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Background
Congenital heart disease (CHD) is the most common human birth defect, and clinicians need to understand the anatomy to effectively care for patients with CHD. However, standard two-dimensional (2D) display methods do not adequately carry the critical spatial information to reflect CHD anatomy. Three-dimensional (3D) models may be useful...
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Context 1
... the session, two questionnaires, each with 5 ques- tions, were provided. The first questionnaire was de- signed to measure learners' satisfaction with the teaching session (Fig. 2). The second questionnaire was designed to measure learners' self-reported confidence in their knowledge of tetralogy of Fallot and its management (Fig. 3). Each question had a Likert scale rating from 1 to 5. For both questionnaires, composite score was mea- sured with total possible scores ranging from 5 to ...
Similar publications
Introduction
Multiple studies have demonstrated the feasibility and accuracy of 3D printed models in the field of congenital heart diseases. These models seem enhance conceptual 3D understanding of complex anatomy. Our aim was to evaluate the usefulness of these models as a teaching tool for medical students to improve learning of congenital heart...
Citations
... The clinical management of congenital heart disease (CHD) poses significant challenges owing to its diverse morphologies that vary among individuals [1][2][3][4][5]. A comprehensive understanding of anomalous cardiac structures is crucial for successful surgical intervention, if necessary. ...
... (www.preprints.org) | NOT PEER-REVIEWED | Posted: 4 June 2024 doi:10.20944/preprints202406.0131.v15 ...
Diagnosing congenital heart disease (CHD) remains challenging because of its complex morphology. Representing the intricate structures of CHD on conventional two-dimensional flat screens is difficult owing to wide variations in the pathologies. Technological advancements, such as three-dimensional printed heart models (3DPHM) and virtual reality (VR), could potentially address the limitations of viewing complex structures using conventional methods. This study aimed to investigate the usefulness and clinical value of four visualization modalities across three different cases of CHD, including ventricular septal defect, double outlet right ventricle, and tetralogy of fallot. Seventeen cardiac specialists were invited to participate in this study, which was aimed at assessing the usefulness and clinical value of four visualization modalities, namely, DICOM images, 3DPHM, VR, and 3D PDF. Of these modalities, 76.4% of the specialists ranked VR as the best for understanding the spatial associations among cardiac structures and for presurgical planning. Meanwhile, 94.1% ranked 3DPHM as the best modality for communicating with patients and their families. Of the various visualization modalities, VR was the best tool for assessing anatomical locations and vessels, comprehending the spatial relationships among cardiac structures, and for presurgical planning. The 3DPHM models were the best tool for medical education as well as communication. In summary, both 3DPHM and VR have their own advantages and outperform the other two modalities, i.e., DICOM images and 3D PDF, in terms of visualizing and managing CHD.
... Previous studies showed that 3D printed models have been gaining considerable attention (LI et al., 2018;SMITH;JONES, 2018;SUZUKI et al., 2018) once they allow the repetitive review of anatomical structures outside the laboratory and promote kinesthetic learning engaging the user's handling (LOKE et al., 2017;WAINMAN et al., 2018). In the specific case of ovine stomach, Mendaza-Decal & Rojo (2021) published a study presenting several advantages regarding the use of the 3D model and suggest that a 3D-printed ovine stomach by surface scanning is a valuable model to support the learning of surface morphology and topography. ...
The traditional teaching of Anatomy requires the use of cadaveric pieces that are often difficult to obtain, preserve and maintain. In this sense, additive manufacturing (AM), also known as 3D printing, can be a useful tool since it makes it possible to produce synthetic models from real anatomical structures. The main goal of this work was to develop anatomical models of an ovine stomach by 3D modeling and printing. A conserved ovine stomach was computed tomography scanned and the anatomical images obtained were reconstructed from the DICOM files using the InVesalius software and used for modeling and printing anatomical models in reduced scale with their peculiar anatomical characteristics. Three models were defined to represent the external and internal morphology: i. closed stomach; ii. stomach opened laterally, and iii. stomach cut sagitally. All models were printed on polylactic acid (PLA) by extrusion material process on an Ender 5 Pro printer. The models produced were adequate since they allowed observing details of the external and internal morphology of the ovine stomach. In addition, these models are presented as an innovative approach to anatomical study when combined with real organs.
