Effect of Mediastinum Model Printed with 3D Printer on Learning Lymph Node Stations and Zones Within the Scope of Thoracic Anatomy Course Explained to 5th Grade Students

Yıl 2020, Cilt: 42 Sayı: 4, 428 - 433, 13.07.2020

Nevin Aydın , Didem Arslantas , Meryem Cansu Şahin , Nilgün Işıksalan Özbülbül Mehmet Salih Özcan Ceren Fettahlı Ömer Furtuna Halime Başaran Muharrem Bolluk

https://doi.org/10.20515/otd.568552

Öz

The aim of this study was to determine the
effect of mediastinum lymph nodes on CT examinations and to measure the effect
of using 3D printer-mediated mediastinum model in the education of fifth grade
students in order to facilitate this process. This study was carried out in two
cycles in the scope of Thorax Anatomy, which was described prospectively
between the dates of 15.02.2018-15.05.2019 in the 5th grade students of ESOGU
Faculty of Medicine. Fifth grade students were informed firstly and the lymph node
stations in 1-14 range and their zones were supported by cross-sectional
two-dimensional images according to IASLC (International Association for the
Study of Lung Cancer) lymph node map. Then, at the end of the practical time of
the course, students with written informed consent were divided into two
groups; one group was told with lymph node stations and zones with power point
course materials. The other group was described by using the Ultimaker 3
Extended three-dimensional (3D) printer and the mediastinum model with layer
cumulative modeling method. The results were analyzed with dependent sample t
test in SPSS and the results were tabulated. According to the dependent sample
t test, the group of students described with the mediastin model printed by 3D
printer had a higher mean number of questions than the student group described
by power point and a significant difference was found (t: 3.07, p: 0.05). The
3D printer has an important place in demonstrating the anatomical structures
and practicing in medical education. In difficult, confusing anatomical
localizations such as mediastinal lymph nodes, it will give positive results
for the students to support the lecture with the 3D printer.

Anahtar Kelimeler

Three-dimensional printer; layered modeling; mediastinum; thorax.

5. Sınıf Öğrencilerine Anlatılan Toraks Anatomisi Dersi Kapsamında 3D Printer ile Basımı Yapılmış Mediasten Modelinin Lenf Nodu İstasyonlarını ve Zonlarını Öğrenmedeki Etkisi

Öz

Çalışmamızda mediasten lenf nodlarının BT
incelemelerde doğru anlaşılması ve akılda tutulması özellikle tıp öğrencileri
için zor bir süreç olup bu süreci kolaylaştırmak adına 3D yazıcı ile basımı
yapılmış mediasten modelini beşinci sınıf öğrencilerinin eğitiminde kullanarak
öğrenmedeki etkisini ölçmeyi hedefledik. Bu çalışma ESOGÜ Tıp Fakültesi’nde 15.02.2018-15.05.2019 tarihleri
arasında prospektif olarak beşinci sınıf öğrencilerinin Radyoloji stajı
içerisinde anlatılan Toraks Anatomisi dersi kapsamında iki döngü halinde
yapıldı. beşinci sınıf öğrencilerine önce teorik ders anlatılıp, IASLC (International
Association for the Study of Lung Cancer) lenf nodu haritasına göre 1-14
aralığındaki lenf nodu istasyonları ve zonları kesitsel iki boyutlu görsellerle
desteklenerek anlatıldı. Daha sonra dersin pratik saatinin sonunda yazılı onamı
alınmış öğrenciler iki gruba ayrıldı, bir gruba lenf nodu istasyonları ve
zonları power point ders materyalleriyle anlatıldı. Diğer gruba Ultimaker 3 Extended
üç boyutlu (3D) yazıcı ile katman birikimli modelleme yöntemi ile yapılan
mediasten modelinden faydalanılarak anlatım yapıldı. Sonuçlar SPSS’de bağımlı örneklem t testi ile analiz edilip sonuçlar
tablo haline getirildi. Bağımlı örneklem t testine göre 3D yazıcı ile basımı
yapılan mediasten modeli ile anlatılan öğrenci grubu,  power point ile anlatılan öğrenci grubuna
göre daha fazla soru sayısı ortalamasına sahip olup anlamlı farklılık saptandı
(t: 3.07, p:0.05).3D yazıcı tıp eğitiminde anatomik yapıları göstermede, pratik
yaptırmada önemli bir yere gelmiştir. Mediastinal lenf nodları gibi zor, kafa
karıştıran anatomik lokalizasyonlarda 3D yazıcı ile ders anlatımını desteklemek
öğrenciler için olumlu sonuçlar verecektir.

