Take away body parts! An investigation into the use of 3D-printed anatomical models in undergraduate anatomy education

Mid-Term Clinical and Radiographic Results of Complex Hip Revision Arthroplasty Based on 3D Life-Sized Model: A Prospective Case Series

Background: The pre-operative three-dimensional (3D) assessment of acetabular bone defects may not be evaluated properly with conventional radiographic and computed tomography images. This paper reports mid-term clinical and radiographic outcomes of complex revision total hip arthroplasty (r-THA) based on a 3D life-sized printed model. Methods: Patients who underwent r-THA for septic or aseptic acetabular loosening with acetabular defects Paprosky types IIc, IIIa, and IIIb between 2019 and 2021 were included. The outcomes of the study were to determine clinical and radiographic assessment outcomes at the time of the last follow-up. Results: 25 patients with mean age of 62.9 ± 10.8 (18-83) years old were included. The mean Harris hip score improved from 34.8 ± 8.1 pre-operative to 81.6 ± 10.4 points (p < 0.001). The mean visual analog scale decreased from 6.7 ± 1.4 points pre-operative to 2.4 ± 1.0 points (p < 0.001). The mean limb length discrepancy improved from -2.0 ± 1.2 cm pre-operative to -0.6 ± 0.6 cm (p < 0.001). The mean vertical position of the center of rotation (COR) changed from 3.5 ± 1.7 cm pre-operative to 2.0 ± 0.7 cm (p < 0.05). The mean horizontal COR changed from 3.9 ± 1.5 cm pre-operative to 3.2 ± 0.5 cm (p < 0.05). The mean acetabular component abduction angle changed from 59.7° ± 29.6° pre-operative to 46° ± 3.9 (p < 0.05). Conclusions: A three-dimensional-printed model provides an effective connection between the pre-operative bone defects' evaluation and the intraoperative findings, enabling surgeons to select optimal surgical strategies.

Integration of 3D printing and case-based learning in clinical practice for the treatment of developmental dysplasia of the hip

BACKGROUND

Case-based learning (CBL) utilizing three-dimensional (3D) printed hip joint models is a problem-solving teaching method that combines the tactile and visual advantages of 3D-printed models with CBL. This study aims to investigate the impact of integrating 3D printing with CBL on learning developmental dysplasia of the hip (DDH).

METHODS

We conducted a prospective study from 2022 to 2023, including 120 fourth-year clinical medical students at Xuzhou Medical University. Students were randomly allocated into two groups of 60 participants each. The CBL group received conventional CBL teaching methods, while the 3D + CBL group utilized 3D-printed models in conjunction with CBL. Post-teaching, we analyzed and compared the theoretical and practical achievements of both groups. A questionnaire was designed to assess the impact of the educational approach on orthopedic surgery learning.

RESULTS

The theory scores of the CBL group (62.88 ± 7.98) and 3D + CBL group (66.35 ± 8.85) were significantly different (t = 2.254, P = 0.026); the practical skills scores of the CBL group (57.40 ± 8.80) and 3D + CBL group (63.42 ± 11.14) were significantly different (t = 3.283, P = 0.001). The questionnaire results showed that the 3D + CBL group was greater than the CBL group in terms of hip fundamentals, ability to diagnose cases and plan treatments, interesting teaching content, willingness to communicate with the instructor and satisfaction.

CONCLUSIONS

The integration of 3D printing with case-based learning has yielded positive outcomes in teaching DDH, providing valuable insights into the use of 3D-printed orthopedic models in clinical education.

Development, implementation, and perceptions of a 3D-printed human skull in a large dental gross anatomy course

Skull anatomy is a difficult region for anatomy students to learn and understand but is necessary for a variety of health professional students. To improve learning, a 3D-printed human skull was developed, produced, and distributed to a course of 83 dental students for use as a take-home study tool over the 10-week anatomy course. The 70% scale human skull derived from CT data had a fully articulating mandible, simulated temporomandibular joint, and accurate cranial structures. At the course end, students completed a perception survey and responses were compared with those who made a grade of A, B, or C in the course. Students overall reported using the model less than 3 h per week, but those who scored an A in the course reported using the model more frequently than those who scored a B or C. Free responses revealed that students used the model in a variety of ways, but found that the model was quick and easily accessible to check understanding while studying at home in the absence of direct observation by faculty. Overall, this study provides evidence on the feasibility of large-scale 3D printing and the benefits of the use of a 3D-printed model as a take-home study aid.

A review of the ethical considerations for the use of 3D printed materials in medical and allied health education and a proposed collective path forward

3D scanning and printing technologies are quickly evolving and offer great potential for use in gross anatomical education. The use of human body donors to create digital scans and 3D printed models raises ethical concerns about donor informed consent, potential commodification, and access to and storage of potentially identifiable anatomical reproductions. This paper reviews available literature describing ethical implications for the application of these emerging technologies, existing published best practices for managing and sharing 2D imaging, and current adherence to these best practices by academic body donation programs. We conclude that informed consent is paramount for all uses of human donor and human donor-derived materials and that currently there is considerable diversity in adherence to established best practices for the management and sharing of 3D digital content derived from human donors. We propose a new and simplified framework for categorizing donor-derived teaching materials and the corresponding level of consent required for digital sharing. This framework proposes an equivalent minimum level of specific consent for human donor and human donor-derived materials relative to generalized, nonidentical teaching materials (i.e., artificial plastic models). Likewise, we propose that the collective path forward should involve the creation of a centralized, secure repository for digital human donor 3D content as a mechanism for accumulating, regulating, and controlling the distribution of properly consented human donor-derived 3D digital content that will also increase the availability of ethically created human-derived teaching materials while discouraging commodification.

Use of 3D foot and ankle puzzle enhances student understanding of the skeletal anatomy in the early years of medical school

PURPOSE

3D visualization is an important part of learning anatomy with cadavers generally used to effectuate this. However, high cost, ethical considerations, and limited accessibility can often limit the suitability of cadavers as teaching tools. Anatomical 3D printed models offer an alternative tool for teaching gross anatomy due to their low cost and accessibility. This study aims to investigate if combing gamification with 3D printed models can enhance the learning experience and be effective for teaching anatomy.

METHODS

3D printed models of the bones of the foot and ankle were generated, and 267 first-year medical students from 2 consecutive cohorts worked in groups to put it together as a puzzle. Participants completed a questionnaire regarding perceptions of 3D models and their knowledge of foot anatomy, before and after the session and were asked to provide comments.

RESULTS

Analysis of the responses showed a significant increase in the confidence of the learners in their anatomy knowledge and an increased appreciation of the role that 3D models have in enhancing the learning experience. After the session, there were many comments saying how enjoyable and engaging 3D models were.

CONCLUSION

Through the puzzle element of the session, the students were challenged mentally to work out the anatomical features of the foot and ankle. The combined elements of the puzzle and the features of the 3D model assembly made the activity fun and conducive to active learning. The possibility of having fun was not something the students had considered before the session.

Metamaterial design for aortic aneurysm simulation using 3D printing

INTRODUCTION

The use of three-dimensional (3D) printed anatomic models is steadily increasing in research and as a tool for clinical decision-making. The mechanical properties of polymers and metamaterials were investigated to evaluate their application in mimicking the biomechanics of the aortic vessel wall.

METHODOLOGY

Uniaxial tensile tests were performed to determine the elastic modulus, mechanical stress, and strain of 3D printed samples. We used a combination of materials, designed to mimic biological tissues' properties, the rigid VeroTM family, and the flexible Agilus30™. Metamaterials were designed by tessellating unit cells that were used as lattice-reinforcement to tune their mechanical properties. The lattice-reinforcements were based on two groups of patterns, mainly responding to the movement between links/threads (chain and knitted) or to deformation (origami and diamond crystal). The mechanical properties of the printed materials were compared with the characteristics of healthy and aneurysmal aortas.