... [65][66][67] Generally, the cost of 3D-printed models varies widely, typically ranging from $15-$2,500 USD depending on the type of 3D printer and the raw materials utilized. [68][69][70][71] Thus, 3D-printing technology can serve as a convenient and affordable alternative for traditional manikins, making it a promising option for institutions with financial constraints. ...
Background:
Three-dimensional (3D)-printed models are cost-effective and can be customized by trainers. This study designed a 3D-printed airway suction simulator for use by respiratory therapy (RT) students. The objective was to demonstrate the cost-effectiveness and application of 3D-printed models in respiratory care training, aiming to enhance the educational experience for RT students.
Methods:
This study developed a 3D-printed airway suction simulator that was cost-effective. A randomized controlled trial was conducted involving RT students to compare effectiveness in a 3D-model group and a control group. Skill assessments and written examinations were used to evaluate the participants' knowledge and skills.
Results:
A total of 38 second-year RT students were randomly assigned to either the 3D-model group (n = 19) or the control group (n = 19). One participant in the 3D-model group was lost to follow-up during the planned direct observation of procedural skills (DOPS) assessment and satisfaction questionnaire completion. The posttest written examination scores were significantly higher in the 3D-model group than in the control group (100% vs 80%, P = .02). The scores from the DOPS and satisfaction questionnaire were comparable in the 2 groups.
Conclusions:
This study demonstrated that 3D printing can be used to create a safe and cost-effective airway suction simulator for use by RT students, with potential to enhance training methods. Further research is necessary.
... Patient-specific 3D models have been used to enhance communication between providers and parents [10]. Our group and others have shown its efficacy for medical trainees [11,12] and patients [13]. Other strategies include educational sessions with individualized health professional-led didactics, videos, video games, and/or the use of ACHD "passports" [7][8][9]14,15] to succinctly summarize a patient's cardiac medical history, key vital signs, and diagnostics; however, these did not include 3D models. ...
... Other studies have used the creation of a passport, online tools, or virtual apps, but did not incorporate a 3D model [8,9,14]. For medical trainees, such models allow for better spatial understanding of complex cardiac conditions and have been generally met with increased learner satisfaction [11,12]. In our study [13], we successfully used digital 3D models and demonstrated improvement in measured actual knowledge under the same schema as Biglino et al. [10]. ...
... To the best of our knowledge, no prior study has attempted to automatically model changes in cardiac anatomy across a spectrum of CHDs. Nevertheless, a few studies have concentrated on constructing CHD anatomical models from images for computational simulations [24,25], shape analysis [26,7], and 3D printing [27,28,29] for specific CHD types. For instance, Govil et al. [30] and Tang et al. [31] developed mesh templates for specific congenital heart defects, namely tetralogy of Fallot (ToF) and hypoplastic left heart syndrome (HLHS), respectively. ...
... In contrast, our approach is designed to represent a wide range of CHD topologies using a single neural function, thus enabling shape analysis for all CHD types. Loke et al. [28] and Ryan et al. [29] reported the beneficial impact of using 3D-printed congenital heart disease models on the learning experiences of clinical residents. However, the 3D-printed anatomies were derived from manually segmenting patient image data, which relies on the availability of patient data and significant user intervention, especially for rare CHD cases. ...
