The Value and Standardization of 3D Printed Medical Educational Models

The Value and Standardization of 3D Printed Medical Educational Models | Research Square window.SnipcartSettings = { analytics: { enabled: false } }; (function() { var accessVector = localStorage.getItem('access_vector') || ''; window.dataLayer = window.dataLayer || []; if (accessVector) { window.dataLayer.push({ user: { profile: { profileInfo: { snid: accessVector } } } }); } })(); (function(w,d,s,l,i){w[l]=w[l]||[];w[l].push({'gtm.start':new Date().getTime(),event:'gtm.js'});var f=d.getElementsByTagName(s)[0],j=d.createElement(s),dl=l!='dataLayer'?'&l='+l:'';j.async=true;j.src='https://www.googletagmanager.com/gtm.js?id='+i+dl;f.parentNode.insertBefore(j,f);})(window,document,'script','dataLayer','GTM-K279D39R'); Browse Preprints In Review Journals COVID-19 Preprints AJE Video Bytes Research Tools Research Promotion AJE Professional Editing AJE Rubriq About Preprint Platform In Review Editorial Policies Our Team Advisory Board Help Center Sign In Submit a Preprint Cite Share Download PDF Research Article The Value and Standardization of 3D Printed Medical Educational Models Faisal S. Fakhouri, Llama F. Alothman, Abdulaziz S. Fakhouri, and 3 more This is a preprint; it has not been peer reviewed by a journal. https://doi.org/ 10.21203/rs.3.rs-7545658/v1 This work is licensed under a CC BY 4.0 License Status: Posted Version 1 posted You are reading this latest preprint version Abstract The rapid advancements in 3D printing technology have transformed the field of medical education and presurgical planning. Given the novelty of this area, the literature is limited regarding end-users' feedback on how they benefited from the models. Thus, this study aimed to evaluate the impact of 3D printed educational models (3DP-EM) on educational outcomes from the end-user perspective. Surveys were conducted to assess the views of medical professionals and students on the effectiveness of 3DP-EM in enhancing their understanding of anatomical structures and surgical procedures. Results indicatsed that the use of 3DP-EM significantly improved the respondents’ understanding and retention of medical concepts (p < 0.001). Due to the positive effects of 3DP-EM on the end-users, there is a need for standardization of the 3D printing process for such models to ensure their accuracy and reproducibility. 3D printing Additive Manufacturing Education Medical Education Figures Figure 1 Background Research and application in preoperative planning combined with medical education have grown extensively over the past two decades to minimize operative risk and maximize surgery success rates 1 . Traditional preoperative planning depends on medical imaging such as computed tomography (CT) and magnetic resonance imaging (MRI) and clinical experience, but the absence of physical interaction and limited spatial accuracy can impede surgeons' readiness, particularly in complex cases 2 . Although virtual three-dimensional (3D) imaging has shown beneficial results, it fails to represent the actual anatomical structures of the patient fully. These limitations have been addressed by one of the rapidly advancing technologies in the field of medical education and preoperative planning, namely additive manufacturing (3D printing). 3D printing significantly influenced medical education and revolutionized how surgeons plan and execute complex procedures 3 . One of the medical 3D printing applications is the creation of intricate, patient-specific anatomical models for educational purposes. These 3D printed educational models (3DP-EM) have great potential to improve academic and surgical outcomes 3 , 4 . As 3DP-EM emerges, the existing literature remains scarce; however, aspects like dimensional accuracy were addressed 5 – 9 . In 1994, a stereolithography (SLA) study demonstrated an accuracy rate between 97.7 and 99.12% 6 . Another study found that human skull models printed using selective laser sintering (SLS) differed by 0.5 mm to 1.05 mm compared to the computed tomography (CT) scans 10 , 11 . Recently, Salmi et al. evaluated models produced via a PolyJet 3D printer, with a dimensional error of only 0.18 ± 0.12% 12 . The accuracy of 3D printed models (3DPMs) can be measured in different ways, such as comparing digital computer-aided design (CAD) models to 3D printed ones 13 . On the other hand, CT scans of the patient's imaging are compared to the 3DPMs 14 , using a coordinate measuring machine (CMM) 12 , either by referencing anatomical landmarks or by incorporating external landmarks such as spheres or tracking dots. Lastly, osteometric analysis is commonly used for bone models 7 . 