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.     

Take away body parts! An investigation into the use of 3D‐printed anatomical models in undergraduate anatomy education

Understanding the three‐dimensional (3D) nature of the human form is imperative for effective medical practice and the emergence of 3D printing creates numerous opportunities to enhance aspects of medical and healthcare training. A recently deceased, un‐embalmed donor was scanned through high‐resolution computed tomography. The scan data underwent segmentation and post‐processing and a range of 3D‐printed anatomical models were produced. A four‐stage mixed‐methods study was conducted to evaluate the educational value of the models in a medical program. (1) A quantitative pre/post‐test to assess change in learner knowledge following 3D‐printed model usage in a small group tutorial; (2) student focus group (3) a qualitative student questionnaire regarding personal student model usage (4) teaching faculty evaluation. The use of 3D‐printed models in small‐group anatomy teaching session resulted in a significant increase in knowledge (P = 0.0001) when compared to didactic 2D‐image based teaching methods. Student focus groups yielded six key themes regarding the use of 3D‐printed anatomical models: model properties, teaching integration, resource integration, assessment, clinical imaging, and pathology and anatomical variation. Questionnaires detailed how students used the models in the home environment and integrated them with anatomical learning resources such as textbooks and anatomy lectures. In conclusion, 3D‐printed anatomical models can be successfully produced from the CT data set of a recently deceased donor. These models can be used in anatomy education as a teaching tool in their own right, as well as a method for augmenting the curriculum and complementing established learning modalities, such as dissection‐based teaching. Anat Sci Educ 11: 44–53. © 2017 American Association of Anatomists.     

Three‐dimensional printing of X‐ray computed tomography datasets with multiple materials using open‐source data processing

Advances in three‐dimensional (3D) printing allow for digital files to be turned into a “printed” physical product. For example, complex anatomical models derived from clinical or pre‐clinical X‐ray computed tomography (CT) data of patients or research specimens can be constructed using various printable materials. Although 3D printing has the potential to advance learning, many academic programs have been slow to adopt its use in the classroom despite increased availability of the equipment and digital databases already established for educational use. Herein, a protocol is reported for the production of enlarged bone core and accurate representation of human sinus passages in a 3D printed format using entirely consumer‐grade printers and a combination of free‐software platforms. The comparative resolutions of three surface rendering programs were also determined using the sinuses, a human body, and a human wrist data files to compare the abilities of different software available for surface map generation of biomedical data. Data shows that 3D Slicer provided highest compatibility and surface resolution for anatomical 3D printing. Generated surface maps were then 3D printed via fused deposition modeling (FDM printing). In conclusion, a methodological approach that explains the production of anatomical models using entirely consumer‐grade, fused deposition modeling machines, and a combination of free software platforms is presented in this report. The methods outlined will facilitate the incorporation of 3D printed anatomical models in the classroom. Anat Sci Educ 10: 383–391. © 2017 American Association of Anatomists.     

Does Augmented Visual Feedback from Novel,Multicolored, Three-Dimensional-Printed Teeth Affect Dental Students' Acquisition of Manual Skills?

Although three-dimensional (3D) printing technology is increasingly used in dental education, its application regarding the provision of online visual augmented feedback has not been tested. Thus, this study aimed to: (1) develop two generations of multicolored 3D-printed teeth that provide visual augmented feedback for students conducting the cavity preparation process, (2) assess students' clinical performance after training on the 3D models, and (3) acquire student feedback. For the first-generation model, augmented feedback was obtained from five 3D-printed teeth models for five cavity preparation procedures. Each model comprised three layers printed in green, yellow, and red indicating whether preparation was acceptable, limited, or unacceptable, respectively. The study used a crossover design in which the experimental group trained on five multicolored models and 10 standard plastic teeth, and the control group trained on 15 standard plastic teeth. Students gave positive feedback of the methodology but complained about the printed material's hardness. Therefore, a second-generation model was developed: the model's occlusal plane was replaced with a harder printed acrylic material, and the experiment was repeated. During training, instructors provided external terminal feedback only for performance on standard plastic teeth. Manual grades for cavity preparations on standard plastic teeth were compared. No significant differences were found between the control and experimental groups in both generations' models. However, less instructor time was needed, and similar clinical results were obtained after training with both generations. Thus, multicolored 3D-printed teeth models promote self-learning during the process of acquiring manual skills and reduce student dependency on instructors.     