RESULTS

Uniaxial tensile tests showed that the use of a lattice-reinforcement increased rigidity and may increase the maximum stress generated. The pattern and material of the lattice-reinforcement may increase or reduce the strain at maximum stress, which is also affected by the base material used. Printed samples showed max stress ranging from 0.39 ± 0.01 MPa to 0.88 ± 0.02 MPa, and strain at max stress ranging from 70.44 ± 0.86% to 158.21 ± 8.99%. An example of an application was created by inserting a metamaterial designed as a lattice-reinforcement on a model of the aorta to simulate an abdominal aortic aneurysm.

CONCLUSION

The maximum stresses obtained with the printed models were similar to those of aortic tissue reported in the literature, despite the fact that the models did not perfectly reproduce the biological tissue behavior.

Three-dimensional models of physeal fractures in the femur for the teaching of veterinary medicine

PURPOSE

To develop and assess three-dimensional models of physeal fractures in dog femurs (3D MPFDF) using radiographic imaging.

METHODS

The study was conducted in three phases: development of 3D MPFDF; radiographic examination of the 3D MPFDF; and comparative analysis of the anatomical and radiographic features of the 3D MPFDF.

RESULTS

The base model and the 3D MPFDF achieved high fidelity in replicating the bone structures, accurately maintaining the morphological characteristics and dimensions such as length, width, and thickness, closely resembling natural bone. The radiographs of the 3D MPFDF displayed distinct radiopaque and radiolucent areas, enabling clear visualization of the various anatomical structures of the femur. However, in these radiographs, it was challenging to distinguish between the cortical and medullary regions due to the use of 99% internal padding in the printing process. Despite this limitation, the radiographs successfully demonstrated the representation of the Salter-Harris classification.

CONCLUSIONS

This paper presents a pioneering project focused on technological advancement aimed at developing a method for the rapid and cost-effective production of three-printed models and radiographs of physeal fractures in dogs.

Using design thinking to create and implement a 3D digital library of anatomical specimens

Design thinking (DT) is a five-stage process (empathize, define, ideate, prototype, and test) that guides the creation of user-centered solutions to complex problems. DT is in common use outside of science but has rarely been applied to anatomical education. The use of DT in this study identified the need for flexible access to anatomical specimens outside of the anatomy laboratory and guided the creation of a digital library of three-dimensional (3D) anatomical specimens (3D Anatomy Viewer). To test whether the resource was fit for purpose, a mixed-methods student evaluation was undertaken. Student surveys (n = 46) were employed using the system usability scale (SUS) and an unvalidated acceptability questionnaire. These verified that 3D Anatomy Viewer was usable (SUS of 72%) and acceptable (agreement range of 77%-93% on all Likert-type survey statements, Cronbach's alpha = 0.929). Supplementary interviews (n = 5) were analyzed through content analysis and revealed three main themes: (1) a credible online supplementary learning resource; (2) learning anatomy with 3D realism and interactivity; (3) user recommendations for expanding the number of anatomical models, test questions, and gamification elements. These data demonstrate that a DT framework can be successfully applied to anatomical education for creation of a practical learning resource. Anatomy educators should consider employing a DT framework where student-centered solutions to learner needs are required.

Three-dimensional modeling in anatomy-Tool or terror?

Three-dimensional (3D) modeling is a recent, innovative approach to teaching anatomy. There is little literature, however, to suggest how 3D modeling is best used to teach students and whether or not students can gain the same level of understanding as they might use more traditional, hands-on, teaching methods. This study evaluated the use of a 3D modeling software in both a flipped classroom curriculum and as an active learning tool in comparison to traditional, physical model-based teaching. Pre- and post-course content-based assessments were used to evaluate students' learning. Our findings indicated no significant difference between standard and flipped classroom learning; however, the students who used 3D modeling software as an active learning tool significantly underperformed students in the standard group (F(2,1060) = 112.43, p < 0.0001). These findings suggest that these technologies may not yet be useful as a primary means of instruction. Possible explanations may include cognitive overload in navigating the system, intrinsic limitations of the software, or other factors. Further development and research of these technologies is necessary prior to their adoption into teaching practices in anatomy.

From 2D slices to a 3D model: Training students in digital microanatomy analysis techniques through a 3D printed neuron project

The reconstruction of two-dimensional (2D) slices to three-dimensional (3D) digital anatomical models requires technical skills and software that are becoming increasingly important to the modern anatomist, but these skills are rarely taught in undergraduate science classrooms. Furthermore, learning opportunities that allow students to simultaneously explore anatomy in both 2D and 3D space are increasingly valuable. This report describes a novel learning activity that trains students to digitally trace a serially imaged neuron from a confocal stack and to model that neuron in 3D space for 3D printing. By engaging students in the production of a 3D digital model, this learning activity is designed to provide students a novel way to enhance their understanding of the content, including didactic knowledge of neuron morphology, technical research skills in image analysis, and career exploration of neuroanatomy research. Moreover, students engage with microanatomy in a way that starts in 2D but results in a 3D object they can see, touch, and keep. This discursive article presents the learning activity, including videos, instructional guides, and learning objectives designed to engage students on all six levels of Bloom's Taxonomy. Furthermore, this work is a proof of principle modeling workflow that is approachable, inexpensive, achievable, and adaptable to cell types in other organ systems. This work is designed to motivate the expansion of 3D printing technology into microanatomy and neuroanatomy education.

#Anatomynotes: A temporal content analysis of anatomy education posts on Instagram

Social media platforms such as Instagram are becoming increasingly popular sources for students to access anatomy educational resources. This review used content analysis to examine posts under the hashtag #anatomynotes and is the first to map the characteristics of anatomy education posts on Instagram and determine any temporal changes. Sample posts were gathered from April 2019 and April 2021 and categorized according to the technical format, purpose and author credentials. Engagement was recorded in the form of likes and comments. Overall, posts depicting illustrations remained the most popular format within both time periods. Three-dimensional models saw an increase in popularity with a 62.5% rise. Students remained the most common author type throughout and increased further in 2021 by 25%. Clinician authors and posts focusing on clinical education also increased in 2021 by 17.9% and 227%, respectively. Humor-based posts saw the greatest increase among the post purposes, with 1000% more recorded in 2021. Engagement overall saw a decline with notably significant reductions in average likes per post among all text-based posts (-72%, p < 0.0001), all illustrative posts (-51%, p = 0.0013), and a decline in the presence of comments among all text-based posts (-65.1%, p = 0.0158). These findings highlight that Instagram is a popular platform for facilitating near-peer teaching while increasingly providing a space where students and clinicians can interact. Additionally, it highlights the benefits of the platform for visually focused learners. However, future research should seek to determine whether Instagram can facilitate deeper learning and have an impact on academic and clinical performance.

Show them what they can't see! An evaluation of the use of customized 3D printed models in head and neck anatomy

Difficulty in visualizing anatomical structures has been identified as a challenge in anatomy learning and the emergence of three-dimensional printed models (3DPMs) offers a potential solution. This study evaluated the effectiveness of 3DPMs for learning the arterial supply of the head and neck region. One hundred eighty-four undergraduate medical students were randomly assigned to one of four learning modalities including wet specimen, digital model, 3DPM, and textbook image. Posttest scores indicated that all four modalities supported participants' knowledge acquisition, most significantly in the wet specimen group. While the participants rated 3DPMs lower for helping correct identification of structures than wet specimens, they praised 3DPMs for their ability to demonstrate topographical relationships between the arterial supply and adjacent structures. The data further suggested that the biggest limitation of the 3DPMs was their simplicity, thus making it more difficult for users to recognize the equivalent structures on the wet specimens. It was concluded that future designs of 3DPMs will need to consider the balance between the ease of visualization of anatomical structures and the degree of complexity required for successful transfer of learning. Overall, this study presented some conflicting evidence of the favorable outcomes of 3DPMs reported in other similar studies. While effective for anatomy learning as a standalone modality, educators must identify the position 3DPM models hold relative to other modalities in the continuum of undergraduate anatomy education in order to maximize their advantages for students.

