RESEARCH REPORT

Perceptions Among Occupational and Physical TherapyStudents of a Nontraditional Methodology for TeachingLaboratory Gross Anatomy

K. Jackson Thomas,1* Bryan E. Denham,2 John D. Dinolfo3

1Division of Physical Therapy, College of Health Professions, Medical University of South Carolina,Charleston, South Carolina2Department of Communication Studies, Clemson University, Clemson, South Carolina3Department of English, Clemson University, Clemson, South Carolina

This pilot study was designed to assess the perceptions of physical therapy (PT) and occu-pational therapy (OT) students regarding the use of computer-assisted pedagogy and pro-section-oriented communications in the laboratory component of a human anatomy courseat a comprehensive health sciences university in the southeastern United States. The goalwas to determine whether student perceptions changed over the course of a summer sessionregarding verbal, visual, tactile, and web-based teaching methodologies. Pretest and post-test surveys were distributed online to students who volunteered to participate in the pilotstudy. Despite the relatively small sample size, statistically significant results indicated thatPT and OT students who participated in this study perceived an improved ability to namemajor anatomical structures from memory, to draw major anatomical structures frommemory, and to explain major anatomical relationships from memory. Students differed intheir preferred learning styles. This study demonstrates that the combination of smallgroup learning and digital web-based learning seems to increase PT and OT students’ confi-dence in their anatomical knowledge. Further research is needed to determine which formsof integrated instruction lead to improved student performance in the human gross anat-omy laboratory. Anat Sci Educ 4:71–77. © 2011 American Association of Anatomists.

Key words: gross anatomy; teaching methodologies; student perceptions; occupationaltherapy; physical therapy; prosections; e-learning; computer assisted learning

INTRODUCTION

The study of human anatomy remains a keystone in post-graduate health sciences education in the United States andabroad (Mukhtar et al., 2009, Sugand et al., 2010). Currentdebates about ways to finance the teaching of human anat-

omy courses have assumed greater urgency, given the signifi-cant challenges that many medical, dental, and allied healthschools are facing, such as curricular and time constraints,availability of suitable cadavers, and availability of suffi-ciently trained instructional personnel (Mattingly and Barnes,1994; McLachlan and Patten, 2006; Drake et al., 2009;Hildebrandt, 2010). Such challenges are occurring even asenrollments are increasing in many academic health sciencesprograms in order to offset existing or anticipated practi-tioner shortages in primary care medicine, certain surgicalspecialties, nursing, physical therapy (PT), occupational ther-apy (OT), and other clinical disciplines. Against that back-drop, various significant developments are distinguishable inundergraduate and postgraduate human anatomy courses inthe United States and abroad. When implemented, eachdevelopment has the potential to support and enhance stu-dent learning in the anatomical sciences. These developmentsinclude an increased reliance on:

*Correspondence to: Dr. K. Jackson Thomas, Division of PhysicalTherapy, College of Health Professions, Medical University of SouthCarolina, 151 Rutledge Avenue, Charleston, SC 29425, USA.E-mail: thomaskj@musc.edu

Received 22 November 2010; Revised 12 January 2011; Accepted 13January 2011.

Published online 8 March 2011 in Wiley Online Library(wileyonlinelibrary.com). DOI 10.1002/ase.208

© 2011 American Association of Anatomists

Anatomical Sciences Education MARCH/APRIL 2011 Anat Sci Educ 4:71–77 (2011)

1. Small group and team-based instruction (Chan andGanguly, 2007; Vasan et al., 2008, 2009).

2. Peer and near-peer teaching (Youdas et al., 2008; Bentleyand Hill, 2009; Evans and Cuffe, 2009; Wait et al., 2009).

3. Computer-assisted and web-based instruction that typicallyuses digitalized anatomical images to supplement traditionalteaching and learning through cadaver dissections and pro-sections (Berube et al., 1999; Plack, 2000; Bukowski, 2002;Foreman et al., 2005; Hisley et al., 2008; Yip and Rajen-dran, 2008; Drake et al., 2009, Petersson et al., 2009).

