Using 3D Modeling Techniques to Enhance Teaching of Difficult Anatomical Concepts

A pilot study for the evaluation of 3D anatomy application 'Complete Anatomy' as an additional non-mandatory study tool for the functional anatomy classes of first year physical therapy students

For this pilot study, the use of the digital 3D anatomy application Complete Anatomy was evaluated as a non-mandatory additional study tool throughout the semester. The aim of the study was to investigate if the Complete Anatomy usage time had an effect on final exam grades and how the app was used post-Covid19. This cross-sectional study asked first year bachelor/freshman university students of Physical Therapy and Rehabilitation Sciences to fill out a questionnaire to gauge Complete Anatomy usage time, the student's exam results, and how the app was used, for example, in relation to other study tools. A positive correlation was found between the proportion of students that passed the final exam and the number of hours of Complete Anatomy usage (rs (4) = 0.94, p = 0.016). Compared to students who didn't use Complete Anatomy, these positive effects were observed when students used Complete Anatomy for at least 10 h (p = 0.04). The app was well-used with almost half of the respondents reporting >10 h of usage time. The results from this study provide a good overview of how and how often Complete Anatomy is used. Although a positive correlation between the hours of use and the number of passing grades was found in this pilot study, a future study to prove the causality between these two factors is warranted to further investigate the effect of Complete Anatomy as an additional non-mandatory study tool.

Comparative Study of the Flipped Classroom and Traditional Lecture Methods in Anatomy Teaching

Background The National Medical Commission (NMC), the regulatory body for medical education in India introduced competency-based medical education (CBME) in 2019. It is an outcome-based learner-centric approach. To implement it, active and innovative learning strategies are being introduced. A flipped classroom (FC) is one such teaching method in which learners are provided learning materials before class with active discussion during teaching sessions. This promotes critical thinking, better retention, and future clinical applicability. This study aimed to compare FC and traditional teaching methods for first-phase medical learners for the anatomy curriculum. The objectives of this study were to evaluate the effectiveness of FC viz-a viz traditional lecture method for certain topics of clinical relevance from the anatomy curriculum and assess students' perception of the FC method.  Methodology The study was conducted on 96 phase-one medical learners after obtaining approval from the Institutional Ethics Committee. After obtaining informed consent, a simple random sampling method was used to group the students into two groups. For the same topic, one group was taught with the FC method, while the other group was taught using the didactic lecture (DL) method. A crossover was done for another topic. Students were assessed by pre- and post-tests. Students' perceptions' were recorded by a pre-validated questionnaire quantified on a Likert scale. Results The difference in posttest scores for the topics taught between the two groups was found to be statistically significant. Perception regarding various aspects of the FC method was affirmative. Conclusions The results of this study indicated that FC is advantageous for students. It improves learner engagement and performance, and students' perception of the method was positive. Effective execution of this method requires detailed planning, constant motivation, and consistent efforts. Therefore, this method should be used more often for the benefit of students.

Anatomical variation is the norm: A novel curriculum framework

Anatomical variation is an inherent part of every health curriculum, due in large to the negative clinical consequences that can ensue if anatomical variation is not thoroughly understood. However, current literature fails to describe any structured whole-of-course pedagogy for the teaching of anatomical variation in higher education. This study therefore aimed to (i) propose a whole-of-course curriculum framework to guide academic development and implementation of anatomical variation resources and assessment; and (ii) assess the depth of anatomical variation knowledge in a multiyear undergraduate health-science cohort (n = 152) at the Queensland University of Technology. Current anatomical variation pedagogy, and subsequently the need for the curriculum framework, were explored using a scoping review protocol. As part of this study, anatomical variation was novelly defined as macroscopic differences in morphology (shape and size), topography (location), developmental timing, or frequency (number) of an anatomical structure between individuals that form during embryological or subadult development and result in no substantive, observable interruption to physiological function. The framework incorporated three themes of anatomical variation learning outcomes: description of anatomical variation, theories of the professional implications of variation, and investigation of variant formation. These themes were strongly aligned with the concepts recommended for teaching identified through the scoping review. Significant deficits in anatomical variation student knowledge were identified, with the third-year cohort recording a mean total score of only 54.6%. A strong recommendation to implement the anatomical variation curriculum framework in all medical and health-science curricula is made to intentionally develop student understanding of anatomical variation and improve future clinical practice.

Model-based individual life-spanning documentation in visceral surgery: a proof of concept

INTRODUCTION

Surgical documentation has many implications. However, its primary function is to transfer information about surgical procedures to other medical professionals. Thereby, written reports describing procedures in detail are the current standard, impeding comprehensive understanding of patient-individual life-spanning surgical course, especially if surgeries are performed at a timely distance and in diverse facilities. Therefore, we developed a novel model-based approach for documentation of visceral surgeries, denoted as 'Surgical Documentation Markup-Modeling' (SDM-M).

MATERIAL AND METHODS

For scientific evaluation, we developed a web-based prototype software allowing for creating hierarchical anatomical models that can be modified by individual surgery-related markup information. Thus, a patient's cumulated 'surgical load' can be displayed on a timeline deploying interactive anatomical 3D models. To evaluate the possible impact on daily clinical routine, we performed an evaluation study with 24 surgeons and advanced medical students, elaborating on simulated complex surgical cases, once with classic written reports and once with our prototypical SDM-M software.

RESULTS

Leveraging SDM-M in an experimental environment reduced the time needed for elaborating simulated complex surgical cases from 354 ± 85 s with the classic approach to 277 ± 128 s. (p = 0.00109) The perceived task load measured by the Raw NASA-TLX was reduced significantly (p = 0.00003) with decreased mental (p = 0.00004) and physical (p = 0.01403) demand. Also, time demand (p = 0.00041), performance (p = 0.00161), effort (p = 0.00024), and frustration (p = 0.00031) were improved significantly.

DISCUSSION

Model-based approaches for life-spanning surgical documentation could improve the daily clinical elaboration and understanding of complex cases in visceral surgery. Besides reduced workload and time sparing, even a more structured assessment of individual surgical cases could foster improved planning of further surgeries, information transfer, and even scientific evaluation, considering the cumulative 'surgical load.'

CONCLUSION

Life-spanning model-based documentation of visceral surgical cases could significantly improve surgery and workload.

Role of patient specific 3D printed models in patient confidence, understanding and satisfaction of care in Singapore

Introduction

Patient specific 3D models have been widely used for pre-op planning and intra-op guidance in orthopaedic surgery. These models however are not often used in pre-operative doctor-patient communication. This study evaluates the roles of customized 3D models in improving patient understanding, confidence, and satisfaction of patient care when they were used during preoperative counselling.

Materials and methods

A prospective survey was conducted on 33 orthopaedic trauma patients who were required to rate on a scale of 1-5, the effectiveness of patient specific 3D models in: 1) improving patient's understanding and, 2) helping patients cope with the condition, 3) boosting patients' confidence in the treatment and 4) in the surgeon; and on a scale of 0-10, their overall satisfaction. Subgroup analysis was done to compare ratings of patients by age and by education levels.

Results

Over 90% patients rated agree or strongly agree on customised 3D models' effectiveness in improving understanding of injury and boosting confidence in treatments and surgeons. 87% patients agreed or strongly agreed that the models enhanced patient self-efficacy. No significant correlation was identified between age and patients' perceived effectiveness of customised 3D models in improving patient care. Ratings on four areas evaluated by pre-secondary and post-secondary groups were comparable. Post-secondary group had significantly higher satisfaction level than the pre-secondary group.