Artificial intelligence and clinical anatomical education: Promises and perils

Anatomy educators are often at the forefront of adopting innovative and advanced technologies for teaching, such as artificial intelligence (AI). While AI offers potential new opportunities for anatomical education, hard lessons learned from the deployment of AI tools in other domains (e.g., criminal justice, healthcare, and finance) suggest that these opportunities are likely to be tempered by disadvantages for at least some learners and within certain educational contexts. From the perspectives of an anatomy educator, public health researcher, medical ethicist, and an educational technology expert, this article examines five tensions between the promises and the perils of integrating AI into anatomy education. These tensions highlight the ways in which AI is currently ill-suited for incorporating the uncertainties intrinsic to anatomy education in the areas of (1) human variations, (2) healthcare practice, (3) diversity and social justice, (4) student support, and (5) student learning. Practical recommendations for a considered approach to working alongside AI in the contemporary (and future) anatomy education learning environment are provided, including enhanced transparency about how AI is integrated, AI developer diversity, inclusion of uncertainty and anatomical variations within deployed AI, provisions made for educator awareness of AI benefits and limitations, building in curricular "AI-free" time, and engaging AI to extend human capacities. These recommendations serve as a guiding framework for how the clinical anatomy discipline, and anatomy educators, can work alongside AI, and develop a more nuanced and considered approach to the role of AI in healthcare education.

Perceptions of Students and Teachers Regarding the Impact of Cadaver-Less Online Anatomy Education on Quality of Learning, Skills Development, Professional Identity Formation, and Economics in Medical Students

Anatomy is one of the most important basic sciences in medical education and is the foundation for doctors to develop clinical skills. In the last few years, anatomy teaching has been transformed from hands-on practice into online modalities. In this study, we aimed to determine the perceptions of students and teachers about learning anatomy without using cadavers (cadaver-less) from a knowledge, technological, and humanistic perspective. The research was carried out in the Faculty of Medicine at Hasanuddin University, located in South Sulawesi, Indonesia, over a period from June to August 2021. A focus group discussion was extended to all medical students in their first year of study following their completion of online anatomy lessons. Furthermore, educators responsible for instructing anatomy in the initial year were sent an invitation to participate in a one-on-one interview with the principal investigator. In general, the results of the study complied with what has been known from the literature about the quality of online learning and its advantages and disadvantages. However, our discussions with students and interviews with teachers revealed that anatomy education without the use of cadavers is perceived as undesirable as it negatively impacts the identity formation of the future physician. It also takes away the opportunity for students to develop empathy for humanity.

Cardiovascular Computed Tomography in the Diagnosis of Cardiovascular Disease: Beyond Lumen Assessment

Cardiovascular CT is being widely used in the diagnosis of cardiovascular disease due to the rapid technological advancements in CT scanning techniques. These advancements include the development of multi-slice CT, from early generation to the latest models, which has the capability of acquiring images with high spatial and temporal resolution. The recent emergence of photon-counting CT has further enhanced CT performance in clinical applications, providing improved spatial and contrast resolution. CT-derived fractional flow reserve is superior to standard CT-based anatomical assessment for the detection of lesion-specific myocardial ischemia. CT-derived 3D-printed patient-specific models are also superior to standard CT, offering advantages in terms of educational value, surgical planning, and the simulation of cardiovascular disease treatment, as well as enhancing doctor-patient communication. Three-dimensional visualization tools including virtual reality, augmented reality, and mixed reality are further advancing the clinical value of cardiovascular CT in cardiovascular disease. With the widespread use of artificial intelligence, machine learning, and deep learning in cardiovascular disease, the diagnostic performance of cardiovascular CT has significantly improved, with promising results being presented in terms of both disease diagnosis and prediction. This review article provides an overview of the applications of cardiovascular CT, covering its performance from the perspective of its diagnostic value based on traditional lumen assessment to the identification of vulnerable lesions for the prediction of disease outcomes with the use of these advanced technologies. The limitations and future prospects of these technologies are also discussed.

Chinese anatomy educators' perceptions of blended learning in anatomy education: A national survey in the post-COVID-19 era

Blended learning, which combines face-to-face lectures with online learning, has emerged as a suitable teaching approach during the COVID-19 pandemic. This study used a national survey of anatomy educators in Mainland China to evaluate the changes in the implementation of blended learning in anatomical pedagogy. A total of 297 responses were collected from medical schools across all provinces. Respondents included 167 males and 130 females, with an average age of 44.94 (±8.28) and average of 17.72 (±9.62) years of professional experience. The survey showed adoption of online teaching and assessment by Chinese anatomy educators increased by 32.7% and 46.8%, respectively, compared to pre-pandemic levels. Perceptions of blended learning outcomes varied, with 32.3% and 37% educators considering it superior and inferior to traditional teaching, respectively. Faculty training programs related to blended learning increased significantly, fostering a collaborative learning environment; however, challenges remained in achieving satisfactory online assessment outcomes. Anatomy educators' attitudes reflected a strong preference for classroom learning (4.941 ± 0.856) and recognition of the importance of relevant technology (4.483 ± 0.954), whereas online learning received lower acceptance (4.078 ± 0.734). Female anatomy teachers demonstrated effective time management in online teaching. Meanwhile, educators with over 15 years of experience encountered difficulties with relevant technology, consistent with negative attitudes toward blended learning. Overall, this survey highlights the persistent challenges in implementing blended learning in anatomy education and provides insights for enhancing the pedagogical model in the post-COVID-19 era.

The Educational Impact of Radiology in Anatomy Teaching: A Field Study Using Cross-Sectional Imaging and 3D Printing for the Study of the Spine

INTRODUCTION

Cross-sectional imaging and 3D printing represent state-of-the-art approaches to improve anatomy teaching compared to traditional learning, but their use in medical schools remains limited. This study explores the utility of these educational tools for teaching normal and pathological spinal anatomy, aiming to improve undergraduate medical education.

MATERIALS AND METHODS

A field study was conducted on a cohort of undergraduate medical students who were exposed to anatomy lessons of the spine considering three learning paradigms: traditional learning, cross-sectional imaging examinations, and 3D printed models. 20 students (intervention group) received the three approaches, and other 20 students (control group) received the conventional (traditional) approach. The students were examined through a multiple-choice test and their results were compared to those of a control group exposed to traditional learning matched by age, sex and anatomy grades. In addition, students in the experimental group were assessed for their satisfaction with each learning method by means of an ad hoc questionnaire.

RESULTS

Students exposed to cross-sectional imaging and 3D printing demonstrated better knowledge outcomes compared to the control group. They showed high satisfaction rates and reported that these technologies enhanced spatial understanding and facilitated visualization of specific pathologies. However, limitations such as the representativeness of non-bone conditions in 3D printed models and the need for further knowledge on imaging fundamentals were highlighted.

CONCLUSION

Cross-sectional imaging and 3D printing offer valuable tools for enhancing the teaching of spinal anatomy in undergraduate medical education. Radiologists are well positioned to lead the integration of these technologies, and further research should explore their potential in teaching anatomy across different anatomical regions.

Empowering human anatomy education through gamification and artificial intelligence: An innovative approach to knowledge appropriation

Gamification has appeared as an alternative educational methodology to traditional tools. Specifically, in anatomy teaching, multiple technological applications have emerged in response to the difficulties of accessing cadaveric material; however, there is insufficient information about the effects of these applications on the performance achieved by students, or about to the best way to adapt learning to meet their educational needs. In this study, we investigated how teaching human anatomy through a mobile gamified technological tool containing recommendation systems can be combined with a virtual assistant to improve the learning and academic performance of medical students in the Anatomy Department at the Universidad de La Frontera in Temuco, Chile and the Anatomy Department at the Pontificia Universidad Católica de Chile. In total, 131 students participated in the experiment, which was divided into two case studies. The main findings led to the conclusion that gamified components support students in learning anatomy. In addition, the predictions and recommendations provided by the virtual assistant enabled the academic aspects that the students needed to improve to be extracted adequately. Future work is expected to support adaptive learning by incorporating new artificial intelligence in education elements that can generate personalized scenarios for studying anatomy based on the application.