Production of accurate skeletal models of domestic animals using three‐dimensional scanning and printing technology

Access to adequate anatomical specimens can be an important aspect in learning the anatomy of domestic animals. In this study, the authors utilized a structured light scanner and fused deposition modeling (FDM) printer to produce highly accurate animal skeletal models. First, various components of the bovine skeleton, including the femur, the fifth rib, and the sixth cervical (C6) vertebra were used to produce digital models. These were then used to produce 1:1 scale physical models with the FDM printer. The anatomical features of the digital models and three‐dimensional (3D) printed models were then compared with those of the original skeletal specimens. The results of this study demonstrated that both digital and physical scale models of animal skeletal components could be rapidly produced using 3D printing technology. In terms of accuracy between models and original specimens, the standard deviations of the femur and the fifth rib measurements were 0.0351 and 0.0572, respectively. All of the features except the nutrient foramina on the original bone specimens could be identified in the digital and 3D printed models. Moreover, the 3D printed models could serve as a viable alternative to original bone specimens when used in anatomy education, as determined from student surveys. This study demonstrated an important example of reproducing bone models to be used in anatomy education and veterinary clinical training. Anat Sci Educ 11: 73–80. © 2017 American Association of Anatomists.     

FDM3D打印鳄鱼模型翘曲变形分析与优化

随着3D打印技术的发展与推广应用,打印件质量更加受到重视.针对某细长类鳄鱼模型FDM3D打印成型后在高度方向翘曲变形严重的现象,对产生翘曲变形的原因进行了分析和探讨,发现其主要由模型冷却凝固时收缩不均匀引起.试验表明,通过提高环境温度、降低打印层厚、加快打印速度和减少内部填充量,可有效改善翘曲变形情况.     

The Effects of a Functional Three-dimensional (3D) Printed Knee Joint Simulator in Improving Anatomical Spatial Knowledge

In recent decades, three-dimensional (3D) printing as an emerging technology, has been utilized for imparting human anatomy knowledge. However, most 3D printed models are rigid anatomical replicas that are unable to represent dynamic spatial relationships between different anatomical structures. In this study, the data obtained from a computed tomography (CT) scan of a normal knee joint were used to design and fabricate a functional knee joint simulator for anatomical education. Utility of the 3D printed simulator was evaluated in comparison with traditional didactic learning in first-year medical students (n = 35), so as to understand how the functional 3D simulator could assist in their learning of human anatomy. The outcome measure was a quiz comprising 11 multiple choice questions based on locking and unlocking of the knee joint. Students in the simulation group (mean score = 85.03%, ±SD 10.13%) performed significantly better than those in the didactic learning group, P < 0.05 (mean score = 70.71%, ±SD 15.13%), which was substantiated by large effect size, as shown by a Cohen’s d value of 1.14. In terms of learning outcome, female students who used 3D printed simulators as learning aids achieved greater improvement in their quiz scores as compared to male students in the same group. However, after correcting for the modality of instruction, the sex of the students did not have a significant influence on the learning outcome. This randomized study has demonstrated that the 3D printed simulator is beneficial for anatomical education and can help in enriching students’ learning experience.     

Criss-cross heart three-dimensional printed models in medical education: A multicenter study on their value as a supporting tool to conventional imaging

