3D Anatomy Models and Impact on Learning: A Review of the Quality of the Literature

The impacts of three-dimensional anatomical atlas on learning anatomy

Gross anatomy has traditionally been the foundation of medical education. Medical students have learned the structure of the human body through dissection, lecture, and textbooks. As tablets and three-dimensional (3D) applications are developed, 3D atlas applications are utilized in learning anatomy by medical students. The purpose of this research is to investigate the impacts of 3D atlas applications on students' understanding of gross anatomy. This research was targeted at medical students taking the Anatomy and Embryology class in 2017 and 2018, at Ewha Womans University. The correlation between use of 3D atlas and student's results on the Anatomy and Embryology test was analyzed. An open-book anatomy quiz was also carried out to analyze the correlation between the type of atlas each student refers to and the results of the quiz. Independent t test between groups did not show statistically significant difference in the results of the Anatomy and Embryology test. However, the group referring to 3D atlas showed significantly higher results on the simple questions of the open-book anatomy quiz (P<0.05). In conclusion, 3D atlas is not very helpful in acquiring deep anatomical knowledge or memorizing the location of anatomical structures, but it can simply aid in the rapid identification of anatomical structures. Additionally, the 3D atlas will show good synergy with the two-dimensional atlas if used properly in anatomy education, because most students think it is useful to use the 3D atlas.

How Haptics and Drawing Enhance the Learning of Anatomy

Students' engagement with two-dimensional (2D) representations as opposed to three-dimensional (3D) representations of anatomy such as in dissection, is significant in terms of the depth of their comprehension. This qualitative study aimed to understand how students learned anatomy using observational and drawing activities that included touch, called haptics. Five volunteer second year medical students at the University of Cape Town participated in a six-day educational intervention in which a novel "haptico-visual observation and drawing" (HVOD) method was employed. Data were collected through individual interviews as well as a focus group discussion. The HVOD method was successfully applied by all the participants, who reported an improvement of their cognitive understanding and memorization of the 3D form of the anatomical part. All the five participants described the development of a "mental picture" of the object as being central to "deep learning." The use of the haptic senses coupled with the simultaneous act of drawing enrolled sources of information that were reported by the participants to have enabled better memorization. We postulate that the more sources of information about an object, the greater degree of complexity could be appreciated, and therefore the more clearly it could be captured and memorized. The inclusion of haptics has implications for cadaveric dissection versus non-cadaveric forms of learning. This study was limited by its sample size as well as the bias and position of the researchers, but the sample of five produced a sufficient amount of data to generate a conceptual model and hypothesis.

The Affordances of 3D and 4D Digital Technologies for Computerized Facial Depiction

3D digital technologies have advanced rapidly over recent decades and they can now afford new ways of interacting with anatomical and cultural artefacts. Such technologies allow for interactive investigation of visible or non-observable surfaces, haptic generation of content and tactile experiences with digital and physical representations. These interactions and technical advances often facilitate the generation of new knowledge through interdisciplinary and sympathetic approaches.Scientific and public understanding of anatomy are often enhanced by clinical imaging technologies, 3D surface scanning techniques, 3D haptic modelling methods and 3D fabrication systems. These digital and haptic technologies are seen as non-invasive and allow scientists, artists and the public to become active investigators in the visualisation of, and interaction with, human anatomy, remains and histories.Face Lab is a Liverpool John Moores University research group that focuses on creative digital face research; specifically the further development of a 3D computerized craniofacial depiction system, utilizing 3D digital technologies in facial analysis and identification of human remains for forensic investigation, or historical figures for archaeological interpretation.This chapter explores the affordances of such interactions for the non-destructive production of craniofacial depiction, through a case-study based exploration of Face Lab workflow.

Using Interactive 3D Visualisations in Neuropsychiatric Education

Obsessive compulsive disorder (OCD) is a neuropsychiatric disorder with a global prevalence of 2-3%. OCD can have an enormous impact on the lives of those with the disorder, with some studies suggesting suicidal ideation is present in over 50% of individuals with OCD, and other data showing a significant number of individuals attempt suicide. It is therefore important that individuals with OCD receive the best possible treatment. A greater understanding of the underlying pathophysiology of neuropsychiatric disorders among professionals and future clinicians can lead to improved treatment. However, data suggests that many students and clinicians experience "neurophobia", a lack of knowledge or confidence in cases involving the nervous system. In addition, research suggests that the relationship many students have with neurological conditions deteriorates over time, and can persist into practice.If individuals living with conditions such as OCD are to receive the best possible treatment, it is crucial that those administering care are equipped with a thorough understanding of such disorders. While research has shown that the use of interactive 3D models can improve anatomy education and more specifically neurology education, the efficacy of using of such models to engage with neuropsychiatric conditions, specifically OCD, has not been assessed. This study seeks to address this gap.In this study an interactive application for Android devices was designed using standardised software engineering methods in order to improve neuropsychiatry literacy by empowering self-pace learning through interactive 3D visualisations and animations of the neural circuitry involved in OCD. A pilot test and a usability assessment were conducted among five postgraduate life science students. Findings relating to user experience were promising, and pre-test vs. post-test evaluation suggested encouraging outcomes regarding the effectiveness of the application in improving the knowledge and understanding of OCD. In short, this study suggests that interactive 3D visualisations can improve neuropsychiatry education. For this reason, more efforts should be made to construct similar applications in order to ensure patients always receive the best possible care. Fig. 2.1 A diagrammatic representation of the CSTC circuit, based on a similar diagram by Robertson et al. (2017).

