Bristol Medical School, University of Bristol, Bristol, UK.
Children's Services Directorate, Newcastle Upon Tyne Hospitals NHS Foundation Trust, Newcastle Upon Tyne, UK.
BMJ Paediatr Open. 2021 Dec;5(1). doi: 10.1136/bmjpo-2021-001050.
In the UK, undergraduate paediatric training is brief, resulting in trainees with a lower paediatric knowledge base compared with other aspects of medicine. With congenital conditions being successfully treated at childhood, adult clinicians encounter and will need to understand these complex pathologies. Patient-specific 3D printed (3DP) models have been used in clinical training, especially for rarer, complex conditions. We perform a systematic review to evaluate the evidence base in using 3DP models to train paediatricians, surgeons, medical students and nurses.
Online databases PubMed, Web of Science and Embase were searched between January 2010 and April 2020 using search terms relevant to "paediatrics", "education", "training" and "3D printing". Participants were medical students, postgraduate trainees or clinical staff. Comparative studies (patient-specific 3DP models vs traditional teaching methods) and non-comparative studies were included. Outcomes gauged objective and subjective measures: test scores, time taken to complete tasks, self-reported confidence and personal preferences on 3DP models. If reported, the cost of and time taken to produce the models were noted.
From 587 results, 15 studies fit the criteria of the review protocol, with 5/15 being randomised controlled studies and 10/15 focussing on cardiovascular conditions. Participants using 3DP models demonstrated improved test scores and faster times to complete procedures and identify anatomical landmarks compared with traditional teaching methods (2D diagrams, lectures, videos and supervised clinical events). User feedback was positive, reporting greater user self-confidence in understanding concepts with users wishing for integrated use of 3DP in regular teaching. Four studies reported the costs and times of production, which varied depending on model complexity and printer. 3DP models were cheaper than 'off-the-shelf' models available on the market and had the benefit of using real-world pathologies. These mostly non-randomised and single-centred studies did not address bias or report long-term or clinically translatable outcomes.
3DP models were associated with greater user satisfaction and good short-term educational outcomes, with low-quality evidence. Multicentred, randomised studies with long-term follow-up and clinically assessed outcomes are needed to fully assess their benefits in this setting.
CRD42020179656.
在英国，本科儿科培训时间短暂，导致受训者的儿科基础知识相对薄弱，而其他医学领域的知识则相对较强。由于先天性疾病在儿童时期得到成功治疗，成年临床医生会遇到并需要理解这些复杂的病理。患者特异性 3D 打印（3DP）模型已在临床培训中使用，尤其是在更罕见、更复杂的情况下。我们进行了系统评价，以评估使用 3DP 模型培训儿科医生、外科医生、医学生和护士的证据基础。
在 2010 年 1 月至 2020 年 4 月期间，使用与“儿科”、“教育”、“培训”和“3D 打印”相关的搜索词，在在线数据库 PubMed、Web of Science 和 Embase 中进行了搜索。参与者为医学生、研究生受训者或临床工作人员。纳入了比较研究（患者特异性 3DP 模型与传统教学方法）和非比较研究。评估的结果包括客观和主观测量指标：测试成绩、完成任务所需的时间、自我报告的信心和对 3DP 模型的个人偏好。如果有报告，还记录了模型的制作成本和时间。
从 587 项研究结果中，有 15 项研究符合审查方案的标准，其中 5 项为随机对照研究，10 项研究聚焦于心血管疾病。与传统教学方法（二维图、讲座、视频和监督临床事件）相比，使用 3DP 模型的参与者在测试成绩和完成程序以及识别解剖学标志物方面表现出了更好的成绩（2D 图、讲座、视频和监督临床事件）。用户反馈积极，报告称用户对理解概念的信心增强，希望将 3DP 集成到常规教学中使用。有 4 项研究报告了生产成本和时间，这取决于模型的复杂性和打印机。3DP 模型比市场上现有的“现成”模型更便宜，并且具有使用真实病理的优势。这些大多数非随机和单中心的研究没有解决偏倚问题，也没有报告长期或具有临床转化意义的结果。
3DP 模型与更高的用户满意度和良好的短期教育成果相关，但证据质量较低。需要多中心、随机研究进行长期随访和临床评估结果，以充分评估其在该环境中的益处。
PROSPERO 注册号：CRD42020179656。