4. Principles and strategies from visual communicationstheory to address pedagogical issues in anatomy education(John and Lim, 2007; Thakore and McMahon, 2008).

CONTEXT FOR THIS STUDY

Clinical anatomists and anatomy instructors have long arguedthat dissections should remain a primary form of human anat-omy instruction to prepare health sciences students for futureclinical work (McLachlan and Patten, 2006). Students echo theconsensus among anatomy educators that hands-on learning inanatomy laboratories is central to professional training in theclinical sciences (Moxham and Plaisant, 2007). Other research-ers have assessed the relative advantages of dissections versusprosections in medical school anatomy courses, typically con-cluding that cadaver dissections are a preferable way to teachfuture clinicians about the clinical relevance of anatomical factsand relationships (Hisley et al, 2008). Yet other studies havedocumented the value of innovation and reform in medicalschool anatomical education in the United States (Gregoryet al., 2009; Hildebrandt, 2010; Sugand et al., 2010); the bene-fits of digital, and in some cases three-dimensional anatomy sim-ulations to support undergraduate and postgraduate anatomyinstruction (Hisley et al., 2008; Thakore and Mahon, 2008; Yipand Rajendran, 2008; Daruwalla et al., 2010), and the role ofanatomy education in transmitting professional values to clinicalstudents (Pawlina, 2006; Pearson and Hoagland, 2010).

Researchers also have investigated the benefits of explora-tory learning to teach clinical reasoning and to prepare anat-omy students for future clinical work (Philip et al., 2008), thebenefits of developing writing skills regarding anatomicalknowledge as a preparation for communicating effectivelywith patients (Evans, 2008), the learning benefits of verbaldiscussions and oral presentations by students in anatomyeducation (Lake, 2001; Philip et al, 2008), and the need toidentify and consider different learning styles of clinical stu-dents (Lujan and DiCarlo, 2006). Other scholars have dis-cussed the recommendations of allied health clinicians regard-ing instructional content of anatomy courses for students in theallied health professions (Latman and Lanier, 2001), the role ofevidence-based learning in PT education (McKenzie and Gutier-rez, 2007), the merits of interprofessional education amongmedical students and PT students (Hamilton et al., 2008),among other salient issues in anatomical sciences education.

Goals of this Study

To the authors’ knowledge, no studies have identified andassessed the perceptions and preferences of PT and OT stu-dents regarding teaching, learning, and modes of instructionand communication in a human gross anatomy course andrelated laboratories. Given this paucity of information, our

study was designed to help fill the gap in existing knowledge.We asked if a measurable change could be detected in PT andOT student perceptions and preferences for learning labora-tory gross anatomy with verbal, visual, tactile, and web-basedpedagogies. During summer 2009, we surveyed PT and OTstudents who were enrolled in a required human gross anat-omy course at a comprehensive health sciences university inthe southeastern United States. First, we wanted to receive spe-cific feedback from our students regarding their perceptions asto how effective our teaching methodologies were for learninghuman gross anatomy in the laboratory setting. Second, weanticipated that the findings of the study would supplementexisting knowledge regarding PT and OT anatomy educationduring a time of nationwide debate about how to support thecost of postgraduate instruction in human anatomy.

METHODS

Participants

At the university in which the study occurred, PT and OT stu-dents are required to have a baccalaureate degree fromaccredited colleges or universities. All PT and OT studentsalso are required to have passed a specific list of undergradu-ate prerequisite courses, including an undergraduate anatomycourse. However, the opportunity to participate in a suffi-ciently rigorous undergraduate anatomy course can varywidely among students. Thus, some are highly prepared toperform well in an intensive summer course in human grossanatomy, whereas for other students, this is their first immer-sion in a rigorous course in human gross anatomy that isdesigned to build a foundation for the application of anat-omy-learning to clinical situations.

