The reproduction of human pathology specimens using three-dimensional (3D) printing technology for teaching purposes

Application of 3D Printing in Cleft Lip and Palate Repair

This manuscript reviews the transformative impact of 3-dimensional (3D) printing technologies in the treatment and management of cleft lip and palate (CLP), highlighting its application across presurgical planning, surgical training, implantable scaffolds, and postoperative care. By integrating patient-specific data through computer-aided design and manufacturing, 3D printing offers tailored solutions that improve surgical outcomes, reduce operation times, and enhance patient care. The review synthesizes current research findings, technical advancements, and clinical applications, illustrating the potential of 3D printing to revolutionize CLP treatment. Further, it discusses the future directions of combining 3D printing with other innovative technologies like artificial intelligence, 4D printing, and in situ bioprinting for more comprehensive care strategies. This paper underscores the necessity for multidisciplinary collaboration and further research to overcome existing challenges and fully utilize the capabilities of 3D printing in CLP repair.

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.

Exploring the transformative role of 3D printing in advancing medical education in Africa: a review

With the increasing demand for quality healthcare and the scarcity of resources, medical education in Africa faces numerous challenges. Traditional teaching methods often need help to adequately prepare medical students for the complex and diverse healthcare scenarios they will encounter in practice. 3D printing technology holds significant promise in addressing these challenges by providing innovative solutions for medical education. This review examines the various applications of 3D printing in medical education, focusing on its potential to enhance anatomy education, surgical training and medical device development. It explores how 3D printing can offer realistic and customisable anatomical models, enabling students to understand human anatomy better and improve their surgical skills through realistic simulations. Furthermore, this paper discusses the potential of 3D printing in developing low-cost medical devices, prosthetics and surgical instruments, which can significantly benefit resource-limited settings in Africa. It explores the concept of distributed manufacturing, where 3D printing can decentralise the production of essential medical equipment, reducing reliance on external suppliers and improving access to healthcare. The review also highlights the challenges and limitations associated with implementing 3D printing in medical education in Africa, such as limited infrastructure, high costs and the need for specialised training. However, it presents successful initiatives and collaborations that have overcome these obstacles, demonstrating the feasibility and potential impact of integrating 3D printing into medical education in Africa.

Tridimensional models and radiographic study of dorsal laminectomy and thoracolumbar hemilaminectomy in dogs

PURPOSE

To create three-dimensional anatomical models of the thoracic and lumbar portions of the canine spine that reproduce the vertebral surgical approaches of dorsal laminectomy and hemilaminectomy, and to perform the respective radiographic evaluations of each approach.

METHODS

In a digital archive of the canine spine, digitally replicate the dorsal laminectomy and hemilaminectomy in the thoracic and lumbar portions and, then, make tridimensional prints of the vertebral models and obtain radiographs in three dorsoventral, ventrodorsal and laterolateral projections.

RESULTS

The anatomical models of the surgical spinal canal accesses of the thoracic and lumbar portions showed great fidelity to the natural bones. The created accesses have the proper shape, location and size, and their radiographic images showed similar radiodensities.

CONCLUSIONS

The replicas of the dorsal laminectomy and hemilaminectomy developed in the anatomical models in the thoracic and lumbar portions are able to represent the technical recommendations of the specialized literature, as well as their respective radiographic images, which have certain radiological properties that allow to make a deep radiological study. Therefore, the models are useful for neurosurgical training.

A workflow for the creation of photorealistic 3D cadaveric models using photogrammetry

Three-dimensional (3D) representations of anatomical specimens are increasingly used as learning resources. Photogrammetry is a well-established technique that can be used to generate 3D models and has only been recently applied to produce visualisations of cadaveric specimens. This study has developed a semi-standardised photogrammetry workflow to produce photorealistic models of human specimens. Eight specimens, each with unique anatomical characteristics, were successfully digitised into interactive 3D models using the described workflow and the strengths and limitations of the technique are described. Various tissue types were reconstructed with apparent preservation of geometry and texture which visually resembled the original specimen. Using this workflow, an institution could digitise their existing cadaveric resources, facilitating the delivery of novel educational experiences.

