jallesdantas@gmail.com

Gilberto Santos Cerqueira**

giufarmacia@gmail.com

*Graduado em Enfermagem

Especialista em Ciências Morfológicas

pela Universidade Federal do Rio Grande do Norte

Mestre em Neurociência Cognitiva e Comportamento

pela Universidade Federal da Paraíba

Doutor em Ciências Morfofuncionais

pela Universidade Federal do Ceará

Estágio Pós-doutoral em Educação

pela Universidade Federal do Ceará em andamento

Atualmente, leciona no curso de Bacharelado

em Medicina do UNIFSM e do UNINTA (Itapipoca)

Coordena o Grupo de Pesquisa "Grupo de estudos do Esqueleto Nordestino - GEEN"

no UNIFSM, cadastrado no CNPQ

**Possui Bacharelado em Farmácia

Licenciatura em Ciências Biológicas

Especialista em Análises Clínicas e Hematologia clínica

pela Universidade Federal do Ceará

Mestrado em Farmacologia de Produtos Naturais

pela Universidade Federal da Paraíba

Doutor em Farmacologia pela Universidade Federal do Ceará

Possui o Título de Proficiência em Anatomia, Modalidade

Anatomia Humana Macroscópica, pela Sociedade Brasileira de Anatomia

Professor Permanente do Programa de Pós-graduação em Educação (PPGE)

da Faculdade de Educação e PPG Ciências Morfofuncionais

da Faculdade de Medicina onde Desenvolve Pesquisas

na linha de pesquisa Gamificação, Tecnologias Digitais

na Educação, Impressão 3D

Coordenador do Laboratório de Tecnologias 3D e Educação Médica

(Brasil)

Recepción: 29/10/2024 - Aceptación: 29/11/2024

1ª Revisión: 22/11/2024 - 2ª Revisión: 26/11/2024

Accessible document. Law N° 26.653. WCAG 2.0

Cita sugerida: Lucena, J.D. de, y Cerqueira, G.S. (2025). Use of 3D Printing in Teaching Human Anatomy in the Medical Course. Literature Review. Lecturas: Educación Física y Deportes, 29(320), 176-192. https://doi.org/10.46642/efd.v29i320.7990

 

Abstract

    Introduction: Three-dimensional (3D) printing is a modern technique of creating 3D-printed models that allows reproduction of anatomical models for teaching anatomy. It has the advantage of higher reproducibility and manipulation by the students. Objective: The objective of this review was to describe the advantages and disadvantages of the utilization of 3D printing in teaching human anatomy. Methods: Literature review study with articles published in 2019-2023. A literature search was performed in the electronic PubMed database (National Library of Medicine, NCBI) using the following terms: anatomy, learning, teaching, medical education and 3D printing. Results: The search yielded 235 results, which were narrowed down to 31 articles after application of exclusion criteria. The literature supported that 3D printing is a useful tool for teaching anatomy. The main advantages were visual characteristics, such as authenticity, variability of consistencies, colors and transparency, reproducibility, possibility of manipulation by the students, long-term knowledge retention, and student satisfaction. However, the main disadvantages are related to the design such as: consistency, lack of detail, overly bright colors, long printing time, and high cost. Conclusion: This review demonstrates that 3D printed models have the potential to aid students in learning anatomy. From a pedagogical perspective, 3D printing is an effective tool for teaching anatomy, as evidenced by long-term knowledge retention and student satisfaction.

    Keywords: Anatomy. Learning. Teaching. Medical education. 3D printing.

 

