05 Feb 2018

Application of 3D Printing for Better Teaching of Human Anatomy:

Hours spent enduring the unmistakable scent of formaldehyde in dissection halls to master the nuances of gross human anatomy is a rite of passage for every medical student.

Anatomy has been a cornerstone of medical education for hundreds of years. It provides a platform of knowledge indispensable to all the branches of medicine. The real objective of learning anatomy is to integrate an understanding of normal function with recognition of normal structure. This provides the foundation to develop the logic, spatial reasoning skills, inference, and problem-solving skills that are needed to diagnose diseases and manage patients.

The current status of anatomy knowledge: Where are we now?

The format of teaching anatomy in terms of content and method has evolved over the last couple of decades. Acquiring in-depth knowledge of human structures and the ability to apply this knowledge within the clinical context is an imperative in many medical disciplines.

But while on one side there is a continuing debate concerning how much to teach, and what to teach, there exists another common debate which talks about the best approach to teach.

Learning anatomy on cadavers is expensive, time-consuming, and can be emotionally disturbing for students. Preserved tissues don’t always provide an accurate impression of the living body. In addition to this, the fact that the time allotted for studying anatomy is very limited and at the same time there is an exponential increase in the wealth of information to be learned, it has become crucial for both the teachers and the learners to constantly reinvent themselves to keep a pace with the changing demand.

So the question that arises here is “Is anatomy teaching in crisis?”

Students often face difficulties achieving a conceptual understanding of anatomy which leads to misconceptions about physiological phenomena which are persistent and hard to address. Inadequate understanding of anatomy becomes a cause for not pursuing a career in surgery. Furthermore, there has been an increase in the number of qualified doctors who lack confidence in their clinical abilities.

Radiological imaging and anatomy learning
“The ability to teach human anatomy with real patient data—beyond the use of cadavers.”

Study of anatomy has traditionally depended on cutting up, or dissection, but now, with imaging technology, it is increasingly possible to see how a body is constituted, without dissection. Imaging techniques such as computed tomography, magnetic resonance imaging, positron emission tomography, and ultrasonography have provided fresh opportunities to present anatomy to medical students and graduates.

Recent advances in information technology and easy access to the internet are reshaping medical education. For instance, 3D printing provides an important alternative pedagogical tool which can be an effective supplement to the conventional method of teaching. 3D printing uses a digital image to create a three-dimensional print of the organ and associated structures. Horizontal layers are printed sequentially, and the edges are blended to generate the final 3D print. There were several reasons for the decision to start the 3D-printing project with human bones. First, bones almost naturally lend themselves to printing as they are generally monochromatic and made of hard tissue. This makes them technically the easiest component of the human body to duplicate in 3D printing, with high levels of accuracy, preserving both visual and haptic values of the real tissue.

Secondly, obtaining bones for anatomical study is a complex process, and the main resources used for teaching osteology are thus anatomical bone models. As they are limited in number, quite fragile and were used only for demonstration, it gives very limited opportunity for the students to handle and examine them directly. Through the advent of 3D printing, students are now able to handle and examine their exact replicas which are printed in several copies.

This innovative method of printing is revolutionizing many areas of the medical field.

Role of 3D printing in Ocular anatomy

Ocular anatomy training has always depended on the use of cadavers or the eyes of sheep and cows, but there are ethical, financial, and practical concerns regarding the use of preserved specimens. Plastic models of eyes that exist are often highly stylized and are of exorbitant cost. On the other hand, in the clinical settings, explaining ocular pathology in 2D images to patients also can be challenging which in turn may lead to reduced patient participation in the treatment procedure. The need for a better way and approach to teaching is very apparent.

3D orbit printing can be an innovative strategy to enhance the education of medical students and patients. They can enable low-cost, detailed models of the orbit which can mark as an important advancement in the training of ophthalmology and optometry students, eliminating many of the concerns associated with the use of cadavers.

Clinically, patients would benefit from 3D prints because a better understanding of basic ocular anatomy will facilitate a better comprehension of ocular pathology. The application of 3D print during surgical planning, highlights subtle distinctions in the patient's anatomy, which can affect the surgical approach. The 3D prints were deemed "highly realistic" and offered enhanced visualization of the delicate nerves that are often difficult to identify in traditional orbital dissections, such as the trochlear and nasociliary nerves.

Application of 3D printing in Macquarie University and Western Sydney University

The use of 3D printed anatomical replicas for medical education and training is steadily increasing, driven by a desire to find alternatives to expensive, hard-to-get cadavers. Application of 3D-printed bones has been successfully applied in anatomy education at Macquarie University and Western Sydney University. It is believed that the application of 3D prints will further expand into other subjects. Furthermore, the 3D-printing project will soon involve other anatomical structures, particularly those that are difficult to observe and manipulate.