Assessing the impact of 3D image segmentation workshops on anatomical education and image interpretation: A prospective pilot study

Three-dimensional (3D) segmentation, a process involving digitally marking anatomical structures on cross-sectional images such as computed tomography (CT), and 3D printing (3DP) are being increasingly utilized in medical education. Exposure to this technology within medical schools and hospitals remains limited in the United Kingdom. M3dicube UK, a national medical student, and junior doctor-led 3DP interest group piloted a 3D image segmentation workshop to gauge the impact of incorporating 3D segmentation technology on anatomical education. The workshop, piloted with medical students and doctors within the United Kingdom between September 2020 and 2021, introduced participants to 3D segmentation and offered practical experience segmenting anatomical models. Thirty-three participants were recruited, with 33 pre-workshop and 24 post-workshop surveys completed. Two-tailed t-tests were used to compare mean scores. From pre- to post-workshop, increases were noted in participants' confidence in interpreting CT scans (2.36 to 3.13, p = 0.010) and interacting with 3D printing technology (2.15 to 3.33, p = 0.00053), perceived utility of creating 3D models to aid image interpretation (4.18 to 4.45, p = 0.0027), improved anatomical understanding (4.2 to 4.7, p = 0.0018), and utility in medical education (4.45 to 4.79, p = 0.077). This pilot study provides early evidence of the utility of exposing medical students and healthcare professionals in the United Kingdom to 3D segmentation as part of their anatomical education, with additional benefit in imaging interpretation ability.

3D printing as a pedagogical tool for teaching normal human anatomy: a systematic review

BACKGROUND

Three-dimensional-printed anatomical models (3DPAMs) appear to be a relevant tool due to their educational value and their feasibility. The objectives of this review were to describe and analyse the methods utilised for creating 3DPAMs used in teaching human anatomy and for evaluating its pedagogical contribution.

METHODS

An electronic search was conducted on PubMed using the following terms: education, school, learning, teaching, learn, teach, educational, three-dimensional, 3D, 3-dimensional, printing, printed, print, anatomy, anatomical, anatomically, and anatomic. Data retrieved included study characteristics, model design, morphological evaluation, educational performance, advantages, and disadvantages.

RESULTS

Of the 68 articles selected, the cephalic region was the most studied (33 articles); 51 articles mentioned bone printing. In 47 articles, the 3DPAM was designed from CT scans. Five printing processes were listed. Plastic and its derivatives were used in 48 studies. The cost per design ranged from 1.25 USD to 2800 USD. Thirty-seven studies compared 3DPAM to a reference model. Thirty-three articles investigated educational performance. The main advantages were visual and haptic qualities, effectiveness for teaching, reproducibility, customizability and manipulability, time savings, integration of functional anatomy, better mental rotation ability, knowledge retention, and educator/student satisfaction. The main disadvantages were related to the design: consistency, lack of detail or transparency, overly bright colours, long printing time, and high cost.

CONCLUSION

This systematic review demonstrates that 3DPAMs are feasible at a low cost and effective for teaching anatomy. More realistic models require access to more expensive 3D printing technologies and substantially longer design time, which would greatly increase the overall cost. Choosing an appropriate image acquisition modality is key. From a pedagogical viewpoint, 3DPAMs are effective tools for teaching anatomy, positively impacting the learning outcomes and satisfaction level. The pedagogical effectiveness of 3DPAMs seems to be best when they reproduce complex anatomical areas, and they are used by students early in their medical studies.

A new dimension in medical education: Virtual reality in anatomy during COVID-19 pandemic

Virtual reality technology has been increasingly used in the field of anatomy education, particularly in response to the COVID-19 pandemic. Virtual reality in anatomy (VRA) allows the creation of immersive, three-dimensional environments or experiences that can interact in a seemingly real or physical way. A comprehensive search of electronic databases was conducted to identify relevant studies. The search included studies published between 2020 and June 2023. The use of VRA education has been shown to be effective in improving students' understanding and retention of knowledge, as well as developing practical skills such as surgical techniques. VRA can allow students to visualize and interact with complex structures and systems in a way that is not possible with traditional methods. It can also provide a safe and ethical alternative to cadavers, which may be in short supply or have access restrictions. Additionally, VRA can be used to create customized learning experiences, allowing students to focus on specific areas of anatomy or to repeat certain exercises as needed. However, there are also limitations to the use of VRA education, including cost and the need for specialized equipment and training, as well as concerns about the realism and accuracy of VRA models. To fully utilize the potential of VRA education, it is important for educators to carefully consider the appropriate use of VR and to continuously evaluate its effectiveness. It is important for educators to carefully consider the appropriate use of VRA and to continuously evaluate its effectiveness to fully utilize its potential.

An Opportunity to See the Heart Defect Physically: Medical Student Experiences of Technology-Enhanced Learning with 3D Printed Models of Congenital Heart Disease

Three-dimensional (3D) printing is increasingly used in medical education and paediatric cardiology. A technology-enhanced learning (TEL) module was designed to accompany 3D printed models of congenital heart disease (CHD) to aid in the teaching of medical students. There are few studies evaluating the attitudes and perceptions of medical students regarding their experience of learning about CHD using 3D printing. This study aimed to explore senior medical students' experiences in learning about paediatric cardiology through a workshop involving 3D printed models of CHD supported by TEL in the form of online case-based learning. A mixed-methods evaluation was undertaken involving a post-workshop questionnaire (n = 94 students), and focus groups (n = 16 students). Focus group and free-text questionnaire responses underwent thematic analysis. Questionnaire responses demonstrated widespread user satisfaction; 91 (97%) students agreed that the workshop was a valuable experience. The highest-level satisfaction was for the physical 3D printed models, the clinical case-based learning, and opportunity for peer collaboration. Thematic analysis identified five key themes: a variable experience of prior learning, interplay between physical and online models, flexible and novel workshop structure, workshop supported the learning outcomes, and future opportunities for learning using 3D printing. A key novel finding was that students indicated the module increased their confidence to teach others about CHD and recommended expansion to other parts of the curriculum. 3D printed models of CHD are a valuable learning resource and contribute to the richness and enjoyment of medical student learning, with widespread satisfaction.

Supplementary Information

The online version contains supplementary material available at 10.1007/s40670-023-01840-w.

Self-Standing 3D-Printed PEGDA-PANIs Electroconductive Hydrogel Composites for pH Monitoring

Additive manufacturing (AM), or 3D printing processes, is introducing new possibilities in electronic, biomedical, sensor-designing, and wearable technologies. In this context, the present work focuses on the development of flexible 3D-printed polyethylene glycol diacrylate (PEGDA)- sulfonated polyaniline (PANIs) electrically conductive hydrogels (ECHs) for pH-monitoring applications. PEGDA platforms are 3D printed by a stereolithography (SLA) approach. Here, we report the successful realization of PEGDA-PANIs electroconductive hydrogel (ECH) composites produced by an in situ chemical oxidative co-polymerization of aniline (ANI) and aniline 2-sulfonic acid (ANIs) monomers at a 1:1 equimolar ratio in acidic medium. The morphological and functional properties of PEGDA-PANIs are compared to those of PEGDA-PANI composites by coupling SEM, swelling degree, I-V, and electro-chemo-mechanical analyses. The differences are discussed as a function of morphological, structural, and charge transfer/transport properties of the respective PANIs and PANI filler. Our investigation showed that the electrochemical activity of PANIs allows for the exploitation of the PEGDA-PANIs composite as an electrode material for pH monitoring in a linear range compatible with that of most biofluids. This feature, combined with the superior electromechanical behavior, swelling capacity, and water retention properties, makes PEGDA-PANIs hydrogel a promising active material for developing advanced biomedical, soft tissue, and biocompatible electronic applications.

