How thoughtful textbook design can lower the barriers to reading dense, technical A&P content
“Students don't read the textbook.”
I've heard some version of that throughout my teaching career. I've probably said it myself.
Of course, some students do read. Some read selectively. Some start with good intentions and get overwhelmed. Others decide that lecture notes, videos, Quizlet, AI, or whatever else they can find will get them where they need to go faster. And some don't open the book unless an exam is bearing down on them.
This isn't exactly breaking news. Research on college reading compliance has documented the problem for years. But a 2026 study that asked undergraduates why they read—or don't—adds some useful nuance. Students reported skipping readings because they weren't a priority, because another approach seemed more efficient, because the reading was long or difficult, or because it seemed unnecessary.
That sounds less like students are lazy and more like students are constantly making decisions about where to spend limited time and effort.
Which raises a question for textbook authors:
What can we do about it?
We can't make students read. But perhaps we can make the book easier to enter, easier to navigate, and more obviously worth the effort.
We've been working on that for a long time.
This isn't a new idea
Helping students actually read our A&P textbook didn't suddenly become a goal for the 12th edition.
Years ago, I wrote here about reducing text anxiety, chunking chapters, breaking content into smaller pieces, helping students recognize patterns, explicitly teaching terminology, and embedding little hints about how to use a textbook effectively. Those weren't disconnected features that happened to accumulate over the years. They came from a basic design philosophy:
A textbook shouldn't merely contain the information students need. It should help them learn that information.
That sounds obvious. It isn't always.
First, make the mountain into smaller hills
A&P is a lot.
There are anatomical structures, physiological processes, chemical principles, new terminology, illustrations, tables, clinical applications, and endless relationships among all of them. For a beginning student, opening a conventional 50-page chapter on one body system can feel a little like being told, There's the mountain. See you at the top.
We've deliberately taken another approach. Anatomy & Physiology, 12th Edition divides that big A&P story into 49 relatively short chapters. We've been moving in that direction for several editions, breaking not only chapters but also sections, paragraphs, and other elements into more manageable chunks.
This isn't about pretending there's less A&P to learn. The mountain is still there. We're simply trying to give students more places to stop, orient themselves, see how far they've come, and begin the next piece.
That's consistent with a well-established principle from learning science: when complex material is divided into meaningful segments, learners can devote more of their limited cognitive resources to making sense of it rather than simply keeping track of it.
Smaller chapters can make ideas bigger
There's another reason I like short chapters. They let us give some important ideas their own place in the story.
Homeostasis has its own chapter. So does the lymphatic system. Stress gets a short chapter instead of being tucked away as part of another topic. And now, in the 12th edition, the human microbiome has its own concise Chapter 49.
That doesn't merely make chapters shorter. It can make an idea easier to see. If homeostasis is buried inside a large introductory chapter, a beginning student may reasonably conclude that it's one more subtopic to memorize before getting to the “real” A&P. Give it a chapter of its own, and the structure of the book quietly says:
Pay attention. This idea matters.
Smaller modules also give instructors more flexibility. A chapter on stress can move. Homeostasis can move. The microbiome chapter can be assigned early, late, alongside another topic, or wherever it best fits a particular course.
So chunking is not simply about shortening the reading assignment. It's also about making the conceptual architecture of the course easier to see.
Give readers some road signs
Shorter chapters don't solve everything. A student can get lost in a short chapter, too.
So the next question is: What happens inside the chapter?
That's where headings, outlines, bold terms, illustrations, tables, Hints, Quick CHECK questions, and Chapter Summaries come in. Experienced textbook readers may hardly notice these structural signals. We automatically use them to figure out where we are and how the pieces fit together.
Beginning readers may not.
There's some particularly interesting recent evidence on this. In a 2025 study, researchers reduced the cohesion of an educational text by removing topic headings, bolded terms, and take-home boxes. Readers who were relatively skilled at constructing a coherent representation of what they read managed reasonably well either way. Readers with lower structure-building skill learned less when those signals disappeared.
Some readers can build the map for themselves. Others benefit when we put up some road signs.
That's one reason our chapters begin with a brief Chapter Outline, use visible headings throughout the narrative, and end with a much fuller Chapter Summary. I recently took a closer look at that strategy in Lost in the Chapter? Why A&P Students Get Two Outlines.
The same idea extends throughout the page design. A summary table can expose a pattern that's harder to notice in prose. A well-designed illustration can make relationships visible. An embedded Hint can stop a reader for a moment and say, in effect, Here's how to approach this.
None of those features is magic. Together, however, they can help readers see structure rather than a pile of facts.
Say it. Take it apart. Learn it.
Then there's the language.
A&P students aren't merely learning anatomy and physiology. They're simultaneously learning a new scientific vocabulary that may include hundreds of unfamiliar terms. Try understanding a paragraph when three of the important words in every sentence look like somebody spilled a box of Greek and Latin Scrabble tiles.
So we've long treated terminology as part of the learning problem, not as something students should simply figure out on their own. Chapter word lists, pronunciation guides, and word-part translations give students ways to become familiar with important terms before and while they're trying to learn the concepts those terms represent.
I've already gone into this in much more detail in Say It. Take It Apart. Learn It., my recent look at the revised terminology tools in the 12th edition, and in the earlier Word Parts Help Students Master the Language of Science.
The point here is simply that lowering barriers to reading also means lowering unnecessary barriers created by unfamiliar language.
Maybe we should teach students how to read the book
There's another assumption worth questioning. We tend to assume that students arriving in college already know how to read a textbook.
