Reducing Cognitive Load and Promoting Long-Term Knowledge Retention: Evidence-Based Study on Drawing and Collaborative Learning in Regional Anatomy Education

Abstract Research Background While visualization (e.g., drawing) and structured collaborative learning (e.g., the Highlight, Question, Assist (HQA) pedagogy) are advocated to optimize learning by reducing cognitive load and enhancing retention, empirical evidence for their integrated application in regional anatomy education is lacking. This study systematically evaluates the multidimensional effects of a combined "drawing + HQA" model on learning pressure, engagement, and academic performance. Research Methods A mixed-methods approach was employed. First, a questionnaire surveyed students' subjective evaluations of four teaching methods, identifying the drawing + HQA model as having the highest acceptance and lowest perceived learning pressure. Subsequently, a randomized controlled trial was conducted with clinical students (2022 & 2023 cohorts), comparing an experimental group (drawing + HQA) with a control group (traditional lecture-dissection). Outcomes measured included immediate performance (theory and specimen tests), classroom participation, satisfaction, and long-term memory assessed one month post-intervention. Data were analyzed using statistical tests (e.g., t-tests). Research Results Questionnaire results showed the drawing + HQA model was rated easiest to understand by 32.82% of students and associated with significantly lower learning pressure. In the controlled trial, the experimental group achieved significantly higher accuracy in clinical case analyses and specimen tests (P < 0.05) compared to the control. Furthermore, model demonstrated significantly greater satisfaction, classroom participation, and long-term retention scores across practical, theoretical, and analytical assessments (P < 0.05). These improvements were stable across both student cohorts. Research Conclusion The integrated "drawing + HQA" teaching model is highly effective in regional anatomy education. It is well-accepted by students, significantly reduces perceived learning pressure, and enhances immediate performance, classroom engagement, and long-term knowledge retention. The model provides a robust, empirically validated strategy for anatomy education reform. Trial registration Retrospectively registered.