‘Sequence graphics’ for gross anatomy diagrams and their objective evaluation

Background and Objectives: Drawing diagrams is an integral part of learning anatomy. The objective of the study was to evaluate sequence graphics to impart drawing skills among medical undergraduates. The other objective of the study was to design and evaluate an objective method of assessment of clinically relevant moderately complex gross anatomy diagrams. Methodology: In an experimental study, participated by 92 students, were asked to draw coronal section of male pelvis (moderately complex diagram) projected on the board. The same diagram was redone with PowerPoint in such a way that each component appears sequentially on command from the teacher, technique called sequence graphics. Sequence labelling followed appearance of each component. The perineal membrane was the key component. Prostate gland (with urethra), deep transverse perineal muscle (with bulbourethral glands) and Colle’s fascia were accessory components. Both diagrams were analyzed for the centeredness, appropriate color usage, bilateral symmetry, and representation of key and accessory components and labelling. Deviation of three accessory components of student images of more than one grid was considered as grossly disproportional diagram. Results: Sequence graphics image scores were significantly more than the scores from projected image tracing (6.04 + 2.03 vs. 4.72 + 2.18). The improvement was particularly in terms of symmetry, representation of key and accessory components, labelling and use of appropriate colors. Conclusions: Sequence graphics resulted in drawings with predefined components with labelling. Defining key component and accessory components for moderately difficult diagrams shall result in objective evaluation. Sequence graphics principles aids better drawing skills.