Pelvic + Anatomy: A new interactive pelvic anatomy model. Prospective randomized control trial with first-year midwife residents

Detailed knowledge of female pelvic floor anatomy is essential for midwifery and other professionals in obstetrics. Physical models have shown great potential for teaching anatomy and enhancing surgical skills. In this article, we introduce an innovative physical anatomy model called "Pelvic+" to teach anatomical relationships in the female pelvis. The Pelvic+ model's value was compared to a traditional lecture in 61 first-year midwifery students randomly allocated to either the Pelvic+ (n = 30) or a control group (n = 32). The primary outcome measure was a quiz comprised of 15 multiple choice questions on pelvic anatomy. Participants were assessed at baseline (Pre-Test), upon completion of the intervention (Post-Test1) and 4 months afterward (Post-Test2). Satisfaction with the approach was assessed at Post-Test1. Increase in knowledge was greater and the approach more accepted among resident midwives when Pelvic+ was used instead of standard lectures. Four months after the intervention, the improvement in knowledge was preserved in the Pelvic+ group. This randomized study demonstrates that the Pelvic+ simulator is more effective than classical learning for pelvic anatomy education, and offers a higher level of satisfaction among students during the educational process. Medical students training in obstetrics and gynecology, or any professional who specializes in the female pelvic floor might also benefit from incorporation of the Pelvic+ model into their training program.

Effects of the individual three-dimensional printed craniofacial bones with a quick response code on the skull spatial knowledge of undergraduate medical students

Understanding the three-dimensional (3D) structure of the human skull is imperative for medical courses. However, medical students are overwhelmed by the spatial complexity of the skull. Separated polyvinyl chloride (PVC) bone models have advantages as learning tools, but they are fragile and expensive. This study aimed to reconstruct 3D-printed skull bone models (3D-PSBs) using polylactic acid (PLA) with anatomical characteristics for spatial recognition of the skull. Student responses to 3D-PSB application were investigated through a questionnaire and tests to understand the requirement of these models as a learning tool. The students were randomly divided into 3D-PSB (n = 63) and skull (n = 67) groups to analyze pre- and post-test scores. Their knowledge was improved, with the gain scores of the 3D-PSB group (50.0 ± 3.0) higher than that of the skull group (37.3 ± 5.2). Most students agreed that using 3D-PSBs with quick response codes could improve immediate feedback on teaching (88%; 4.41 ± 0.75), while 85.9% of the students agreed that individual 3D-PSBs clarified the structures hidden within the skull (4.41 ± 0.75). The ball drop test revealed that the mechanical strength of the cement/PLA model was significantly greater than that of the cement or PLA model. The prices of the PVC, cement, and cement/PLA models were 234, 1.9, and 10 times higher than that of the 3D-PSB model, respectively. These findings imply that low-cost 3D-PSB models could revolutionize skull anatomical education by incorporating digital technologies like the QR system into the anatomical teaching repertoire.

Novel Three-Dimensionally Printed Ultrasound Probe Simulator and Heart Model for Transthoracic Echocardiography Education

Simulation-based training is an essential component in the education of transthoracic echocardiography (TTE). Nevertheless, current TTE teaching methods may be subject to certain limitations. Hence, the authors in this study aimed to invent a novel TTE training system employing three-dimensional (3D) printing technology to teach the basic principles and psychomotor skills of TTE imaging more intuitively and understandably. This training system comprises a 3D-printed ultrasound probe simulator and a sliceable heart model. The probe simulator incorporates a linear laser generator to enable the visualization of the projection of the ultrasound scan plane in a 3D space. By using the probe simulator in conjunction with the sliceable heart model or other commercially available anatomic models, trainees can attain a more comprehensive understanding of probe motion and related scan planes in TTE. Notably, the 3D-printed models are portable and low-cost, suggesting their potential utility in various clinical scenarios, particularly for just-in-time training.

Evaluation of a 3D Computer Model of the Equine Paranasal Sinuses as a Tool for Veterinary Anatomy Education

Detailed knowledge of anatomical systems is vital for clinical veterinary practice. However, students often find it difficult to transfer skills learned from textbooks to real-life practice. In this study, a three-dimensional computer model representing equine paranasal sinus anatomy (3D-ESM) was created and evaluated for its contribution to student understanding of the 3D dynamic nature of the system. Veterinary students and equine professionals at the University of Bristol were randomly allocated into experimental (3D model) and control (2D lecture) groups. A pre-/post-study design was used to evaluate the efficacy of the 3D model through a pre-/post-multiple-choice question (MCQ) anatomical knowledge exam and a pre-/post-questionnaire gathering information on participant demographics, confidence, and satisfaction. No statistically significant difference was found between 3D and 2D groups' post-MCQ exam scores (t39 = 1.289, p = .205). 3D group participant feedback was more positive than 2D group feedback, and 3D group satisfaction scores on Likert questions were significantly higher (t118 = -5.196, p < .001). Additionally, confidence scores were significantly higher in the 3D group than in the 2D group immediately following the study (p < .05). Participants' open-text responses indicated they found the 3D model helpful in learning the complex anatomy of the equine paranasal sinuses. Findings suggest the 3D-ESM is an effective educational tool that aids in confidence, enjoyment, and knowledge acquisition. Though it was not better than traditional methods in terms of anatomy knowledge exam scores, the model is a valuable inclusion into the veterinary anatomy curriculum.

A comparative analysis of lecturers' satisfaction with Anatomage and Pirogov virtual dissection tables during clinical and topographic anatomy courses in Russian universities

Anatomy is increasingly taught using computer-assisted learning tools, including electronic interactive anatomy dissection tables. Anatomage was he first virtual anatomy dissection table introduced in Russian medical universities and gained popularity among lecturers and students. The Pirogov interactive anatomy table was recently released, but the strengths and weakness of each platform is currently unknown. The objective of this article is to survey lecturers in anatomy to understand their perspectives on the Pirogov versus Anatomage virtual dissection tables' application to teaching in medical universities. A total of 80 anatomy educators from 12 Russian universities, using Anatomage (n = 40) and Pirogov (n = 40) tables were surveyed regarding their satisfaction with the application of the respective tables. Using a five-point Likert scale, both tables were assessed, and responses were statistically analyzed. In addition, qualitative analysis was performed on free response comments provided by survey respondents. There was no significant difference in overall satisfaction ratings between Pirogov (4.38 ± 0.53) and Anatomage (3.94 ± 0.60) interactive tables (p > 0.05). The Anatomage table ranked significantly higher on the accuracy of displayed anatomical details, resolution of the images, and its suitability for teaching senior medical and postgraduate students. Pirogov table performed significantly better on survey items measuring ergonomics, ability to assess students' performance, and teaching basic anatomy to junior first- and second-year medical students. Thus, in summary, anatomists' responses indicated that while both tables are suitable for teaching anatomy, the Pirogov table was superior in undergraduate medical education and the Anatomage table was more beneficial for teaching more senior trainees.

Novel Three-Dimensional Printed Human Heart Models and Ultrasound Omniplane Simulator for Transesophageal Echocardiography Training

Simulation-based training plays an essential role in transesophageal echocardiography (TEE) education. Using 3-dimensional printing technology, the authors invented a novel TEE teaching system consisting of a series of heart models that can be segmented according to actual TEE views, and an ultrasound omniplane simulator to demonstrate how ultrasound beams intersect the heart at different angles and generate images. This novel teaching system is able to provide a more direct way to visualize the mechanics of obtaining TEE images than traditional online or mannequin-based simulators. It can also provide tangible feedback of both an ultrasound scan plane and a TEE view of the heart, which has been proven to improve trainees' spatial awareness and can significantly help in understanding and memorizing complex anatomic structures. This teaching system itself is also portable and inexpensive, making it conducive to teaching TEE in regions of diverse economic status. This teaching system also can be expected to be used for just-in-time training in a variety of clinical scenarios, including operating rooms, intensive care units, etc.

