Effect of 3D‐Printed Models on Cadaveric Dissection in Temporal Bone Training

Abstract

Objective Mastoidectomy is a cornerstone in the surgical management of middle and inner ear diseases. Unfortunately, training is challenged by insufficient access to human cadavers. Three-dimensional (3D) printing of temporal bones could alleviate this problem, but evidence on their educational effectiveness is lacking. It is largely unknown whether training on 3D-printed temporal bones improves mastoidectomy performance, including on cadavers, and how this training compares with virtual reality (VR) simulation. To address this knowledge gap, this study investigated whether training on 3D-printed temporal bones improves cadaveric dissection performance, and it compared this training with the already-established VR simulation. Study Design Prospective cohort study of an educational intervention. Setting Tertiary university hospital, cadaver dissection laboratory, and simulation center in Copenhagen, Denmark. Methods Eighteen otorhinolaryngology residents (intervention) attending the national temporal bone dissection course received 3 hours of mastoidectomy training on 3D-printed temporal bones. Posttraining cadaver mastoidectomy performances were rated by 3 experts using a validated assessment tool and compared with those of 66 previous course participants (control) who had received time-equivalent VR training prior to dissection. Results The intervention cohort outperformed the controls during cadaver dissection by 29% ( P < .001); their performances were largely similar across training modalities but remained at a modest level (~50% of the maximum score). Conclusion Mastoidectomy skills improved from training on 3D-printed temporal bone and seemingly more so than on time-equivalent VR simulation. Importantly, these skills transferred to cadaveric dissection. Training on 3D-printed temporal bones can effectively supplement cadaver training when learning mastoidectomy.

3D-printing a cost-effective model for mastoidectomy training

“…whether the trainees actual gain surgical skills) should rely on objective performance outcomes using established assessment tools [18]. Recently, we collected such validity evidence supporting that training using 3D-printed temporal bone models improve trainees' subsequent cadaver dissection performance [9]. Knowing that trainees actually benefit from the specific educational intervention warrants using trainee opinions as an outcome in the present study.…”

“…This reduces the risk of bias compared to evaluation at the home institution. Finally, the 3D-printed temporal bone model described is derived from freely available data, and has undergone collection of educational validity evidence ("validation") according to modern educational methodology [9]. Nonetheless, despite the positive attitude towards the 3D-printed temporal bone models, this was a single-site evaluation with a relatively small sample size representing a limitation of this study.…”

“…Despite a general assumption that 3D-printed models hold great potential in the context of surgical training in otology, systematic implementation into surgical curricula is scarce, and evidence on educational effectiveness limited [2,5,7]. Only recently has it been documented that training mastoidectomy on 3D-printed models actually improves novices' surgical performance during subsequent cadaveric dissection (i.e., transfer of skills) [8,9]. However, poor physical resemblance and high costs are substantial barriers to implementation [10].…”

3-D-Printed Models for Temporal Bone Training: A Validity Study

“…Most existing studies on 3-D-printed temporal bone models have relied strictly on the trainees' feedback on the model (i.e., face validity of a relatively inexperienced group). This is not considered acceptable as validity evidence and only a couple of studies have considered the actual outcome on surgical skills performance from training on these models (9)(10)(11).…”

Reconsidering laboratory‐based anatomy within the backdrop of digital transformation: Bringing an old practice into a new world

“…Despite existing evidence that student dissection affords little if any advantage over study from prosected specimens (Wisco et al, 2015;Aziz et al, 2019;Lackey-Cornelison, 2020) or technologically derived models (Fasel et al, 2016;McMillan et al, 2020;Frithioff et al, 2021), the act of dissection especially for novice first-year medical or other health professions students continues to hold a highly acclaimed position in the teaching and learning of anatomy (McMenamin et al, 2018;Wilson et al, 2019;Basavanna et al, 2022). Its claim, built solely on perceptions of students and teaching faculty appears to be marked by consistent indications of student anxiety, discomfort, and lack of confidence in their ability to meet expectations of high-quality outcomes.…”