Investigating the anatomy learning experiences of undergraduate paramedic students


paramedic students
undergraduate education

How to Cite

Carnicelli A, Williams A-M, Edwards D. Investigating the anatomy learning experiences of undergraduate paramedic students. Australasian Journal of Paramedicine [Internet]. 2022Aug.24 [cited 2023May28];19. Available from:



The study of human anatomy forms a foundational knowledge base essential for healthcare professional practice including paramedicine. However, little is known about the experiences and perceptions of undergraduate student paramedics towards learning anatomy. The aim of this study was to investigate this, utilising a questionnaire previously validated in medical students.


To explore anatomy learning experiences, a 32-item anatomy learning experiences questionnaire (ALEQ) modified for use with paramedicine students was distributed online to students enrolled in the Bachelor of Paramedic Practice at the University of Tasmania. Quantitative statistics were used to identify differences in responses between student groups. Cronbach’s alpha assessed the reliability of the modified ALEQ.


Fifty-one usable responses were obtained (20% response rate). Psychometric analysis demonstrated good overall reliability (Cronbach’s alpha of 0.88). The students perceived several learning activities as positive including textbooks, online learning and practical classes. However, it was generally felt the amount of content to learn was daunting. Furthermore, the students indicated working with cadavers would be highly beneficial for their learning. The relevance of anatomy was also recognised as being important to future clinical practice.


Despite the low response rate, the modified ALEQ was a reliable instrument to investigate the anatomy learning experiences and perceptions of paramedicine students. Further research with a larger cohort is required to confirm the reliability and generalisability of the results.


Bintley HL, Bell A, Ashworth R. Remember to breathe: teaching respiratory physiology in a clinical context using simulation. Adv Physiol Educ 2019;43(1):76–81.

Lai H, Lee Y, Lai K. The influence of humanised anatomical pedagogy on psychophysiological responses and academic achievement in nursing students. J Prof Nurs 2020;36(4):245–50 .

Whyte DG, Madigan V, Drinkwater EJ. Predictors of academic performance of nursing and paramedic students in first year bioscience. Nurse Educ Today 2011;31(8):849–54.

Sinnayah P, Rathner JA, Loton D, Klein R, Hartley P. A combination of active learning strategies improves student academic outcomes in first-year paramedic bioscience. Adv Physiol Educ 2019;43(2):233–40.

Friedel J, Treagust D. Learning bioscience in nursing education: perceptions of the intended and prescribed curriculum. Learn Health Soc Care 2005;4(4):203–16.

Davis G. What is provided and what the registered nurse needs – bioscience learning through the pre-registration curriculum. Nurse Educ Today 2010;30(8):707–12.

Johnston A, Hamill J, Barton M, Baldwin S, Percival J, Williams-Pritchard G, et al. Student learning styles in anatomy and physiology courses: meeting the needs of nursing students. Nurse Educ Pract 2015;15(6):415–20.

Smith CF, Martinez-Alvarez C, McHanwell S. The context of learning anatomy: does it make a difference? J Anat 2014;224(3):270–8.

Anderton RS, Chiu LS, Aulfrey S. Student perceptions to teaching undergraduate anatomy in health sciences. Int J High Educ 2016;5(3). doi: 10.5430/ijhe.v5n3p201.

Lim D, Bartlett S, Horrocks P, Grant-Wakefield C, Kelly J, Tippett V. Enhancing paramedics procedural skills using a cadaveric model. BMC Med Educ 2014;14:138.

Ebben RHA, Vloet LCM, Speijers RF, Tonjes NW, Loef J, Pelgrim T, et al. A patient-safety and professional perspective on non-conveyance in ambulance care: a systematic review. Scand J Trauma Resusc Emerg Med 2017;25(1):71.

O’Meara P. Paramedics marching towards professionalism. Australas J Paramedicine 2009;7(1). doi: 10.33151/ajp.7.1.153.

Xiang-Yu H, Rego J, Service M. Review article: paramedic education opportunities and challenges in Australia. Emerg Med Australas 2013;25:114–9.

Joyce CM, Wainer J, Archer F, Wyatt A, Pitermann L. Trends in the paramedic workforce: a profession in transition. Aust Health Rev 2009;33(4):533–40.

Andrew E, de Wit A, Meadley B, Cox S, Bernard S, Smith K. Characteristics of patients transported by a paramedic-staffed helicopter emergency medical service in Victoria, Australia. Prehosp Emerg Care 2015;19(3):416–24.

Hannon L, St Clair T, Smith K, Fitzgerald M, Mitra B, Olaussen A, et al. Finger thoracostomy in patients with chest trauma performed by paramedics on a helicopter emergency medical service. Emerg Med Australas 2020;32(4):650–6.

Waterman B, Van Aarsen K, Lewell M, Tien H, Myslik F, Peddle M, et al. Abdominal ultrasound image acquisition and interpretation by novice practitioners after minimal training on a simulated patient model. CJEM 2020;22(S2):S62–S66.

Pietersen PI, Mikkelsen S, Lassen AT, Helmerik S, Jørgensen G, Nadim G, et al. Quality of focused thoracic ultrasound performed by emergency medical technicians and paramedics in a prehospital setting: a feasibility study. Scand J Trauma Resusc Emerg Med 2021;29(1):40.

