It is widely believed that the process of dissection gives students an important three-dimensional (3D) view of human anatomy which reinforces and elaborates on knowledge acquired didactically. The number of programs teaching gross anatomy predominantly using cadaver dissection has been decreasing with concurrent reliance on a variety of 3D anatomy applications, in addition to plastinated models.  Does this migration from traditional dissection affect student learning, especially for the kinesthetic learner studying complex structures? Learning the brachial plexus proves challenging for many students given its complexity. It is unknown what effect learning in a lab without cadavers has on learning this important structure for physical therapy students

 

This study assessed the effects of student-built 3D portable brachial plexus models with pipe cleaners on student learning in a physical therapy program with limited access to a cadaver lab.

 

Twenty four first-year physical therapy students enrolled in an anatomy course participated. All students completed assigned readings and virtual didactics before the lab.  During the lab, students accessed an online video that gave step-by-step instructions on building their plexus using different colored pipe cleaners. Each nerve root was given a specific colored pipe cleaner which was then joined to other roots by twisting to form the trunks, divisions, cords, and the peripheral branches. Five different colored pipe cleaners were used to represent the C5 – T1 nerve roots comprising the brachial plexus.  A 10 item multiple-choice (MCQ) quiz regarding the brachial plexus was completed before and after lab to assess student learning.

 

A t-test was used to compare for significant differences in addition to the calculation of effect size (Cohen’s d). Pre and post-quiz mean (SD) grades were 52% (10.8) and 97% (7.0) respectively.   This represented a significant change (p<.001) and large within-group effect size (d=4.91, r=0.54).

 

 

The results of this study support the use of an inexpensive 3D model to supplement student learning and understanding of the brachial plexus. The interactive nature of building a 3D brachial plexus engaged students and provided an inexpensive method of learning the complexities of all its components.  The model also proved useful as a prop during lab breakout sessions where small student groups reviewed case studies that required knowledge of the brachial plexus and required explanation of findings to their peers and faculty.  Students also reported the lab to be enjoyable and effective in improving their understanding. 

 

An exquisite understanding of 3D musculoskeletal anatomy is essential for physical therapists. Despite the myriad of computer based technology available for students learning anatomy in universities and online it seems students are still challenged when learning intricate and complex structures such as the brachial plexus. In fact, a recent Google search for “learn the brachial plexus” revealed 425,000 hits. The pipe cleaner 3D model offers portability, tactile manipulation and can be used by students in a multitude of settings from home to the clinic.