title: Do Three-dimensional Visualization and Three-dimensional Printing Improve Hepatic Segment Anatomy Teaching? A Randomized Controlled Study.
abstract: BACKGROUND
  Hepatic segment anatomy is difficult for medical students to learn. Three-dimensional visualization (3DV) is a useful tool in anatomy teaching, but current models do not capture haptic qualities. However, three-dimensional printing (3DP) can produce highly accurate complex physical models. Therefore, in this study we aimed to develop a novel 3DP hepatic segment model and compare the teaching effectiveness of a 3DV model, a 3DP model, and a traditional anatomical atlas.
  
  
  METHODS
  A healthy candidate (female, 50-years old) was recruited and scanned with computed tomography. After three-dimensional (3D) reconstruction, the computed 3D images of the hepatic structures were obtained. The parenchyma model was divided into 8 hepatic segments to produce the 3DV hepatic segment model. The computed 3DP model was designed by removing the surrounding parenchyma and leaving the segmental partitions. Then, 6 experts evaluated the 3DV and 3DP models using a 5-point Likert scale. A randomized controlled trial was conducted to evaluate the educational effectiveness of these models compared with that of the traditional anatomical atlas.
  
  
  RESULTS
  The 3DP model successfully displayed the hepatic segment structures with partitions. All experts agreed or strongly agreed that the 3D models provided good realism for anatomical instruction, with no significant differences between the 3DV and 3DP models in each index (p > 0.05). Additionally, the teaching effects show that the 3DV and 3DP models were significantly better than traditional anatomical atlas in the first and second examinations (p < 0.05). Between the first and second examinations, only the traditional method group had significant declines (p < 0.05).
  
  
  CONCLUSIONS
  A novel 3DP hepatic segment model was successfully developed. Both the 3DV and 3DP models could improve anatomy teaching significantly.
authors: Department of Anatomy, Guangdong Province Key Laboratory of Medical Biomechanics, School of Basic Medicine Science, Southern Medical University, Guangzhou, Guangdong, China.
authors: Xiangxue
authors: X
authors: Kong
authors: Department of Traumatic Orthopedics, Nanfang Hospital, Southern Medical University, Guangzhou, China.
authors: Lanying
authors: L
authors: Nie
authors: Department of Urology, Nanfang Hospital, Southern Medical University, Guangzhou, China.
authors: Huijian
authors: H
authors: Zhang
authors: Department of Anatomy, Guangdong Province Key Laboratory of Medical Biomechanics, School of Basic Medicine Science, Southern Medical University, Guangzhou, Guangdong, China.
authors: Zhanglin
authors: Z
authors: Wang
authors: Department of Radiology, The 3rd Affiliated Hospital, Southern Medical University, Guangzhou, China.
authors: Qiang
authors: Q
authors: Ye
authors: Department of Anatomy, Guangdong Province Key Laboratory of Medical Biomechanics, School of Basic Medicine Science, Southern Medical University, Guangzhou, Guangdong, China.
authors: Lei
authors: L
authors: Tang
authors: Department of Anatomy, Guangdong Province Key Laboratory of Medical Biomechanics, School of Basic Medicine Science, Southern Medical University, Guangzhou, Guangdong, China. Electronic address: lijianyi@outlook.com.
authors: Jianyi
authors: J
authors: Li
authors: Department of Anatomy, Guangdong Province Key Laboratory of Medical Biomechanics, School of Basic Medicine Science, Southern Medical University, Guangzhou, Guangdong, China. Electronic address: hwh@fimmu.com.
authors: Wenhua
authors: W
authors: Huang
mesh_terms: D003198:Computer Simulation; D003287:Contrast Media; D004504:Education, Medical, Undergraduate; D004521:Educational Measurement; D005260:Female; D013502:General Surgery / Q000193:education*; D006801:Humans; D021621:Imaging, Three-Dimensional; D008099:Liver / Q000033:anatomy & histology* / Q000601:surgery*; D008875:Middle Aged; D008953:Models, Anatomic; D066330:Printing, Three-Dimensional; D011446:Prospective Studies; D011795:Surveys and Questionnaires; D014057:Tomography, X-Ray Computed
chemical_list: D003287:Contrast Media
keywords: 3D printing; 3D visualization; Likert scale; Medical Knowledge; Professionalism; Systems-Based Practice; anatomical education; hepatic segments