Conclusion

Customized 3D models help patients visualise complex pathology to facilitate patients' understanding of their condition and treatment, resulting in improved self-efficacy, confidence, and overall satisfaction. The use of patient specific 3D models in pre-operative counselling allows greater patient involvement therefore prompting patient-centred healthcare. Age does not influence patients' perceived effectiveness of customised 3D models in improving patient care. Patients with higher education level are likely to experience higher satisfaction level due to their willingness to take responsibility for their care.

3D bioprinting: a review and potential applications for Mohs micrographic surgery

Mohs Micrographic Surgery (MMS) is effective for treating common cutaneous malignancies, but complex repairs may often present challenges for reconstruction. This paper explores the potential of three-dimensional (3D) bioprinting in MMS, offering superior outcomes compared to traditional methods. 3D printing technologies show promise in advancing skin regeneration and refining surgical techniques in dermatologic surgery. A PubMed search was conducted using the following keywords: "Three-dimensional bioprinting" OR "3-D printing" AND "Mohs" OR "Mohs surgery" OR "Surgery." Peer-reviewed English articles discussing medical applications of 3D bioprinting were included, while non-peer-reviewed and non-English articles were excluded. Patients using 3D MMS models had lower anxiety scores (3.00 to 1.7, p < 0.0001) and higher knowledge assessment scores (5.59 or 93.25% correct responses), indicating better understanding of their procedure. Surgical residents using 3D models demonstrated improved proficiency in flap reconstructions (p = 0.002) and knowledge assessment (p = 0.001). Additionally, 3D printing offers personalized patient care through tailored surgical guides and anatomical models, reducing intraoperative time while enhancing surgical. Concurrently, efforts in tissue engineering and regenerative medicine are being explored as potential alternatives to address organ donor shortages, eliminating autografting needs. However, challenges like limited training and technological constraints persist. Integrating optical coherence tomography with 3D bioprinting may expedite grafting, but challenges remain in pre-printing grafts for complex cases. Regulatory and ethical considerations are paramount for patient safety, and further research is needed to understand long-term effects and cost-effectiveness. While promising, significant advancements are necessary for full utilization in MMS.

Application of artificial intelligence-assisted image diagnosis software based on volume data reconstruction technique in medical imaging practice teaching

BACKGROUND

In medical imaging courses, due to the complexity of anatomical relationships, limited number of practical course hours and instructors, how to improve the teaching quality of practical skills and self-directed learning ability has always been a challenge for higher medical education. Artificial intelligence-assisted diagnostic (AISD) software based on volume data reconstruction (VDR) technique is gradually entering radiology. It converts two-dimensional images into three-dimensional images, and AI can assist in image diagnosis. However, the application of artificial intelligence in medical education is still in its early stages. The purpose of this study is to explore the application value of AISD software based on VDR technique in medical imaging practical teaching, and to provide a basis for improving medical imaging practical teaching.

METHODS

Totally 41 students majoring in clinical medicine in 2017 were enrolled as the experiment group. AISD software based on VDR was used in practical teaching of medical imaging to display 3D images and mark lesions with AISD. Then annotations were provided and diagnostic suggestions were given. Also 43 students majoring in clinical medicine from 2016 were chosen as the control group, who were taught with the conventional film and multimedia teaching methods. The exam results and evaluation scales were compared statistically between groups.

RESULTS

The total skill scores of the test group were significantly higher compared with the control group (84.51 ± 3.81 vs. 80.67 ± 5.43). The scores of computed tomography (CT) diagnosis (49.93 ± 3.59 vs. 46.60 ± 4.89) and magnetic resonance (MR) diagnosis (17.41 ± 1.00 vs. 16.93 ± 1.14) of the experiment group were both significantly higher. The scores of academic self-efficacy (82.17 ± 4.67) and self-directed learning ability (235.56 ± 13.50) of the group were significantly higher compared with the control group (78.93 ± 6.29, 226.35 ± 13.90).

CONCLUSIONS

Applying AISD software based on VDR to medical imaging practice teaching can enable students to timely obtain AI annotated lesion information and 3D images, which may help improve their image reading skills and enhance their academic self-efficacy and self-directed learning abilities.

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.

Evaluating medical undergraduates' and dermatology faculty members' perception of using three-dimensional images as part of dermatology education in a time of COVID-19: a mixed-methods study

BACKGROUND

The coronavirus-19 pandemic has impacted the delivery of medical education in dermatology, leading to decreased patient contact. There arose a need to pioneer innovative teaching tools to augment current methods for now and beyond the pandemic.

OBJECTIVES

We aimed to assess the utility of three-dimensional (3D) images in the learning and teaching of dermatology by analysing the perceptions of medical undergraduates and faculty members in a qualitative and quantitative study.

METHODS

Medical undergraduates (n = 119) and dermatology faculty members (n = 20) were recruited on a voluntary basis to watch a showcase session using a portable 3D imaging system allowing 3D images of skin lesions to be examined and digitally manipulated. After the session, participants filled in an anonymous questionnaire evaluating their perceptions.

RESULTS

Of the 119 learners, most (> 84%) strongly agreed/agreed that (i) they would have more confidence in the field of dermatology; (ii) their ability to describe skin lesions would increase; (iii) their understanding of common dermatological conditions would increase; (iv) 3D images allow a greater approximation to real-life encounters than 2D images; and (v) learning with this modality would be useful. Of the 20 faculty members, most (> 84%) strongly agreed/agreed that (i) it is easier to teach with the aid of 3D images, and (ii) they would want access to 3D images during teaching sessions. Skin tumours were perceived to be learnt best via this modality in terms of showcasing topography (P < 0.01) and close approximation to real-life (P < 0.001). Overall, thematic analysis from qualitative analysis revealed that conditions learnt better with 3D images were those with surface changes and characteristic topography.

CONCLUSIONS

Our results show that the greatest utility of 3D images lies in conditions where lesions have skin surface changes in the form of protrusions or depressions, such as in skin tumours or ulcers. As such, 3D images can be useful teaching tools in dermatology, especially in conditions where appreciation of surface changes and topography is important.

Exploring the Application of the Artificial-Intelligence-Integrated Platform 3D Slicer in Medical Imaging Education

Artificial Intelligence (AI) has revolutionized medical imaging procedures, specifically with regard to image segmentation, reconstruction, interpretation, and research. 3D Slicer, an open-source medical image analysis platform, has become a valuable tool in medical imaging education due to its integration of various AI applications. Through its open-source architecture, students can gain practical experience with diverse medical images and the latest AI technology, reinforcing their understanding of anatomy and imaging technology while fostering independent learning and clinical reasoning skills. The implementation of this platform improves instruction quality and nurtures skilled professionals who can meet the demands of clinical practice, research institutions, and technology innovation enterprises. AI algorithms' application in medical image processing have facilitated their translation from the lab to practical clinical applications and education.

Virtual Surgical Planning and Three-Dimensional Models for Precision Sinonasal and Skull Base Surgery

Sinonasal and skull base malignancies represent a rare, heterogenous group of pathologies with an incidence of 0.556 per 100,000 persons in the population. Given the numerous critical anatomic structures located adjacent to the sinonasal cavity and skull base, surgery for tumors in this region requires careful pre-operative planning with the assistance of radiological imaging and intraoperative image guidance technologies to reduce the risk of complications. Virtual surgical planning (VSP) and three-dimensional models (3DMs) are adjunctive technologies which assist clinicians to better visualize patient anatomy using enhanced digital radiological images and physical stereolithographic models based on patients' personal imaging. This review summarizes our institutional experience with VSP and 3DMs in sinonasal and skull base surgical oncology. A clinical case series is used to thematically illustrate the application of VSP and 3DMs in surgical ablation, reconstruction, patient communication, medical education, and interdisciplinary teamwork in sinonasal and skull base surgery.