Which Tool Is Best: 3D Scanning or Photogrammetry - It Depends on the Task

In many educational and clinical settings we are increasingly looking into methodologies for accurate 3D representations of structures and specimens. This is relevant for anatomy teaching, pathology, forensic and anthropological sciences, and various clinical fields. The question then arises which tool best suits the task at hand - both 3D scanning and photogrammetry are options. For the use in medical education the aim is to create 3D models of anatomical specimens with high quality and resolution. Various qualitative and quantitative criteria determine the performance fidelity and results of 3D scanning versus photogrammetry. In our work we found that photogrammetry provides more realistic surface textures and very good geometries for most specimens. 3D surface scanning captures more accurate geometries of complex specimens and in specimens with reflective surfaces. The 3D scanning workflow and capture method is more practical for soft specimens where movement of the sample can lead to distortions. Overall, both methods are highly recommended dependent on the nature of the specimen and the use case of the 3D model.

Using Electronic Tools and Resources to Meet the Challenges of Anatomy Education in Sub-Saharan Africa

Anatomy education forms the foundation of a successful medical education. This has necessitated the development of innovative ideas to meet up with current realities. Despite these innovative ideas, there are challenges facing anatomy education, especially in sub-Saharan Africa. Problems such as inadequate teaching experts and outdated curricula have made anatomy education in sub-Saharan Africa uninviting and disinteresting. Several interventions have been suggested, such as the procurement of teaching tools and upgrading of teaching infrastructure. However, in this age of information technology; anatomy education, especially in sub-Saharan Africa could benefit from the integration of electronic tools and resources. This article explores the electronic tools and resources such as three-dimensional printing, educational games, and short videos that are readily available for the teaching of anatomy in sub-Saharan Africa. The author concludes by discussing how these electronic tools and resources can be used to address many of the challenges facing anatomy education in sub-Saharan Africa.

Innovative, Simple Models for Teaching Neuroanatomy Using the Elnady Technique

Plastination is a valuable tool for the teaching of neuroanatomy. However, the high cost of the process and the complexity of sheet plastination for brain slices remains a challenge. This article describes an innovative, simple, and inexpensive method, called the Elnady Technique, to develop brain slices of various domestic animals. The slices are either enveloped in lamination sheets using an electric iron, or enveloped in transparent plastic using an impulse sealer. This fast, effortless process results in realistic, durable, odorless, soft, flexible slices. The models provide accurate three-dimensional (3D) reference guides for demonstration of neuroanatomical structures that show soft tissue contrast between the gray and white matter. This makes them invaluable for interpretation of clinical imaging modalities, such as computed tomography (CT) and magnetic resonance imaging (MRI). These ethically sourced models can provide a replacement for the killing of animals for practical classes.

Improving Online Interactions: Lessons from an Online Anatomy Course with a Laboratory for Undergraduate Students

An online section of a face-to-face (F2F) undergraduate (bachelor's level) anatomy course with a prosection laboratory was offered in 2013-2014. Lectures for F2F students (353) were broadcast to online students (138) using Blackboard Collaborate (BBC) virtual classroom. Online laboratories were offered using BBC and three-dimensional (3D) anatomical computer models. This iteration of the course was modified from the previous year to improve online student-teacher and student-student interactions. Students were divided into laboratory groups that rotated through virtual breakout rooms, giving them the opportunity to interact with three instructors. The objectives were to assess student performance outcomes, perceptions of student-teacher and student-student interactions, methods of peer interaction, and helpfulness of the 3D computer models. Final grades were statistically identical between the online and F2F groups. There were strong, positive correlations between incoming grade average and final anatomy grade in both groups, suggesting prior academic performance, and not delivery format, predicts anatomy grades. Quantitative student perception surveys (273 F2F; 101 online) revealed that both groups agreed they were engaged by teachers, could interact socially with teachers and peers, and ask them questions in both the lecture and laboratory sessions, though agreement was significantly greater for the F2F students in most comparisons. The most common methods of peer communication were texting, Facebook, and meeting F2F. The perceived helpfulness of the 3D computer models improved from the previous year. While virtual breakout rooms can be used to adequately replace traditional prosection laboratories and improve interactions, they are not equivalent to F2F laboratories.

