Three-dimensional (3D) printing has become a useful tool within the field of medicine as a way to produce custom anatomical models for teaching, surgical planning, and patient education. This technology is quickly becoming a key component in simulation-based medical education (SBME) to teach hands-on spatial perception and tactile feedback. Within fields such as interventional radiology (IR), this approach to SBME is also thought to be an ideal instructional method, providing an accurate and economical means to study human anatomy and vasculature. Such anatomical details can be extracted from patient-specific and anonymized CT or MRI scans for the purpose of teaching or analyzing patient-specific anatomy. There is evidence that 3D printing in IR can also optimize procedural training, so learners can rehearse procedures under fluoroscopy while receiving immediate supervisory feedback. Such training advancements in IR hold the potential to reduce procedural operating time, thus reducing the amount of time a patient is exposed to radiation and anaesthetia. Using a program evaluation approach, the purpose of this technical report is to describe the development and application of 3D-printed vasculature models within a radiology interest group to determine their efficacy as supplementary learning tools to traditional, lecture-based teaching. The study involved 30 medical students of varying years in their education, involved in the interest group at Memorial University of Newfoundland (MUN). The session was one hour in length and began with a Powerpoint presentation demonstrating the insertion of guide wires and stents using 3D-printed vasculature models. Participants had the opportunity to use the models to attempt several procedures demonstrated during the lecture. These attempts were supervised by an educational expert/facilitator. A survey was completed by all 30 undergraduate medical students and returned to the facilitators, who compiled the quantitative data to evaluate the efficacy of the 3D-printed models as an adjunct to the traditional didactic teaching within IR. The majority of feedback was positive, supporting the use of 3D=printed vasculature as an additional tactile training method for medical students within an IR academic setting. The hands-on experience provides a valuable training approach, with more opportunities for the rehearsal of high-acuity, low-occurrence (HALO) procedures performed in IR.
Objectives: Three-dimensional (3D) printing has emerged in the past decade as a promising tool for the world of medicine. The focus of this article is to review how 3D printed models have been used in medical education.Methods: PubMed was the article database used, and the search criteria included the terms 3D printing and education. The exclusion criteria filtered out articles that were older than ten years, were not in English, and did not target a human population. There were 90 discovered articles, and 38 appropriate articles were determined after reviewing titles and abstracts.Results: Three main themes emerged from this review: general medical education, surgical education, and patient education. The more specific findings can be further divided into: using 3D printed models for teaching anatomy and simulation training; and preoperative planning, intraoperative guidance, and postoperative evaluation.Conclusions: The general consensus was that 3D haptic modelling was a useful tool for educating trainees, staff physicians, and patients. The models helped in increasing participants’ understanding of anatomy and pathologies, and improving trainee skill set and confidence. There is much support to continue research in this area and to further develop ways in which 3D printing can help improve medical education. Objectifs : L’impression tridimensionnelle (3D) s’annonce comme un outil prometteur pour le monde de la médecine. Le présent article révisera comment les méthodes d’impression 3D ont été utilisées dans l’éducation médicale.Méthodes : La base de données utilisée pour les articles fut PubMed et les critères de recherche ont inclus les termes impression 3D et éducation. Les critères d’exclusion ont omis des articles qui dataient de plus de dix ans, qui n’étaient pas en anglais, et qui n’avaient pas comme cible la population humaine. Il y a 90 articles qui furent trouvés en tout et 38 de ces articles ont été jugés adéquats pour la révision.Résultats : Trois grands thèmes ont été ressortis lors de cette révision : éducation médicale générale, éducation chirurgicale, et éducation des patients. De façon plus précise, les thèmes spécifiques suivants furent dégagés : l’utilisation d’impression de modèles 3D pour l’enseignement de l’anatomie et la formation par simulation, la préparation préopératoire, le guide intraopératoire, et l’évaluation postopératoire.Conclusion : Les modèles haptiques 3D étaient reconnus comme un outil efficace pour éduquer les stagiaires, les médecins, et les patients. Ces modèles ont aidé à augmenter la compréhension de l’anatomie et de la pathologie des participants et ont augmenté la confiance et les habiletés des stagiaires. Ces preuves démontrent l’importance de continuer la recherche dans ce domaine afin de développer davantage de façons d’optimiser l’éducation médicale à l’aide de l’impression tridimensionnelle.
