Practice Before Theory? Rethinking Instructional Order in Undergraduate Anatomy

Abstract

BACKGROUND

Instructional sequencing in anatomy education—specifically the order in which theoretical and practical content is delivered—can significantly influence how students engage with and absorb material. Traditionally, anatomy curricula favour a lecture-first model, assuming foundational knowledge is necessary before hands-on learning. However, recent educational literature has increasingly challenged this assumption, proposing that beginning with practical experiences may better support active learning, retention, and concept application through context-rich environments (Estai & Bunt, 2016; Trelease, 2016). 

AIMS

This study aimed to evaluate whether delivering practical sessions prior to lectures improves student performance in a first-year undergraduate anatomy course. Specifically, it explored the influence of instructional sequencing on both short-term, topic-specific assessments and a broader integrative evaluation.

DESCRIPTION OF INTERVENTION

In 2023, an opportunity arose through timetabling to reverse the conventional structure. Students first engaged in weekly practicals that introduced anatomical content through hands-on dissection, specimen analysis, and small-group problem-solving. Lectures followed these sessions, reinforcing core concepts and integrating theoretical detail.

DESIGN AND METHODS

This comparative study examined performance data from two cohorts: 2022 (lecture-before-practical, n=201) and 2023 (practical-before-lecture, n=177). Assessments included six topic-specific practicals (P1–P6), a mid-semester exam, and a final integrative "Woolly Mammoth" task. Independent samples t-tests were used to analyse differences between groups. Data were collected throughout the semester across both years.

RESULTS

The 2023 cohort significantly outperformed the 2022 cohort in five of six practical assessments. The most notable improvements were seen in P2 (Cells and Integumentary System) and P6 (Reproductive Structures, Brain & Topography), with effect sizes ranging from moderate to large. However, the 2022 cohort achieved higher scores on the integrative Woolly Mammoth task, suggesting lecture-first sequencing may support more complex knowledge integration.

CONCLUSIONS

Reversing the instructional sequence appears to support topic-specific learning and immediate application, consistent with experiential learning principles. However, the lecture-first approach may better scaffold the development of integrated understanding. These findings align with calls for instructional strategies that are tailored to both content type and assessment design (Wilson et al., 2019). Curriculum design in anatomy education should consider sequencing as a strategic variable influencing diverse learning outcomes.