Prespecialist perceptions of three-dimensional heart models in anatomical education

PURPOSE

This article aims to discuss the use of three-dimensional (3D) printed models of vascular variation cases as an educational tool for undergraduate and postgraduate anatomy students.

METHODS

This advanced study involved ten anatomy assistants who were provided with five distinct cases of congenital cardiovascular variations, each accompanied by a computed tomography angiography (CT-A) and 1:1 solid model format. The residents were asked to generate perceptions for both formats and then compare these perceptions based on identifying the variation, defining the structural features, and evaluating relevant educational perspectives.

RESULTS

The vascular origin measurement values compared to the statistically evaluated real values of the related cases showed that models were 1:1 identical copies. Qualitative assessment feedback from five stations supported the usefulness of 3D models as educational tools for organ anatomy, simulation of variational structures, and overall medical education and anatomy training. Models showcasing different anatomical variations such as aortic arch with Type 2 pattern, a right-sided aortic arch with Type 2 pattern, an aberrant right subclavian artery, arteria lusoria in thorax, and a left coronary artery originating from pulmonary trunk in an Alcapa type pattern allow for better analysis due to their complex anatomies, thus optimizing the study of variation-specific anatomy. The perception level in the 3D model contained higher points in all of the nine parameters, namely identification of cardiovascular variations, defining the vessel with anomaly, aortic arch branch count and appearance order, feasibility of using it in peers and student education. 3D models received a score 9.1 points, while CT-A images were rated at 4.8 out of 10.

CONCLUSION

3D printed anatomical models of variational cardiovascular anatomy serve as essential components of anatomy training and postgraduate clinical perception by granting demonstrative feedback and a superior comprehension of the visuospatial relationship between the anatomical structures.

Foundations and guidelines for high-quality three-dimensional models using photogrammetry: A technical note on the future of neuroanatomy education

Hands-on dissections using cadaveric tissues for neuroanatomical education are not easily available in many educational institutions due to financial, safety, and ethical factors. Supplementary pedagogical tools, for instance, 3D models of anatomical specimens acquired with photogrammetry are an efficient alternative to democratize the 3D anatomical data. The aim of this study was to describe a technical guideline for acquiring realistic 3D anatomic models with photogrammetry and to improve the teaching and learning process in neuroanatomy. Seven specimens with different sizes, cadaveric tissues, and textures were used to demonstrate the step-by-step instructions for specimen preparation, photogrammetry setup, post-processing, and display of the 3D model. The photogrammetry scanning consists of three cameras arranged vertically facing the specimen to be scanned. In order to optimize the scanning process and the acquisition of optimal images, high-quality 3D models require complex and challenging adjustments in the positioning of the specimens within the scanner, as well as adjustments of the turntable, custom specimen holders, cameras, lighting, computer hardware, and its software. MeshLab® software was used for editing the 3D model before exporting it to MedReality® (Thyng, Chicago, IL) and SketchFab® (Epic, Cary, NC) platforms. Both allow manipulation of the models using various angles and magnifications and are easily accessed using mobile, immersive, and personal computer devices free of charge for viewers. Photogrammetry scans offer a 360° view of the 3D models ubiquitously accessible on any device independent of operating system and should be considered as a tool to optimize and democratize the teaching of neuroanatomy.

The role of anatomical context in soft-tissue multi-organ segmentation of cadaveric non-contrast-enhanced whole body CT

BACKGROUND

Cadaveric computed tomography (CT) image segmentation is a difficult task to solve, especially when applied to whole-body image volumes. Traditional algorithms require preprocessing using registration, or highly conserved organ morphologies. These requirements cannot be fulfilled by cadaveric specimens, so deep learning must be used to overcome this limitation. Further, the widespread use of 2D algorithms for volumetric data ignores the role of anatomical context. The use of 3D spatial context for volumetric segmentation of CT scans as well as the anatomical context required to optimize the segmentation has not been adequately explored.

PURPOSE

To determine whether 2D slice-by-slice UNet algorithms or 3D volumetric UNet (VNet) algorithms provide a more effective method for segmenting 3D volumes, and to what extent anatomical context plays in the segmentation of soft-tissue organs in cadaveric, noncontrast-enhanced (NCE) CT.

METHODS

We tested five CT segmentation algorithms: 2D UNets with and without 3D data augmentation (3D rotations) as well as VNets with three levels of anatomical context (implemented via image downsampling at 1X, 2X, and 3X) for their performance via 3D Dice coefficients, and Hausdorff distance calculations. The classifiers were trained to segment the kidneys and liver and the performance was evaluated using Dice coefficient and Hausdorff distance on the segmentation versus the ground truth annotation.

RESULTS

Our results demonstrate that VNet algorithms perform significantly better (p < 0.05 $p<0.05$ ) than 2D models. Among the VNet classifiers, those that use some level of image downsampling outperform (as calculated through Dice coefficients) the VNet without downsampling. Additionally, the optimal amount of downsampling depends on the target organ.

CONCLUSIONS

Anatomical context is an important component of soft-tissue, multi-organ segmentation in cadaveric, NCE CT imaging of the whole body. Different amounts of anatomical contexts are optimal depending on the size, position, and surrounding tissue of the organ.

Spatial ability and 3D model colour-coding affect anatomy performance: a cross-sectional and randomized trial

Photorealistic 3D models (PR3DM) have great potential to supplement anatomy education; however, there is evidence that realism can increase cognitive load and negatively impact anatomy learning, particularly in students with decreased spatial ability. These differing viewpoints have resulted in difficulty in incorporating PR3DM when designing anatomy courses. To determine the effects of spatial ability on anatomy learning and reported intrinsic cognitive load using a drawing assessment, and of PR3DM versus an Artistic colour-coded 3D model (A3DM) on extraneous cognitive load and learning performance. First-year medical students participated in a cross-sectional (Study 1) and a double-blind randomised control trial (Study 2). Pre-tests analysed participants' knowledge of anatomy of the heart (Study 1, N = 50) and liver (Study 2, N = 46). In Study 1, subjects were first divided equally using a mental rotations test (MRT) into low and high spatial ability groups. Participants memorised a 2D-labeled heart valve diagram and sketched it rotated 180°, before self-reporting their intrinsic cognitive load (ICL). For Study 2, participants studied a liver PR3DM or its corresponding A3DM with texture-homogenisation, followed by a liver anatomy post-test, and reported extraneous cognitive load (ECL). All participants reported no prior anatomy experience. Participants with low spatial ability (N = 25) had significantly lower heart drawing scores (p = 0.001) than those with high spatial ability (N = 25), despite no significant differences in reported ICL (p = 0.110). Males had significantly higher MRT scores than females (p = 0.011). Participants who studied the liver A3DM (N = 22) had significantly higher post-test scores than those who studied the liver PR3DM (N = 24) (p = 0.042), despite no significant differences in reported ECL (p = 0.720). This investigation demonstrated that increased spatial ability and colour-coding of 3D models are associated with improved anatomy performance without significant increase in cognitive load. The findings are important and provide useful insight into the influence of spatial ability and photorealistic and artistic 3D models on anatomy education, and their applicability to instructional and assessment design in anatomy.