Meta-analyzing the efficacy of 3D printed models in anatomy education

Three-dimensional printing models (3DPs) have been widely used in medical anatomy training. However, the 3DPs evaluation results differ depending on such factors as the training objects, experimental design, organ parts, and test content. Thus, this systematic evaluation was carried out to better understand the role of 3DPs in different populations and different experimental designs. Controlled (CON) studies of 3DPs were retrieved from PubMed and Web of Science databases, where the participants were medical students or residents. The teaching content is the anatomical knowledge of human organs. One evaluation indicator is the mastery of anatomical knowledge after training, and the other is the satisfaction of participants with 3DPs. On the whole, the performance of the 3DPs group was higher than that of the CON group; however, there was no statistical difference in the resident subgroup, and there was no statistical difference for 3DPs vs. 3D visual imaging (3DI). In terms of satisfaction rate, the summary data showed that the difference between the 3DPs group (83.6%) vs. the CON group (69.6%) (binary variable) was not statistically significant, with p > 0.05. 3DPs has a positive effect on anatomy teaching, although there are no statistical differences in the performance tests of individual subgroups; participants generally had good evaluations and satisfaction with 3DPs. 3DPs still faces challenges in production cost, raw material source, authenticity, durability, etc. The future of 3D-printing-model-assisted anatomy teaching is worthy of expectation.

The Third Dimension: 3D Printed Replicas and Other Alternatives to Cadaver-Based Learning

Capturing the 'third dimension' of complex human form or anatomy has been an objective of artists and anatomists from the renaissance in the fifteenth and sixteenth centuries onwards. Many of these drawings, paintings, and sculptures have had a profound influence on medical teaching and the learning resources we took for granted until around 40 years ago. Since then, the teaching of human anatomy has undergone significant change, especially in respect of the technologies available to augment or replace traditional cadaver-based dissection instruction. Whilst resources such as atlases, wall charts, plastic models, and images from the Internet have been around for many decades, institutions looking to reduce the reliance on dissection-based teaching in medical or health professional training programmes have in more recent times increasingly had access to a range of other options for classroom-based instruction. These include digital resources and software programmes and plastinated specimens, although the latter come with a range of ethical and cost considerations. However, the urge to recapitulate the 'third dimension' of anatomy has seen the recent advent of novel resources in the form of 3D printed replicas. These 3D printed replicas of normal human anatomy dissections are based on a combination of radiographic imaging and surface scanning that captures critical 3D anatomical information. The final 3D files can either be augmented with false colour or made to closely resemble traditional prosections prior to printing. This chapter details the journey we and others have taken in the search for the 'third dimension'. The future of a haptically identical, anatomically accurate replica of human cadaver specimens for surgical and medical training is nearly upon us. Indeed, the need for hard copy replicas may eventually be superseded by the opportunities afforded by virtual reality (VR) and augmented reality (AR).

Technology-Enhanced Preclinical Medical Education (Anatomy, Histology and Occasionally, Biochemistry): A Practical Guide

The recent explosion of technological innovations in mobile technology, virtual reality (VR), digital dissection, online learning platform, 3D printing, and augmented reality (AR) has provided new avenues for improving preclinical education, particularly in anatomy and histology education. Anatomy and histology are fundamental components of medical education that teach students the essential knowledge of human body structure and organization. However, these subjects are widely considered to be some of the most difficult disciplines for healthcare students. Students often face challenges in areas such as the complexity and overwhelming volume of knowledge, difficulties in visualizing body structures, navigating and identifying tissue specimens, limited exposure to learning materials, and lack of clinical relevance. The COVID-19 pandemic has further exacerbated the situation by reducing face-to-face teaching opportunities and affecting the availability of body donations for medical education.To overcome these challenges, educators have integrated various educational technologies, such as virtual reality, digital 3D anatomy apps, 3D printing, and AI chatbots, into preclinical education. These technologies have effectively improved students' learning experiences and knowledge retention. However, the integration of technologies into preclinical education requires appropriate pedagogical approaches and logistics to align with educational theories and achieve the intended learning outcomes.The chapter provides practical guidance and examples for integrating technologies into anatomy, histology, and biochemistry preclinical education. The author emphasizes that every technology has its own benefits and limitations and is best suited to specific learning scenarios. Therefore, it is recommended that educators and students should utilize multiple modalities for teaching and learning to achieve the best outcomes. The chapter also acknowledges that cadaver-based anatomy education is essential and proposes that educational technologies can serve as a crucial complement for promoting active learning, problem solving, knowledge application, and enhancing conventional cadaver-based education.

Utility of 3D Printed Models Versus Cadaveric Pathology for Learning: Challenging Stated Preferences

INTRODUCTION

3D printing has recently emerged as an alternative to cadaveric models in medical education. A growing body of research supports the use of 3D printing in this context and details the beneficial educational outcomes. Prevailing studies rely on participants' stated preferences, but little is known about actual student preferences.

METHODS

A mixed methods approach, consisting of structured observation and computer vision, was used to investigate medical students' preferences and handling patterns when using 3D printed versus cadaveric models in a cardiac pathology practical skills workshop. Participants were presented with cadaveric samples and 3D printed replicas of congenital heart deformities.

RESULTS

Analysis with computer vision found that students held cadaveric hearts for longer than 3D printed models (7.71 vs. 6.73 h), but this was not significant when comparing across the four workshops. Structured observation found that student preferences changed over the workshop, shifting from 3D printed to cadaveric over time. Interactions with the heart models (e.g., pipecleaners) were comparable.

CONCLUSION

We found that students had a slight preference for cadaveric hearts over 3D printed hearts. Notably, our study contrasts with other studies that report student preferences for 3D printed learning materials. Given the relative equivalence of the models, there is opportunity to leverage 3D printed learning materials (which are not scarce, unlike cadaveric materials) to provide equitable educational opportunities (e.g., in rural settings, where access to cadaveric hearts is less likely).

Has pedagogy, technology, and Covid-19 killed the face-to-face lecture?

The lecture has been around for centuries and has featured as a popular and frequent component in higher education courses across many disciplines including anatomy. In more recent years, there has been a growing shift toward blended learning and related pedagogies that encourage active participation of students in both face-to-face and online learning environments. Unfortunately, in many cases, the lecture, which has typically focused on the transmission of information from educator to student has not been adapted to become a more learner-oriented approach with opportunities for students to actively interact and engage. As a result, the future of whether the lecture should continue has once again become a center of debate. The consequence of the Covid-19 pandemic and its aftermath have added to this with institutions now looking to stop all lectures or offer them in an online format only. This commentary argues that lecture-style components could still feature within face-to-face and online provision, but only if they are used sparingly within a blended curriculum, have a defined use that aligns well to learning outcomes, are assessed as the most effective method pedagogically, and importantly integrate approaches and activities that promote student engagement. Anatomy educators have demonstrated for years that they are able to be at the forefront of pedagogical change and evidenced during the pandemic their agile and innovative ability to adapt and do things differently. Therefore, the fate of the lecture, at least in anatomy, may well be in their hands.

