Drawing-based instruction enhances practical performance and academic flow in cardiovascular and respiratory anatomy...

Relying on passive, traditional methods in anatomy education hinders deep understanding, whereas adopting active and creative teaching strategies fosters engagement and improves outcomes. Achieving deep immersion and sustained engagement in learning anatomy through learner-centered and active teaching strategies allows learners to understand complex spatial and functional relationships better. Therefore, this study aimed to examine the effect of drawing-based instruction on learning outcomes and the academic flow of medical students in the cardiovascular and respiratory system anatomy course. In this quasi- experimental study, 233 (Response rate 99.15%) medical students who were selected through the census method participated and were divided into two groups: control (n = 117) and intervention (n = 116). The control group received traditional lectures, while the intervention group was taught using drawing-based instruction. To implement this method, students were grouped and, as a team, completed drawing worksheets related to the topics of cardiovascular and respiratory system anatomy. At the end of the course, a station-based practical exam was administered to both groups. The Flow scale, developed by Martin and Jackson, was used to assess the flow level. The Persian version of this scale has confirmed validity and reliability, and its internal consistency has been assessed at a desirable level (Cronbach's alpha = 0.85). Statistical analysis was conducted using SPSS software version 26. 0. Data analysis showed that the mean scores of students in the intervention group were significantly higher than those in the control group in respiratory system (3.11 ± 0.88 vs. 2.52 ± 0.80, d = -0.71, t = -5.262, P < 0.01) and cardiovascular (3.21 ± 0.88 vs. 2.58 ± 0.83, d = -0.74, t = -5.642, P < 0.01) courses. Additionally, the flow level in students trained with the drawing method was significantly higher than in the lecture group (24.31 ± 5.30 vs. 20.15 ± 4.73, d = - 0.83, t = -6. 315, P < 0. 01). The findings of this study indicate that incorporating learner-centered and active teaching methods, such as drawing, into anatomy education significantly improves learning outcomes and enhances the academic flow of medical students. Drawing acts as an active learning tool in anatomy education, ultimately leading to a better understanding of the material and a more engaging experience for students.