Apprendre l’anatomie radiographique en présentiel ou en ligne ? Une étude randomisée contrôlée

Résumé

L’enseignement de l’anatomie repose sur diverses techniques: les cours, les dissections, les modèles 3D ou encore les supports en ligne. Ces derniers sont généralement considérés comme des moyens d’apprentissage complémentaires. Cette étude vise à comparer les performances des étudiants vétérinaires (N=83) en anatomie radiographique (radioanatomie) après un apprentissage en ligne ou conventionnel, et de voir dans quelle mesure ces méthodes sont interchangeables. Trois stratégies sont comparées : apprentissage en ligne exclusif, apprentissage en ligne avec des os de chevaux, apprentissage sur radiographies conventionnelles avec des os de chevaux. Les performances au test de rotation mentale et au test de connaissance en radioanatomie sont similaires entre les 3 groupes à la base, lors du test préliminaire. Après l’apprentissage (test final), les scores de rotation mentale et de radioanatomie augment significativement de 6.7/40 points (CI : 5.2–8.2; p < .001) et de 5.1/20 points (CI: 4.3–5.9; p< .001). Il n’y a pas de différence entre les groupes pour les scores de rotation mentale et de radioanatomie après l’apprentissage. Le score de rotation mentale est influencé par le genre, et significativement plus élevé chez les hommes que chez les femmes au test préliminaire (M= 23.0, SD = 8.8 vs. M= 16.5, SD= 6.9; p= .001) et au test final (M= 32.1, SD= 5.5 vs. M= 22.7, SD= 8.6; p< .001). Les performances en radioanatomie ne sont pas influencées par le genre. Ces résultats suggèrent que l’enseignement de la radioanatomie peut être réalisé en présentiel avec des radiographies conventionnelles ou en ligne. Cette interchangeabilité entre apprentissage en présentiel et en distanciel est intéressante au regard des impératifs liés aux crises sanitaires, et des besoins d’adaptation rapide en distanciel.

This translation was provided by the authors. To view the original article visit: https://doi.org/10.3138/jvme-2021-0153

Can Online Teaching of Radiographic Anatomy Replace Conventional On-Site Teaching? A Randomized Controlled Study

Different modalities such as lectures, dissections, 3D models, and online learning are used for teaching anatomy. To date, online learning has been considered a useful additional didactic tool. This study aimed to compare veterinary students' performance in radiographic anatomy (radio-anatomy) after online or classroom-based teaching to assess the extent to which the two methods were interchangeable. Three strategies were compared in a cohort of 83 learners. Students were committed to online learning only, online learning with the use of specimen equine bones, or learning on conventional radiographs with specimen equine bones. At baseline (pre-test), scores from a mental rotation test and radio-anatomy knowledge test were similar between groups. After training (post-test), scores in mental rotation and radio-anatomy significantly increased by 6.7/40 units (95% CI: 5.2-8.2; p < .001) and 5.1/20 units (95% CI: 4.3-5.9; p < .001), respectively. There was no difference in scores for mental rotation and radio-anatomy knowledge between groups at post-test. Gender influenced the mental rotation, with men scoring significantly higher than women at pre-test (M = 23.0, SD = 8.8 vs. M = 16.5, SD = 6.9; p = .001) and post-test (M = 32.1, SD = 5.5 vs. M = 22.7, SD = 8.6; p < .001). However, radio-anatomy knowledge was not influenced by gender. These results suggest radio-anatomy teaching can be safely achieved with either conventional radiographs or online resources. This is of interest since, due to the COVID-19 outbreak, rapidly changing from on-site to online methods for teaching veterinary medical education proved necessary.

The Impact of a Gross Anatomy Curriculum With Donor Family Interaction: Thematic Analysis of Student Letters to Silent Mentors

PURPOSE

Tzu Chi University's anatomy curriculum incorporates interaction with donors' families and regards body donors as silent teachers and altruistic role models. In this silent mentor program (SMP), students learn about their donor's life before dissection to better appreciate the selfless donation. This study explores the influence of the program on students' humanistic literacy based on student letters to silent mentors, which students wrote near the end of the program and laid by the silent mentor during the coffining ceremony.

METHOD

The study included 125 letters from third-year medical students who took the gross anatomy curriculum in academic years 2015, 2016, and 2017. With student consent, the program collated and published the letters in the open-access SMP yearbook. Using thematic analysis, the authors manually analyzed the letters in their original Mandarin, with the names of students made anonymous to ensure the authors were blind to students' identity throughout the study.

RESULTS

The analysis identified 3 themes and 11 subthemes. Theme 1, my silent mentor, included 3 subthemes: life characteristics, altruistic attitude, and expectation of offering body. Theme 2, connection to silent mentor and family, included 4 subthemes: intersubjective bonding, emotive first encounter, spiritual communication, and encouragement from silent mentor. Theme 3, reflection and transformation, included 4 subthemes: reflection on life and death, professional self-expectation, inner transformation, and feedback action.

CONCLUSIONS

The findings suggest that interactions with donors' families increased students' appreciation of the donation and enhanced students' humanistic literacy. Further, the letters seem to indicate that the SMP inspired students to develop a grateful, respectful, and empathic attitude toward life and their career. Thus, by implementing similar programs, gross anatomy curricula could go beyond the acquisition of structural knowledge to the cultivation of medical students' humanistic literacy.

Technological resources for teaching and learning about human anatomy in the medical course: Systematic review of literature

The consolidation of technology as an alternative strategy to cadaveric dissection for teaching anatomy in medical courses was accelerated by the recent Covid-19 pandemic, which caused the need for social distance policies and the closure of laboratories and classrooms. Consequently, new technologies were created, and those already been developed started to be better explored. However, information about many of these instruments and resources is not available to anatomy teachers. This systematic review presents the technological means for teaching and learning about human anatomy developed and applied in medical courses in the last ten years, besides the infrastructure necessary to use them. Studies in English, Portuguese, and Spanish were searched in MEDLINE, Scopus, ERIC, LILACS, and SciELO databases, initially resulting in a total of 875 identified articles, from which 102 were included in the analysis. They were classified according to the type of technology used: three-dimensional (3D) printing (n = 22), extended reality (n = 49), digital tools (n = 23), and other technological resources (n = 8). It was made a detailed description of technologies, including the stage of the medical curriculum in which it was applied, the infrastructure utilized, and which contents were covered. The analysis shows that between all technologies, those related to the internet and 3D printing are the most applicable, both in student learning and the financial cost necessary for its structural implementation.

Application of a 3D-printed eye model for teaching direct ophthalmoscopy to undergraduates

PURPOSE

This study aims to design an eye model that can simulate the fundus for teaching direct ophthalmoscopy and to evaluate its effectiveness.

METHODS

We first used 3D printing materials to make an eye model and then randomly assigned 92 undergraduates into group A (model-assisted training group) and group B (traditional training group) to test our model. After the same training time, real patients were used to test the students, with 120 s as the examination time limit. We recorded the students' ability to clearly see the optic disk, the time to determine the cup-to-disk ratio, and whether they were correct.

RESULTS

Forty-three students in group A (93.48%) successfully saw the fundus, while 21 in group B (45.65%) succeeded. The difference between the two groups was 47.83% (95% confidence interval, 29.59-66.07%, P < 0.0001). The median time to see the fundus was 29s (95% confidence interval 23-45 s) in group A, while an estimated minimum time in group B was 80 s, indicating that group A was significantly faster than group B (P < 0.0001).