Study participants consisted of volunteers enrolled as first-year entry level master’s degree students in OT or first yearentry level doctoral degree students in PT. All participantswere enrolled in human gross anatomy, which was taughtduring the ten week summer session of 2009. This particularoffering in human gross anatomy is a general survey coursethat covers the entire body (head and neck, extremities, back,thorax, abdomen, and perineum). Although physician assist-ant (PA) students also were enrolled in the course, the PA stu-dents were not surveyed for the study because their labora-tory learning method involved dissections, virtually all ofwhich they performed themselves, rather than prosectionsand prosection-demonstrations, which occurred for OT andPT students. PA students’ laboratory sessions followed a dis-section format due to the request of their core faculty.

A total of 175 students were enrolled in the human grossanatomy course in summer 2009, with a distribution of 42OT students, 64 PT students, and 69 PA students. Eightcadavers were used for the prosections. OT and PT studentswere assigned to one of three laboratory sections, with eachstudent being required to attend a two-hour prosectionsession once per week.

Integrated Instructional Procedure

In addition to attending regular didactic lectures, OT and PTstudents learned anatomy in the laboratory by attending teach-ing assistant (TA)-narrated prosections. Students were assignedin small groups of four to five to a TA, each of whom was arising second year medical student who had successfully takenand completed gross anatomy the previous year. No specific

72 Thomas et al.

grade earned in the medical school gross anatomy course wasrequired for being a TA. There were eight TA’s altogether, eachof whom taught an anatomical region that had been previouslyassigned. TA’s were selected on the basis of recommendationsfrom the medical school faculty and from impressions gainedthrough individual interviews. TA’s discussed the regions thatthey were assigned to teach with each other to help assurecontent validity. All teaching by TA’s was overseen and super-vised by a trained and experienced anatomist, who is the firstauthor of this research report.

All PT and OT students were required to attend a two-hour laboratory prosection session each week for ten weeks.TA’s received a list of anatomical terms before every labora-tory session, all of which were to be demonstrated to studentsin a TA’s group over a time period of 12–14 minutes. Stu-dents each had an identical copy of the list of structures to bedemonstrated, which comprised a section of the course sylla-bus. At the end of the 12–14 min time period, each smallgroup of PT and OT students moved to another table whereanother TA demonstrated a different group of anatomicalstructures. Small groups of students moved to successivetables approximately every 12–14 min until all students hadattended each of the TA prosection-demonstrations.

To keep the prosection-demonstrations from becomingmerely passive exercises for the PT and OT students, TAswere instructed to make each demonstration an interactiveexperience. TAs asked students about various anatomicalstructures pertinent to the respective prosection demonstra-tions, and students responded orally. No grades wererecorded for the verbal responses. TAs were directed to keepthat portion of the learning experience relevant and non-threatening. In addition to scheduled lectures and laboratorysessions, students participated in didactic supplementarymeetings where TAs reviewed key teaching points regardinganatomical facts and relationships. At key stages of thesummer session, during regularly scheduled classes, multiplechoice exams were administered to test students on theirknowledge of human gross anatomy of the head and neck,extremities, back, thorax, abdomen, and perineum.

Cost Management

The budgetary costs to teach the human anatomy course aremanaged by utilizing rising second year medical students asTA’s to instruct PT and OT students using laboratory prosec-tions. In addition, PT and OT students are required to viewand learn anatomy through sequential assignments takenfrom Human Anatomy online version 2.2 (Rarey et al.,1997), to which all students enrolled in the human grossanatomy course have access. Human Anatomy online version2.2 is a web-based anatomy tutorial that includes digitizedphotographs of dissections and allows viewers to study ana-tomical structures on a regional basis.

