Date of Award


Degree Type


Degree Name

Doctor of Philosophy in Biological and Environmental Sciences

First Advisor

Bryan Dewsbury


This dissertation explores learning in context. Undergraduate introductory human anatomy and human physiology courses are either taught as discipline-specific or integrated anatomy and physiology (A&P) sequences. These courses are critically important to future health care professionals yet a consensus is lacking on the optimal course approach. Our institution underwent a curricular revision to change pedagogical methodologies from discipline-specific human anatomy and human physiology to an integrated A&P I and II sequence. Thus, providing a unique opportunity to study the potential impact of contextual learning. Specifically, over three years the effects integrating physiological concepts had on anatomy education were explored as they relate to undergraduate students’ academic behavior and performance.

The distinct chapters of this dissertation are arranged according to subtopics and type of data used to inform this research. Chapter 1 qualitatively analyzed student reasons for their preference in course approach, discipline-specific or integrated A&P. Chapter 2 used questionnaires and the Approaches to Study Skills Inventory for Students (ASSIST) to examine how different pedagogical methodologies affected undergraduate motivation, learning approach (surface, strategic, deep), and study strategies, and what relationship those factors had on academic achievement. Chapter 3 utilized academic data (lecture exam grades, lab practical grades, and anatomy content retention rates) to better understand contextual learning influences on undergraduate student academic performance and anatomy content retention. Chapter 4 presents a mixed-method study of student perceptions on what they found difficult, confusing, and interesting about anatomy through the perspective of different pedagogical methodologies. Perception data was collected through word associations, open-ended surveys, and course evaluations. Additionally, dissertation appendices contain: A) a brief overview of the development of the A&P sequence, B) a curricular comparison between discipline-specific and integrated A&P based on the learning outcomes for each course, and C) a list of the required anatomical structures students needed to know in both course approaches.

Chapter 1 voiced undergraduate students’ preference for an integrated A&P course approach over separate discipline-specific courses. The qualitative analysis determined students felt an integrated course approach would form stronger connections between the subjects. Students felt these connections would better allow new information to be built on prior knowledge, making it easier to learn and understand A&P when taught together. Thematically coded reasons expressed for a discipline-specific preference are also included in Chapter 1.

Chapter 2 determined incoming motivation was the same between course approaches with students reporting higher rates of intrinsic motivation overall. Surface learning increased in the discipline-specific course approach between human anatomy and human physiology yet stayed steady in an integrated A&P, suggesting learning in context might reduce surface learning. Across academic outcomes, surface learners tended to be less successful. They earned lower lecture exam grades, laboratory practical grades, and retained less anatomy content at the end of the year. Positive correlations were evident between extrinsic motivation and surface learning as well as intrinsic motivation and deep learning. Therefore, the relationship between motivation and academic performance seems to be mediated by a deeper learning approach. Students displayed incongruence between their conception of learning, their learning approach, and their preference for teaching style. Even when students reported a deeper concept and approach to learning, they favored passive study strategies, such as flashcards and re-reading course notes, which aligned with their preference for a surface teaching style.

Chapter 3 found students enrolled in the integrated course approach were more successful on lecture exams and retained more anatomy content at the end of the year. These findings suggest contextual learning increases academic performance. In areas where contextual learning was minimal, such as in the lab or between human physiology and A&P II, differences in academic achievement were not significant.

Research shows student perceptions influence student motivation, learning approach, and academic success, therefore understanding student perceptions was the focus of Chapter 4. Undergraduate student perceptions changed more between the first and second course in the sequence rather than between course approaches. Overall, students found similar interests, difficulties, and confusion with learning anatomy. Student perceptions were described through the lens of the implicit and explicit curriculum. A common theme expressed by students was the perception that learning anatomy was memorization intensive. This perception could explain student preference for the passive study strategies seen in Chapter 2. Course evaluation data revealed significant differences between course approaches. Students in the discipline-specific course felt the lab complemented their understanding of lectures more than the integrated A&P students. By contrast, students in the integrated course approach felt more strongly that the course developed their ability to think critically about the subject. This indicates contextual learning in the integrated course approach increased the perception of critical thinking development, perhaps leading to a deeper approach to learning.

This dissertation found students preferred to have anatomy and physiology integrated into an A&P sequence (Chapter 1). This integration led to higher lecture exam grades and greater anatomy content retention (Chapter 3), along with the perception of an enhanced ability to think critically (Chapter 4). Intrinsically motivated students had a deeper approach to learning, which led to more successful outcomes academically (Chapter 2). Student perceptions provided valuable information on what they consider difficult, confusing, and interesting components of anatomy content (Chapter 4). Given the more interested a student is, the more motivated they are to learn—our perception findings suggest that to motivate students, interest must be maintained through the incorporation and expansion of the implicit curriculum focused on a personal connection to the content. Implementation of an instructional design should also be aimed at increasing undergraduate students’ intrinsic motivation to enhance a deeper approach to learning, thereby increasing academic performance (Chapter 2). Learning anatomy in the context of physiology aided students’ use of knowledge and reinforced learning. Undergraduate students in the integrated A&P I curriculum performed significantly better on lecture exams and retained more anatomy content at the end of the year (Chapter 3). In total, this dissertation supports planning quality curricular improvements with efforts towards increasing contextual learning and intrinsic motivation.

Available for download on Friday, December 16, 2022