CONCLUSIONS

This 3D-printed eye model significantly improved the students' study interest, study efficiency, and study results and is worthy of being promoted.

The transparent minds: methods of creation of 3D digital models from patient specific data

This paper focuses on the method for creating 3-dimensional (3D) digital models extracted from patient- specific scans of the brain. The described approach consists of several cross-platform stages: raw data segmentation, data correction in 3D-modelling software, post-processing of the 3D digital models and their presentation on an interactive web-based platform. This method of data presentation offers a cost and time effective option to present medical data accurately. An important aspect of the process is using real patient data and enriching the traditional slice-based representation of the scans with 3D models that can provide better understanding of the organs' structures. The resulting 3D digital models also form the basis for further processing into different modalities, for example models in Virtual Reality or 3D physical model printouts. The option to make medical data less abstract and more understandable can extend their use beyond diagnosis and into a potential aid in anatomy and patient education. The methods presented in this paper were originally based on the master thesis 'Transparent Minds: Testing for Efficiency of Transparency in 3D Physical and 3D Digital Models', which focussed on creating and comparing the efficiency of transparent 3D physical and 3D digital models from real-patient data.

Support for using a three-dimensional anatomy application over anatomical atlases in a randomized comparison

To investigate to what extent the use of a three-dimensional (3D) anatomy computer application can improve the acquisition of anatomical knowledge compared with anatomical atlases, junior and advanced medical students participated in an experiment. Participants were asked to answer anatomical questions with the use of a 3D anatomy application (developed at the University Medical Center in Utrecht, the Netherlands) or anatomy atlases. Every student had to complete two assignments, either with an atlas or with the 3D anatomy application. One assignment consisted of 20 questions about the anatomy of the hand, the other one had 20 questions about the anatomy of the foot. The scores on the assignments and time to complete the assignments were registered and investigated. A total of 76 students participated. Students scored significantly higher and were significantly faster when they used the 3D anatomy application. Junior medical students were significantly faster than advanced medical students and particularly, advanced students who worked with an atlas needed most time. These results suggest that the 3D anatomy application is more effective as a studying tool, when compared to the use of paper atlases, for both junior and advanced medical students. The difference in time could indicate an influence of the increased number of mental steps it takes to convert two-dimensional atlas images to a 3D mental representation compared to using the 3D anatomy application, although practical issues explaining this cannot be ruled out. Future studies should establish whether the application leads to better learning/retention and to more time-efficient studying.

Case-based radiological anatomy instruction using cadaveric MRI imaging and delivered with extended reality web technology

PURPOSE

Extended reality (XR) technology enhances learning in medical education. The purpose of this study was to develop and apply a case-based approach for teaching radiological anatomy utilizing XR technology for improved student exploration and engagement.

METHODS

The workflow consisted of MRI scanning cadavers followed by radiological, pathological, and anatomical assessment, and finally case presentation based on XR visualizations and student interaction. Case information (Subject, History, and Physical Exam) was presented to student groups who generated and recorded hypotheses using Google Forms.

RESULTS

Use of all components of the system was voluntary and a total of 74 students responded to the survey request (response rate = 95%). Assessment of the experience was conducted through a qualitative survey comprising four Likert scale questions (1-5, 1 lowest), three binary questions, and open-ended comments. Mean, standard deviation, and overall agreement (mean ± SD, OA) showed that students found MRI scans of cadavers to be helpful for dissections (4.14 ± 1.1, 74.3%) and provided an understanding of relevant anatomy (4.32 ± 0.9, 79.7%), while 78.4% of students used the DICOM viewer to visualize scans of cadavers. The difficulty of use was found to be average (2.90 ± 1.0, 23%). zSpace visualizations were used by 40.5% of students, generally agreeing that an understanding of spatial relationships improved as a result (3.60 ± 1.0, 43.2%). More case-based sessions were favored by 97.3% of students.

CONCLUSIONS

Results suggest that cadaveric MRI radiological visualization and XR technology enhance understanding of case-based anatomical dissections and encourage student exploration and engagement.

Incorporating virtual reality in nurse education: A qualitative study of nursing students' perspectives

BACKGROUND

Recent challenges to nurse education have resulted in an increased use of virtual reality which serves as an immersive and effective medium for skill and knowledge acquisition. Virtual reality technology is being included in nurse curricula at undergraduate level. This technology remains a relatively new experience for many nursing students with limited evidence regarding students' perspectives regarding virtual reality.

OBJECTIVE

To explore nursing students' perspectives of incorporating virtual reality in nurse education.

DESIGN

Qualitative descriptive study using thematic analysis.

SETTING

Public university in Ireland.

PARTICIPANTS

Undergraduate nursing students were recruited using purposive and snowball sampling.

METHODS

Students (n = 26) participated in face-to-face semi-structured individual interviews and focus groups in January and February 2020. Data were analysed using inductive thematic analysis.

RESULTS

Three themes were constructed from the interviews: captivating, innovative, and empowering nature of virtual reality; contextual transfer; and challenges and threats to actualisation. Participants believed that virtual reality affords a novel, fun, memorable, inclusive, and engaging means of learning. Many believed that virtual reality would complement current teaching and learning approaches, help build learners' confidence, and provide nursing students with a safe space for trial, error, and problem-solving. The use of virtual reality was recommended to practise various nursing skills and learn about human anatomy, physiology, problem-solving, and clinical decision-making. Participants identified the resources incurred by the technology as challenges to implementing virtual reality in nurse education and stressed the need for continuous face-to-face feedback.

CONCLUSIONS

Findings suggest that virtual reality technology has the potential to facilitate learning, complement current educational approaches, and provide nurse educators with novel and engaging means of content delivery.

Creation of Anatomically Correct and Optimized for 3D Printing Human Bones Models

Educational institutions in several countries state that the education sector should be modernized to ensure a contemporary, individualized, and more open learning process by introducing and developing advance digital solutions and learning tools. Visualization along with 3D printing have already found their implementation in different medical fields in Pauls Stradiņš Clinical University Hospital, and Rīga Stradiņš University, where models are being used for prosthetic manufacturing, surgery planning, simulation of procedures, and student education. The study aimed to develop a detailed methodology for the creation of anatomically correct and optimized models for 3D printing from radiological data using only free and widely available software. In this study, only free and cross-platform software from widely available internet sources has been used—“Meshmixer”, “3D Slicer”, and “Meshlab”. For 3D printing, the Ultimaker 5S 3D printer along with PLA material was used. In its turn, radiological data have been obtained from the “New Mexico Decedent Image Database”. In total, 28 models have been optimized and printed. The developed methodology can be used to create new models from scratch, which can be used will find implementation in different medical and scientific fields—simulation processes, anthropology, 3D printing, bioprinting, and education.

Computer assisted three-dimensional reconstruction of scene in firearm homicide

Worldwide advances in computer techniques are not yet recognised in the practice of forensic medicine. A promising application is their use in making a three-dimensional reconstruction of the crime scene. This study analyses this technique in a homicide by firearm. Queries regarding the direction and number of shots, position of the victim inside the car when shot at and presence of the accused at the crime scene were answered by a scientific model. Similar reconstruction of the scene, nailing the accused in a heinous crime, has not previously been reported as a study or a case. The paper anticipates impetus to the growth of literature in criminology and forensic sciences. It will also expedite the delivery of justice based on scientific evidence in controversial causes of death.