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.

In jars: The integration of historical anatomical and pathological potted specimens in undergraduate education

INTRODUCTION

Across the UK, many anatomy departments possess historical potted wet cadaveric specimen collections, such as organs preserved in fluid-filled jars. Although considered obsolete by some for anatomical education, there is immense potential for their utilisation in teaching, particularly in institutes that have limited access to cadavers or have had body donation rates impacted by the Covid-19 pandemic. Another benefit of historical potted cadaveric specimens is that severe pathology, often not seen today, can be observed by the student.

MATERIAL AND METHODS

The aim of this study was to understand students' opinions and attitudes towards the use of historical anatomical and pathological potted wet specimen collections in undergraduate science teaching. Following their integration into the anatomy program of a Clinical Sciences degree, seventy-seven undergraduate students completed a five-point Likert questionnaire on their perspective for the integration of the historical potted specimens in anatomical education. This study was approved by the Research Ethics committee at the University of Bradford RESULTS: The study demonstrated that 90 % of students found the collection useful in teaching, 92 % would like to see the collection used more in teaching, and 76 % of students found that the collection encouraged them to consider medical ethics and the donor.

CONCLUSIONS

In conclusion, the survey findings suggest that further utilisation of historical potted wet specimen collections would be useful in the teaching of anatomy and that these collections could potentially encourage conversations on post-mortem bodily integrity, ethics, and organ donation.

Online, Interactive, Digital Visualisation Resources that Enhance Histology Education

Teaching histology is expensive, particularly in some universities with limited or ageing resources such as microscope equipment and inadequate histological slide collections. Increasing numbers of student enrolments have required duplications of laboratory classes. Such practical classes are staff intensive and so teaching hours are increased. Technology can now solve many of these issues but perhaps, more importantly, can also cater to the self-directed and independent learning needs of today's learners.This chapter will describe and evaluate distinct innovations available on a global scale, utilising both technology-enhanced and interactive learning strategies to revolutionise histology teaching via successful online delivery of learning resources. Histology students can access these innovations to maximise their learning and enable them to complete all learning outcomes away from the traditional classroom environment (i.e., online). Most appropriately, all of these innovations address and help solve cognitive challenges that students experience in histology learning.Lecture recording platforms with engaging functionalities have enabled students to view lectures online. Using new innovative histology resources has eliminated the need for students to attend practical histology laboratory sessions. Instead, students can now study histology successfully and enjoyably in their own time. Learners can interact with unlimited numbers of high-quality images and click on hyperlinked text to identify key features of histological structures. Students can now use virtual microscopy to view digitised histological sections (virtual microscopy) at increasing levels of magnification. Consequently, there is no requirement for academic staff to be present when directing students through their learning objectives, which therefore eliminates formal, scheduled practical classes. The learning platforms offer a variety of formative assessment formats. On completion of a quiz, instant feedback can be provided for students, which makes histology learning efficient and can significantly improve student performance in examinations.However, there remains the issue that three-dimensional (3D) interpretation from traditional two-dimensional (2D) representations of cell, tissue, and organ structure can be cognitively challenging for many students. The popularity of using animations and 3D reconstructions to help learners understand and remember information has greatly increased since the advent of powerful graphics-oriented computers. This technology allows animations to be produced much more easily and cheaply than in previous years, whilst Cinema 4D technology has enhanced a new paradigm shift in teaching histology. 3D reconstruction and animations can meet the educational need and solve the dilemma.

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).

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).

