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How to learn anatomy holistically

Contents

Introduction

“You don’t understand anything until you learn it more than one way” - Marvin Minsky

“Finally it’s done and dusted!” You’re sitting at your desk and you just completed a four hour study session in anatomy. Your mind aches and the only thing you see floating in front of your eyes are the muscles, vessels, and nerves you’ve just studied. You’ve read the information, understood it, and drilled it into your head (hopefully using one of Kenhub’s learning strategies).

Unfortunately, you forget the knowledge when asked by your supervisor in the clinic and you wish the ground would just swallow you up. You survived the exam, but many months or years passed since then. In addition, a lot of qualified health professionals forget an incredible amount of anatomy learned during the pre-clinical years. All the stress, hard work and sleepless nights are going to waste. It’s just sad…

Clock

Although repetition is the mother of all learning and is extremely effective, it still takes a lot of time to constantly revise. What if a reason for this forgetting and need for repetition is a fundamental mistake in encoding the information when you first learned it? Just like the cognitive scientist Minsky said, learning anything one way is insufficient for understanding. Understanding in this case doesn’t mean that an artery is an artery and its course is a certain one. It’s more about absorbing the information at a deeper level of learning in order to remember it long term. The method that can accomplish this is holistic learning and you are about to find out how to project your anatomy learning to a totally different level.

What is holistic learning?

Holistic learning is the zenith of education and learning. Everyone knows it’s the ideal way and usually tries to tackle it by taking baby steps. Unfortunately, they keep stumbling and falling because they haven’t learned the proper method behind it.

Holistic learning is an approach in which you encode knowledge by exploring and further expanding it. It actually reflects how information is stored within our brains and is the opposite of rote memorization. It’s about relating different ideas together and expanding your web of knowledge. Information is not stored in your brain in discrete boxes; one for anatomy, one for maths, etc. It’s rather stored as an interconnected map where anatomy is similar to food, history can resemble economics, and maths can be compared to literature.

"Web of knowledge"

The strategy

Generally, learners use fragments of holistic learning without even realising it - a test here, an application there. They know these are the correct approaches for meaningful learning. The challenge is how to use this approach more systematically and repeatedly, so here are the steps behind it:

Acquire phase

Acquiring the information is the first step of holistic learning. It involves transferring the anatomy knowledge from the page to your brain. Anatomy books are usually very long, with anything less than one thousand pages becoming extinct. They are filled with a lot of words and diagrams, but a lot of the information is redundant. Combine these three aspects and you obtain a learner’s nightmare. To succeed, you need to aim for three aspects:

  • Simplicity
  • Volume
  • Speed

Essentially, you need to simplify as much knowledge as possible in as little time as possible. Unfortunately, there’s no magic recipe to effectively speed this process (that’s right, stay away from speed reading!). You could however, adopt a flow-based notetaking approach. It involves using arrows and sketches to connect ideas more organically in a way that makes the most sense to you. The result is a free flowing and messier way in comparison to linear notes, but it enhances learning by creating hierarchies and a lot of connections between ideas, pictures, references, etc. It fits holistic learning because it accurately reflects how information is consolidated and linked inside your mind, similar to a mind map.

Flow-based notes

Understand phase

Acquiring all the anatomical knowledge is useless without comprehension. Luckily, this phase is quite intuitive for you, and anatomy is a subject which doesn’t require an incredible deal of understanding. For example; the femur has specific characteristics and landmarks, the maxillary nerve has a specific course and that’s that. There’s not a lot of head scratching. In fact, you perform this step automatically during your acquiring phase.

The problem is if you stop at the understand phase. You write some information about the aorta, you understand it, repeat it a few times, and hopefully remember it. Unfortunately, it is not enough. You just know some characteristics about it and that it’s not the pulmonary artery, for instance. This is where incredible learners go beyond the call of duty and continue the process of deeper learning.

Explore phase

This is where holistic learning actually starts and it involves exploring the previously acquired information. In this phase, you start connecting topics, like roads are linked via highways. To ease this step, you should embrace curiosity. In other words, you need to be genuinely interested to get to the core of the topic rather than simply scratching the surface. Here are the methods to achieve this:

  • Depth exploration - This method allows you to dive deeper into the subject and build a foundation for the specific knowledge you are trying to learn. For illustration purposes, let’s stick to the aorta. For depth exploration you should ask yourself: “Why is it called aorta (etymology)? Who and how was it discovered? Why does it branch so extensively? What’s inside it?” (link physiology, histology and other subjects), etc. Just imagine that you’re an annoying five year old who keeps asking “why?” and “how?” and it’s easy.
  • Lateral exploration - This method is all about connecting the subject with other aspects. For example, comparing the aorta with other medical structures. Simply ask yourself: “What other arteries are similar to this one? What makes it so special compared to others? What other anatomical aspects did its discoverer find? Why is it not a vein? What structures are adjacent to it?” etc. It’s all about finding similarities and differences between features that are not apparent initially.
  • Vertical exploration - This revolves around relating your topic with other aspects from a completely different subject area. For example, comparing the aorta with something from nature, physics, maths, economics, etc. Just ask yourself: “Can I compare the aorta with a tree and the water flowing through its branches? How does it relate to the plumbing system in my home? Does it behave like a water hose? What about its layers - what does it remind me of?” etc. Vertical exploration is the most creative out of those three, so take the bull by the horns and have fun with it!

