3D-Printed Liver Biomodels and Problem-Based Learning for Teaching Hepatobiliary Pathological Anatomy.
Abstract
The teaching of pathological anatomy is facing increasingly limited access to real anatomical material, which has led to the incorporation of digital modelling and 3D printing technologies as a complementary teaching resource. Objective: To evaluate the effect of a combined teaching strategy, which links the design and production of 3D-printed liver biomodels by the students themselves with their application through Problem-Based Learning (PBL), compared with traditional lecture-based teaching. In addition, the study analysed the technological acceptance of the process of designing and producing the biomodels and its relationship with academic performance among fourth-semester medical students at the National University of Chimborazo (Ecuador). Methods: A quasi-experimental pre-test–post-test study was conducted with an experimental group (n=40) and a control group (n=32), comprising 72 students in total. Under the guidance of a tutor, students in the experimental group segmented and designed, using DICOM images from a patient with confirmed liver cirrhosis, a biomodel of the cirrhotic liver and, through digital post-processing of the same case, a biomodel of the healthy liver; both were produced using FDM printing with PLA and were used in the classroom within a problem-based learning (PBL) context. A Knowledge Test and the Technology Acceptance Model (TAM) questionnaire were used, the latter relating specifically to the process of designing and producing the 3D biomodels. Results: There was no difference between the groups in the pre-test (p=0.908). The experimental group showed greater learning gain than the control group (7.79 versus 5.58 points) and a high level of technological acceptance of the design and fabrication process, with no significant correlation with academic performance, possibly due to a marked ceiling effect in the post-test. Conclusion: The combination of 3D liver biomodels and PBL was associated with better academic performance than traditional teaching, although high technological acceptance was not related to that performance. As the quasi-experimental design does not allow the effect of the three-dimensional resource to be separated from that of the active methodology, the improvement cannot be attributed in isolation to 3D printing, but rather to both components together (3D-ABP).
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