The effect of autostereoscopic holograms on anatomical knowledge: a randomised trial

CONTEXT

Three-dimensional (3-D) visualisation in anatomical education has been shown to be broadly beneficial for students. However, there is limited research on the relative efficacy of 3-D modalities. This study compares knowledge performance, mental effort and instructional efficiency between autostereoscopic 3-D visualisation (holograms), monoscopic 3-D visualisation (3-DPDFs) and a control (2-D printed images).

METHODS

A cardiac anatomy model was used to generate holograms, 3-DPDFs and 2-D printed images. Nursing student participants (n = 179) were randomised into three groups: holograms (n = 60), 3-DPDFs (n = 60) and printed images (n = 59). Participants completed a pre-test followed by a self-study period using the anatomical visualisation. Afterwards, participants completed the NASA-Task Load Index (NASA-TLX) cognitive load instrument and a knowledge post-test.

RESULTS

Post-test results showed participants studying with holograms (median = 80.0, interquartile range [IQR] = 66.7-86.7) performed significantly better regarding cardiac anatomy knowledge than participants using 3-DPDF (median = 66.7, IQR = 53.3-80.0, p = 0.008) or printed images (median = 66.7, IQR = 53.3-80.0, p = 0.007). Mental effort scores, on a scale from 1 to 20, showed hologram (mean = 4.9, standard deviation [SD] = 3.56) and 3-DPDF participants (mean = 4.9, SD = 3.79) reported significantly lower cognitive load than printed images (mean = 7.5, SD = 4.9, p < 0.005). Instructional efficiency (E) of holograms (E = 0.35) was significantly higher than printed images (E = -0.36, p < 0.001), although not significantly higher than 3-DPDF (E = 0.03, p = 0.097).

CONCLUSIONS

Participants using holograms demonstrated significant knowledge improvement over printed images and monoscopic 3-DPDF models, suggesting additional depth cues from holographic visualisation provide benefit in understanding spatial anatomy. Mental effort scores and instructional efficiency of holograms indicate holograms are a cognitively efficient instructional medium. These findings highlight the need for further study of novel 3-D technologies and learning performance.

3D-Printed specimens as a valuable tool in anatomy education: A pilot study

Three-dimensional (3D) printing is a modern technique of creating 3D-printed models that allows reproduction of human structures from MRI and CT scans via fusion of multiple layers of resin materials. To assess feasibility of this innovative resource as anatomy educational tool, we conducted a preliminary study on Curtin University undergraduate students to investigate the use of 3D models for anatomy learning as a main goal, to assess the effectiveness of different specimen types during the sessions and personally preferred anatomy learning tools among students as secondary aim. The study consisted of a pre-test, exposure to test (anatomical test) and post-test survey. During pre-test, all participants (both without prior experience and experienced groups) were given a brief introduction on laboratory safety and study procedure thus participants were exposed to 3D, wet and plastinated specimens of the heart, shoulder and thigh to identify the pinned structures (anatomical test). Then, participants were provided a post-test survey containing five questions. In total, 23 participants completed the anatomical test and post-test survey. A larger number of participants (85%) achieved right answers for 3D models compared to wet and plastinated materials, 74% of population selected 3D models as the most usable tool for identification of pinned structures and 45% chose 3D models as their preferred method of anatomy learning. This preliminary small-size study affirms the feasibility of 3D-printed models as a valuable asset in anatomy learning and shows their capability to be used adjacent to cadaveric materials and other widely used tools in anatomy education.

Tools and resources for neuroanatomy education: a systematic review

BACKGROUND

The aim of this review was to identify studies exploring neuroanatomy teaching tools and their impact in learning, as a basis towards the implementation of a neuroanatomy program in the context of a curricular reform in medical education.

METHODS

Computer-assisted searches were conducted through March 2017 in the PubMed, Web of Science, Medline, Current Contents Connect, KCI and Scielo Citation Index databases. Four sets of keywords were used, combining "neuroanatomy" with "education", "teaching", "learning" and "student*". Studies were reviewed independently by two readers, and data collected were confirmed by a third reader.

RESULTS

Of the 214 studies identified, 29 studies reported data on the impact of using specific neuroanatomy teaching tools. Most of them (83%) were published in the last 8 years and were conducted in the United States of America (65.52%). Regarding the participants, medical students were the most studied sample (37.93%) and the majority of the studies (65.52%) had less than 100 participants. Approximately half of the studies included in this review used digital teaching tools (e.g., 3D computer neuroanatomy models), whereas the remaining used non-digital learning tools (e.g., 3D physical models).

CONCLUSIONS

Our work highlight the progressive interest in the study of neuroanatomy teaching tools over the last years, as evidenced from the number of publications and highlight the need to consider new tools, coping with technological development in medical education.