Anatomy education for medical students in the United Kingdom and Republic of Ireland in 2019: A 20-year follow-up

Anatomical education in the United Kingdom (UK) and Ireland has long been under scrutiny, especially since the reforms triggered in 1993 by the General Medical Council's "Tomorrow's Doctors." The aim of the current study was to investigate the state of medical student anatomy education in the UK and Ireland in 2019. In all, 39 medical schools completed the survey (100% response rate) and trained 10,093 medical students per year cohort. The teachers comprised 760 individuals, of these 143 were employed on full-time teaching contracts and 103 were employed on education and research contracts. Since a previous survey in 1999, the number of part-time staff has increased by 300%, including a significant increase in the number of anatomy demonstrators. In 2019, anatomy was predominantly taught to medical students in either a system-based or hybrid curriculum. In all, 34 medical schools (87%) used human cadavers to teach anatomy, with a total of 1,363 donors being used per annum. Gross anatomy teaching was integrated with medical imaging in 95% of medical schools, embryology in 81%, living anatomy in 78%, neuroanatomy in 73%, and histology in 68.3%. Throughout their five years of study, medical students are allocated on average 85 h of taught time for gross anatomy, 24 h for neuroanatomy, 24 h for histology, 11 h for living anatomy, and 10 for embryology. In the past 20 years, there has been an average loss of 39 h dedicated to gross anatomy teaching and a reduction in time dedicated to all other anatomy sub-disciplines.

Investigating the effectiveness of three-dimensionally printed anatomical models compared with plastinated human specimens in learning cardiac and neck anatomy: A randomized crossover study

Three-dimensional printing (3DP) technology has been increasingly applied in health profession education. Yet, 3DP anatomical models compared with the plastinated specimens as learning scaffolds are unclear. A randomized-controlled crossover study was used to evaluate the objective outcomes of 3DP models compared with the plastinated specimens through an introductory lecture and team study for learning relatively simple (cardiac) and complex (neck) anatomies. Given the novel multimaterial and multicolored 3DP models are replicas of the plastinated specimens, it is hypothesized that 3DP models have the same educational benefits to plastinated specimens. This study was conducted in two phases in which participants were randomly assigned to 3DP (n = 31) and plastinated cardiac groups (n = 32) in the first phase, whereas same groups (3DP, n = 15; plastinated, n = 18) used switched materials in the second phase for learning neck anatomy. The pretest, educational activities and posttest were conducted for each phase. Miller's framework was used to assess the cognitive outcomes. There was a significant improvement in students' baseline knowledge by 29.7% and 31.3% for Phase 1; 31.7% and 31.3% for Phase 2 plastinated and 3DP models. Posttest scores for cardiac (plastinated, 3DP mean ± SD: 57.0 ± 13.3 and 60.8 ± 13.6, P = 0.27) and neck (70.3 ± 15.6 and 68.3 ± 9.9, P = 0.68) phases showed no significant difference. In addition, no difference observed when cognitive domains compared for both cases. These results reflect that introductory lecture plus either the plastinated or 3DP modes were effective for learning cardiac and neck anatomy.

Effectiveness of 3D-printed models prepared from radiological data for anatomy education: A meta-analysis and trial sequential analysis of 22 randomized, controlled, crossover trials

BACKGROUND

Many academicians suggested the supplementary use of 3D-printed models reconstructed from radiological images for optimal anatomy education. 3D-printed model is newer technology available to us. The purpose of this systematic review was to capture the usefulness or effectiveness of this newer technology in anatomy education.

MATERIALS AND METHODS

Twenty-two studies met the inclusion and exclusion criteria for quantitative synthesis. The included studies were sub-grouped according to the interventions and participants. No restrictions were applied based on geographical location, language and publication years. Randomized, controlled trial, cross-sectional and cross-over designs were included. The effect size of each intervention in both participants was computed as a standardized mean difference (SMD).

RESULTS

Twenty-two randomized, controlled trials were included for quantitative estimation of effect size of knowledge acquisition as standardized mean difference in 1435 participants. The pooled effect size for 3D-printed model was 0.77 (0.45-1.09, 95% CI, P < 0.0001) with 86% heterogeneity. The accuracy score was measured in only three studies and estimated effect size was 2.81 (1.08-4.54, 95% CI, P = 0.001) with 92% heterogeneity. The satisfaction score was examined by questionnaire in 6 studies. The estimated effect size was 2.00 (0.69-3.32, 95% CI, P = 0.003) with significant heterogeneity.

CONCLUSION

The participants exposed to the 3D-printed model performed better than participants who used traditional methodologies. Thus, the 3D-printed model is a potential tool for anatomy education.

[The anatomical model collection at the Universidade Federal de Ouro Preto's Museum of Pharmacy]

The Ouro Preto School of Pharmacy was founded in 1839 and was the first pharmacy school in Latin America independent from a medical school. At the end of the nineteenth century, it had a collection of French anatomical models made by Deyrolle, Dr. Auzoux, and Vasseur-Tramod, many produced from wax or papier-mâché. This project involved recovering, identifying, cleaning, restoring, and exhibiting seventeen models found in various facilities from Universidade Federal de Ouro Preto. The models in good condition were exhibited in the Museum of Pharmacy (where this work was carried out) as part of the teaching collection for the Ouro Preto pharmacy course.

Students' learning experiences of three-dimensional printed models and plastinated specimens: a qualitative analysis

BACKGROUND

Traditional cadaveric dissection is declining whilst plastinated and three-dimensional printed (3DP) models are increasingly popular as substitutes to the conventional anatomy teaching and learning methods. It is unclear about the pros and cons of these new tools and how they impact students' learning experiences of anatomy including humanistic values such as respect, care and empathy.  METHODS: Ninety-six students' views were sought immediately after a randomized cross-over study. Pragmatic design was used to investigate the learning experiences of using plastinated and 3DP models of cardiac (in Phase 1, n = 63) and neck (in Phase 2, n = 33) anatomy. Inductive thematic analysis was conducted based on 278 free text comments (related to strengths, weaknesses, things to improve), and focus group (n = 8) transcriptions in full verbatim about learning anatomy with these tools.

RESULTS

Four themes were found: perceived authenticity, basic understanding versus complexity, attitudes towards respect and care, and multimodality and guidance.

CONCLUSIONS

Overall, students perceived plastinated specimens as more real and authentic, thus perceived more respect and care than 3DP models; whereas 3DP models were easy to use and prefered for learning basic anatomy.

Standardizing evaluation of patient-specific 3D printed models in surgical planning: development of a cross-disciplinary survey tool for physician and trainee feedback

BACKGROUND

3D printed models are becoming increasingly popular in healthcare as visual and tactile tools to enhance understanding of anatomy and pathology in medical trainee education, provide procedural simulation training, and guide surgical procedures. Patient-specific 3D models are currently being used preoperatively for trainee medical education in planning surgical approaches and intraoperatively to guide decision-making in several specialties. Our study group utilized a modified Delphi process to create a standardized assessment for trainees using patient-specific 3D models as a tool in medical education during pre-surgical planning.

METHODS

A literature review was conducted to identify survey questions administered to clinicians in published surgical planning studies regarding the use of patient-specific 3D models. A core study team reviewed these questions, removed duplicates, categorized them, mapped them to overarching themes, and, where applicable, modified individual questions into a form generalizable across surgical specialties. The core study panel included a physician, physician-scientist, social scientist, engineer/medical student, and 3D printing lab manager. A modified Delphi process was then used to solicit feedback on the clarity and relevance of the individual questions from an expert panel consisting of 12 physicians from specialties including anesthesiology, emergency medicine, radiology, urology, otolaryngology, and obstetrics/gynecology. When the Radiological Society of North America (RSNA)/American College of Radiology (ACR) 3D Printing Registry Data Dictionary was released, additional survey questions were reviewed. A final cross-disciplinary survey of the utility of 3D printed models in surgical planning medical education was developed.

RESULTS

The literature review identified 100 questions previously published in surveys assessing patient-specific 3D models for surgical planning. Following the review, generalization, and mapping of survey questions from these studies, a list of 24 questions was generated for review by the expert study team. Five additional questions were identified in the RSNA/ACR 3D Printing Registry Data Dictionary and included for review. A final questionnaire consisting of 20 questions was developed.

CONCLUSIONS

As 3D printed models become more common in medical education, the need for standardized assessment is increasingly essential. The standardized questionnaire developed in this study reflects the interests of a variety of stakeholders in patient-specific 3D models across disciplines.