The utility of three-dimensional (3D) printed models for medical education in complex congenital heart disease (CHD) is sparse and limited. The purpose of this study was to evaluate the utility of 3D printed models for medical education in criss-cross hearts covering a wide range of participants with different levels of knowledge and experience, from medical students, clinical fellows up to senior medical personnel. Study participants were enrolled from four dedicated imaging workshops developed between 2016 and 2019. The study design was a non-randomized cross-over study to evaluate 127 participants' level of understanding of the criss-cross heart anatomy. This was evaluated using the scores obtained following teaching with conventional images (echocardiography and magnetic resonance imaging) versus a 3D printed model learning approach. A significant improvement in anatomical knowledge of criss-cross heart anatomy was observed when comparing conventional imaging test scores to 3D printed model tests [76.9% (61.5%–87.8%) vs. 84.6% (76.9%–96.2%), P < 0.001]. The increase in the questionnaire marks was statistically significant across all academic groups (consultants in pediatric cardiology, fellows in pediatric cardiology, and medical students). Ninety-four percent (120) and 95.2% (121) of the participants agreed or strongly agreed, respectively, that 3D models helped them to better understand the medical images. Participants scored their overall satisfaction with the 3D printed models as 9.1 out of 10 points. In complex CHD such as criss-cross hearts, 3D printed replicas improve the understanding of cardiovascular anatomy. They enhanced the teaching experience especially when approaching medical students.     

A validated instrument measuring students' perceptions on plastinated and three-dimensional printed anatomy tools

Due to the modernization of the medical curriculum and technological advancements, anatomy education has evolved beyond cadaveric dissection alone. Plastination techniques, three-dimensional (3D) modeling, and 3D printing technologies have progressively gained importance. However, there are limited valid and reliable surveys to evaluate students' perceptions of these new anatomy tools. Hence, this study aimed to develop a validated instrument to measure students' learning satisfaction, self-efficacy, humanistic values, and perceived limitations of plastinated and 3D printed models. A 41-item survey (five-point Likert scale, 1 = strongly disagree to 5 = strongly agree) was administered to Year 1 undergraduate medical students following a randomized controlled crossover study that evaluated plastinated and 3D printed cardiac and neck models. Ninety-six responses were received, and a factor analysis was performed with the Kaiser–Meyer–Olkin sampling adequacy of 0.878. The confirmatory factor analysis yielded a 4-factor, 19 items model that had a good fit with the latent constructs of $x$² (147) = 211.568, P < 0.001, root mean square error of approximation = 0.068, root mean square residual = 0.064, comparative fit index = 0.946, and Tucker Lewis index = 0.937. The Cronbach's alpha for the individual factors ranged from 0.74 to 0.95, indicating good internal consistency. This demonstrated a psychometrically valid and reliable instrument to measure students' perceptions toward plastinated and 3D printed models.     

Three-dimensional Printing in Anatomy Education: Assessing Potential Ethical Dimensions

New technological developments have frequently had major consequences for anatomy education, and have raised ethical queries for anatomy educators. The advent of three-dimensional (3D) printing of human material is showing considerable promise as an educational tool that fits alongside cadaveric dissection, plastination, computer simulation, and anatomical models and images. At first glance its ethical implications appear minimal, and yet the more extensive ethical implications around clinical bioprinting suggest that a cautious approach to 3D printing in the dissecting room is in order. Following an overview of early groundbreaking studies into 3D printing of prosections, organs, and archived fetal material, it has become clear that their origin, using donated bodies or 3D files available on the Internet, has ethical overtones. The dynamic presented by digital technology raises questions about the nature of the consent provided by the body donor, reasons for 3D printing, the extent to which it will be commercialized, and its comparative advantages over other available teaching resources. In exploring questions like these, the place of 3D printing within a hierarchical sequence of value is outlined. Discussion centers on the significance of local usage of prints, the challenges created by regarding 3D prints as disposable property, the importance of retaining the human side to anatomy, and the unacceptability of obtaining 3D-printed material from unclaimed bodies. It is concluded that the scientific tenor of 3D processes represents a move away from the human person, so that efforts are required to prevent them accentuating depersonalization and commodification.     