Congenital heart disease (CHD) encompasses a spectrum of cardiovascular structural abnormalities, often requiring customized treatment plans for individual patients. Computational modeling and analysis of these unique cardiac anatomies can improve diagnosis and treatment planning and may ultimately lead to improved outcomes. Deep learning (DL) methods have demonstrated the potential to enable efficient treatment planning by automating cardiac segmentation and mesh construction for patients with normal cardiac anatomies. However, CHDs are often rare, making it challenging to acquire sufficiently large patient cohorts for training such DL models. Generative modeling of cardiac anatomies has the potential to fill this gap via the generation of virtual cohorts; however, prior approaches were largely designed for normal anatomies and cannot readily capture the significant topological variations seen in CHD patients. Therefore, we propose a type- and shape-disentangled generative approach suitable to capture the wide spectrum of cardiac anatomies observed in different CHD types and synthesize differently shaped cardiac anatomies that preserve the unique topology for specific CHD types. Our DL approach represents generic whole heart anatomies with CHD type-specific abnormalities implicitly using signed distance fields (SDF) based on CHD type diagnosis, which conveniently captures divergent anatomical variations across different types and represents meaningful intermediate CHD states. To capture the shape-specific variations, we then learn invertible deformations to morph the learned CHD type-specific anatomies and reconstruct patient-specific shapes. Our approach has the potential to augment the image-segmentation pairs for rarer CHD types for cardiac segmentation and generate cohorts of CHD cardiac meshes for computational simulation.
... 3D printing technology allows for the creation of physical cardiac models that can be used for teaching medical student. Such models can be instructional for the teaching of medical professionals about normal and abnormal structural relationships, and even to help the lay public better understand certain structural heart conditions [37][38][39] . ...
Aim
This paper aimed to explore the application of Three-dimensional (3D) printing in cardiovascular diseases, to reach an insight in this field and prospect the future trend.
Methods
The articles were selected from the Web of Science Core Collection database. Excel 2019, VOSviewer 1.6.16, and CiteSpace 6.1.R6 were used to analyze the information.
Results
A total of 467 papers of 3D printing in cardiovascular diseases were identified, and the first included literature appeared in 2000. A total of 692 institutions from 52 countries participated in the relevant research, while the United States of America contributed to 160 articles and were in a leading position. The most productive institution was Curtin University , and Zhonghua Sun who has posted the most articles (n=8) was also from there. The Frontiers in Cardiovascular Medicine published most papers (n=25). The Journal of Thoracic and Cardiovascular Surgery coveted the most citations (n=520). Related topics of frontiers will still focus on congenital heart disease, valvular heart disease, and left atrial appendage closure.
Conclusions
We summarized the publication information of the application of 3D printing in cardiovascular diseases related literature from 2000 to 2023, including country and institution of origin, authors, and publication journal. This study can reflect the current hotspots and novel directions for the application of 3D printing in cardiovascular diseases.
... To the best of our knowledge, no prior study has attempted to automatically model changes in cardiac anatomy across a spectrum of CHDs. Nevertheless, a few studies have concentrated on constructing CHD anatomical models from images for computational simulations [24,25], shape analysis [26,7], and 3D printing [27,28,29] for specific CHD types. For instance, Govil et al. [30] and Tang et al. [31] developed mesh templates for specific congenital heart defects, namely tetralogy of Fallot (ToF) and hypoplastic left heart syndrome (HLHS), respectively. ...
... In contrast, our approach is designed to represent a wide range of CHD topologies using a single neural function, thus enabling shape analysis for all CHD types. Loke et al. [28] and Ryan et al. [29] reported the beneficial impact of using 3D-printed congenital heart disease models on the learning experiences of clinical residents. However, the 3D-printed anatomies were derived from manually segmenting patient image data, which relies on the availability of patient data and significant user intervention, especially for rare CHD cases. ...