Anahtar Kelimeler

Üç boyutlu yazıcı, Katmanlı modelleme, Mediasten, Toraks

Kaynakça

• 1. Schubert C, van Langeveld MC, Donoso LA. Innovations İn 3D Printing: A 3D Overview From Optics To Organs. Br J Ophthalmol. 2014;98(2):159-61. doi: 10.1136/bjophthalmol-2013-304446.
• 2. Esses SJ, Berman P, Bloom AI, Sosna J. Clinical Applications of Physical 3D Models Derived From MDCT Data and Created by Rapid Prototyping. American Journal of Roentgenology. 2011;196: W683-W688. doi:10.2214/AJR.10.5681.
• 3. Tam et al. 3D Printing of an Aortic Aneurysm to Facilitate Decision Making and Device Selection for Endovascular Aneurysm Repair in Complex Neck Anatomy J Endovasc Ther. 2013 Dec;20(6):863-7
• 4. Waran V, Narayanan V, Karuppiah R, Owen SLF, Aziz T. Injecting realism in surgical training-initial simulation experience with custom 3D models. J Surg Educ. 2014 Mar-Apr;71(2):193-7.
• 5. Rengier et al. 3D printing based on imaging data: review of medical applications. Int J Comput Assist Radiol Surg. 2010 Jul;5(4):335-41.
• 6. Estevez et al. A novel three-dimensional tool for teaching human neuroanatomy. Anat Sci Educ. 2010 Nov-Dec;3(6):309-17.
• 7. Rusch VW, Asamura H. Watanabe H et al The IASLC lung cancer staging project: a proposal for a new international lymph node map in the forthcoming seventh edition of the TNM classification for lung cancer. J Thorac Oncol. 2009 May;4(5):568-77.
• 8. Suwatanapongched T CT of thoracic lymph nodes. Part I: anatomy and drainage.Br J Radiol. 2006 Nov;79(947):922.
• 9. Gross BC, Erkal JL, Lockwood SY, Chen C, Spence DM. Evaluation of 3D printing and its potential impact on biotechnology and the chemical sciences. Anal Chem. 2014 Apr 1;86(7):3240-53. doi: 10.1021/ac403397r.
• 10. Cui X, Boland T, D’Lima DD, Lotz MK. Thermal inkjet printing in tissue engineering and regenerative medicine. Recent Pat Drug Deliv Formul. 2012 Aug;6(2):149-55.
• 11. Ballard DH, Trace AP, Sayed A, Hodgdon T, Zygmont EM, DeBenedectis CM, Smith SE, Richardson ML, Patel MJ, Decker SJ, Lenchik L. Clinical Applications of 3D Printing. Academic Radiology. 2018 Jan; Volume 25, Issue 1, Pages 52–65. doi: https://doi.org/10.1016/j.acra.2017.08.004
• 12. Trace AP, Ortiz D, Deal A, Retrouvey M, Elzie C, Goodmurphy C, Morey J, Hawkins CM. Radiology's Emerging Role in 3-D Printing Applications in Health Care. J Am Coll Radiol. 2016 Jul;13(7):856-862.e4. doi: 10.1016/j.jacr.2016.03.025. Epub 2016 May 26.
• 13. Kah Heng Alexander Lim Zhou Yaw Loo Stephen J. Goldie Justin W. Adams Paul G. McMenamin. Use of 3D printed models in medical education: A randomized control trial comparing 3D prints versus cadaveric materials for learning external cardiac anatomy. Anatomical Sciences Education. 2015; Volume 9, Issue 3 doi: https://doi.org/10.1002/ase.1573.
• 14. Frank AC, Rybicki J. Maintaining safety and efficacy for 3D printing in medicine. 3D Printing in Medicine. 2017 March; 3:1.
• 15. Yoo SJ, Spray T, Austin EH, Yun TJ, van Arsdell GS. Hands-on surgical training of congenital heart surgery using 3-dimensional print models. J Thorac Cardiovasc Surg. 2017 Jun;153(6):1530-1540. doi: 10.1016/j.jtcvs.2016.12.054. Epub 2017 Feb 9.
• 16. Rusch VW, Asamura H, Watanabe H, Giroux DJ, Rami-Porta R, Goldstraw P; Members of IASLC Staging Committee. The IASLC lung cancer staging project: a proposal for a new international lymph node map in the forthcoming seventh edition of the TNM classification for lung cancer. J Thorac Oncol. 2009 May;4(5):568-77. doi: 10.1097/JTO.0b013e3181a0d82e.
• 17. Suwatanapongched T, Gierada DS. CT of thoracic lymph nodes. Part II: diseases and pitfalls. Br J Radiol. 2006 Dec;79(948):999-1000. Epub 2006 Apr 26. doi: 10.1259/bjr/82484604.