They know how to read, certainly. But reading a dense, illustrated, technical A&P chapter effectively is a specialized academic skill. It's not much like reading a novel from beginning to end.
That's why we've embedded Hints throughout the textbook that occasionally step outside the A&P narrative and talk directly to the reader about how to approach the learning task.
Preview this before diving in. Look at that illustration while reading this explanation. Notice the pattern in this table. Try answering this before moving ahead. Go back and review that earlier concept because we're about to use it again.
There's evidence supporting this kind of explicit approach. Researchers studying college reading have argued that faculty should make the goals of assigned reading clear, teach effective strategies for approaching it, and connect the reading visibly to what students are expected to do in the course.
In other words, maybe we shouldn't just assign the reading.
Maybe we should teach students how to use it.
Prime the pump
That's part of the thinking behind our Unit Opener pretests, too.
At the beginning of each unit, students encounter a small set of illustrated questions that review useful prior knowledge and preview some of the ideas coming next. We're not expecting students to know all the answers. That's the point.
The questions activate what they already know, expose what they don't yet know, and give the upcoming reading somewhere to connect.
Before pouring in more information, we prime the pump.
But don't lose the forest among all those trees
Chunking creates another potential problem. If we keep breaking A&P into smaller pieces, students can become very good at seeing the pieces and never reconstruct the whole.
So we have to keep connecting them.
Our Big Picture discussions deliberately pull students back from the details and ask them to think about how body systems interact. Summary tables help reveal recurring patterns and relationships. Cross-references connect the concept being discussed now with something encountered earlier—or something coming later.
This is the other half of our approach:
Break complicated material into manageable pieces. Then keep reconnecting the pieces.
Chunking without reconnection can produce fragments. Reconnection turns those fragments into a conceptual framework.
Design for different readers
There's another reason for all this that matters to me.
Not every student who struggles with an A&P textbook is simply choosing not to read it.
Some students genuinely struggle with reading. There can be many reasons. Others read perfectly well but have limited experience with dense scientific prose, are learning in a language other than the one they grew up speaking, have gaps in their scientific background, or simply need more help seeing the structure in unfamiliar material.
And even a strong reader isn't equally strong under every circumstance. Fatigue, stress, unfamiliar terminology, competing demands, and the sheer cognitive load of A&P can change the reading experience.
This is one reason I've long been attracted to Universal Design for Learning (UDL). Rather than designing instruction for some imaginary “average” learner and adding fixes later for everyone else, UDL encourages us to anticipate learner variability and reduce unnecessary barriers from the beginning.
CAST's current UDL framework emphasizes, among other things, clarifying vocabulary and symbols, connecting prior knowledge to new learning, highlighting patterns and important relationships, and providing multiple ways of representing information.
Sound familiar?
A textbook obviously can't provide every possible learning pathway for every student. But prose, diagrams, tables, pronunciation help, word-part translations, chapter structure, digital resources, and explicit learning hints can give readers more than one way into an idea.
That matters for the student who genuinely struggles with reading. But it also helps the student who's tired, inexperienced, distracted, uncertain where to begin, or simply encountering a very difficult concept for the first time.
To me, that's part of inclusiveness, too.
We don't have to know in advance exactly which student will need which bit of help. We can simply design the learning environment with human variability in mind.
The textbook can't solve everything
Here's the uncomfortable part.
We can produce the clearest prose we know how to write. We can shorten chapters, signal structure, explain terminology, build useful illustrations, provide summaries, and scatter helpful Hints everywhere.
And a student can still leave the book closed.
A beautifully designed unread textbook is still an unread textbook.
This is where instructors matter enormously. The recent research I mentioned at the beginning is useful here. Students reported being more likely to read when the reading helped them prepare for class, succeed in the course, understand something, or participate in what was happening next. They were less likely to read when it seemed unnecessary or when another route appeared more efficient.
That suggests that textbook design and course design have to work together.
If I tell students, “Read Chapter 18,” and then spend the next class telling them everything that was in Chapter 18, I've taught them something besides nerve tissue. I've taught them that reading Chapter 18 may not be a very good use of their time.
Instead, we can make reading part of the learning process. Ask students to retrieve ideas from it, apply them, bring questions from it, compare an illustration with a specimen, use a table to solve a problem, or come to class prepared to do something that assumes they've at least encountered the basic story.
The textbook can't make that happen by itself. Neither can the instructor. But together, perhaps we can improve the odds.
One more question when choosing an A&P textbook
When we evaluate textbooks for adoption, we naturally ask important questions. Is the content accurate and current? Does it fit our course? Are the illustrations clear? Are the resources useful? Is the cost reasonable?
Does the publisher's rep bring me donuts?
Okay, that last one isn't exactly a pedagogical criterion.
But let's admit that human relationships can influence adoption decisions, too. When several perfectly good A&P textbooks seem fairly similar, our sense of connection—to the authors, the publisher, the support team, or simply the people who keep showing up for us—can matter.
That's human. And sometimes those relationships probably do tip the balance.
All the more reason to ask one more question:
What has this textbook actually done to help my students read it?
Not just buy it. Not just carry it around. Not just open it the night before the exam.
Read it. Navigate it. Understand it. Learn from it.
We haven't solved the problem of students not reading the A&P textbook.
But we haven't given up on it, either.
And we don't plan to.
If you don't have your own copy to review, please request a free instructor review copy of the new 12th Edition of Anatomy & Physiology.
High-school A&P instructors: These updates and insights also apply to Anthony’s Textbook of Anatomy & Physiology, 22nd Edition, the high-school edition of the two-semester Patton A&P program.
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