Guided Drawing to Strengthen Conceptual Understanding and Knowledge Transfer in Musculoskeletal Anatomy

Traditional approaches to anatomy often emphasize memorization of muscle attachments and actions, which limits students' ability to reason through structure-function relationships. Guided drawing engages learners in actively constructing simplified representations that clarify these relationships. This activity was developed to strengthen conceptual understanding of shoulder anatomy and evaluate whether reasoning gained through drawing could transfer to analogous structures.

The guided drawing activity was embedded as a station in an upper extremity gross anatomy laboratory for first-year medical students. Guided by two facilitators, groups of 10-12 students completed a 20-minute session following an observe-simplify-discuss sequence focused on the rotator cuff. Knowledge was assessed at three time points (pre-, post-, and delayed posttests) using multiple-choice items addressing an Intervention Set (shoulder, directly taught using the drawing activity) and a Transfer Set (hip, analogous and not reinforced using the drawing activity). Student perceptions were collected immediately and six weeks later.

Eighty-two of 84 students participated (98%). Knowledge scores improved significantly from pre- to posttest for the Intervention Set (p < .0001). Transfer Set scores also improved (p = .0320), suggesting application of learned principles to an analogous region. Students rated the session as engaging (86%) and helpful for understanding muscle function (88%); 37% later used drawing for other anatomy topics. No long-term retention was evident at delayed testing.

A brief guided drawing activity improved conceptual understanding of muscle function and supported transfer of anatomical reasoning across analogous joints. Simplified drawing offers a scalable, active-learning approach to promote learning and deeper integration of anatomy knowledge.