Resumo

    Introdução: A impressão tridimensional (3D) é uma técnica moderna de criação de modelos impressos em 3D que permite a reprodução de modelos anatômicos para o ensino de anatomia. Ela tem a vantagem de maior reprodutibilidade e manipulação pelos alunos. Objetivo: O objetivo desta revisão foi descrever as vantagens e desvantagens da utilização da impressão 3D no ensino de anatomia humana. Métodos: Estudo de revisão de literatura com artigos publicados entre 2019-2023. Uma busca bibliográfica foi realizada no banco de dados eletrônico PubMed (National Library of Medicine, NCBI), usando os seguintes termos: anatomia, aprendizagem, ensino, educação médica e impressão 3D. Resultados: A busca gerou 235 resultados, que foram reduzidos a 31 artigos após a aplicação dos critérios de exclusão. A literatura apoiou que a impressão 3D é uma ferramenta útil para o ensino de anatomia. As principais vantagens foram características visuais, como autenticidade, variabilidade de consistências, cores e transparência, reprodutibilidade, possibilidade de manipulação pelos alunos, retenção de conhecimento a longo prazo e satisfação do aluno. No entanto, as principais desvantagens estão relacionadas ao design, como: consistência, falta de detalhes, cores muito brilhantes, longo tempo de impressão e alto custo. Conclusão: Esta revisão demonstra que os modelos impressos em 3D têm o potencial de auxiliar os alunos no aprendizado de anatomia. Do ponto de vista pedagógico, a impressão 3D é uma ferramenta eficaz para o ensino de anatomia, como evidenciado pela retenção de conhecimento a longo prazo e pela satisfação dos alunos.

    Unitermos: Anatomia. Aprendizagem. Ensino. Educação médica. Impressão 3D.

 

Resumen

    Introducción: La impresión tridimensional (3D) es una técnica moderna de creación de modelos impresos en 3D que permite la reproducción de modelos anatómicos para la enseñanza de la anatomía. Tiene la ventaja de mayor reproducibilidad y manipulación por parte de los estudiantes. Objetivo: Describir las ventajas y desventajas del uso de la impresión 3D en la enseñanza de anatomía humana. Métodos: Estudio de revisión de literatura con artículos publicados entre 2019-2023. Se realizó una búsqueda bibliográfica en la base de datos electrónica PubMed (National Library of Medicine, NCBI), utilizando los siguientes términos: anatomía, aprendizaje, enseñanza, educación médica e impresión 3D. Resultados: La búsqueda generó 235 resultados, los cuales se redujeron a 31 artículos luego de aplicar los criterios de exclusión. La literatura respalda que la impresión 3D es una herramienta útil para la enseñanza de anatomía. Las principales ventajas fueron las características visuales, como autenticidad, variabilidad de consistencias, colores y transparencia, reproducibilidad, posibilidad de manipulación por parte de los estudiantes, retención de conocimientos a largo plazo y satisfacción de los estudiantes. Sin embargo, las principales desventajas están relacionadas con el diseño, tales como: consistencia, falta de detalle, colores muy brillantes, largo tiempo de impresión y alto costo. Conclusión: Esta revisión demuestra que los modelos impresos en 3D tienen el potencial de ayudar a los estudiantes a aprender anatomía. Desde una perspectiva pedagógica, la impresión 3D es una herramienta eficaz para la enseñanza de anatomía, como lo demuestran la retención de conocimientos a largo plazo y la satisfacción de los estudiantes.

    Palabras clave: Anatomía. Aprendizaje. Enseñanza. Educación médica. Impresión 3D.

 

Lecturas: Educación Física y Deportes, Vol. 29, Núm. 320, Ene. (2025)

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Introduction 

 

    Human anatomy is one of the basic subjects taught in medical curricula (Netterstrøm, & Kayser, 2008). Anatomy is essential to ensure safe clinical practice, especially in the fields of surgery and imaging (Triepels et al., 2018). When learning anatomy, medical students learn about the structure of the human body, providing them with the basic knowledge for understanding pathology and clinical problems. (Vaccarezza, & Papa, 2015)

 

    The cadaver dissection is one of the main methods used to teach anatomy. Furthermore, cadaveric dissection performed during practical sessions in the anatomy laboratory, supports the theoretical lessons given to medical students (Ghosh, 2017; Varner, Dixon, & Simons, 2021). However, there are many obstacles to using human cadavers, such as costs associated with obtaining and preservation of cadavers, decrease in the hours devoted to teaching anatomy, maintenance of anatomy laboratories, ensuring safety of students and staff (Papa, & Vaccarezza, 2013; Drake, McBride, & Pawlina, 2014; Bergman, 2015; Garas, Vaccarezza, Newland, McVay-Doornbusch, & Hasani, 2018). Another problem is the careful dissection is time-consuming and there is a lack of cadavers for study (Vaccarezza, & Papa, 2015). Aside from ethical, legal and religious issues relating to body donation. (Mchanwell et al., 2008)

