Introduction
Introduction
Anatomical sciences are fundamental to both medical education and clinical practice . Many students however , perceive anatomy courses as challenging , complex , and demanding ( Cheung et al ., 2021 ; Kramer and Soley , 2002 ; Rokade and Shinde , 2020 ), despite continuous efforts by educators to enhance the learning experience . Students and teachers alike believe that visual and spatial reasoning skills are key to learning anatomy ( Cheung et al ., 2021 ; Diaz and Woolley , 2021 ; Shapiro et al ., 2020 ). The lack of visualisation skills was described by students as an obstacle to the learning process ( Cheung et al ., 2021 ). In fact , it has been shown that students with higher spatial and visual abilities had significantly outperformed their counterparts in written and practical examinations ( Lufler et al ., 2020 ). Many innovative teaching strategies aim to promote a deep understanding of anatomy by targeting spatial , visualisation , and observation skills ( Gonzales et al ., 2020 ; Jain et al ., 2017 ; Langlois et al ., 2020 ; Moore et al ., 2011 ; Na et al ., n . d .; Naug et al ., 2016 ; Wu et al ., 2018 ).
Haptico-visual observation and drawing ( HVOD ) derived exercises have been designed to improve the understanding of spatial relationships between anatomical parts ( Reid et al ., 2019 ). The HVOD approach can facilitate spatial understanding of anatomical structures , allowing the construction of a 3D mental picture ( Reid et al ., 2019 ; Shapiro et al ., 2020 ). The Oxford English Dictionary defines “ haptics ” as perceiving objects by touch or proprioception without the involvement of verbal communication . It is derived from the Greek word “ haptikos ” which means able to touch or grasp (“ HAPTIC | Meaning & Definition for UK English | Lexico . com ,” n . d .)
We tend to rely on our vision to perceive objects around us , however , evidence has shown that inferences about 3D objects based solely on visual input can be inaccurate , and that more realistic 3D percepts can be achieved by complementing visual input with haptic information ( Helbig and Ernst , 2007 ; Wijntjes et al ., 2009 ). A major flaw in the visual modality is that an object present in a 3D environment will be projected on the retina as a 2D image , which will later be processed as a 3D mental representation ( Klatzky and Lederman , 2011 ; Wijntjes et al ., 2009 ). Touch input , through the activation of mechanoreceptors , can convey many aspects of shape and volume simultaneously to the brain ( Klatzky and Lederman , 2011 ). However , if the object is not completely accessible by touch , limited haptic information can be acquired ( Lederman et al ., 1990 ). Given these limitations , we can assume that a holistic 3D understanding is more likely achievable by multisensory observation . The HVOD approach employs sight and touch to achieve an understanding of the form , which is further emphasised by the simultaneous act of drawing it ( Reid et al ., 2019 ; Shapiro et al ., 2020 ).
Drawing can also support visual learning ( Kohnle et al ., 2020 ). Drawing-based learning activities are believed to support visual learning ( Kohnle et al ., 2020 ), enhance comprehension , knowledge retention , and student engagement ( Alsaid and Bertrand , 2016 ; Borrelli et al ., 2018 ; Lyon et al ., 2018 ; Slominski et al ., 2017 ). Anatomy students who supported their cadaveric studies with personal sketches achieved higher scores on anatomy tests compared to those who did not use any form of drawing ( Alsaid and Bertrand , 2016 ). According to Mayer ’ s cognitive theory of multimedia-learning ( Mayer , 2014 ), drawing can be thought of as a stepwise process involving the selection of relevant verbal and visual information , sorting them into a single coherent mental model , and finally integrating these models with one another , or with formerly established models . Schmeck et al 2014 conducted two experiments to determine the impact of the generative drawing effect – defined as the improvements in test performance by engaging in appropriate drawing activities ( Schmeck et al ., 2014 ). Using two different comprehension tests , generative drawing , was found to be correlated with enhanced test performance , while no significant differences were found in perceived task difficulty . In other words , students can enjoy the added benefits of drawing without experiencing an extra cognitive load .
While visual and haptic inspection are undeniably important in learning anatomy , little is known about the effect of combined multisensory observation and drawing . We conducted this pilot study as part of a more objective study to expand further on the available evidence on this approach and to inform any future inclusion of the HVOD in anatomical education .