The Role of 3D Printing Technology in Paediatric Teaching and Training: a Systematic Review

Ashar Asif, Elgin Lee, Massimo Caputo, Giovanni Biglino, Andrew I U Shearn*

*Corresponding author for this work

Research output: Contribution to journalArticle (Academic Journal)peer-review

Abstract

Background
In the United Kingdom, undergraduate paediatric training is brief resulting in trainees with a lower paediatric knowledge base compared to 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. Here we perform a systematic review to evaluate the evidence base in using 3DP models to train paediatricians, surgeons, medical students, and nurses.

Methods
Online databases PubMed, Web of Science and EMBASE and 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.

Results
From 587 results, 15 studies fit the criteria of the review protocol, with 5/15 being randomised control studies and 10/15 focussing on cardiovascular conditions. Participants using 3DP models had greater improvement in test scores and faster times to complete procedures and identify anatomical landmarks compared to traditional teaching methods (2D diagrams, lectures, videos, 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 utilising real-world pathologies. These, mostly non-randomised and single-centred, studies did not address bias or report long-term or clinically translatable outcomes.

Conclusions
3DP models were associated with greater user satisfaction and good short-term educational outcomes, with low quality evidence. Multi-centred, randomised studies with long-term follow-up and clinically assessed outcomes are needed to fully assess their benefits in this setting.

Systematic review registration
The review is registered on Prospero. Prospero ID: CRD42020179656
Available from: https://www.crd.york.ac.uk/prospero/display_record.php?ID=CRD42020179656
Original languageEnglish
JournalBMJ Paediatrics Open
Publication statusAccepted/In press - 15 May 2021

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