3D printing allows creating patient-specific 3DP-EM with high accuracy 6 , 15 , with an average variance of ± 120 µm in volume dimensions 16 . Also, 3DP-EMs have advantages over real structures as they do not decay, are easily accessible, and easily reproducible at a low cost 9 , 17 – 19 . A randomized controlled trial conducted in 2015 involving undergraduate medical students with no formal cardiac anatomy background 20 . The study revealed an increase of almost 42.16% in post-test scores for the group exclusively utilizing 3DP-EM, compared to only 21.9% and 20.01% for those relying on cadaveric materials or a combination of both, respectively 20 . In a recent study, students who learned with 3DP-EM scored 11% better compared to students who were taught with traditional methods 21 , indicating the efficacy of 3DP-EM in medical academia 20 ., In a study focusing on patient education by Bernhard et al., the authors concluded that patients’ understanding improved by 37.6% after viewing a 3DP-EM of their kidney 22 . Multiple articles concluded that there is an absence of standardization for the creation and assessment of 3DPMMs 12 , 23 – 25 . In 2016, three institutes received identical data sets of Digital Imaging and Communications in Medicine (DICOM) and were asked to convert them into a 3D model with (.STL) file format using their preferred software. There were significant variations in the size and anatomical geometries of the final models 26 . This shows the need for standardization to improve model accuracy and reproducibility across different users. Various methodologies were employed to measure the value of 3DP-EM, such as surveys targeting medical practitioners and students. Questions directed to students include “Do you prefer 3D models of the bones to study anatomy?” 27 , “In the anatomy classes, with the choice of standard anatomical specimen (cadaver) and an accurately mapped 3D model, what would you choose?” 28 , “The model was useful for simulation teaching.” 28 . Other investigators employed quantitative approaches to assess the accuracy of 3DP-EM, as mentioned earlier; these methodologies include the application of volumetric intersection indexes 14 , osteometric analysis 7 , and the utilization of CMM 12 . In addition, some used comparative methods to evaluate results before and after the implementation of 3DP-EM, such as comparing students’ test results before and after using 3DP-EM 20 , 29 , 30 . To date, and to our knowledge, the literature evaluating educational outcomes of 3DP-EM in a clear, structured, and analytically thorough way remains limited. In addition, there is a lack of standardized methods and processes to 3D print such medical models, leading to variations in the quality and size of the 3DP-EM 25 , 31 . Therefore, this study aims to first assess the efficacy of 3DP-EM in improving the learning outcomes of medical students and trainees. Second, suggest a standardized methodology for the creation of 3DP-EM, beginning at the first stages of CT and MRI image acquisition, image segmentation, 3D modeling, 3D printing, and post-processing. Finally, the 3DP-EM will be compared to the real structures. Methods Survey-Based Assessment An institutional review board (IRB)-approved survey-based approach was employed to assess the effect of 3DP-EM on learning outcomes. Participants in this survey included 30 medical students and 10 medical practitioners taking medical educational courses. The survey focused on comprehension, knowledge retention, and overall educational experience, as shown in Table 1 . The answers to the survey were based on a Likert scale (i.e., Strongly Agree, Agree, Neutral, Disagree, Strongly Disagree) 28 . Analysis of responses provided insights into the perceived benefits of 3DP-EM on learning outcomes. Table 1 3D Printed Medical Education Questionnaire Medical Education (targeted audience: medical students and practitioners) 1. The 3D printed medical model helped me to better understand the targeted anatomy. 2. I would use a 3D printed medical model in the future 28 . 3. I am willing to pay to acquire the 3D printed medical model for my own learning. 4. I am willing to participate in courses with 3D printed medical models in the future. 5. The use of the 3D printed medical model enhanced my ability to understand the surgical procedure. 6. The use of the 3D printed medical model enhanced my ability to retain information. 7. The use of the 3D printed medical model helped me reach the course's educational objectives. 