Computer Assisted Instruction

Students were assigned appropriate portions of Human Anat-omy online version 2.2 and directed to use those modules asindependent study. In addition, students used the same lists ofanatomical structures for identification that were in thecourse syllabus and were used by the TA’s during the labora-tory prosection sessions. Students were directed to locateeach structure in the computer program, using the list of ana-tomical structures as a guide. To increase learner efficiency,

the computer program has a subject index and photographicenlargement features for students to locate, visualize, andlearn anatomical features. Students were informed that theirpractical examinations would be drawn from the lists of ana-tomical structures mentioned above, and that the practicalexaminations would be based on their knowledge of the dis-sections shown in Human Anatomy online version 2.2.

Survey Tool and Quantitative Measurementsfor the Study

PT and OT student perceptions regarding laboratory instruc-tion were obtained with pre- and post-test questionnairesadministered online. During the second week of the summersemester, PT and OT students were invited to complete a pre-test questionnaire that contained 12 five-point Likert scalestatements (Table 1). The questionnaire was designed to mea-sure student perceptions regarding the teaching of human an-atomical structures and their relationships, along with studentattitudes regarding three communication activities: listening,viewing, and conversing. Data were collected through theonline program SurveyMonkeyTM (SurveyMonkey, 2010).

Table 1.

Statements Included on Pre- and Post-test Questionnaires

1. I can name major anatomical structures from memory.

2. I can draw major anatomical structures from memory.

3. I can explain major anatomical relationships frommemory.

4. I learn about anatomy primarily by reading about

anatomical facts and relationships.

5. I learn about anatomy primarily by looking atanatomical art and anatomical drawings.

6. I learn about anatomy primarily through hands-on,

tactile experience in laboratory activities.

7. I learn about anatomy primarily by listening tolectures, podcasts, and other informed talks.

8. I learn about anatomy primarily by discussing

anatomy with instructors or classmates.

9. I learn about anatomy primarily by participating inlaboratory dissections, which means that I cut apart

the structures myself.

10. I learn about anatomy primarily by viewing online

dissections on the Internet.

11. I learn about anatomy primarily by participating in

laboratory prosections, which are dissections that

have been prepared by someone else in advance.

12. To learn anatomy, I rely upon supplemental instructionand tutoring.

Response were evaluated on the five-point Likert scale: StronglyDisagree 5 1, Disagree 5 2, Unsure 5 3, Agree 5 4, andStrongly Agree 5 5.

Anatomical Sciences Education MARCH/APRIL 2011 73

During the final week of the summer session, OT and PT stu-dents completed a post-test questionnaire. Again, surveyitems measured student perceptions of how well they learnedanatomy during the laboratory prosection sessions in relationto the three communication activities of listening, viewing,and conversing. Students also were asked to rate their percep-tions regarding how well they were able to learn anatomyfrom lectures and from using the web-based program HumanAnatomy online version 2.2 (Rarey et al., 1997).

The IRB of the university approved the study. Before stu-dents answered any survey questions, PT and OT studentswere advised in writing that participation in the survey wasvoluntary, and responses would remain confidential, for useonly in the aggregation of data.

STATISTICAL ANALYSIS

While survey respondents were identified by group, their indi-vidual identities were not known to the authors, thus preclud-ing the use of repeated measures. Consequently, in makinggroup comparisons, the authors used one-way nonparametricanalysis of variance (ANOVA) procedures (i.e., Kruskall-Wallis tests) to examine differences between groups. Likeparametric ANOVA models, Kruskall-Wallis tests provide anoverall indication of statistical significance. In this study,

when Kruskall-Wallis tests indicated significant differences,the authors used nonparametric Mann Whitney U tests toexamine within-group differences on a post hoc basis. Theauthors recognize the importance of considering family P-val-ues for multiple comparisons and interpret results with thosein mind. All statistical analyses were performed with the Sta-tistical Package for the Social Sciences (IBM SPSS software)version 18 (SPSS Inc., Chicago, IL).