Congenital heart disease (CHD) encompasses a spectrum of cardiovascular structural abnormalities, often requiring customized treatment plans for individual patients. Computational modeling and analysis of these unique cardiac anatomies can improve diagnosis and treatment planning and may ultimately lead to improved outcomes. Deep learning (DL) methods have demonstrated the potential to enable efficient treatment planning by automating cardiac segmentation and mesh construction for patients with normal cardiac anatomies. However, CHDs are often rare, making it challenging to acquire sufficiently large patient cohorts for training such DL models. Generative modeling of cardiac anatomies has the potential to fill this gap via the generation of virtual cohorts; however, prior approaches were largely designed for normal anatomies and cannot readily capture the significant topological variations seen in CHD patients. Therefore, we propose a type-and shape-disentangled generative approach suitable to capture the wide spectrum of cardiac anatomies observed in different CHD types and synthesize differently shaped cardiac anatomies that preserve the unique topology for specific CHD types. Our DL approach represents generic whole heart anatomies with CHD type-specific abnormalities implicitly using signed distance fields (SDF) based on CHD type diagnosis, which conveniently captures divergent anatomical variations across different types and represents meaningful intermediate CHD states. To capture the shape-specific variations, we then learn invertible deformations to morph the learned CHD type-specific anatomies and reconstruct patient-specific shapes. Our approach has the potential to augment the image-segmentation pairs for rarer CHD types for cardiac segmentation and generate cohorts of CHD cardiac meshes for computational simulation.
... Importantes resultados comprovam a efetividade do uso da impressão 3D no ensino de doenças congênitas (Loke et al., 2017;Su et al., 2018;. No estudo de Karsenty et al., em 2021, estudantes Considerável parte dos estudos extraídos das bases de dados realiza testes randomizados com peças em 3D sobre o sistema esquelético. ...
... to de modelos 3D impressos na identificação de fraturas espinais para estudantes de Medicina, assim como, comparar os benefícios relatados, em comparação com imagens 2D e com apresentações 3D.Este estudo randomizado revelou que os modelos impressos 3D marcadamente melhoraram a identificação da anatomia da fratura espinal por estudantes de Medicina.Loke et al., 2017. Avaliar o impacto de modelos 3D para residentes em Pediatria compreenderem tetralogia de Fallot durante sessões de ensino.Os modelos 3D melhoram a educação de residentes no que tange à doença cardíaca congênita, especialmente na tetralogia de Fallot. ...
O estudo da Anatomia Humana tem passado por inúmeras mudanças ao longo do tempo. Os métodos tradicionais de ensino, como o estudo em cadáveres, ao apresentarem limitações, encontraram na produção de modelos anatômicos a partir da impressão tridimensional (3D) uma solução inovadora para ser utilizada nas práticas de ensino. Assim, o objetivo do presente estudo foi analisar a possibilidade da aplicação da impressão tridimensional nas áreas de ensino e aprendizagem da Anatomia Humana nas escolas médicas. Realizou-se uma análise descritiva, baseada em revisão integrativa da literatura, em estudos publicados entre 2013 e 2022, utilizando os termos (DeCS/MeSH): “Three-Dimensional Printing”, “Medical Education” e “Anatomy”, aplicado em Inglês e seus correspondentes em Espanhol e Português. A impressão 3D mostrou-se uma importante ferramenta para o estudo da Anatomia Humana, de forma a permitir melhor identificação das estruturas anatômicas nos diferentes Sistemas, propiciando maior retenção, a longo prazo, das informações estudadas e potencializando o aprendizado anatômico, em conjunto com outros materiais impressos e virtuais, peças cadavéricas e realidade virtual aumentada. Ressalta-se a importância de investimento no uso da impressão 3D em abordagens educacionais e exploração das possíveis melhorias na educação médica.
... 3DP models can have both realistic anatomy and textures derived from patients' individual CT and/ or MRI images, thus facilitating the creation of patientspecific physical models with high precision; these models seem to be capable of satisfying the needs for tactile and spatial perception of human anatomical structures [16,17]. The models can help trainees understand organ physiology, anatomy, tumour characteristics, and surgical procedures more accurately [18]. The application of 3DP models bridges the gap between two-dimensional (2D) imaging and realistic anatomy, as it accurately reproduces anatomical structures and pathologies, thereby providing more tangible information than conventional imaging data [19]. ...
Background
Simulation-based medical education (SBME) and three-dimensional printed (3DP) models are increasingly used in continuing medical education and clinical training. However, our understanding of their role and value in improving trainees’ understanding of the anatomical and surgical procedures associated with liver surgery remains limited. Furthermore, gender bias is also a potential factor in the evaluation of medical education. Therefore, the aim of this study was to evaluate the educational benefits trainees receive from the use of novel 3DP liver models while considering trainees’ experience and gender.