Exploration

All the above might sound obvious, childish, or even stupid. However, the vast majority of learners store anatomical facts into a mental “Anatomy” box and physiology into the “Physiology” one, keeping them completely separated in their mind. Through exploration you are integrating the new information within your knowledge, improving your learning, reducing forgetfulness, and making it more accessible in years to come!

You now know the importance of exploration, but how do you actually link ideas? Here are some methods to start you off:

  • Metaphors - Relating two ideas together using words such as “like/as”
  • Visceralization - Composed of visuals/images and sensations/emotions (visceral)
  • Diagrams - Anatomy is full of diagrams, but why not try and simplify them, and create your own?

Debug phase

Initially, learning is never 100% correct. Some links and relations between concepts are bound to be imperfect. For example, your cardiovascular system is similar to the plumbing system in your home, but the heart does not start only when it’s needed, such as in cold temperatures. On the contrary, it beats constantly and regularly. When you come across such a mistake, you need to correct it.

However, not every slip up is a death sentence. Some of them are only minor and would just result in a warning. You can repair them by simply being aware of the mistake and not repeating it. Alternatively, there are fundamental ones which would instantly put your head on the chopping block. These ones are more difficult to rectify and you need to go all the way back, re-create your links and relations, or even acquire the information again.

With practice, debugging should diminish dramatically, or even disappear. The more you learn holistically, the more this phase will become like understanding - automatic and simultaneous with exploring. You can debug using two methods:

  • Tests/Quizzes - There is nothing better to show you that you learned the wrong information than tests (more details later).
  • Extra reading - The more you know about any topic, the easier it is for you to spot discrepancies. Better yet, you might not make them in the first place!

Stack of books

Apply phase

Learning becomes complete at this stage. Only when you start applying all that anatomy knowledge to the real world you can truly say that you have mastered it. This is especially significant for a healthcare professional. Many times, anatomy is learned purely descriptively with very little clinical applications. Unless you are in the United States (Western Americas - includes Canada as well) (or read Kenhub’s articles), applying anatomy almost never happens in the pre-clinical stage of your anatomical education.

Therefore, to learn the subject even more deeply, you need to apply it as much as you can. Luckily, doing this with anatomy is extremely easy and here’s how:

  • What if? -  Become obsessed with these words! “What if I perform a surgery and I cut the aorta? What if a blood clot blocks the aorta? What if the blood pressure of a patient increases?” etc. Just imagine yourself being in a hospital, imagine scenarios, and ask yourself such questions. You only have your wits about you, no books and no help.
  • Always think anatomically - Think about your actions during your everyday life: “What happens when I eat my dinner? What lower limb muscles are acting when I go to the shop?” etc. Learning doesn’t have to be boring, so mix it up!

The apply phase gives context and forces you to connect many different subjects together, helping you see the big picture.

Imagining 'What if?'

Test phase

Testing is a crucial part of learning. It simultaneously helps you learn by forming the backbone of active recall and it also provides feedback about the accuracy of your knowledge, so test yourself after each topic! Here are some suggestions:

  • Kenhub’s quizzes - By answering various styles of questions, you can easily pinpoint where the problem is. Did you misidentify a vein in a picture? Acquiring or debugging was done incorrectly. Did a muscle function or innervation trip you up? Go back over to the explore and apply phases.
  • Self-awareness - You can stop and think if you covered every angle at the end of each phase. This might sound like a waste of time, but with practice you’ll sprint through it faster than Usain Bolt! The only requirement is to be completely honest because you’d  only be fooling yourself!

Kenhub ipad

Naturally, you don’t have time to use holistic learning for every piece of knowledge or you would still be studying anatomy by the time you become a professional! The type of information you should use it for is critical and difficult information. If either of these are cloudy, it will be very difficult for you to add more layers onto your existing knowledge.

On the whole, everyone is trying to emulate the method of holistic learning, but rarely succeeds. Following just these six phases makes it very straightforward. The challenge is how you follow them and this is where many learners trip up. It may feel lengthy and inefficient at the beginning, but stick with it and you can forget about all those time consuming revision sessions forever!

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Show references

References

  • Scott Young: Learn More, Study Less!, 2008.

Article, Review and Layout:

  • Adrian Rad
  • Francesca Salvador

Illustrators:

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