Is This Mine to Keep? Three-dimensional Printing Enables Active,Personalized Learning in Anatomy

Understanding orbital anatomy is important for optometry students, but the learning resources available are often fragile, expensive, and accessible only during scheduled classes. Drawing on a constructivist, personalized approach to learning, this study investigated students’ perceptions of an alternative learning resource: a three-dimensional (3D) printed model used in an active learning task. A human skull was three-dimensionally scanned and used to produce a 3D printed model for each student. Students actively participated in model creation by tracing suture lines and coloring individual orbital bones during a practical class, then keeping the model for future study. Students’ perceptions of the 3D orbital model were examined through a questionnaire: the impact the model had on their learning; perceptions of the 3D orbit compared to traditional resources; and utility of having their own personalized model. The 3D orbit was well received by the student cohort. Participants (n = 69) preferred the 3D orbit as a resource for learning orbital bone anatomy compared to traditional learning resources, believing the model helped them to understand and visualize the spatial relationships of the bones, and that it increased their confidence to apply this knowledge. Overall, the participants liked that they co-created the model, could touch and feel it, and that they had access to it whenever they liked. Three-dimensional printing technology has the potential to enable the creation of effective learning resources that are robust, low-cost and readily accessible to students, and should be considered by anyone wishing to incorporate personalized resources to their multimodal teaching repertoire.     

The production of anatomical teaching resources using three‐dimensional (3D) printing technology

The teaching of anatomy has consistently been the subject of societal controversy, especially in the context of employing cadaveric materials in professional medical and allied health professional training. The reduction in dissection‐based teaching in medical and allied health professional training programs has been in part due to the financial considerations involved in maintaining bequest programs, accessing human cadavers and concerns with health and safety considerations for students and staff exposed to formalin‐containing embalming fluids. This report details how additive manufacturing or three‐dimensional (3D) printing allows the creation of reproductions of prosected human cadaver and other anatomical specimens that obviates many of the above issues. These 3D prints are high resolution, accurate color reproductions of prosections based on data acquired by surface scanning or CT imaging. The application of 3D printing to produce models of negative spaces, contrast CT radiographic data using segmentation software is illustrated. The accuracy of printed specimens is compared with original specimens. This alternative approach to producing anatomically accurate reproductions offers many advantages over plastination as it allows rapid production of multiple copies of any dissected specimen, at any size scale and should be suitable for any teaching facility in any country, thereby avoiding some of the cultural and ethical issues associated with cadaver specimens either in an embalmed or plastinated form. Anat Sci Educ 7: 479–486. © 2014 American Association of Anatomists.     

桌面3D打印机工作台贴面材料分析

3D打印技术也称为快速成型,是一门新兴的技术。其中基于融熔沉积技术的桌面3D打印机应用日益广泛。为了使打印材料牢固的涂覆在打印机工作台表面,需要将一些利于粘附的材料贴附到3D打印机工作台表面。根据不同的打印耗材,应使用不同的贴面材料。文章分析了几种贴面材料的性能,使用方法,适用范围。并以使用PLA （聚乳酸）线材进行3D打印为例,分析了几种工作台贴面材料的优缺点。     

Three-Dimensional Printing of Archived Human Fetal Material for Teaching Purposes

The practical aspect of human developmental biology education is often limited to the observation and use of animal models to illustrate developmental anatomy. This is due in part to the difficulty of accessing human embryonic and fetal specimens, and the sensitivity inherent to presenting these specimens as teaching materials. This report presents a new approach using three-dimensional (3D) printed replicas of actual human materials in practical classes, thus allowing for the inclusion of accurate examples of human developmental anatomy in the educational context. A series of 3D prints have been produced from digital data collected by computed tomography (CT) imaging of an archived series of preserved human embryonic and fetal specimens. The final versions of 3D prints have been generated in a range of single or multiple materials to illustrate the progression of human development, including the development of internal anatomy. Furthermore, multiple copies of each replica have been printed for large group teaching. In addition to the educational benefit of examining accurate 3D replicas, this approach lessens the potential for adverse student reaction (due to cultural background or personal experience) to observing actual human embryonic/fetal anatomical specimens, and reduces the potential of damage or loss of original specimens. This approach, in combination with ongoing improvements in the management and analysis of digital data and advances in scanning technology, has enormous potential to allow embryology students access to both local and international collections of human gestational material. Anat Sci Educ 00: 000–000. © 2018 American Association of Anatomists.     

