title: Usage of 3D models of tetralogy of Fallot for medical education: impact on learning congenital heart disease.
abstract: 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 in improving the understanding of CHD, without requiring a mastery of cardiac imaging. The study aimed to evaluate the impact of 3D models on how pediatric residents understand and learn about tetralogy of Fallot following a teaching session.
  
  
  METHODS
  Pediatric residents rotating through an inpatient Cardiology rotation were recruited. The sessions were randomized into using either conventional 2D drawings of tetralogy of Fallot or physical 3D models printed from 3D cardiac imaging data sets (cardiac MR, CT, and 3D echocardiogram). Knowledge acquisition was measured by comparing pre-session and post-session knowledge test scores. Learner satisfaction and self-efficacy ratings were measured with questionnaires filled out by the residents after the teaching sessions. Comparisons between the test scores, learner satisfaction and self-efficacy questionnaires for the two groups were assessed with paired t-test.
  
  
  RESULTS
  Thirty-five pediatric residents enrolled into the study, with no significant differences in background characteristics, including previous clinical exposure to tetralogy of Fallot. The 2D image group (n = 17) and 3D model group (n = 18) demonstrated similar knowledge acquisition in post-test scores. Residents who were taught with 3D models gave a higher composite learner satisfaction scores (P = 0.03). The 3D model group also had higher self-efficacy aggregate scores, but the difference was not statistically significant (P = 0.39).
  
  
  CONCLUSIONS
  Physical 3D models enhance resident education around the topic of tetralogy of Fallot by improving learner satisfaction. Future studies should examine the impact of models on teaching CHD that are more complex and elaborate.
authors.affiliation: Division of Cardiology, Children's National Health System, 111 Michigan Ave NW, Washington, DC, 20010-2970, USA. yloke@childrensnational.org.
authors.forename: Yue-Hin
authors.identifier: http://orcid.org/0000-0003-1003-1903
authors.initials: YH
authors.lastname: Loke
authors.affiliation: Division of Cardiology, Children's National Health System, 111 Michigan Ave NW, Washington, DC, 20010-2970, USA.
authors.forename: Ashraf S
authors.initials: AS
authors.lastname: Harahsheh
authors.affiliation: Bioengineering Institute, Sheikh Zayed Institute for Pediatric Surgical Innovation, Children's National Health System, 111 Michigan Ave NW, Washington, DC, 20010-2970, USA.
authors.forename: Axel
authors.initials: A
authors.lastname: Krieger
authors.affiliation: Division of Cardiology, Children's National Health System, 111 Michigan Ave NW, Washington, DC, 20010-2970, USA.|Bioengineering Institute, Sheikh Zayed Institute for Pediatric Surgical Innovation, Children's National Health System, 111 Michigan Ave NW, Washington, DC, 20010-2970, USA.
authors.forename: Laura J
authors.initials: LJ
authors.lastname: Olivieri
mesh_terms: D019560:Echocardiography, Three-Dimensional; D004501:Education, Medical / Q000379:methods*; D006321:Heart / Q000000981:diagnostic imaging; D006330:Heart Defects, Congenital / Q000175:diagnosis / Q000473:pathology*; D006801:Humans; D008279:Magnetic Resonance Imaging; D008953:Models, Anatomic; D066330:Printing, Three-Dimensional; D011795:Surveys and Questionnaires; D013663:Teaching; D013771:Tetralogy of Fallot / Q000175:diagnosis / Q000000981:diagnostic imaging / Q000473:pathology*; D014057:Tomography, X-Ray Computed
keywords: 3D printing; Congenital heart disease; Resident education