With exams approaching in a few weeks, I’ve been asked the same question by quite a few students: how do I get ready for the anatomy lab practical exam? They’re overwhelmed by the mountain of new material that they’ve been taught, and they’re not sure how to approach this uniquely difficult challenge.

For many first-year students, an anatomy lab practical exam, also known as a bell ringer, is a completely new experience. About 50 stations are set up around the lab, each one containing a specimen, model or picture. An anatomical structure is tagged with an arrow or a pin and the student has to identify what it is. After one minute at a station, a bell rings and students move to the next station.

Every other exam is stressful enough, and on most of those, students work at their own pace and get to choose an answer from multiple choices. Bell ringers are a whole new beast. There’s no skipping ahead or going back. Students have to recall the correct answer from thin air and they only have one minute to show that they know it.

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I remember my first anatomy bell ringer exam. It was about six years ago in my first anatomy class of undergrad. I also remember the anxiety in the weeks and days leading up to it and the pressure I felt during the exam. Can you say sweaty ‘pits? I don’t remember what grade I earned, but surprisingly, I passed. Looking back, I recognize now that I was grossly underprepared.

Since then, I’ve prepared for and taken over a dozen anatomy bell ringer exams. Now, I’m helping to set up and proctor the same exams that I took as a student. Like anything, the more you do it, the more comfortable you feel. And in my opinion,

Anyone can be successful on an anatomy bell ringer exam when they properly prepare and practice.

Listed below are some preparation strategies that I’ve used over the years as an anatomy student. They’re divided up into how to prepare outside the lab and how to practice in the lab. I recommend using all of these steps, in order, well in advance of the date of your bell ringer exam. Do NOT attempt to complete all these steps the night before the exam.

How to Prepare Outside the Lab

It may be tempting to skip these steps in favor of ‘figuring it out’ inside the lab, but diligent and focused preparation outside the lab increases the effectiveness of your time inside the lab.

1. Rewrite the names of anatomical structures by category

Often, each course has a lab list, a list of the anatomical structures that students are responsible for being able to identify in the lab. Pay special attention to how your lab list is organized; if it’s not already divided into categories, create your own based on specific body regions. Rewriting helps you to learn the new terminology and having structures broken into categories will create a short list to choose an answer from when taking the exam.

2. Define each structure on your lab list based on its relationships

Since learning anatomy is all about learning the relationships between structures, every anatomical structure can be defined by its relationship to other structures. Creating your own description of a structure, based on its location relative to your points of certainty, is a powerful exercise. Also, try to describe how to distinguish one structure from a similar-looking structure in the same area. Avoid exclusively describing a structure based on its appearance as this may not be consistent between specimens.

Below is an example of how I would prepare outside of the lab to learn the branches of the external carotid artery. I created 4 categories based on the different directions of the branches (anterior, posterior, medial, and terminal). I rewrote the names of the branches from my lab list and I created a definition for each structure, a way to find each branch based on its relationship to other anatomical structures that I know. It may also be helpful to use different colors and to incorporate your own sketches.

How to Practice Inside the Lab

If possible, practice in the same format that your exam will be: cadavers, models, and/or pictures. While practicing, look at as many different examples as possible.

1. Reinforce the categories and definitions (assisted identification)

With your lab list in front of you, use the categories and definitions that you previously created to find each structure. If you can’t find a structure, consult with an anatomy atlas, colleagues or an instructor to locate it. Then modify the definition of the structure if it was wrong or confusing. Make sure you review the relationships that are difficult to remember and the structures that you struggled to find.

2. Test yourself (unassisted identification)

Depending on how well you study with others, work with a classmate on a specimen or model. Take turns identifying as many structures of a category as you can without looking at your notes. When you’re done, check your lab list to make sure you didn’t miss anything that you need to know. When possible, write your answers down on a piece of paper to practice correct spelling and to practice committing to an answer.

PRO TIP: If you’re trying to practice for a cadaver lab exam outside of times that the lab is available, Rohen’s Color Atlas of Anatomy (affiliate link) is an excellent resource. You can easily choose a body region, identify structures labeled with a number and check your work from the answer key. There is also a collection of online anatomy photos through Utah Med Library. And don’t forget to use the additional resources that your instructor provides for your class.

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As you get comfortable with these steps, feel free to get creative. Mix and match the different strategies and resources, and do what you need to do in order to feel prepared. Remember, the best way to succeed on your upcoming anatomy bell ringer exam is to properly prepare and practice.

Keep learning,

Dr. K

Check out the next post, How to Take an Anatomy Bell Ringer Exam for strategies on how to perform your best on the anatomy bell ringer exam.

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Comment below:

What strategies and resources have you used to prepare for anatomy bell ringer exams?