25. Using 3-D Printed Models as Educational Tools: A Randomized Controlled Trial Comparing Traditional Lectures to Hands-On Methods in Craniosynostosis education.

Abstract

Background: Three-dimensional (3D) printed models have been described as a tool for medical education, surgical training, pre-operative planning, research, and innovation. This study analyzes the effectiveness of using such 3D printed skull models to teach concepts central to craniosynostosis (CS) in a medical student elective course Methods: Medical students in a Plastic Surgery elective were randomly assigned to receive a traditional lecture on craniosynostosis alone (control group), or receive the lecture plus participate in a hands-on session using 3D printed skull models demonstrating craniosynostosis (intervention group). Prior to this study, the senior author collaborated with the Department of Radiology at a large tertiary care urban children’s hospital to have 12 models 3D printed from computed tomography (CT) scans of representative craniosynostosis patients. Pathologies represented include sagittal, metopic, lambdoid, unicoronal, and bicoronal craniosynostosis as well as pansynostosis resulting in Kleeblattschadel skull. Three of the skulls demonstrate post-operative changes following surgery for craniosynostosis with reconstructive techniques including strip craniectomy, modified Pi procedure, and frontoorbital advancement. A 23-question test evaluating knowledge of CS was administered at three timepoints: prior to the course, after the lecture +/- the intervention, and three weeks later. Statistical analysis compared test performance between cohorts. Results: 21 students were enrolled; 11 were randomized to the control group, 10 to the intervention group. Test 1 (pre-intervention) showed no significant difference in the mean overall score (defined as total percent of correct answers) between groups (control=61%, intervention=57% correct; p=0.67). On Test 2 (post-intervention), both groups had significant increases in overall score. The control group improved by 21.3% (p=0.004) and the intervention group improved by 34.4% (p=0.002). Moreover, the mean score for the intervention group was significantly higher compared to that of the controls, with 92.1% correct versus 82.6% (p=0.041). Test 3 overall scores were not statistically different from test 2 scores, indicating little temporal decay. Students were highly satisfied with the quality and content of the intervention. Conclusion: 3D printed skull models are effective educational adjuncts in craniofacial surgery. 3D printing technology is an inexpensive tool with high satisfaction rates that can be increasingly applied to medical student and resident education.