 

    In this way, instigation a search for new pedagogical tools for teaching anatomy (Fornaziero, & Gil, 2003; Papa, & Vaccarezza, 2013). Some of these new tools are digital tools, extended reality, and 3D printing. Recent studies show that 3D printing appears to be one of the most relevant resources both in terms of its educational value to students and the feasibility of its implementation. (McMenamin, Quayle, McHenry, & Adams, 2014; Vaccarezza, & Papa, 2015; Lim, Loo, Goldie, Adams, & McMenamin, 2016; Cai, Rajendran, Bay, Lee, & Yen, 2019; Santos, Barreira, & Saad, 2022; Brumpt, Bertin, Tatu, & Louvrier, 2023)

 

    3D printing has been successfully utilized in different medical fields, including education (Chytas et al., 2020; Ye et al., 2020; Salazar, Thompson, Rosen, & Zuniga, 2022; Ye et al., 2023). It is a technology that can improve surgical education and clinical practice. (Jones, Sung, Weinberg, Korelitz, & Andrews, 2016; Brumpt et al., 2023)

 

    Studies point out some advantages of using 3D printing, the visual or tactile qualities of their models (Low, Choby, Viozzi, & Morris, 2020; Williams, Smillie, Richard, & Cosker, 2020; Mogali et al., 2022), strength and durability (Cai et al., 2019). Other advantages were that the students could manipulate the structures, the teacher could save time, they were easier to preserve than a cadaver. (Casciato, Builes, & Singh, 2018; Backhouse, Taylor, & Armitage, 2019)

 

    Furthermore, the 3D anatomical models are effective as pedagogical tools in terms of achievement (Smith, Tollemache, Covill, & Johnston, 2018; Yi et al., 2019; Chedid et al., 2020), long-term knowledge retention (O'Brien, Souza, Sheikh, Miguel, & Wood, 2021) and student satisfaction. (Yi et al., 2019; Chedid et al., 2020)

 

    The 3D anatomical models are a relevant tool due to their educational value and their feasibility. The objective of this review was to describe the advantages and disadvantages of the utilization of 3D printing in teaching human anatomy.

 

Methods 

 

    This review of the literature was conducted in October and November 2023, with articles published in 2019-2023. A literature search was performed in the electronic PubMed database (National Library of Medicine, NCBI) to identify relevant studies published up to October 2023. The following search terms found in Descriptors in Health Sciences/Medical Subject Headings - DeCS/MeSH were used: Anatomy, Learning, Teaching, Medical Education and, 3D Printing. The Boolean operator AND was used to combine the search terms.

 

    Inclusion criteria were all research papers dealing with 3D printing in human anatomy teaching/learning and published in English. The anatomical models were of normal anatomy. Literature reviews, meta-analysis, letters, or articles studying pathological models, animal models and medical/surgical training models were excluded. Articles without available online abstracts were excluded.

 

Results and discussion 

 

    Three hundred and sixty-four studies were identified in the PubMed database; 235 articles were excluded by the filters: human, published in 2019-2023, literature reviews and, meta-analysis. Three hundred and sixty-four studies were identified in the PubMed database; 235 articles were excluded by the filters: human, published in 2019-2023, literature reviews and, meta-analysis. After the title and abstract were analyzed, 37 studies were selected for reading of the full text. A total of 31 articles were included in this review (Table 1).