Evaluating the value of a 3D printed model for hands-on training of gynecological pelvic examination

Background

Simulation in the field of gynecological pelvic examination with educational purposes holds great potential. In the current manuscript we evaluate a 3D printed model of the female pelvis, which improves practical teaching of the gynecological pelvic examination for medical staff.

Methods

We evaluated the benefit of a 3D printed model of the female pelvis (Pelvisio®) as part of a seminar (“skills training”) for teaching gynecological examination to medical students. Each student was randomly assigned to Group A or B by picking a ticket from a box. Group A underwent the skills training without the 3D printed model. Group B experienced the same seminar with integration of the model. Both groups evaluated the seminar by answering five questions on Likert scales (1–10, 1 = “very little” or “very poor”, 10 equals “very much” or “very good”). Additionally, both groups answered three multiple-choice questions concerning pelvic anatomy (Question 6 to 8). Finally, Group B evaluated the 3D printed model with ten questions (Question 9 to 18, Likert scales, 1–10).

Results

Two of five questions concerning the students’ satisfaction with the seminar and their gained knowledge showed statistically significant better ratings in Group B (6.7 vs. 8.2 points and 8.1 vs. 8.9 points (p < 0.001 and p < 0.009). The other three questions showed no statistically significant differences between the traditional teaching setting vs. the 3D printed model (p < 0.411, p < 0.344 and p < 0.215, respectively). The overall mean score of Question 1 to 5 showed 8.4 points for Group B and 7.8 points for Group A (p < 0.001). All three multiple-choice questions, asking about female pelvic anatomy, were answered more often correctly by Group B (p < 0.001, p < 0.008 and p < 0.001, respectively). The mean score from the answers to Questions 9 to 18, only answered by Group B, showed a mean of 8.6 points, indicating, that the students approved of the model.

Conclusion

The presented 3D printed model Pelvisio® improves the education of female pelvic anatomy and examination for medical students. Hence, training this pivotal examination can be supported by a custom designed anatomical model tailored for interactive and explorative learning.

Clinicians' opinions on the clinical relevance of anatomy education at Stellenbosch University

Anatomical science is a fundamental element of undergraduate medical education; thus, it is imperative that the course serves future medical professionals when entering clinical practice. However, anatomical education has faced challenges in recent years including decreased allocated time, increased class sizes and over-stretched staff. Technological advancements in anatomical education may provide relief to these issues. Therefore, exploring clinicians' perspective on the clinical relevance and efficacy of anatomical education, within an African context, can inform its future. This study used a qualitative research approach within an interpretive paradigm. Eight semi-structured one-on-one interviews were conducted with clinicians associated with Stellenbosch University and Tygerberg Hospital. Thematic analysis was employed to analyze the data, creating themes and codes. Trust worthiness of the data was ensured through peer debriefing and member checking. Results reveal that clinicians find clinically relevant anatomy valuable to students. However, some feel that this is not delivered effectively at present. Clinicians see potential for the incorporation of clinical technologies into anatomical pedagogy. Although clinicians are hopeful for new technological developments in anatomical education, concerns were reported about its autonomous nature. This study concludes that although clinically relevant anatomical education is beneficial to students, the time and the resources via which it is delivered should be considered. There is optimism for the future of anatomical education with the advancements of technologically based educational resources, however, new resources should be incorporated with planning and supervision.

Three-Dimensional Printed Models of the Heart Represent an Opportunity for Inclusive Learning

Three-dimensional (3D) printed models of anatomic structures offer an alternative to studying manufactured, "idealized" models or cadaveric specimens. The utility of 3D printed models of the heart for clinical veterinary students learning echocardiographic anatomy is unreported. This study aimed to assess the feasibility and utility of 3D printed models of the canine heart as a supplementary teaching aid in final-year vet students. We hypothesized that using 3D printed cardiac models would improve test scores and feedback when compared with a control group. Students (n = 31) were randomized to use either a video guide to echocardiographic anatomy alongside 3D printed models (3DMs) or video only (VO). Prior to a self-directed learning session, students answered eight extended matching questions as a baseline knowledge assessment. They then undertook the learning session and provided feedback (Likert scores and free text). Students repeated the test within 1 to 3 days. Changes in test scores and feedback were compared between 3DM and VO groups, and between track and non-track rotation students. The 3DM group had increased test scores in the non-track subgroup. Track students' test scores in the VO group increased, but not in the 3DM group. Students in the 3DM group had a higher completion rate, and more left free-text feedback. Feedback from 3DM was almost universally positive, and students believed more strongly that these should be used for future veterinary anatomy teaching. In conclusion, these pilot data suggest that 3D printed canine cardiac models are feasible to produce and represent an inclusive learning opportunity, promoting student engagement.

Veterinary Anatomy Education and Spatial Ability: Where Now and Where Next?

The expanding use of technology to support or replace dissection has implications for educators, who must first understand how students mentally manipulate anatomical images. The psychological literature on spatial ability and general intelligence is relevant to these considerations. This article situates current understandings of spatial ability in the context of veterinary anatomy education. As in medical education, veterinary courses are increasingly using physical and computer-based models and computer programs to supplement or even replace cadavers. In this article, we highlight the importance of spatial ability in the learning of anatomy and make methodological recommendations for future studies to ensure a robust evidence base is developed. Recommendations include ensuring that (a) studies aiming to demonstrate changes in spatial ability include anatomically naïve students and also account for previous anatomical knowledge, (b) studies employ a control group in order to account for the practice effect, and (c) the relationship between spatial ability and general intelligence, and thus other cognitive abilities, is acknowledged.

A 3D printed model of the female pelvis for practical education of gynecological pelvic examination

Background

Pelvic palpation is a core component of every Gynecologic examination. It requires vigorous training, which is difficult due to its intimate nature, leading to a need of simulation. Up until now, there are mainly models available for mere palpation which do not offer adequate visualization of the concerning anatomical structures. In this study we present a 3D printed model of the female pelvis. It can improve both the practical teaching of gynecological pelvic examination for health care professionals and the spatial understanding of the relevant anatomy.

Methods

We developed a virtual, simplified model showing selected parts of the female pelvis. 3D printing was used to create a physical model.

Results

The life-size 3D printed model has the ability of being physically assembled step by step by its users. Consequently, it improves teaching especially when combining it with commercial phantoms, which are built solely for palpation training. This is achieved by correlating haptic and visual sensations with the resulting feedback received.

Conclusion

The presented 3D printed model of the female pelvis can be of aid for visualizing and teaching pelvic anatomy and examination to medical staff. 3D printing provides the possibility of creating, multiplying, adapting and sharing such data worldwide with little investment of resources. Thus, an important contribution to the international medical community can be made for training this challenging examination.

Development and implementation of a three-dimensional (3D) printing elective course for health science students

Three-dimensional (3D) printing technology has become more affordable, accessible, and relevant in healthcare, however, the knowledge of transforming medical images to physical prints still requires some level of training. Anatomy educators can play a pivotal role in introducing learners to 3D printing due to the spatial context inherent to learning anatomy. To bridge this knowledge gap and decrease the intimidation associated with learning 3D printing technology, an elective was developed through a collaboration between the Department of Anatomy and the Makers Lab at the University of California, San Francisco. A self-directed digital resource was created for the elective to guide learners through the 3D printing workflow, which begins with a patient's computed tomography digital imaging and communication in medicine (DICOM) file to a physical 3D printed model. In addition to practicing the 3D printing workflow during the elective, a series of guest speakers presented on 3D printing applications they utilize in their clinical practice and/or research laboratories. Student evaluations indicated that their intimidation associated with 3D printing decreased, the clinical and research topics were directly applicable to their intended careers, and they enjoyed the autonomy associated with the elective format. The elective and the associated digital resource provided students with the foundational knowledge of 3D printing, including the ability to extract, edit, manipulate, and 3D print from DICOM files, making 3D printing more accessible. The aim of disseminating this work is to help other anatomy educators adopt this curriculum at their institution.