Visual-spatial dimension integration in digital pathology education enhances anatomical pathology learning

Literature review demonstrated a surprising lack of publications on digital e-learning pathology resources for senior medical undergraduates and interns. An interactive Digital Pathology Repository (iDPR) integrating two- and three-dimensional (2D, 3D) high-resolution anatomical pathology images with correlated digital histopathology was developed. The novel iDPR was rigorously evaluated using mixed methods to assess pathology knowledge gains (pre- and post-tests), quality impact analysis (questionnaire), user feedback (focus group discussions) and user visual behaviour (eye gaze tracking analysis of 2D/ 3D images).Exposure to iDPR appeared to improve user pathology knowledge, as observed by significantly increased test scores on topic-related quizzes (n = 69, p < 0.001). In addition, most users were highly satisfied with the key design elements of the iDPR tool. Focus group discussion revealed the iDPR was regarded as a relevant online learning resource, although some minor technical issues were also noted. Interestingly, visual behaviour trends indicated that specific diagnostic pathological lesions could be correctly identified faster in 3D images, when compared to 2D images.The iDPR offers promise and potential in pathology education for senior clinical students and interns, gauging from both qualitative and quantitative positive user feedback. With incorporation of image annotations and interactive functionality, and with further technology development, this would prove a useful tool for diagnostic pathology and telepathology. As images with added visual-spatial dimension can provide enhanced detail and aid more rapid diagnosis, future applications of the iDPR could include virtual reality or holographic images of anatomical pathology specimens.

The utility of a gross dissection anatomical model for simulation-based learning in pathology

INTRODUCTION

The examination of morphological alterations in tissues is fundamental in Pathology. Traditional training in gross dissection has several limitations, including the risk of transmissible diseases, formaldehyde exposure and limited specimen availability. We describe a teaching method using anatomical simulators.

METHODS

Liquid silicone-based artisan neoplastic anatomical models were used in conjunction with clinical scenarios. Eighty-five medical students participated in a gross dissection experience and were asked to complete a feedback questionnaire. Additionally, a workshop was organized for students to compare three different teaching methods. The first one used still images (Group1-G1), the second a video explanation (Group2-G2), and the third directly observed a pathologist while grossing (Group3-G3).

RESULTS

The knowledge acquisition questionnaire showed an average value of 4.4 out of 5 (1-5) (range 3.4-4.7, σ0.89). The categories 'knowledge of resection margins' and 'macroscopic diagnosis' received the highest values (4.8, σ0.11 and 4.7, σ0.32, respectively), followed by 'understanding of handling and gross examination of the surgical specimen' (4.5, σ0.49), 'prognosis' (4.3, σ0.67) and 'understanding of a tumor resection' (3.9, σ0.96) (p<0.05). Regarding teaching methods, G3 spent less time than G2 and G1 with mean times of 15'39″ (σ2'12″), 16'50″ (σ3'45″), and 17'52″ (σ2'12″), respectively (p<0.05). Gross dissection marks (0-5) showed statistically significant differences (p<0.05). G2 obtained better results (3.7;σ0.54) than G3 (3.4;σ0.94) or G1 (3.1;σ0.8).

CONCLUSIONS

This preliminary study demonstrates that it is possible to implement a gross dissection simulation module at medical school and thus enable the acquisition of skills in a secure environment.

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.

Applications of 3D printed bone tissue engineering scaffolds in the stem cell field

Due to traffic accidents, injuries, burns, congenital malformations and other reasons, a large number of patients with tissue or organ defects need urgent treatment every year. The shortage of donors, graft rejection and other problems cause a deficient supply for organ and tissue replacement, repair and regeneration of patients, so regenerative medicine came into being. Stem cell therapy plays an important role in the field of regenerative medicine, but it is difficult to fill large tissue defects by injection alone. The scientists combine three-dimensional (3D) printed bone tissue engineering scaffolds with stem cells to achieve the desired effect. These scaffolds can mimic the extracellular matrix (ECM), bone and cartilage, and eventually form functional tissues or organs by providing structural support and promoting attachment, proliferation and differentiation. This paper mainly discussed the applications of 3D printed bone tissue engineering scaffolds in stem cell regenerative medicine. The application examples of different 3D printing technologies and different raw materials are introduced and compared. Then we discuss the superiority of 3D printing technology over traditional methods, put forward some problems and limitations, and look forward to the future.