problematic. Moreover, as Herreid (2) suggests, “Even devotees [of the approach] admit that it is not the best method to deliver a plethora of facts, figures and principles.”
Herreid (2) also suggests that the occasional use of case analyses can “spice up the semester and show students how their esoteric learning impacts on the world. ’ ’ This has been the approach taken by many anatomy and physiology instructors and by the authors of the major introductory textbooks in anatomy and physiology. The cases are given to provide realworld relevance or to enhance motivation for continued learning of the scientific facts and figures. Yet, the instructional utility of this case approach is open to question. Our experience with the cases found in the textbooks suggests that students tend to skip, ignore, or casually read them if the instructor makes only occasional or limited use of them. Unless emphasized, this motivational use of cases appears to have little benefit in improving student understanding of the facts and concepts of anatomy and physiology. A regular program of case analysis is a suitable compromise. Students work the cases frequently enough to become accustomed to learning from them. Enough weight is placed on the grading of case analyses so that each student sees the importance of successfully solving them. Yet the cases remain learning accessories. They are not intended to be the primary means of instruction. Lectures, textbook reading, and laboratory exercises still serve as the most important methods for conveying the vast amount of facts, figures, and principles that a student must learn. When used in such a fashion, we have found the directed case approach to be a highly valuable learning accessory. When used regularly, it reinforced facts and concepts and helped solidify student understanding in ways that few other methods were able. Case analysis promoted active learning. Students were forced to read their textbooks and supplemental materials to find the solutions to their cases, rather than relying passively on the instructor to provide the answers. They had to analyze appropriate graphs, figures, and tables. Complete responsibility for learning a particular subject was passed on to the student if the instructor chose to assign a case on textual material that was not covered in the lecture. As they solved the cases, students were forced to reformulate concepts in their own words, integrate diverse principles in anatomy and physiology, and decide what information is important and what is superfluous. In this way, students were also improving their higherorder reasoning skills. Finally, the cases regularly reminded students that what they are learning about the human body has relevance in the real world of medicine, health, and fitness.
Our experience with using directed case analysis in an integrated course in anatomy and physiology has convinced us that case studies can be a helpful adjunct. The students have indicated their enthusiasm for working the case studies, and they have brought measurable improvement in student comprehension of the subject material (as measured by exam performance). They represent an extra avenue for teaching the content of human anatomy and physiology that complements the traditional approach of lecture, textbook, and laboratory.