Improving Undergraduate Students' Self-efficacy and Attitude by Art Work

Anatomy is one of the prominent and essential disciplines in healthcare and medical education, and study the shape and structure of the body, the systems and organs that make up the body, and the relationships between these systems and organs. In health care fields, it is necessary for students to have a strong foundation in this area. However, learning anatomy can be challenging and complicated due to the complexity of the concepts and terminologies involved; it plays a crucial role in preparing future healthcare providers. (Banovac et al., 2023). Healthcare students and medical professionals need to be adequately knowledgeable about anatomy and understand the functions and spatial context of organs before performing any invasive procedures on patients (Roxburgh \& Evans, 2021). Studies have shown that students without basic anatomy knowledge and skills encounter serious difficulties in advanced classes (Ghosh, 2017).

Traditional anatomy education is based predominantly on passive learning methods, such as lecture-based instruction, which may not effectively promote active student participation and knowledge retention (Ma et al., 2016). Nowadays, a revised teaching-learning approach known as active learning is implemented to ensure the curriculum remains relevant to the constantly connected and resource-rich world. It involves learners actively participating in the learning process through cooperative or hands-on tasks. Critical thinking and problem-solving skills are emphasized in this method and can improve student learning in numerous subjects (Bonatto-Costa et al., 2021). Students studying healthcare in the first year may experience challenges with the complexity and volume of anatomy subjects. However, many innovative learning tools, such as three-dimensional models, cadaver dissection, and artistic activities, such as drawing and body painting, have been conducted to enhance active learning and improve the quality of education in colleges (Rekhari \& Sinnayah, 2018). Nurses and midwives rely heavily on anatomy knowledge to perform procedures such as injection sites, monitoring vital signs, administering first aid, and performing childbirth and episiotomies. A strong foundation in anatomy can facilitate professional development in these specialized areas and advanced nursing and midwifery education. Moreover, possessing a comprehensive understanding of anatomy can enhance students' self-esteem and confidence when practicing in clinical settings (Satoh et al., 2023).

Attitude refers to a student's overall evaluation of the subject, and Studies show that healthcare students have positive attitudes about anatomy during their education period. It has been believed that along with Self-efficacy, students' perspectives and attitudes toward basic science subjects, such as anatomy, can significantly affect education outcomes (Plaisant et al., 2014).

Studies show that possessing a positive attitude towards anatomy, coupled with self-efficacy, can significantly impact students' academic performance and professional development in nursing and midwifery. This underscores the importance of acquiring a strong foundation in anatomy and cultivating a positive perspective and belief in one's ability to succeed in the subject (Acar et al., 2017).

Self-efficacy is the belief in one's capability to manage and take the actions needed to succeed in learning a subject (Woolcock et al., 2016). Self-efficacy has been a leading and also reliable predictor of university student progress for years and is significantly correlated with students' grade point averages and their motivation to learn (Bartimote-Aufflick et al., 2016). Academic self-efficacy determines how well students perceive their capacity to organize and carry out courses of action related to their studies (Tembo \& Ngwira, 2016).

This study aims to evaluate the effectiveness of Art working learning approaches in improving undergraduate students' attitudes and self-efficacy about anatomy courses.

Method:

This study was conducted on two groups of first-year nursing and midwifery students to compare the effectiveness of teaching anatomy using the active learning method of artwork versus anatomy atlases-based education. Questionnaires were distributed to both groups immediately after the first session of the anatomy course and 14 weeks later. The researcher responsible for distributing and collecting the questionnaires did not participate in teaching anatomy to the students. The students were asked to complete a self-report questionnaire that included information regarding their age, grade, sex, and field of study. In addition, both sets of students were also required to complete the Anatomy self-efficacy scale and Anatomy attitude scale.