 

Author (Year)	Article title	Anatomical human region	Initial model	Modality of acquisition	Model used for comparison	Type of student
Miao et al., 2023	Application of 3D-printed pulmonary segment specimens in experimental teaching of sectional anatomy	Lung	Digital database	High-definition digital human anatomy data	Students received traditional teaching	Undergraduate students of medical imaging in second-year
Ben Awadh et al., 2022	Multimodal three-dimensional visualization enhances novice learner interpretation of basic cross-sectional anatomy	Thorax	Patient and database	Computed Tomography (CT)	2D images	1st year medical students
Cercenelli et al., 2022	AEducaAR, anatomical education in augmented reality: A pilot experience of an innovative educational tool combining AR technology and 3D printing	Head	Cadaver	CT	3DPAM and VR versus 2D images	Second year medical students
Chandrasekaran et al., 2022	A validated instrument measuring students’ perceptions on plastinated and three-dimensional printed anatomy tools	Neck and thorax	Not specifed	Not specifed	Plastinated	1st year medical students
Chen et al., 2022	Caregiver Preferences for Three-Dimensional Printed or Augmented Reality Craniosynostosis Skull Models: A Cross-Sectional Survey	Head	Patients	Not specifed	2D diagram	Caregivers
Hammerton et al., 2022	Are 3D printed models acceptable in assessment?	Thorax	Public database	Not specifed	Not specifed	1st year medical students
Harmon et al., 2022	Development and implementation of a three-dimensional (3D) printing elective course for health science students	Upper and lower-limbs, pelvis, thorax	Public database	CT	Not specifed	2nd year doctors, 1st year medical and dental students
Holm et al., 2022	High-resolution 3D reconstructions of human vasculatures: creation of educational tools and benchtop models for transcatheter devices	Human vasculature	Cadavers	CT	Not specifed	Not specifed
Mogali et al., 2022	Investigating the effectiveness of three-dimensionally printed anatomical models compared with plastinated human specimens in learning cardiac and neck anatomy: A randomized crossover study	Thorax and neck	Cadaver (plastinated human prosections	CT	Plastinated	1st year medical students
Tan et al., 2022	Full color 3D printing of anatomical models	Head, Upper-limb	Database from frozen cadaver	Optical	Cadaver and digital	Not specifed
Bertolini et al., 2021	Operative workflow from CT to 3D printing of the heart: opportunities and challenges	Thorax	Patient	CT	CT images	Not specifed
O’Brien et al., 2021	. Use of tracheobronchial tree 3-dimensional printed model: does it improve trainees’ understanding of segmentation anatomy? A prospective study	Thorax	Patient	CT	2D images	1st year medical students
Smillie et al., 2021	Producing three-dimensional printed models of the hepatobiliary system from computed tomography imaging data	Abdomen	Database	Contrast enhanced CT	Not specifed	Not specifed
Weatherall et al., 2021	A Novel 3-dimensional printing fabrication approach for the production of pediatric airway models	Thorax	21-month- old patient and adult woman archived	CT	Not specifed	Not specifed
Abdulcadir et al., 2020	In Vivo imaging-based 3-dimensional pelvic prototype models to improve education regarding sexual anatomy and physiology	Pelvis	Patient	CT and MRI	Not specifed	Not specifed
Chae et al., 2020	Replicating skull base anatomy with 3D technologies: A comparative study using 3D-scanned and 3D-printed models of the temporal bone	Head	Cadaver	3D scan and micro-CT	Cadaver (temporal bone), optic scanner and micro-CT images	Not specifed
Chedid et al., 2020	Three-Dimensional-Printed Liver Model Helps Learners Identify Hepatic Subsegments: A Randomized-Controlled Cross-Over Trial	Abdomen	Not specifed	CT	2D images	Gastroenterology, radiology and general surgery departments
Chen et al., 2020	3D printing technology improves medical interns’ understanding of anatomy of gastrocolic trunk	Abdomen	Patients	CT angiography	2D images	Residents
Low et al., 2020	Construction of three-dimensional printed anatomic models for frontal sinus education	Head	Database	CT	Not specifed	Not specifed
Radzi et al., 2020	Development of a three-dimensional printed heart from computed tomography images of a plastinated specimen for learning anatomy	Thorax	Plastinated heart	CT	Plastinated	1st year medical students
Tanner et al., 2020	A Three-dimensional print model of the pterygopalatine fossa significantly enhances the learning experience	Head	Database	Not specifed	Cadaver	Junior and sophomores in medical education, graduate students of Master of Biomedical Science and 1st year medical students, dental and physicians’ students
Wilk et al., 2020	What would you like to print? Students’ opinions on the use of 3D printing technology in medicine	Not specifed	Not specifed	Not specifed	Teaching with cadaver	Medical students
Williams et al., 2020	Producing 3D printed high-fidelity retroperitoneal models from in vivo patient data: The Oxford Method	Abdomen	Patient	CT and MRI	Not specifed	Not specifed
Backhouse et al., 2019	Is this mine to keep? Three-dimensional printing enables active, personalized learning in anatomy	Head	Cadaver bone piece	3D scan	Not specifed	1st year students in ocular anatomy unit bachelor or vision sciences and master of optometry
Cai et al., 2019	The effects of a functional three-dimensional (3D) printed knee joint simulator in improving anatomical spatial knowledge	Lower-limb	Patient	CT	Cadaver (knee skeleton)	1st year medical students
Hojo et al., 2019	Utility of a Three-Dimensional Printed Pelvic Model for Lateral Pelvic Lymph Node Dissection Education: A Randomized Controlled Trial	Pelvis	Patient	CT	Not specifed	Medical students, residents and one colorectal surgeon
Shen et al., 2019	The process of 3D printed skull models for anatomy education	Head	Patient	CT	Cadaver (skull)	Not specifed
Skrzat et al., 2019	3 D printed replica of the human temporal bone intended for teaching gross anatomy	Head	Cadaver bone piece	CT	Cadaver	Not specifed
Yi et al., 2019	Three-dimensional printed models in anatomy education of the ventricular system: a randomized controlled study	Head	Patient	CT	Not specifed	2nd year medical students
Zhang et al., 2019	Application of three-dimensional reconstruction and printing as an elective course for undergraduate medical students: an exploratory trial	Head, neck, thorax, abdomen, pelvis, reproductive organ, lower-limb	Database	Camera and microscope	Not specifed	5 year medical students
Bannon et al., 2018	3D printing the pterygopalatine fossa: a negative space model of a complex structure	Head	Database	Not specifed	Not specifed	Not specifed