RESULTS

Of the 42 OT students and 64 PT students who were enrolledin the human gross anatomy course and laboratories, the fol-lowing number volunteered for the pilot study:

� OT pre-test n 5 12 and OT post-test n 5 15.� PT pre-test n 5 25 and PT post-test n 5 30.

Table 2 reports pre- and post-test mean scores for OT andPT respondents. As the table indicates, the most significant(nonparametric) differences occurred across three statements:

� ‘‘I can name major anatomical structures from memory.’’� ‘‘I can draw major anatomical structures from memory.’’� ‘‘I can explain major anatomical relationships from memory.’’

Table 2.

Display of Mean Scores and Standard Deviations (SD) for Anatomy Survey Questions

Items OT Pre-test OT Post-test PT Pre-test PT Post-test

n 5 12 n 5 15 n 5 25 n 5 30

Can name major structures 4.00 (0.603) 4.73 (0.458)a 4.16 (0.624) 4.77 (0.430)b

Can draw major structures 3.08 (0.996) 4.40 (0.632)b 3.33 (0.702) 4.53 (0.507)b

Can explain major structures 3.25 (0.866) 4.47 (0.516)b 3.40 (0.764) 4.45 (0.572)b

Learn by reading facts 3.00 (1.128) 3.00 (1.069) 2.84 (1.179) 3.31 (0.891)

Learn from art and drawings 4.00 (0.953) 4.33 (0.900) 4.20 (0.816) 4.17 (0.699)

Learn from tactile and labs 3.25 (1.055) 4.07 (0.799) 3.44 (1.121) 4.20 (0.761)c

Learn from lectures 4.17 (0.577) 3.07 (0.961)c 3.92 (0.909) 3.41 (0.946)c

Learn from discussion 2.67 (1.155) 4.20 (0.676)b 3.40 (1.080) 3.77 (0.898)

Learn from dissections 2.83 (1.193) 2.93 (0.961) 2.84 (1.028) 3.60 (1.037)c,d

Learn from Web dissections 2.92 (1.165) 3.20 (1.207) 2.96 (1.020) 2.93 (0.907)

Learn from prosections 3.75 (0.965) 3.73 (0.884) 3.68 (0.802) 3.74 (0.783)

Learn from supplements 3.83 (0.718) 3.60 (1.298) 3.20 (1.041) 3.23 (1.040)

Five-point Likert Scale: Strongly Disagree 5 1, Disagree 5 2, Unsure 5 3, Agree 5 4, and Strongly Agree 5 5.aP < 0.01.bP < 0.001.cP < 0.05.dPT students’ pre-test/post-test responses to this questionnaire item were somewhat enigmatic. Assuming that PT students did not partic-ipate in dissections on their own or in an unsupervised fashion, the authors speculate that these students equated active exploration, tis-sue separation, and other manual and tactile investigation done during the regularly scheduled laboratory prosections as ‘‘dissections.’’

74 Thomas et al.

In both the PT and OT groups, students indicated greaterlearning over time in the ability to name, draw, and explainmajor structures. Additionally, PT students indicated greaterlearning over time from participating in tactile lessons andlaboratories, as well as from dissections, and OT studentsindicated greater learning over time from participating in dis-cussions with instructors and classmates. Most of the differ-ences were highly significant, with the PT tactile differencebeing significant at P < 0.05.

Among both PT and OT students, learning from lecturesshowed a significant decrease in scores. These findings areincluded in our Discussion.

Notable Trends in the Data

In addition to statistically significant differences, some nota-ble trends emerged that, in the future, should be examined infurther detail. For OT students, mean post-test questionnairescores increased on items addressing art and drawings, tactilelearning and laboratories, and web dissections but declinedwith regard to learning from lectures. For PT students, meanpost-test questionnaire scores increased for reading andunderstanding anatomical facts as well as learning from dis-cussions with instructors and classmates. While not signifi-cant in statistical procedures conducted for the presentresearch, these differences merit additional thought and study.

