Benefits from peer teaching in the dental gross anatomy laboratory

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  • Benefits from peer teaching in the dental gross

    anatomy laboratory

    Jennifer K. Brueckner and Brian R. MacPhersonUniversity of Kentucky Medical Center, Department of Anatomy and Neurobiology, Educational Technology Group, Lexington, KY 40536-0298, USA

    This study examined the impact of implementing a rotatingdissection schedule on the attitudes and performance of first-

    year dental students in the gross anatomy laboratory at theUniversity of Kentucky. In 20022003, half of the students

    assigned to each cadaver dissected the assigned objectivesduring the first 90 min of the laboratory session. During the last

    30 min, the non-dissecting group members came into the labor-atory and had the days dissection demonstrated and explained

    to them via peer instruction. Dissection responsibilities rotatedwith each laboratory session. Eighty-eight percent of student

    participants were satisfied with the rotating dissection approachaccording to a mid-term survey, and this satisfaction level

    remained unchanged at the end of the semester for most

    students. Students perceptions of the quality of peer laboratory

    presentations varied, with only 44% rating them as good orbetter. Eighty percent of students perceived that rotating dissec-

    tion did not impede their performance, and this was confirmed byanalysis of grade data. Student satisfaction and the ability to

    devote additional weekly curriculum time to studying anatomy ina very compressed curriculum were the main student-described


    Key words: peer instruction; gross anatomy; laboratory; basic

    science instruction.

    Blackwell Munksgaard, 2004Accepted for publication 10 November 2003

    I n teaching others, we teach ourselves (proverb).For educators at all academic levels, the learningpyramid has been a longstanding advocate for peer

    training, demonstrating that the process of teaching

    others results in a 90% retention rate of material, as

    compared to the 5% for lecture, 10% for reading, and

    50% for discussion (1). In addition to its intellectual

    benefits, peer teaching also heightens students sense

    of responsibility, increases self-confidence, and allows

    for growth in interpersonal and collaborative relation-

    ships while improving organizational and problem-

    solving skills (25). Peer teachers are often better at

    understanding students learning problems, more

    interested in their lives and personalities, less autho-

    ritarian and yet are still focused on assessment (6).

    In the realm of health science education, peer

    instruction is a cooperative learning technique used

    widely during both basic science (7) and clinical

    training (8, 9) in a variety of contexts, including

    lecture (10, 11) and laboratory (5, 12). For more than

    30 years, the medical education literature has docu-

    mented different forms of peer instruction in gross

    anatomy in order to save time and facilitate learning

    (1319). As curricular demands increase and qualified

    anatomists become scarce (20), medical schools are

    seeking more cost- and time-efficient ways to teach the

    laboratory component of gross anatomy. A number of

    medical schools have replaced the traditional dissec-

    tion method (where all students attend laboratory and

    participate in dissection) with alternative strategies,

    such as the rotating dissection approach. In this

    instructional technique, only a fraction of the students

    at each laboratory station dissect on any given day; at

    the end of the laboratory, they teach the days

    dissection to their peers. To date, the effectiveness of

    this peer teaching method has been evaluated primar-

    ily for medical students; the present study focuses on

    the implementation of rotating dissection in a dental

    anatomy curriculum.

    In the 2002 academic year, the authors restructured

    the laboratory component of the first-year dental gross

    anatomy course at the University of Kentucky in order

    to correct some serious instructional trends. While

    dental gross anatomy had always been a dissection-

    based course, the dedication to the dissection effort by

    the students was highly variable. Some students

    preferred to spend little time in the laboratory during

    the scheduled course dissection, returning to the

    laboratory in the evening to learn the material largely

    by prosection. Other students preferred to monopolize


    Eur J Dent Educ 2004; 8: 7277All rights reserved

    CopyrightBlackwell Munksgaard 2004euro pean journal of

    Dental Education

  • the dissection, theoretically readying themselves for a

    future in oral surgery. In addition, a concern for the

    faculty was a reduction in the number of trained

    laboratory instructors and their potential monopoliza-

    tion by the full class of 52 students in the laboratory.

    Laboratory instructors needed to be able to move

    between dissection tables quickly to ensure that each

    student group received appropriate assistance.

    The purpose of this curricular shift in dental

    anatomy was to ensure all students participated in

    the dissection experience as well as to make more

    effective use of their dissection time/experience. The

    authors took the opportunity to assess the impact of

    rotating dissection on student attitudes and laboratory



    The rotating dissection approach was tested with the

    first-year dental class during the spring semesters of

    2002 and 2003 (52 students each semester). On the first

    day of class, the rationale for and structure of the

    rotating dissection approach was presented to the

    class. Dissection teams of six to eight dental students

    were assigned alphabetically and divided into two

    groups. During each laboratory period, only one group

    at each table attended the first 90 min of laboratory and

    dissected the days objectives. The non-dissectors used

    most of the laboratory time to study anatomy in groups

    or independently. During the last 30 min of laboratory,

    the non-dissecting members of each group came into

    the laboratory and had the days dissection demon-

    strated and explained to them by the dissectors. Each

    student present for the dissection played a specific role

    in the laboratory demonstration, as described below.

    Faculty members were present throughout the labor-

    atory period to answer questions and monitor the

    quality of student presentations.

    Each member of individual dissecting groups

    assumed one of three team roles each day. The reader

    was responsible for leading the dissection by reading

    the dissection instructions to the others and locating

    appropriate atlas images to assist in the dissection.

    The reader was also responsible for narrating the

    laboratory demonstration for the students who did not

    participate in the days dissection. The head dissector

    took a lead role in the dissection process and also

    identified key structures during the laboratory demon-

    stration. One or more assistant dissectors assisted the

    head dissector by retracting structures or dissecting

    the opposite side of the cadaver, when appropriate.

    These roles rotated with each laboratory period so that

    all students had the opportunity to act in each role on

    six different occasions during the semester.

    To evaluate student satisfaction with the rotating

    dissection approach, surveys were conducted at mid-

    term and end of semester time points. The surveys

    were designed to collect quantitative data as well as

    qualitative written comments on many aspects of the

    new dissection experience from the first-year class. In

    addition, the teaching faculty recorded their impres-

    sions on the pros and cons of the rotating dissection


    To ensure that the rotating dissection approach did

    not impact on student laboratory performance negat-

    ively, laboratory examination scores from 2002 to 2003

    (rotating dissection implemented) were compared to

    the performance in 2001, when a traditional laboratory

    schedule was used (in which all students are expected

    to dissect during each laboratory period). spss statis-

    tical software was used to perform statistical analyses

    on the grade data.

    An exemption certification for this study (Protocol

    03-0375-X2Q) was granted for this study from the

    University of Kentuckys Institutional Review Board.


    One hundred and four dental students from the first-

    year classes of 2002 and 2003 participated in the study.

    The overall response rate for the surveys (20022003)

    was 87.5% (91 respondents out of a total of 104

    students). Forty-six of the respondents were male

    students (50.5%), and 45 were female (49.5%).

    Eighty-eight percent of student participants indi-

    cated some level of satisfaction with the rotating

    dissection approach (Fig. 1), according to the mid-

    term survey. This satisfaction level remained

    unchanged at the end of the semester for most

    students (79%), while 17.5% indicated a higher level

    and 3% reported a reduced level of satisfaction.

    With regard to student perceptions of the schedules

    impact on learning, 45.6% felt it enhanced their

    learning, while 34.4% perceived that it had no effect

    and 20% thought that it impeded learning (Fig. 2). In

    order to ensure that rotating dissection did not