Methods
Full-sized 3DP liver models were developed and printed using transparent material based on anonymous CT scans. We used printed 3D models and conventional 2D CT scans of the liver to investigate thirty trainees with various levels of experience and different genders in the context of both small group teaching and formative assessment. We adopted a mixed methods approach involving both questionnaires and focus groups to collect the views of different trainees and monitors to assess trainees’ educational benefits and perceptions after progressing through different training programs. We used Objective Structured Clinical Examination (OSCE) and Likert scales to support thematic analysis of the responses to the questionnaires by trainees and monitors, respectively. Descriptive analyses were conducted using SPSS statistical software version 21.0.
Results
Overall, a 3DP model of the liver is of great significance for improving trainees’ understanding of surgical procedures and cooperation during operation. After viewing the personalized full-sized 3DP liver model, all trainees at the various levels exhibited significant improvements in their understanding of the key points of surgery (p < 0.05), especially regarding the planned surgical procedure and key details of the surgical procedures. More importantly, the trainees exhibited higher levels of satisfaction and self-confidence during the operation regardless of gender. However, with regard to gender, the results showed that the improvement of male trainees after training with the 3DP liver model was more significant than that of female trainees in understanding and cooperation during the surgical procedure, while no such trend was found with regard to their understanding of the base knowledge.
Conclusion
Trainees and monitors agreed that the use of 3DP liver models was acceptable. The improvement of the learning effect for practical skills and theoretical understanding after training with the 3DP liver models was significant. This study also indicated that training with personalized 3DP liver models can improve all trainees’ presurgical understanding of liver tumours and surgery and males show more advantage in understanding and cooperation during the surgical procedure as compared to females. Full-sized realistic 3DP models of the liver are an effective auxiliary teaching tool for SBME teaching in Chinese continuing medical education.
... Inadequate clinician knowledge can lead to suboptimal care of these patients for both simple and complex lesions [12], and thus this is an important area of medical education. Recent efforts have been made to introduce 3D printed models of CHD teaching across a spectrum of learners including undergraduate nursing [13] and medical students [6,7,[14][15][16]; paediatric [17,18], critical-care [19][20][21], and cardiac surgical and physician trainees [22][23][24]; and adult and paediatric cardiac nurses [25]. These studies have demonstrated the feasibility and some efficacy in the use of 3D printed models of CHD as learning aids, but have not comprehensively explored students' attitudes and experiences with these novel learning aids. ...
Three-dimensional (3D) printing is increasingly used in medical education and paediatric cardiology. A technology-enhanced learning (TEL) module was designed to accompany 3D printed models of congenital heart disease (CHD) to aid in the teaching of medical students. There are few studies evaluating the attitudes and perceptions of medical students regarding their experience of learning about CHD using 3D printing. This study aimed to explore senior medical students’ experiences in learning about paediatric cardiology through a workshop involving 3D printed models of CHD supported by TEL in the form of online case-based learning. A mixed-methods evaluation was undertaken involving a post-workshop questionnaire (n = 94 students), and focus groups (n = 16 students). Focus group and free-text questionnaire responses underwent thematic analysis. Questionnaire responses demonstrated widespread user satisfaction; 91 (97%) students agreed that the workshop was a valuable experience. The highest-level satisfaction was for the physical 3D printed models, the clinical case-based learning, and opportunity for peer collaboration. Thematic analysis identified five key themes: a variable experience of prior learning, interplay between physical and online models, flexible and novel workshop structure, workshop supported the learning outcomes, and future opportunities for learning using 3D printing. A key novel finding was that students indicated the module increased their confidence to teach others about CHD and recommended expansion to other parts of the curriculum. 3D printed models of CHD are a valuable learning resource and contribute to the richness and enjoyment of medical student learning, with widespread satisfaction.
Supplementary Information
The online version contains supplementary material available at 10.1007/s40670-023-01840-w.