Application of 3D modeling and fusion technology of medical image data in image teaching

BACKGROUND

We combined anatomy with imaging, transformed the 2D information of various imaging techniques into 3D information, and form the assessment system of real medical imaging cases in order to make up for the deficiencies in the current teaching of the medical imaging technology students.

METHODS

A total of 460 medical imaging students were selected and randomly divided into two groups. The research group received the teaching of the fusion of the original CT and MR data 3D model and the original image combined with 3D anatomical image. CT and MRI data are imported through load DICOM of 3D slicer. Different tissues and organs are segmented by threshold and watershed algorithm of segment editor module. Models are exported through export / import models and label maps in segmentation. Save the NHDR file of the original data and Obj file of the corresponding model through save the NHDR and corresponding Obj files are loaded into probe 1.0 software. The software can give different colors to the three-dimensional models of different organs or tissues to display the stereo models and related data, and display the hook edges of organ models on coronal, sagittal and axial images. At the same time, annotation can be established in the corresponding anatomical position. Finally, it can be saved as a single file of Hwl, and the teaching can be opened at any time through the program of probe 1.0. Statistical analysis Academic self-efficacy scale and Self-directed learning ability scale was adopted by self-directed learning evaluation scale between two groups.

RESULTS

Compare the theoretical scores and case analysis scores of the two groups. The scores of the study and control groups were significantly higher than those of the control group. Before the experiment, no significant difference was detected in the self-efficacy of learning ability and learning behavior between the two groups, while after the experiment, these differences between the two groups were statistically significan. Moreover, the learning ability self-efficacy and learning behavior of the two groups of students after the experiment was significantly higher than that before the experiment. The self-efficacy of the learning behavior of the control group was higher after the experiment than that before the experiment, albeit the difference was not statistically significant.

CONCLUSIONS

The modern, information-based and humanized experimental teaching mode will be constantly improved under the support of PACS system in order to optimize the medical imaging teaching activities for the development of modern medical education.

The Use of 3D Printers in Medical Education with a Focus on Bone Pathology

The purpose of this study was to determine the feasibility and effectiveness of incorporating three-dimensional (3D)-printed models into pathology lectures. 3D models of an osteochondroma and an osteosarcoma were printed from a digital model and MRI, respectively, using both stereolithographic and fused-deposition modeling printing techniques. First year medical students with no prior instruction on bone tumors were randomized into two groups: a control group with 2D images and an experimental group with 3D models. The students viewed a pre-recorded lecture about bone tumors, supplemented with handling either 2D images or 3D models of an osteochondroma and osteosarcoma. Performance on pre- and post-activity assessments was compared to evaluate educational effectiveness. Printing 3D models of bone tumors was relatively simple and inexpensive. Assessment data showed that although both groups had improved performance and greater confidence post-lecture, those that handled the 3D models had a more favorable experience than those with the 2D images. This study demonstrates 3D-printed models can be incorporated into a pathology lecture and can positively influence teaching-learning outcomes.

The use of 3D printing for osteopathic medical education of rib disorders

Context

With the advent of increasingly accessible three-dimensional (3D) printing, the possibility to efficiently design and generate prototype innovations is also increasing. This type of manufacturing can potentially enhance medical education by allowing design of models specific to osteopathic manipulative medicine (OMM).

Objectives

To determine the viability of a 3D-printed mechanically moveable rib cage in enhancing the teaching of rib osteopathic principles.

Methods

A single-blind, qualitative study was conducted to evaluate the use of educating students with this novel 3D-printed, movable rib model vs. a traditional static rib model. A total of 237 first-year medical students participated in the study and received the same standardized lecture on the rib dysfunction. Students were also assigned at random to either a comparison group, which would utilize the 3D printed rib model, or the control group, which would utilize the traditional static model. Students would also complete an entrance and exit surveys assessing subjective scores of overall student satisfaction and objective scores for knowledge of OMM rib dysfunction and treatment. An independent samples t-test was applied to assess potential differences between select student evaluation scores (those with continuous variables) of the rib model in the comparison and experiment groups. Chi-square goodness of fit test was conducted to determine if there were any significant differences in entry and exit survey responses between the two groups. Descriptive statistics of the mean and standard deviation were also reported.

Results

For both comparison and control groups, the mean score on an 11-point scale for the evaluation question, "Please rank on a scale of 0-10 how helpful you thought the rib models were to your education," was 9.08 (SD, 1.397). Independent t-test results showed that the comparison group had higher scores than the control group when queried about whether they felt the model accurately depicted the material presented (comparison group mean, 9.55 [SD, 978] vs. control group mean, 9.06 [SD, 1.33; t(235) = 3.253; p=0.01). Chi-square test of goodness-of-fit showed that the differences between the number of correct answers chosen by participants for Item 3 (a case-based question asking students which rib they would treat for a patient presenting to an OMT clinic) was statistically significantly higher for the comparison group (51.9% correct in comparison group vs. 48.1% in control group), even though both groups scored similarly on this item during the entry survey.

Conclusions

The results of this study suggest that utilizing 3D printing to demonstrate somatic dysfunctions of the rib cage may improve understanding and student satisfaction for diagnosis and treatment.

Impact of the Application of Computer-Based 3D Simulation on Acquisition of Knowledge of Guidance of Mandibular Movement

Recently, computer-aided three-dimensional (3D) simulation has expanded to modern education. This study aims to investigate the effects of 3D computer simulation on the learning and self-assessment of the guidance of the mandibular movement. Sixty second-grade dental students were randomly distributed into three groups in an occlusion class. Various teaching protocols were used for each group. Students in the first group (lecture (L)) were taught exclusively through a textbook and two-dimensional illustrations. The conventional lecture method followed by computer-aided 3D simulation was applied to the second group (lecture-to-simulation (LtS)). Lastly, students in the third group (lecture with simulation (LwS)) were simultaneously taught using the conventional lecture and computer-aided 3D simulation methods. After teaching each group, a paper-based examination was conducted; actual and expected scores were obtained on the same day as the occlusal class. Analyses of variance with Tukey’s post-hoc analysis were used to compare the teaching protocols, whereas the independent t test was used for comparing between actual and expected scores (α = 0.05). The LwS group exhibited significantly higher actual and student-expected scores than the L and LtS groups (p < 0.001). The expected score was significantly lower than the actual score in the L group (p = 0.035). However, in the LtS and LwS groups, no statistical difference was observed between expected (p = 0.114) and actual (p = 0.685) scores. The distribution of actual scores in the grading systems indicated higher percentages of excellent (grade A) and good (grade B) scores in the LwS (96.7%) and LtS (79.7%) groups, respectively, than in the L group (53.4%). Using computer-aided 3D simulation to teach the guidance of mandibular movement improved the learning outcomes and self-assessment of students, especially when 3D simulation was combined with conventional lecturing.

Flipped classroom combined with human anatomy web-based learning system shows promising effects in anatomy education

Flipped classroom has received much attention in medical education. The aim of this study was to evaluate the efficacy of flipped classroom combing with human anatomy web-based learning system in anatomy education.A total of 89 freshmen in medical specialty were enrolled and randomly allocated into either the experimental group (receiving the flipped classroom with human anatomy web-based learning system, n = 45) or control group (receiving the traditional classroom teaching, n = 44). A pre-quiz and a post-quiz were conducted before and after the classes, respectively. The improvement in scores between groups was compared. A 5-point Likert scale questionnaire was used to evaluate perceptions and experience.The mean pre-quiz scores of the 2 groups were comparable (all P > .05). However, the mean post-quiz score in the experimental group was significantly higher than that in the control group (91.44 ± 6.25 vs 86.13 ± 11.67, P < .05). The results of questionnaires showed that 44 (97.8%) students agreed with flipped classroom combined with human anatomy web-based learning system, 43 (95.6%) students obtained improved study interest in anatomy learning, and 42 (93.3%) students felt that the interactive, applied in-class activities during the class greatly enhanced their learning.Flipped classroom combined with human anatomy web-based learning system can be used as an effective learning tool for anatomy education.

