Role of Three-Dimensional Visualization Modalities in Medical Education

Effectiveness of a multi-model teaching strategy to train emergency medicine residents to use point-of-care ultrasound (POCUS) for assessment of shock

OBJECTIVE

To evaluate the effectiveness and feasibility of a multimodal teaching method to train emergency residents to use point-of-care ultrasound (POCUS) in the assessment of shock.

METHODS

The study subjects were Emergency Medicine residents at the Second Affiliated Hospital of Guangzhou University of Chinese Medicine between January 2023 and December 2023. These residents volunteered for the study and were randomly divided into either the teaching reform (TR) group or the traditional teaching (TT) group. The assessment outcomes of the study included the residents' scores on theoretical tests and practical tests and the residents' satisfaction with and evaluation of the teaching method.

RESULTS

A total of 100 residents participated in this study in either the TR or TT groups. Compared with the TT group, the TR group achieved higher scores on both the theoretical test and the practical assessment (p < 0.05). Similarly, analysis of the questionnaire indicated that the TR group was more satisfied with their training and evaluated it higher than the TT group (p < 0.05).

CONCLUSION

Integrating point-of-care ultrasound with a multimodal teaching method in standardized training for emergency medicine residents could effectively improve the teaching effect and quality, which may provide important value in the emergency teaching of residents.

From Cadavers to Codes: The Evolution of Anatomy Education Through Digital Technologies

This review examines the shift from traditional anatomy education to the integration of advanced digital technologies. With rapid advancements in digital tools, such as 3D models, virtual dissections, augmented reality (AR) and virtual reality (VR), anatomy education is increasingly adopting digital environments to enhance learning. These tools offer immersive, interactive experiences, supporting active learning and knowledge retention. Mobile technology and cloud computing have further increased accessibility, allowing flexible, self-paced learning. Despite challenges like educator resistance and institutional barriers, the continued innovation and integration of digital tools have the potential to transform anatomy education and improve medical outcomes.

Comparing the effectiveness of augmented reality and anatomical atlases in student preparation for neuroanatomy dissection

Anatomy teachers urge students to come to education sessions at the dissection rooms as well-prepared as possible. To effectuate optimal preparation, assignments are designed to guide the students' learning processes. These assignment often include the use of anatomical figures in atlases. The role of augmented reality (AR) applications in helping students prepare for body donor-based teaching sessions at the dissection rooms remains quite elusive. Therefore, this study examines the effects of the use of an AR application compared to the use of anatomical atlases in helping students (n = 28) prepare for a neuroanatomy session at the dissection rooms with prosections. The study shows that students from both groups showed a similar improvement in anatomy test scores. The amount of experienced cognitive engagement, however, is higher in the experimental AR group. Based on these results, it can be suggested that an AR application is a valid method to help students prepare and could be an alternative to the use of anatomical atlases. Nevertheless, future studies should re-investigate this research question in larger cohorts. Also, it remains unknown whether cognitive engaged students are indeed the students who are better prepared for educational sessions at the dissection rooms.

Enhancing Facial Filler Training with 3D-Printed Models: A Prospective Observational Study on Medical Student Competence

BACKGROUND This study evaluated the efficacy of 3-dimensional (3D) printed facial models in training medical students for cosmetic facial filler applications. A prospective observational study included 40 medical faculty students without prior filler application or surgical training. They received theoretical and practical training using 3D-printed face models, assessed through pre- and post-training surveys. MATERIAL AND METHODS Facial models were designed using SolidWorks and printed with a Mars 2 PRO 3D printer using PLA filament and high-performance silicone. Training comprised in-class instruction, live demonstrations, hands-on practice, and individual guidance. Students' skills were assessed through self-assessments and objective criteria. RESULTS After training, students showed significant improvement in procedural understanding and application locations, with increased confidence and competence (P<0.001). Statistical analysis confirmed these improvements. CONCLUSIONS 3D-printed facial models are valuable for enhancing medical students' skills in cosmetic facial fillers, offering cost-effective and safe simulation. This approach improves practical skills and confidence, benefiting medical education and patient care.

Reviewing the current state of virtual reality integration in medical education - a scoping review

BACKGROUND

In medical education, new technologies like Virtual Reality (VR) are increasingly integrated to enhance digital learning. Originally used to train surgical procedures, now use cases also cover emergency scenarios and non-technical skills like clinical decision-making. This scoping review aims to provide an overview of VR in medical education, including requirements, advantages, disadvantages, as well as evaluation methods and respective study results to establish a foundation for future VR integration into medical curricula.

METHODS

This review follows the updated JBI methodology for scoping reviews and adheres to the respective PRISMA extension. We included reviews in English or German language from 2012 to March 2022 that examine the use of VR in education for medical and nursing students, registered nurses, and qualified physicians. Data extraction focused on medical specialties, subjects, curricula, technical/didactic requirements, evaluation methods and study outcomes as well as advantages and disadvantages of VR.