Background Three-dimensional (3D) models have the unique ability to replicate individualized cardiac anatomy and may therefore provide clinical benefit. Transcatheter aortic valve implantation (TAVI) currently relies on preoperative imaging for accurate valve sizing, type of valve used, and avoidance of complications. Three-dimensional (3D) modelling may provide benefit for optimal preoperative TAVI planning. The goal of this study is to assess the utility of 3D modelling in the prediction of paravalvular leak (PVL) post TAVI. Methods Retrospective analysis of five patients who underwent TAVI at our center. Pre-operative cardiac gated CT images were utilized to create a 3D printed model with true size aortic root dimensions, including the coronary artery ostium location and left ventricular outflow tract. Deployment of the corresponding model and size TAVI valve into the created 3D model at a similar depth of implantation via fluoroscopy was performed for each patient. Degree of PVL was assessed using a closed system with water infusion under pressure over a duration of 5 s. Correlation was made between the volume obtained in the closed loop model during the pressurized period and the degree of PVL reported on the patients post TAVI placement on transthoracic echocardiogram. Results One female, and four males (age in years ranged from 68 to 87) underwent successful TAVI (0% 30-day mortality). PVL on post procedure TTE ranged from none to trivial. Successful deployment of TAVI valves inside the 3D model occurred in all cases. The average volume of water collected on three trials over 5 s ranged between 19.1–24.1 ml A multivariate linear regression showed significant association between the degree of PVL reported on post-operative transthoracic echocardiogram and the amount of volume detected in the 3D model (difference: -3.9657, 95% CI: (− 4.6761,-3.2554), p < 0.001). Conclusions Our experiments show that replicated 3D models have potential clinical utilization in predicting PVL in the TAVI population. Future research into the role of 3D modelling in the field of TAVI should continue to be explored.
IntroductionA realistic hemorrhagic cervical cancer model was three-dimensionally (3D) printed and used in a postgraduate medical simulation training session.Materials and methodsComputer-assisted design (CAD) software was the platform of choice to create and refine the cervical model. Once the prototype was finalized, another software allowed for the addition of a neoplastic mass, which included openings for bleeding from the neoplasm and cervical os. 3D printing was done using two desktop printers and three different materials. An emergency medicine simulation case was presented to obstetrics and gynecology residents who were at varying stages of their training. The scenario included history taking and physical examination of a standardized patient. This was a hybrid simulation; a synthetic pelvic task trainer that allowed the placement of the cervical model was connected to the standardized patient. The task trainer was placed under a drape and appeared to extend from the standardized patient’s body. At various points in the simulation, the standardized patient controlled the cervical bleeding through a peripheral venous line. Feedback forms were completed, and the models were discussed and evaluated with staff.ResultsA final cervical model was created and successfully printed. Overall, the models were reported to be similar to a real cervix. The models bled well. Most models were not sutured during the scenarios, but overall, the value of the printed cervical models was reported to be high.DiscussionThe models were well received, but it was suggested that more colors be integrated into the cervix in order to better emphasize the intended pathology. The model design requires further improvement, such as the addition of a locking mechanism, in order to ensure that the cervix stays inside the task trainer throughout the simulation. Adjustments to the simulated blood product would allow the bleeding to flow more vigorously. Additionally, a different simulation scenario might be more suitable to explore the residents’ ability to suture the cervical models, as cervical suturing of a neoplasm is not a common emergency department procedure.Conclusion3D-printed cervical models are an economical and anatomically accurate option for simulation training and other educational purposes.
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