The utility of three-dimensional models in complex microsurgical reconstruction

BACKGROUND

Three-dimensional (3D) model printing improves visualization of anatomical structures in space compared to two-dimensional (2D) data and creates an exact model of the surgical site that can be used for reference during surgery. There is limited evidence on the effects of using 3D models in microsurgical reconstruction on improving clinical outcomes.

METHODS

A retrospective review of patients undergoing reconstructive breast microsurgery procedures from 2017 to 2019 who received computed tomography angiography (CTA) scans only or with 3D models for preoperative surgical planning were performed. Preoperative decision-making to undergo a deep inferior epigastric perforator (DIEP) versus muscle-sparing transverse rectus abdominis myocutaneous (MS-TRAM) flap, as well as whether the decision changed during flap harvest and postoperative complications were tracked based on the preoperative imaging used. In addition, we describe three example cases showing direct application of 3D mold as an accurate model to guide intraoperative dissection in complex microsurgical reconstruction.

RESULTS

Fifty-eight abdominal-based breast free-flaps performed using conventional CTA were compared with a matched cohort of 58 breast free-flaps performed with 3D model print. There was no flap loss in either group. There was a significant reduction in flap harvest time with use of 3D model (CTA vs. 3D, 117.7±14.2 minutes vs. 109.8±11.6 minutes; P=0.001). In addition, there was no change in preoperative decision on type of flap harvested in all cases in 3D print group (0%), compared with 24.1% change in conventional CTA group.

CONCLUSIONS

Use of 3D print model improves accuracy of preoperative planning and reduces flap harvest time with similar postoperative complications in complex microsurgical reconstruction.

A Three-Dimensional Print Model of the Pterygopalatine Fossa Significantly Enhances the Learning Experience

The pterygopalatine fossa (PPF) is a bilateral space deep within the skull that serves as a major neurovascular junction. However, its small volume and poor accessibility make it a difficult space to comprehend using two-dimensional illustrations and cadaveric dissections. A three-dimensional (3D) printed model of the PPF was developed as a visual and kinesthetic learning tool for completely visualizing the fossa, its boundaries, its communicating channels, and its neurovascular structures. The model was evaluated by analyzing student performance on pre- and post-quizzes and a student satisfaction survey based on the five-point Likert scale. The first cohort comprised of 88 students who had never before studied the PPF. The second cohort consisted of 30 students who were previously taught the PPF. Each cohort was randomly divided into a control group who were provided with a half skull and an intervention group that were provided with the 3D printed model. The intervention group performed significantly better on the post-quiz as compared to the control group in cohort I (P = 0.001); while not significant, it also improved learning in cohort II students (P = 0.124). Satisfaction surveys indicated that the intervention group found the 3D printed model to be significantly more useful (P < 0.05) as compared to the half skull used by the control group. Importantly, the effect sizes for cohorts I and II (0.504 and 0.581, respectively) validated the statistical results. Together, this study highlights the importance of 3D printed models as teaching tools in anatomy education.

Evaluation of HoloHuman augmented reality application as a novel educational tool in dentistry

AIMS

To investigate dental student's perception of the augmented reality (AR) head and neck anatomy application and to determine whether the learning environment was beneficial for students compared with traditional cadaver learning.

METHODS

A total of 88 students participated in a self-administered questionnaire prior to and after the use of AR. This was conducted during anatomy classes for second-year dentistry students. Descriptive data analysis was performed to determine the perceptions of experience gained through AR.

RESULTS

The study revealed that over two-thirds of participants perceived that it would assist in their learning with 52.3% of participants who agreed and 35.2% of participants who strongly agreed. After the use of HoloHuman, it was found that 43.5% of participants agreed that the 3D anatomical structures improved their understanding of anatomy and 36.5% agreed that they felt more confident about their anatomy skills. The results also demonstrated that only 34.1% agreed that it added value in training compared with relying solely on traditional methods. Overall, 75.3% of participants agreed that HoloHuman teaching should not replace traditional cadaver training.

CONCLUSION

This study suggested that the use of AR offers an additional mean of dental anatomy training; however, it cannot be used as a replacement for traditional modes of cadaver anatomy training. AR has the potential to be used as an adjunct tool in the learning of dental head and neck anatomy as it has demonstrated increased student engagement and enjoyment; however, limitations with the device still remain.

Dissection in the Modern Medical Curriculum: An Exploration into Student Perception and Adaptions for the Future

For centuries cadaveric dissection has been a cornerstone of medical anatomy education. However, time and financial limitations in modern, compressed medical curricula, coupled with the abundance of alternate modalities, have raised questions about the role of dissection. This study was designed to explore student perceptions of the efficacy of a dissection program for learning musculoskeletal anatomy, and possible adaptations for appropriate inclusion of dissection in the modern medical curricula. A paper-based questionnaire was used to collect data from 174 medical students after completion of cadaveric dissections. Data were analyzed using both quantitative and qualitative methods. Students strongly believed that cadaver-based learning is essential to anatomy education and modern teaching modalities only complement this. Moreover, most students reported that dissection provided an additional, immersive learning experience that facilitated active learning and helped in developing manual competencies. Students with previous dissection experience or an interest in anatomy-related specialties were significantly more likely to attend dissection sessions. Students found that the procedural dissection components enhanced the knowledge of applied anatomy and is beneficial for the development of clinical skills. They welcomed the idea of implementing more procedure-based dissections alongside lectures and prosections-based practical (PBP) sessions. Cadaveric dissection plays an integral role in medical anatomy education. Time restraints and an increased focus on clinical significance, however, demand carefully considered adaptations of existing dissection protocols. The introduction of procedure-based dissection offers an innovative, highly engaging and clinically relevant package that would amalgamate skills essential to medical practice while retaining the benefits that have allowed dissection to stand the test of time.

A Randomised Control Trial and Comparative Analysis of Multi-Dimensional Learning Tools in Anatomy

This article presents the results of a study that examined students' ability to retain what they have learned in an anatomy course after thirty days via using various learning tools for twenty minutes. Fifty-two second-year medical students were randomly assigned to three learning tools: text-only, three-dimension visualisation in a two-dimensional screen (3DM), or mixed reality (MR). An anatomy test lasting for twenty minutes measuring spatial and nominal knowledge was taken immediately after the learning intervention and another thirty days later. Psychometric tests were also used to measure participants' memory, reasoning and concentration abilities. Additionally, electroencephalogram data was captured to measure the participants' awakeness during the learning session. Results of this study showed that the MR group performed poorly in the nominal questions compared to the other groups; however, the MR group demonstrated higher retention in both the nominal and spatial type information for at least a month compared to the other groups. Furthermore, participants in the 3DM and MR groups reported increased engagement. The results of this study suggest that three-dimensional visualiser tools are likely to enhance learning in anatomy education. However, the study itself has several limitations; some include limited sample size and various threats to internal validity.