DISCUSSION

Although education in human gross anatomy can contributesignificantly to the foundational knowledge of future health-care professionals, a number of issues cloud the ability of col-leges and universities to offer suitable courses in this academicdiscipline, notably, curricular and time constraints, the avail-ability of suitably trained anatomy instructors, and the avail-ability of cadavers (Mattingly and Barnes, 1994; McLachlanand Patten, 2006; Drake et al., 2009; Hildebrandt, 2010).Data from this study suggest that (a) alternative methods toteach laboratory human gross anatomy to OT and PT studentsmay be deployed and (b) for the students surveyed in thisstudy, satisfaction with integrated multimodal instructionalmethods was high.

Statistical Implications

Although the sample size was relatively small, and studentsfrom only two disciplines in the health sciences participated,the pilot study produced some meaningful findings regardingOT and PT preferences and attitudes. OT responses varied insome areas from PT responses. Yet both groups indicated per-ceived improvement in the ability to name major anatomicalstructures from memory, to draw major anatomical structuresfrom memory, and to explain major anatomical relationshipsfrom memory (Table 2). The PT group indicated greater learn-ing over time from tactile lessons and laboratories, as well asdissections, and the OT group indicated greater learning overtime from discussions with instructors and classmates.

Nonparametric ANOVA tests showed PT students to per-ceive a benefit from participating in dissections (question # 9in the survey). At first glance, this finding may seem paradox-ical. PT and OT students who attended prosection-demonstra-tions in the human gross anatomy laboratory did not partici-pate in prior dissections conducted by the medical student-TAs. However, during laboratory prosections, PT and OT stu-

dents manually traced nerves and muscles and manuallyinspected other anatomical structures with the guidance oftheir respective medical student-TAs, while their classmateswatched. Likewise, throughout the summer session, all PTand OT students observed how TAs manually inspected andpresented dissected anatomical structures at each of the eightprosection-tables. The authors speculate that the PT and OTstudents’ observation of, and in some cases, participation inhands-on anatomical inspection could explain why some PTand OT students perceived a benefit from dissections. Possi-bly, those students, immersed in laboratory learning, wereconflating the concepts of prosection and dissection, which isan assumption that needs to be confirmed or refuted in futureresearch. Analyses also revealed that, for PT students, scoresfor learning from lectures decreased over time. Why some PTstudents assigned a diminished value to lectures and anincreased value to learning from laboratory lessons merits fur-ther investigation, perhaps from the perspective of learningstyles (Fleming and Mills, 1992). These findings could be inves-tigated in a future study, perhaps with the previously mentionedtrend that PT students indicated that they learned from discus-sions with instructors and classmates. Also noteworthy is thefinding from ANOVA analysis that OT students learned overtime from discussions with instructors and classmates, butshowed a trend toward diminished learning from lectures. Whyscores for both PT and OT students declined with regard tolearning from lectures and increased with regard to learningfrom discussions is not understood at the present time andoffers potential substance for future investigation.

Pedagogical Implications

That PT and OT student groups both indicated greater learn-ing over the summer session in the ability to name, draw, andexplain major anatomical structures is not surprising. Thenew knowledge that resulted from this pilot study involvesstudent perceptions regarding modes of teaching and commu-nication that were perceived to enhance students’ ability tolearn anatomical facts and relationships. Our findings suggestthat PT and OT students may approach learning in a differentmanner and thus may have different learning styles. Forexample, OT students appeared to learn best through art anddrawings, tactile input (actually touching the cadaver duringa prosection-demonstration), lab discussions, and web-basedinstruction involving images of dissections. PT students indi-cated that their best learning occurred by reading aboutanatomical facts, learning from laboratory discussions, andlearning from dissections. These findings suggest that studentsbenefited from multiple modes of learning. Furthermore, theobservation that each student group showed a preference fordifferent pedagogical methods suggests a preference amongindividual students for alternative learning styles. However,the best way to actualize each mode of learning through inte-grated multimodal instruction remains undetermined for thispopulation of students.

