Neurocognitive outcomes of reinforced representational modelling in anatomical learning: The role of executive functions

This study examined neurocognitive outcomes of an innovative teaching approach in undergraduate anatomical education, focusing on executive functions with emphasis on cognitive flexibility. Reinforced representational modelling was implemented to assess its potential to support learning processes.

A quasi-experimental study involved first-year anatomy students from two universities (n = 116). Each institution delivered a single 30-hour program with different teaching methods: conventional lectures using 3D atlases and standard drawing tasks (control group) versus reinforced representational modelling (experimental group), taught by its regular instructor and aligned with its syllabus. Pre- and post-intervention outcomes were assessed using psychometric instruments: the Webexec scale for perceived executive difficulties and the Cognitive Flexibility Scale for cognitive flexibility. Statistical analyses included independent-samples t-tests, repeated-measures factorial ANCOVAs (time × treatment), and effect size estimations (Cohen's d, partial η²).

Perceived executive difficulties showed a strong time effect across both groups (F(1) = 20.28, p < 0.001, η²p = 0.176), increasing over the course, whereas no treatment effect appeared after controlling for baseline differences. Cognitive flexibility was higher in the experimental group at post-test (p = 0.044, Cohen's d = 0.36), although this advantage diminished once covariates were controlled.

Reinforced representational modelling may foster flexible learning strategies in anatomy education. Cognitive flexibility showed some responsiveness to the intervention, while increases in perceived executive difficulties likely reflect the cognitive demands of early anatomy learning. Although effects were modest and partly influenced by covariates and baseline differences, findings suggest that executive functioning remains a key neurocognitive determinant in anatomical learning.