3D打印技术在高中立体几何教学中的应用探析

在高中立体几何教学中,灵活运用3D打印技术不仅能够使整体课程更具有实践意义,还能够进一步提升高中立体几何教学的实效性。文章概述3D打印技术,分析高中立体几何教学的现状,探讨3D打印技术在高中立体几何教学中的具体应用,以进一步提升高中立体几何教学的实效性。     

Using a 3D food printer as a teaching tool: Focus groups with dietitians,teachers, and nutrition students

Three‐dimensional (3D) food printing is a new technology that can be used to produce personalized and customized food products. However, very little research has been completed on how 3D food printers could be used as educational tools. As such, the objective of this study was to evaluate how teachers (n = 6), dietitians (n = 6), and nutrition students (n = 11) envision the use of 3D food printers when disseminating information about food and nutrition. Focus groups were conducted with teachers, dietitians, and nutrition students. Initially, the participants were introduced to the concept of 3D food printing and then they were asked how they could use a 3D food printer in their teachings. The participants did not feel that a 3D food printer would enhance their teaching and instead felt it could confuse or frighten people. Also, all of the participants were worried about learning how to 3D print foods. The participants did state that people would be interested in watching a 3D food printer. Furthermore, the teachers and nutrition students indicated they thought a demonstration of a 3D food printer would lead to more interest in food and nutrition. Additionally, they thought a 3D food printer could be used to create visually appealing foods. Overall, until 3D food printers are found in residential and commercial kitchens, the participants did not think it would enhance their teachings; however, they did indicate that 3D food printing demonstrations could lead to students being interested in the food and nutrition fields.     

Evaluation by medical students of the educational value of multi‐material and multi‐colored three‐dimensional printed models of the upper limb for anatomical education

For centuries, cadaveric material has been the cornerstone of anatomical education. For reasons of changes in curriculum emphasis, cost, availability, expertise, and ethical concerns, several medical schools have replaced wet cadaveric specimens with plastinated prosections, plastic models, imaging, and digital models. Discussions about the qualities and limitations of these alternative teaching resources are on‐going. We hypothesize that three‐dimensional printed (3DP) models can replace or indeed enhance existing resources for anatomical education. A novel multi‐colored and multi‐material 3DP model of the upper limb was developed based on a plastinated upper limb prosection, capturing muscles, nerves, arteries and bones with a spatial resolution of ～1 mm. This study aims to examine the educational value of the 3DP model from the learner's point of view. Students (n = 15) compared the developed 3DP models with the plastinated prosections, and provided their views on their learning experience using 3DP models using a survey and focus group discussion. Anatomical features in 3DP models were rated as accurate by all students. Several positive aspects of 3DP models were highlighted, such as the color coding by tissue type, flexibility and that less care was needed in the handling and examination of the specimen than plastinated specimens which facilitated the appreciation of relations between the anatomical structures. However, students reported that anatomical features in 3DP models are less realistic compared to the plastinated specimens. Multi‐colored, multi‐material 3DP models are a valuable resource for anatomical education and an excellent adjunct to wet cadaveric or plastinated prosections. Anat Sci Educ 11: 54–64. © 2017 American Association of Anatomists.     

高校创新创业教育实践中互联网+3D打印技术与STEAM教育理念的融促机制研究

3D打印技术依靠先进的解决方案、庞大的市场需求、独特的技术优势,逐步广泛地应用于高校教育各细分领域。但是我国高校关于3D打印课程的教育体系尚未完善,研究出更适合学生的教育体系是当前的重要任务。文章以双创教育为背景,借助互联网平台,将3D打印技术与STEAM教育理念恰当融合,改进传统教育体系的不足,探索更适合学生成长的教育体系。最后,将此教学体系应用于高校,取得了良好成效。     

面向组织工程实验的3D生物打印机研制

基于挤压成型原理设计了一种低温控制、集成化、小型化的生物打印机,该装置主机包括中央控制系统、温度控制系统、打印底板、打印喷头和三维运动平台等部件,可打印生物墨水材料包括明胶、海藻酸盐、普朗尼克、纤维蛋白等水凝胶及细胞复合物等.该机打印速度可以达到0～50 mm/s,打印精度100μm,打印喷头控制10～90℃.利用该装...