RESULTS

A total of 763 records were identified. After eligibility assessment, 69 studies were included. Nearly half of them were published between 2021 and 2022, predominantly from high-income countries. Most reviews focused on surgical training in laparoscopic and minimally invasive procedures (43.5%) and included studies with qualified physicians as participants (43.5%). Technical, didactic and organisational requirements were highlighted and evaluations covering performance time and quality, skills acquisition and validity, often showed positive outcomes. Accessibility, repeatability, cost-effectiveness, and improved skill development were reported as advantages, while financial challenges, technical limitations, lack of scientific evidence, and potential user discomfort were cited as disadvantages.

DISCUSSION

Despite a high potential of VR in medical education, there are mandatory requirements for its integration into medical curricula addressing challenges related to finances, technical limitations, and didactic aspects. The reported lack of standardised and validated guidelines for evaluating VR training must be overcome to enable high-quality evidence for VR usage in medical education. Interdisciplinary teams of software developers, AI experts, designers, medical didactics experts and end users are required to design useful VR courses. Technical issues and compromised realism can be mitigated by further technological advancements.

Development of an Interactive 3D Visualization Tutorial for Pathophysiology in Graduate Nursing Education

BACKGROUND

A recent revision to the Nurse Practitioner Role Core Competencies will lead to robust changes in graduate education. Incorporating innovative technology into the core courses of advanced practice nursing will prepare practice-ready providers with a high level of competence leading to successful health outcomes, improved patient satisfaction, and decreased health care costs.

PROBLEM

Graduate education lacks effective, innovative, and interactive visualization tools to study pathophysiology. There is a lack of evidence for the use of 3-dimensional (3D) augmented reality (AR) and virtual reality in advanced practice core courses.

APPROACH

A collaborative iterative approach was used to design, develop, analyze, update, and reiterate a 3D AR tutorial for advanced pathophysiology.

OUTCOMES

Students had a positive experience and perceive 3D AR as a learning tool that can increase examination scores. The visualization connected the pathophysiologic process of a disease to the pathogenesis, clinical manifestations, and associated treatments.

CONCLUSIONS

3D AR tutorials are an effective solution to facilitate learning difficult concepts in pathophysiology by incorporating following multiple learning techniques: visual, aural, verbal, kinesthetic, and logical.

Virtual reality-based surgical planning simulator for tumorous resection in FreeForm Modeling: an illustrative case of clinical teaching

The importance of virtual reality (VR) has been emphasized by many medical studies, yet it has been relatively under-applied to surgical operation. This study characterized how VR has been applied in clinical education and evaluated its tutorial utility by designing a surgical model of tumorous resection as a simulator for preoperative planning and medical tutorial. A 36-year-old male patient with a femoral tumor who was admitted to the Affiliated Jiangmen Traditional Chinese Medicine Hospital was randomly selected and scanned by computed tomography (CT). The data in digital imaging and communications in medicine (*.DICOM) format were imported into Mimics to reconstruct a femoral model, and were generated to the format of *.stl executing in the computer-aided design (CAD) software SenSable FreeForm Modeling (SFM). A bony tumor was simulated by adding clay to the femur, the procedure of tumorous resection was virtually performed with a toolkit called Phantom, and its bony defect was filled with virtual cement. A 3D workspace was created to enable the individual multimodality manipulation, and a virtual operation of tumorous excision was successfully carried out with indefinitely repeated running. The precise delineation of surgical margins was shown to be achieved with expert proficiency and inexperienced hands among 43 of 50 participants. This simulative educator presented an imitation of high definition, those trained by VR models achieved a higher success rate of 86% than the rate of 74% achieved by those trained by conventional methods. This tumorous resection was repeatably handled by SFM, including the establishment of surgical strategy, whereby participants felt that respondent force feedback was beneficial to surgical teaching programs, enabling engagement of learning experiences by immersive events which mimic real-world circumstances to reinforce didactic and clinical concepts.

Randomised controlled trial: role of virtual interactive 3-dimensional models in anatomical and medical education

Purpose: Virtual interactive 3-dimensional models (VI3DM) and immersive virtual reality are implemented in medical education and surgical training. VI3DM allow learners to view and interact with a virtual 3D object and help in conceptualising learning objectives that demand high cognitive and visuo-spatial skills. However, the effects of VI3DM in medical education are unknown. We aimed to determine whether VI3DM are helpful in conceptualising complex anatomical structures. Materials and methods: We included 5 specimens, which were assessed by 200 first-year medical students categorised into experimental (n = 100) and control (n = 100) groups using a systemic randomisation method after matching for age and sex. The experimental group was given VI3DM as interventional learning resources while the control group was given 2-dimensional photographs as conventional learning resources for self-directed learning for 30 minutes. Participants completed a questionnaire before and after the learning session to assess their knowledge related to external features, attachments, and relations of anatomical specimens. Results: The scores of the experimental group improved significantly in the post-test compared to those of the control group for all 5 specimens included in the study (p < 0.05, confidence interval = 95%, unpaired student's t-test). Conclusions: VI3DM can help conceptualise external features, attachments, and relations of anatomical structures.