Source: Research data

 

    The articles studied since the cephalic region, the thoracic region, the abdominopelvic region and the limbs (Chen et al., 2020; Low et al., 2020; Tanner et al., 2020; Chen et al., 2022; Holm, Emfield, Iles, & Iaizzo, 2022; Miao et al., 2023). The cephalic region was the most studied, probably because its anatomical complexity makes it difficult for students to picture this anatomical region in 3D space, compared to the limbs or trunk. (Brumpt et al., 2023)

 

    Regarding the original model or file used for designing the 3D printing, the articles mentioned the use of patient data (Bertolini, Rossoni, & Colombo, 2021; Ben Awadh, Clark, Clowry, & Keenan, 2022), the use of cadaver data (Cercenelli et al., 2022; Mogali et al., 2022), and the use of a database (Low et al., 2020; Hammerton, Yip, Manobharath, Myers, & Sturrock, 2022). The 3D printings were designed from CT scans (Abdulcadir et al., 2020; Smillie, Williams, Richard, & Cosker, 2021; Weatherall et al., 2021; Harmon, Klein, Im, & Romero, 2022; Mogali et al., 2022), optical scanners (Backhouse et al., 2019), MRI (Abdulcadir et al., 2020; Williams et al., 2020) and from camera. (Zhang et al., 2019; Tan et al., 2022)

 

    Computed Tomography (CT) scan was by the most used image acquisition modality. This modality is widely available, especially in health services, but its spatial resolution is limited, and its soft-tissue contrast is low (Brumpt et al., 2023). These limitations make CT scan unsuitable for segmentation and modelling of the nervous system for example. MRI, on the other hand, was cited as the reference technology in terms of spatial resolution for the acquisition of images. Higher resolution preserves the subtleties of the anatomy. (Bannon, Parihar, Skarparis, Varsou, & Cezayirli, 2018)

 

    The human corpse was the most used comparator for 3D printing (Cai et al., 2019; Shen et al., 2019; Skrzat, Zdilla, Brzegowy, & Hołda, 2019; Chae et al., 2020; Tanner et al., 2020; Tan et al., 2022). Despite its drawbacks, the cadaveric model remains the main tool for teaching anatomy. One study showed that 3D printing was significantly more effective than plastinated prosections based on learning tests (Mogali et al., 2022). It is likely that few studies have been done on this topic because this comparison is difficult to set up.

