Open Access Open Badges Research article

Relationship of creative projects in anatomy to medical student professionalism, test performance and stress: an exploratory study

Johanna Shapiro1*, Vincent P Nguyen2, Sarah Mourra3, John R Boker4, Marianne Ross5, Trung M Thai6 and Robert J Leonard7

  • * Corresponding author: Johanna Shapiro

  • † Equal contributors

Author Affiliations

1 Department of Family Medicine, University of California Irvine Bldg 200, Rte 81, Medical Center, 101 City Dr. South, Orange, CA 92868, USA

2 Department of Sociology, University of California, Irvine, 3151 Social Sciences Plaza, Irvine, CA 92697 USA

3 Department of Psychiatry, Yale University School of Medicine, 300 George Street, New Haven, CT 06511, USA

4 Office of Medical Education, Geisinger Health System, 100 N. Academic Ave, Danville, Pennsylvania 17822, USA

5 Office of Educational Affairs, University of California Irvine School of Medicine, Berk Hall, Building 802, Irvine, CA 92697

6 Department of Psychiatry & Human Behavior, University of California Irvine Medical Center, Neuropsychiatric Center, Bldg 3, Rte 88, 101 City Dr. South, Orange, CA 92868 USA

7 Department of Anatomy & Neurobiology, University of California School of Medicine, Med Surg II, Room 364, Irvine, CA 92697

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BMC Medical Education 2009, 9:65  doi:10.1186/1472-6920-9-65

Published: 3 November 2009



The anatomy course offers important opportunities to develop professionalism at an early stage in medical education. It is an academically significant course that also engenders stress in some students.


Over a three-year period, 115 of 297 students completed creative projects. Thirty-four project completers and 47 non-completers consented to participate in the study. Projects were analyzed for professionalism themes using grounded theory. A subset of project completers and non-completers were interviewed to determine their views about the stress of anatomy and medical school, as well as the value of the creative projects. We also compared test performance of project completers and non-completers.


Projects completed early in the course often expressed ambivalence about anatomy, whereas later projects showed more gratitude and sense of awe. Project completers tended to report greater stress than noncompleters, but stated that doing projects reduced stress and caused them to develop a richer appreciation for anatomy and medicine. Project completers performed significantly lower than non-completers on the first written exam (pre-project). Differences between groups on individual exams after both the first and second creative project were nonsignificant.


For some students, creative projects may offer a useful way of reflecting on various aspects of professionalism while helping them to manage stress.