Virtual operation for hip joint replacement implemented by Sensable_FreeForm_Modelling: A surgical drill

OBJECTIVE

To design a virtual operation of joint replacement for surgical drills using a haptic device, SenSable_FreeForm_Modelling (SFM), to enhance surgeons' efficiency and enable "Virtual tutorial without reality" for interns.

METHOD

A patient with hip joint osteoarthritis is randomly selected to perform Total Hip Replacement (THR). The hip images were input into Mimics in the format of *.dicom after CT scan and then exported to SFM using the stereolithographic (*.stl) format. A surgical toolkit can be created virtually with Computer Aided Design software such as Pro-E or Ghost SDK and a visual drill scenario of THR directed by a force-respondent stick, namely Phantom.

RESULT

3D models of the hip joint were rebuilt illustrating clearly that the geometrical shapes of the surgical equipment created are similar to real instruments, and the THR operation is emulated distinctly in novelty.

CONCLUSION

In obedience to an ancient maxim, so called 'genuine knowledge originated from practice', this simulative operation offers hands-on experience for students in the orthopaedics field with remarkable effects, contributing not only teaching cases for medical courses but also a planning basis for physical surgery.

An overview of Instructional approaches and decision-making strategies to curtail curricular overload

OBJECTIVES

Curriculum overload often occurs when content is kept in the curriculum that may no longer be necessary to prepare students for professional practice. The overload becomes compounded by the addition of new content from the ever-changing professional practice needs and updates to accreditation standards. Challenges may occur when programs must first determine the "level" of proficiency a new graduate should attain and then determine the appropriate breadth and depth of educational outcomes in relation to proficiency, while examining what content should be retained from past curricula. Thus, the purpose of this manuscript is to summarize institutional approaches for making content delivery more effective and efficient with the goal of curtailing curriculum expansion.

FINDINGS

Four key elements were consistently identified in the literature as important considerations to address curriculum overload - 1) communication and coordination among faculty, 2) incorporation of active learning strategies, 3) effective utilization of technology, and 4) minimizing faculty and student workload and cognitive burden.

SUMMARY

Each pharmacy program will need to take an individualized approach in addressing curriculum overload; however, consideration of the aforementioned key elements can assist in making these decisions. With increased student engagement in the classroom, intentional design to reduce content and student workload, enhanced communication among faculty, and appropriate technology utilization, curriculum overload can be addressed at every level of pharmacy education.

An Overview of Traditional and Advanced Visualization Techniques Applied to Anatomical Instruction Involving Cadaveric Dissection

This work provides an overview of the role, basic concepts, significance, and instructional contributions of current and evolving digital visualization technologies being applied in first-year anatomy curricula. These are visualization methods that have been and are being used to support both basic science and clinical applications of gross anatomical teaching and learning to the health professions (i.e., medical, dental, physical therapy, chiropractic and nursing students). It first presents a foundation as to how this discipline has been and is being taught within the professional school environment using visualization and illustration: aspects of learning, the format of the first-year anatomy curriculum, the nature of the visual information network in support of educational excellence and newer opportunities afforded by advanced technologies placing the student at the center of the learning experience. Then, the nature of each of these new methods is presented with their individual unique characteristics, and the results that anatomy faculty running cadaveric dissection courses had with the evaluation of the new technologies.The Conclusion section lists key points found in the literature as reported. Finally, the Future Work section proposes investigations into standardizing the presentation and assessment of anatomical concepts using prominent in situ structures of viscera, their enclosures and resident compartments for more precise and reproducible measurement of then instructional effectiveness of the new techniques.

The impact of 3D printed models on spatial orientation in echocardiography teaching

PURPOSE

During our transthoracic echocardiography (TTE) courses, medical students showed difficulty in spatial orientation. We implemented the use of 3D printed cardiac models of standard TTE views PLAX, PSAX, and A4C and assessed their efficacy in TTE-teaching.

METHODS

One hundred fifty-three participants were split into two groups. A pre-test-retest of anatomy, 2D -, and 3D orientation was conducted. The intervention group (n = 77) was taught using 3D models; the control group (n = 76) without. Both were comparable with respect to baseline parameters. Besides test-scores, a Likert scale recorded experiences, difficulties, and evaluation of teaching instruments.

RESULTS

From the 153 students evaluated, 123 improved, 20 did worse, and ten achieved the same result after the course. The median overall pre-test score was 29 of 41 points, and the retest score was 35 (p < 0.001). However, the intervention group taught with the 3D models, scored significantly better overall (p = 0.016), and in 2D-thinking (p = 0.002) and visual thinking (p = 0.006) subtests. A backward multivariate linear regression model revealed that the 3D models are a strong individual predictor of an excellent visual thinking score. In addition, our study showed that students with difficulty in visual thinking benefited considerably from the 3D models.

CONCLUSION

Students taught using the 3D models significantly improved when compared with conventional teaching. Students regarded the provided models as most helpful in their learning process. We advocate the implementation of 3D-printed heart models featuring the standard views for teaching echocardiography. These findings may be transferable to other evidence based medical and surgical teaching interventions.