Shaw M, Hughes KE. High-risk, low-volume: evaluation of a reusable cricothyrotomy model in paramedic difficult airway training. Air Med J 2020;39(4):246–7.

Proctor A. Home visits from paramedic practitioners in general practice: patient perceptions. J Paramed Pract 2019;11(3):115–21.

Smith CF, Mathias HS. Medical students’ approaches to learning anatomy: students’ experiences and relations to the learning environment. Clin Anat 2010;23(1):106–14.

Choi-Lundberg DL, Williams AM, Zimitat C. A psychometric evaluation of the anatomy learning experiences questionnaire and correlations with learning outcomes. Anat Sci Educ 2017;10(6):514–27.

de Winter J, Dodou D. Five-point Likert items: t test versus Mann-Whitney-Wilcoxon. Practical Assess Res Eval 2010;15(11):1–12.

Andrade C. Multiple testing and protection against a type 1 (false positive) error using the Bonferroni and Hochberg Corrections. Indian J Psychol Med 2019;41(1):99–100.

VanderWeele TJ, Mathur MB. Some desirable properties of the Bonferroni correction: is the Bonferroni correction really so bad? Am J Epidemiol 2019;188(3):617–8.

Tavakol M, Dennick R. Making sense of Cronbach’s alpha. Int J Med Educ 2011;2:53–5.

Green RA, Whitburn LY, Zacharias A, Byrne G, Hughes DL. The relationship between student engagement with online content and achievement in a blended learning anatomy course. Anat Sci Educ 2018;11(5):471–7.

Vallée A, Blacher J, Cariou A, Sorbets E. Blended learning compared to traditional learning in medical education: systematic review and meta-analysis. J Med Internet Res 2020;22(8):e16504.

Garrison D, Kanuka H. Blended learning: uncovering its transformative potential in higher education. Internet High Educ 2004;7:95–105.

Shead DA, Roos R, Olivier B, Ihunwo AO. Curricular and pedagogical aspects of gross anatomy education for undergraduate physiotherapy students: a scoping review. JBI Evid Synth 2020;18(5):893–951.

Totlis T, Tishukov M, Piagkou M, Kostares M, Natsis K. Online educational methods vs. traditional teaching of anatomy during the COVID-19 pandemic. Anat Cell Biol 2021;54(3):332–9.

Edwards D, Young D. Scaffolded clinical skills development for clinical managers in the Royal Australian Navy. J Mil Veterans Health 2020;20:45. Available at:

Leggio W, Lippert J, Kozlowski I, Meyer A, Miller M, Ernest E. Interprofessional role of cadaver laboratory experience in paramedic education at Creighton University. Ir J Paramedicine 2019;4(2). doi: 10.32378/ijp.v4i2.179.

Alfaro P, Larouche S, Ventura N, Hudon J, Noel G. Nursing and medical students near-peer activity in the anatomy laboratory: format for success. Adv Med Educ Pract 2019;10:769–80.

Keiser M, Murray-Wright M. Autopsy observation as experiential learning for nurse practitioner students in an online advanced pathophysiology course. Nurse Educ 2020;45(2):111–3.

Bereznicki B, Caruso V, Errey J, Parker L, Sward J, Williams A, eds. Learning together: the paramedic, pharmacy and medical student experience of interprofessional education [plenary presentation]. Paramedics Australasia International Conference; Hobart, TAS; 28–30 November 2019.

Bergman E, de Bruin A, Herrler A, Verheijen I, Scherpbier A, van der Vleuten C. Students’ perceptions of anatomy across the undergraduate problem-based learning medical curriculum: a phenomenographical study. BMC Med Educ 2013;13:152.

Pandey P, Zimitat C. Medical students’ learning of anatomy: memorisation, understanding and visualisation. Med Educ 2007;41(1):7–14.

Johnston ANB. Anatomy for nurses: providing students with the best learning experience. Nurse Educ Pract 2010;10:222–6.

Connolly S, Gillingwater T, Chandler C, Grant A, Grieg J, Meskell M, et al. The Anatomical Society’s core anatomy syllabus for undergraduate nursing. J Anat 2018;232(5):721–8.

Jensen K, Knutstad U, Fawcett T. The challenge of the biosciences in nurse education: a literature review. J Clin Nurs 2018;27(9–10):1793–802.

Evensen A, Brataas H, Cui G. Bioscience learning in nursing: a cross-sectional survey of beginning nursing students in Norway. BMC Nurs 2020;19(1):2.

Johnson M, O’Hara R, Hirst E, Weyman A, Turner J, Mason S, et al. Multiple triangulation and collaborative research using qualitative methods to explore decision making in pre-hospital emergency care. BMC Med Res Methodol 2017;17(1):11.

Yuwaraj N, Neumeier M. Second-year nursing students’ retention of gross anatomical knowledge. Anat Sci Educ 2020;13:230–6.

Meskell M, O’Connor J. Nursing students’ perceptions on the use of anatomical prosections as an educational tool. Eur J Anat 2007;11(S1):73–7.

Turney BW. Anatomy in a modern medical curriculum. Ann R Coll Surg Engl 2007;89(2):104–7.

Tabachnick B, Fidell L. Using multivariate statistics. 5th ed. Boston: Pearson Education Inc.; 2007.

Fincham J. Response rates and responsiveness for surveys, standards, and the journal. Am J Pharm Educ 2008;72(2):43.