Reduction of Animal Sacrifice in Biomedical Science & Research through Alternative Design of Animal Experiments

Various upcoming techniques can be used in replacement of experiments requiring animal sacrifice or products of animal sacrifice. In many instances these techniques provide more reproducibility and control of parameter, compared to experiments involving animal or animal products. Use of these techniques can avoid the question of the animal sacrifice during experiment and subsequently permission of ethical approval. In silico simulation, informatics, 3D cell culture models, organ-on-chips are some innovative technology which can reduce the number of animals sacrifice. Scientist evolved some innovative culture procedures and production of animal friendly affinity reagents which are free from the product of animal sacrifice. Direct investigation on human body for treatment as well as further research, electronic health record is also helpful in the reduction of animals sacrifice in biomedical investigations. These techniques and strategies of research can be more cost effective as well as more relevant to various issues related to the human health. Some medical blunder has also been reported after the successful testing of drugs on animal’s model. Hence, the reliability of animal experiment in context with human health is questionable.

Alternative to animal experiments help to reduce the number of animals required for research up to certain extent but is not able to eliminate the need for animals in research completely. Wisely use of animals in teaching & research is expected and the importance of animal experimentation in futuristic development in life science cannot be ignored.

Medical students' perspective on training in anatomy

Gaining sufficient knowledge of anatomy is an important part of medical education. Factors that influence how well students learn anatomical structures include available sources, learning time and study assistance. This study explores the attitude of medical students with regard to studying anatomy and evaluates possibilities for improvement of training in anatomy. Twenty medical students participated in a focus group meeting. Based on this focus group, an online survey consisting of 27 questions was developed and distributed amongst medical students of Maastricht University, the Netherlands. A total of 495 medical students (both Bachelor and Master level) participated in this survey. Master students found studying anatomy less attractive than Bachelor students (36.8% of the Master students vs. 47.9% of the Bachelor students (p=.024)). Although most students responded that they thought it is important to study anatomy, 48% of all students studied anatomy less than 10h per study block of 8 weeks. Only 47.9% of the students rated their knowledge of anatomy as adequate. Students suggested that three-dimensional techniques would help improve their knowledge of anatomy. Therefore investing in three-dimensional tools could prove beneficial in the future.

Photogrammetry of Human Specimens: An Innovation in Anatomy Education

Cadaver-based anatomical education is supplemented by a wide range of pedagogical tools-from artistic diagrams, to photographs and videos, to 3-dimensional (3D) models. However, many of these supplements either simplify the true anatomy or are limited in their use and distribution. Photogrammetry, which overlaps 2-dimensional (2D) photographs to create digital 3D models, addresses such shortcomings by creating interactive, authentic digital models of cadaveric specimens. In this exploratory pilot study, we used a photogrammetric setup and rendering software developed by an outside group to produce digital 3D models of 8 dissected specimens of regional anatomy. The photogrammetrically produced anatomical models authentically and precisely represented their original specimens. These interactive models were deemed accurate and teachable by faculty at the Stanford University Division of Clinical Anatomy. Photogrammetry is, according to these results, another possible method for rendering cadaveric materials into interactive 3D models, which can be used for anatomical education. These models are more detailed than many computer-generated versions and provide more visuospatial information than 2D images. Future researchers and educators could use such technology to create institutional libraries of digital 3D anatomy for medical education.

The effectiveness of virtual and augmented reality in health sciences and medical anatomy

Although cadavers constitute the gold standard for teaching anatomy to medical and health science students, there are substantial financial, ethical, and supervisory constraints on their use. In addition, although anatomy remains one of the fundamental areas of medical education, universities have decreased the hours allocated to teaching gross anatomy in favor of applied clinical work. The release of virtual (VR) and augmented reality (AR) devices allows learning to occur through hands-on immersive experiences. The aim of this research was to assess whether learning structural anatomy utilizing VR or AR is as effective as tablet-based (TB) applications, and whether these modes allowed enhanced student learning, engagement and performance. Participants (n = 59) were randomly allocated to one of the three learning modes: VR, AR, or TB and completed a lesson on skull anatomy, after which they completed an anatomical knowledge assessment. Student perceptions of each learning mode and any adverse effects experienced were recorded. No significant differences were found between mean assessment scores in VR, AR, or TB. During the lessons however, VR participants were more likely to exhibit adverse effects such as headaches (25% in VR P < 0.05), dizziness (40% in VR, P < 0.001), or blurred vision (35% in VR, P < 0.01). Both VR and AR are as valuable for teaching anatomy as tablet devices, but also promote intrinsic benefits such as increased learner immersion and engagement. These outcomes show great promise for the effective use of virtual and augmented reality as means to supplement lesson content in anatomical education. Anat Sci Educ 10: 549-559. © 2017 American Association of Anatomists.