Interestingly, the data do not indicate a statistically signifi-cant change in student perceptions regarding learning fromparticipating in prosections (question # 11 in the survey).This raises the possibility of further research to confirm orrefute these preliminary findings. Such research might focusmore intensively on various aspects of prosection-related ped-agogy and communications to determine which, if any, canenhance student learning. Paradoxically, student responses tosurvey questions 1–3 suggest that they perceived a significant

Anatomical Sciences Education MARCH/APRIL 2011 75

benefit from the integrated teaching methods used in thestudy. As discussed above, a key part of that teaching meth-odology is the active involvement of medical students as pro-section-instructors (TAs). This raises the possibility of furtherresearch in the human gross anatomy laboratory to determinehow pedagogical exchanges among future physicians, futurephysical therapists, and future occupational therapists can con-tribute to interprofessional education in orthopedic and reha-bilitative patient care. In any such future research, a largersample size and a controlled study designed to compare per-ceived student confidence with student learning outcomeswould enhance the authors’ ability to interpret and applyresults. The authors recognize that a selection bias may haveoccurred in this study, given the small sample size for both OTand PT students. We cannot rule out the possibility that stu-dents who typically do well in basic science courses volun-teered to participate in this pilot study. Thus, any follow upstudy of OT and PT student learning in the human gross anat-omy laboratory should control for potential selection bias.

CONCLUSIONS

Despite the pilot study’s limitations, our findings lend supportto the argument that the combination of small group learningin laboratory human gross anatomy, complemented by digitalweb based learning, is a pragmatic, cost effective way toenhance anatomy learning at the postgraduate level. PT andOT students generally reported positive outcomes to learningcriteria, as set forth in the pretest and post-questionnaires. Thefindings suggest the need for more research on integrated mul-timodal methods to teach human gross anatomy to OT andPT students as a preparation for future clinical work. The find-ings also may have implications for human gross anatomyteaching and learning in other disciplines, e.g., in nursing, phy-sician assisting, medicine, and dentistry. Studies of this kindrepresent a promising new line of interdisciplinary research inthe anatomical sciences and in health communications.

NOTES ON CONTRIBUTORS

K. JACKSON THOMAS, P.T., Ed.D., is a professor in theDivision of Physical Therapy, in the College of Health Profes-sions at the Medical University of South Carolina in Charles-ton, South Carolina. He teaches courses in human gross anat-omy, imaging and electrodiagnosis, clinical anatomy of theupper limb, anatomy for nurse anesthetists, clinical reasoningand practice, clinical pathophysiology, and an interprofessionalcourse entitled Transforming Health Care for the Future. Hisresearch interests include interactive computer applications foranatomy and pathology, exercise and aging, efficacy of cardiacrehabilitation, and home exercise programs for individualswith a mobility disorder, such as spinal cord injury.

BRYAN E. DENHAM, Ph.D., is Charles Campbell Profes-sor of Sports Communication in the Department of Commu-nication Studies at Clemson University in Clemson, SouthCarolina. He teaches courses in communication theory,research methods, sports communication, and public rela-tions. His research interests are in health communications,empirical research methods, political and sports communica-tion, media ethics, and public policy formation.

JOHN D. DINOLFO, M.A., is a lecturer in the EnglishDepartment and a Ph.D. student in Rhetorics, Communica-tion, and Information Design at Clemson University in Clem-

son, South Carolina. He teaches courses in science writingand communication. His research interests are in health com-munications, healthcare rhetorics, interprofessional communi-cations, and writing and visual communication across thecurriculum in the life sciences and the humanities.

ACKNOWLEDGMENTS

The authors thank the physical and occupational therapy stu-dents for their willingness to complete the pre- and post-testquestionnaire and for their participation in the study.

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