Role of 3D printing technology in paediatric teaching and training: a systematic review

Abstract

BackgroundIn the UK, undergraduate paediatric training is brief, resulting in trainees with a lower paediatric knowledge base compared with other aspects of medicine. With congenital conditions being successfully treated at childhood, adult clinicians encounter and will need to understand these complex pathologies. Patient-specific 3D printed (3DP) models have been used in clinical training, especially for rarer, complex conditions. We perform a systematic review to evaluate the evidence base in using 3DP models to train paediatricians, surgeons, medical students and nurses.MethodsOnline databases PubMed, Web of Science and Embase were searched between January 2010 and April 2020 using search terms relevant to “paediatrics”, “education”, “training” and “3D printing”. Participants were medical students, postgraduate trainees or clinical staff. Comparative studies (patient-specific 3DP models vs traditional teaching methods) and non-comparative studies were included. Outcomes gauged objective and subjective measures: test scores, time taken to complete tasks, self-reported confidence and personal preferences on 3DP models. If reported, the cost of and time taken to produce the models were noted.ResultsFrom 587 results, 15 studies fit the criteria of the review protocol, with 5/15 being randomised controlled studies and 10/15 focussing on cardiovascular conditions. Participants using 3DP models demonstrated improved test scores and faster times to complete procedures and identify anatomical landmarks compared with traditional teaching methods (2D diagrams, lectures, videos and supervised clinical events). User feedback was positive, reporting greater user self-confidence in understanding concepts with users wishing for integrated use of 3DP in regular teaching. Four studies reported the costs and times of production, which varied depending on model complexity and printer. 3DP models were cheaper than ‘off-the-shelf’ models available on the market and had the benefit of using real-world pathologies. These mostly non-randomised and single-centred studies did not address bias or report long-term or clinically translatable outcomes.Conclusions3DP models were associated with greater user satisfaction and good short-term educational outcomes, with low-quality evidence. Multicentred, randomised studies with long-term follow-up and clinically assessed outcomes are needed to fully assess their benefits in this setting.PROSPERO registration numberCRD42020179656.

A Meta-Review about Medical 3D Printing

“…Further medical fields included are oral and maxillofacial surgery [47][48][49][50][51][52][53][54][55][56], orthopedics and otorhinolaryngology [78][79][80][81][82][83][84]. The field of pediatrics [85][86][87][88][89][90][91][92] included sub-specialties such as, orthopedics [92], otorhinolaryngology [85,86] and oncology [91]. Yang and colleagues [87] mentioned the following pediatric surgical sub-specialties: neurosurgery, cardiothoracic Surgery, plastic Surgery, cardiovascular surgery, urological surgery, orthopedics, ENT surgery, oncological surgery and vascular surgery.…”

“…Materials can be categorised into 5 classes: polymers, metals, ceramics, organic materials and composite materials. In the class of polymers the following materials were found: ABS [1,8,37,38,45,48,61,64,79,88,90,105], clear resin [103,106], HIPS [79,80,84], latex resin [12], nylon [24,28,77,105], PA [11,28,81,92], PS [92], PET-G [25,27,77,106], PCL [83,84], PEEK [77,92],PHA [25], photopolymer [5,6,12,16,25,38,79,80,[103][104][105][106], PLA [4,…”

“…The operation time was reduced by 0.72 -258 minutes [42,94]. The time to produce a 3D-printed model was 20 minutes to 9 days [28,40,88,89,91,101,102]. Morgan and colleagues [95] 95,96,99,112],blood loss [41, 60-62, 64, 65, 69, 70, 73, 75, 95, 96] and fluoroscopy dose [20,61,70,90,95,96].…”

“…The affected organs or organ systems include the aorta [13, 103, 106], bladder [29], brain [35, 37, 39], cranium [30, 31, 34, 36, 44, 48–50, 53–55, 82, 84, 86, 91], ear [48, 78–81, 83,93, female internal genitals [46], heart [2–12, 87, 88, 104], jaw [17, 20, 21, 23, 25, 47–52, 55, 56], kidney [29, 41, 98, 100–102], lip [94], liver [19, 22, 28], musculoskeletal system [20, 21, 24, 31–33, 38, 43, 57–77, 89, 90, 92, 93, 95–97], prostate [98, 99], rectum and colon [14, 40, 42, 45], spine [38, 59, 68, 77, 92], teeth [15–18], thyroid gland [45], upper and lower respiratory tract [1, 45, 85] and vessels [39, 105].…”

Application of 3D printing technology combined with PBL teaching method in clinical teaching of cerebrovascular disease: An observational study

“…[1,2] Owing to continuous advancements in science and technology, 3D printing technology has gradually been applied in clinical teaching and assisted surgery. [3][4][5] Tan et al reported positive results of 3D printing technology application when teaching congenital heart surgery. [6] 3D printing technology transformed from simple vision to a visual-tactile model, facilitating clinical training of neurosurgeons.…”