Use of 3D printed models in student education of craniofacial traumas

A low-cost 3D printed model has been introduced into the oral and maxillofacial surgery teaching program of undergraduate students to improve education and mechanical comprehension of craniofacial trauma. Steps of the 3D printed haptic model building process are listed. 3D printed models of facial fractures were obtained from Data Imaging and Communications in Medicine (DICOM) data. Computed Aided Design and Manufacturing (CAD-CAM) freeware was used to create new fractures on the standard tessellation language (STL) file. 3D printed haptic model appears to be an efficient low-cost support for craniofacial trauma education of undergraduate students.

Teaching anatomy using an active and engaging learning strategy

BACKGROUND

Various evidence-based and student-centered strategies such as team-based learning (TBL), case-based learning (CBL), and flipped classroom have been recently applied to anatomy education and have shown to improve student engagement and interaction. These strategies shift the focus of teaching from knowledge transmission to knowledge construction by students and encourage the use of tasks. This study discusses the use of an active and engaging learning strategy to teach the musculoskeletal system to Year 1 MBBS students (Faculty of Medical Sciences, The University of the West Indies, Cave Hill, Barbados) and examines the correlation between assessment modalities and student performance.

METHODS

The "Active and Engaging Learning Strategy" was used to assess student learning in the form of oral presentations. Students had presentations on muscle attachments, muscle actions, blood and nerve supply, and applied anatomy of the limb musculature. Questions on the limbs (Locomotor System) were included in pre and post-presentation spotters, in-course assessments, and final examinations. Percentages, paired t-test, independent sample t-test, and zero-order correlations were performed to confirm the results for the different objectives of the study.

RESULTS

The main modes of presentation chosen were poems (37.1%), followed by stories (21.2%), songs (11.4%), and skits (10.6%). The majority of students (84%) found the strategies beneficial and recommended such sessions for future cohorts (92%). Students achieved significantly better scores in post-presentation spotters (p < 0.01) and the marks of in-course and final examinations also showed significant improvement (p < 0.01).

CONCLUSION

Our study highlighted that the active and engaging learning strategy can be used as an effective learning tool in anatomy. Students were proactive in preparing the muscle presentations by utilizing their own creativity, curiosity, and intelligence. Further studies should be conducted using randomized controlled trials to assess the effectiveness of various learning strategies which could open a new door to medical education.

Evaluation of the Applicability of 3d Models as Perceived by the Students of Health Sciences

The methodology and style of teaching anatomy in the faculties of Health Sciences is evolving due to the changes being introduced as a result of the application of new technologies. This brings a more positive attitude in the students, enabling an active participation during the lessons. One of these new technologies is the creation of 3D models that reliably recreates the anatomical details of real bone pieces and allow access of anatomy students to bone pieces that are not damaged and possess easily identifiable anatomical details. In our work, we have presented previously created 3D models of skull and jaw to the students of anatomy in the Faculties of Health Sciences of the University of Salamanca, Spain. The faculties included were odontology, medicine, occupational therapy nursing, health sciences and physiotherapy. A survey was carried out to assess the usefulness of these 3D models in the practical study of anatomy. The total number of students included in the survey was 280.The analysis of the results presents a positive evaluation about the use of 3D models by the students studying anatomy in different Faculties of Health Sciences.

Evaluating 3D-printed models of coronary anomalies: a survey among clinicians and researchers at a university hospital in the UK

OBJECTIVE

To evaluate the feasibility of three-dimensional (3D) printing models of coronary artery anomalies based on cardiac CT data and explore their potential for clinical applications.

DESIGN

Cardiac CT datasets of patients with various coronary artery anomalies (n=8) were retrospectively reviewed and processed, reconstructing detailed 3D models to be printed in-house with a desktop 3D printer (Form 2, Formlabs) using white resin.

SETTING

A University Hospital (division of cardiology) in the UK.

PARTICIPANTS

The CT scans, first and then 3D-printed models were presented to groups of clinicians (n=8) and cardiovascular researchers (n=9).

INTERVENTION

Participants were asked to assess different features of the 3D models and to rate the models' overall potential usefulness.

OUTCOME MEASURES

Models were rated according to clarity of anatomical detail, insight into the coronary abnormality, overall perceived usefulness and comparison to CT scans. Assessment of model characteristics used Likert-type questions (5-point scale from 'strongly disagree' to 'strongly agree') or a 10-point rating (from 0, lowest, to 10, highest). The questionnaire included a feedback form summarising overall usefulness. Participants' imaging experience (in a number of years) was also recorded.

RESULTS

All models were reconstructed and printed successfully, with accurate details showing coronary anatomy (eg, anomalous coronary artery, coronary roofing or coronary aneurysm in a patient with Kawasaki syndrome). All clinicians and researchers provided feedback, with both groups finding the models helpful in displaying coronary artery anatomy and abnormalities, and complementary to viewing 3D CT scans. The clinicians' group, who had substantially more imaging expertise, provided more enthusiastic ratings in terms of models' clarity, usefulness and future use on average.

CONCLUSIONS

3D-printed heart models can be feasibly used to recreate coronary artery anatomy and enhance understanding of coronary abnormalities. Future studies can evaluate their cost-effectiveness, as well as potentially explore other printing techniques and materials.

An Investigation of Two Finite Element Modeling Solutions for Biomechanical Simulation Using a Case Study of a Mandibular Bone

The method used in biomechanical modeling for finite element method (FEM) analysis needs to deliver accurate results. There are currently two solutions used in FEM modeling for biomedical model of human bone from computerized tomography (CT) images: one is based on a triangular mesh and the other is based on the parametric surface model and is more popular in practice. The outline and modeling procedures for the two solutions are compared and analyzed. Using a mandibular bone as an example, several key modeling steps are then discussed in detail, and the FEM calculation was conducted. Numerical calculation results based on the models derived from the two methods, including stress, strain, and displacement, are compared and evaluated in relation to accuracy and validity. Moreover, a comprehensive comparison of the two solutions is listed. The parametric surface based method is more helpful when using powerful design tools in computer-aided design (CAD) software, but the triangular mesh based method is more robust and efficient.

Different Digitalization Techniques for 3D Printing of Anatomical Pieces

The use of different technological devices that allow the creation of three-dimensional models is in constant evolution, allowing a greater application of these technologies in different fields of health sciences and medical training. The equipment for digitalization is becoming increasingly sophisticated allowing obtaining three-dimensional which are more defined and similar to real image and original object. In this work, different modalities of designing 3D anatomical models of bone pieces are presented, for use by students of different disciplines in Health Sciences. To do this we digitalized bone pieces, with different models of scanners, producing images that can be transformed for 3D printing, with a Colido X 3045 printer by digital treatment with different software.

3D Models of Female Pelvis Structures Reconstructed and Represented in Combination with Anatomical and Radiological Sections

We present a computer program designed to visualize and interact with three-dimensional models of the main anatomical structures of the female pelvis. They are reconstructed from serial sections of corpse, from the Visible Human project of the Medical Library of the United States and from serial sections of high-resolution magnetic resonance. It is possible to represent these three-dimensional structures in any spatial orientation, together with sectional images of corpse and magnetic resonance imaging, in the three planes of space (axial, coronal and sagittal) that facilitates the anatomical understanding and the identification of the set of visceral structures of this body region. Actually, there are few studies that analysze in detail the radiological anatomy of the female pelvis using three-dimensional models together with sectional images, making use of open applications for the representation of virtual scenes on low cost Windows® platforms. Our technological development allows the observation of the main female pelvis viscera in three dimensions with a very intuitive graphic interface. This computer application represents an important training tool for both medical students and specialists in gynecology and as a preliminary step in the planning of pelvic floor surgery.