 

    The studies by Cai and Miao found significantly better test results for the groups who used associated 3D printing (Cai et al., 2019; Miao et al., 2023). Holm and colleagues used anatomically accurate 3D models of real patient vasculatures that accurately represent significant patient-to-patient variations, the learning is more translatable to what is seen in the clinic (Holm et al., 2022). Tanner and colleagues (2020) demonstrated better post-test results for the group using a 3D printing of the pterygopalatine fossa. Finally, Chen and colleagues demonstrated that the 3D printing gastrocolic trunk model is a very effective teaching tool, which can help interns understand the anatomy of Henle trunk. (Chen et al., 2020)

 

    The educational relevance of 3D printing was evaluated mostly in medical students (O'Brien et al., 2021; Ben Awadh et al., 2022; Chandrasekaran et al., 2022). A pilot study with 430 students at the Medical University of Silesia in Katowice (Poland), the students suggest that 3D printing should be incorporated into their learning of anatomy (Wilk et al., 2020). Eighty-seven percent of students surveyed in the Cercenelli study reported that their second year was the best time to use 3D printing (Cercenelli et al., 2022). These data suggest that the first years of medical school are the best time to incorporate 3D printing into the teaching of anatomy.

 

    Studies show that the 3D printing has effective as pedagogical tools in terms of achievement (Hojo et al., 2019; Yi et al., 2019; Chedid et al., 2020; Holm et al., 2022), long-term knowledge retention (O'Brien et al., 2021; Holm et al., 2022; Miao et al., 2023) and student satisfaction (Hojo et al., 2019; Tanner et al., 2020; Hammerton et al., 2022; Miao et al., 2023). Backhouse et al. (2019) judged 3D printing to be the best alternative to conventional anatomical models.

 

    Regarding the advantages of use 3D printing as a pedagogical tool for teaching human anatomy, the studies cite visual characteristics, such as authenticity (Skrzat et al, 2019), variability of consistencies (Williams et al., 2020; Smillie et al., 2021), colors and transparency (Tan et al., 2022), reproducibility (Williams et al., 2020), possibility of manipulation by the students (Backhouse et al., 2019) and effectiveness for education (Hojo et al., 2019; Yi et al., 2019; Chedid et al., 2020), represented in Figure 1.

 

    Ultimately, regarding the main disadvantages of using 3D printing for teaching human anatomy, the studies cite design-related characteristics such as: consistency (Tan et al., 2022), lack of detail (Tan et al., 2022; Smillie et al., 2021), overly bright colors (Radzi et al., 2020), long printing time (Weatherall et al., 2021; Hojo et al., 2019; Zhang et al., 2019), and high cost (Mogali et al., 2022; Williams et al., 2020), represented in Figure 1.

 

Source: Research data

 

Conclusion 

 

    3D printing is an emerging technique capable of producing high-quality 3D anatomical models for anatomy teaching. This review demonstrates that 3D printed models have the potential to aid students in learning anatomy and that they can be used in conjunction with human cadavers.

 

    3D printed models are easy to store and preserve, can be produced in different colors and sizes, allowing students to manipulate them.

 

    From a pedagogical perspective, 3D printing is an effective tool for teaching anatomy, as evidenced by long-term knowledge retention and student satisfaction.

 

References 

 

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Bannon, R., Parihar, S., Skarparis, Y., Varsou, O., & Cezayirli, E. (2018). 3D printing the pterygopalatine fossa: a negative space model of a complex structure. Surgical and radiologic anatomy: SRA, 40(2), 185-191. https://doi.org/10.1007/s00276-017-1916-x

 

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Bertolini, M., Rossoni, M., & Colombo, G. (2021). Operative Workflow from CT to 3D Printing of the Heart: Opportunities and Challenges. Bioengineering (Basel, Switzerland), 8(10), 130. https://doi.org/10.3390/bioengineering8100130

 

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Lecturas: Educación Física y Deportes, Vol. 29, Núm. 320, Ene. (2025)