8. The anatomical landmarks/features were easy to recognize using the provided 3D printed medical model. 9. The 3D printed medical model was detailed enough to be used in a simulation or a procedure. 10. The 3D printed medical model feels close to real cadaveric materials in the hand in terms of texture. 11. The 3D printed medical model feels close to real cadaveric materials in the hand in terms of weight. 12. The 3D printed medical model accurately reflected the anatomical structure in size 28 . 13. The 3D printed medical model accurately reflected the anatomical structure in shape 28 . To help assess the extent of the lack of standardization for 3DP-EM, professionals were consulted and involved in the creation of the 3DPMs. Their insights about software and 3D printing preferences, and suggestions were gathered through structured questions. Additionally, they provided input on key factors affecting accuracy, such as CT resolution and 3D printing parameters. The responses will be analyzed to identify common practices, challenges, and areas where standardization is crucial for maintaining quality in 3DP-EM. Suggested 3DPMs Standardization The following parameters represent the minimum standards for producing high-quality 3D printed educational medical models. First, the CT scan should be acquired with an image dimension of 512 x 512 pixels and a slice count that preserves anatomical detail, using an in-plane resolution of approximately 0.365 mm and a slice thickness of 2 mm, stored as a short (16-bit) scalar type to capture the necessary grayscale variations for accurate segmentation. During model reconstruction, minimal smoothing should be applied to retain the anatomical fidelity of the model, with the resulting mesh exported in a format like (.STL) or (.OBJ). For the printing process, a layer height of 0.15 mm is recommended to balance detail with print efficiency 32 . The infill percentage should be carefully chosen not only to ensure structural integrity but also to best represent the weight and internal feel of the real anatomical part. In previous experiments, the Gyroid lattice structure with 30% infill can serve as a baseline, as it can be adjusted as needed to mimic the density and tactile characteristics of the original tissue. Consideration should also be given to print orientation; vertical printing may be favored for long structures to minimize warping, and horizontal printing can be beneficial for stable base support 33 , 34 . Finally, dimensional deviation comparisons between the printed models and the original CT data must remain within an acceptable range (ideally within ± 2%) to ensure the accuracy and reliability of the models for both educational and clinical applications. These settings can serve as the baseline minimum standard to ensure that 3DPMs accurately replicate the original anatomical structures while maintaining consistency and quality for educational and clinical applications. 3D Printed Educational Model (3DP-EM) acquisition and fabrication A Siemens Healthineers (Somatom Force Eco, Erlangen, Germany) scanner was used to scan the six different Javan Rusa deer (Rusa timorensis) antlers to create a 3DPM using 3D Slicer 5.1.6 software (Brigham and Women’s Hospital, Harvard, Boston, Massachusetts) 35 , an open-source image processing software for research use. Image segmentation was performed by first selecting the appropriate threshold, ranging from − 500 to 2634 and then from − 500 to 3070, depending on the scan intensity range for each structure. The segments were then manually adjusted to match the scan closely. The 3DPMs were 3D printed using a fused deposition modeling (FDM) technique by using a Creality Ender 3 S-1 Pro (Creality, China) 3D Printer and SunCubic polylactic acid (PLA) filament (SunCubic, China). Printing parameters considered two orientations (vertically 90 and horizontally 0), a layer height of 0.15 mm, with a 0.4 mm standard nozzle, at 200°C, with a bed temperature of 60°C. #####. Each bone structure had a specific infill ranging from 70–100% infill to match the weight of the real bone. After 3D printing the bones, the models were manually measured using a vernier digital caliper and were compared with the measurements of the real bones. Each measurement was repeated three times. Two points of measurement were taken: the length of the bone (from the tip to the base) and a second measurement at around 3.5 mm from the base. Then, the average of these values was calculated. Finally, the results were compared to the CT scans to assess the accuracy of the 3DPM. Statistical Analysis Survey responses were collected on an ordinal Likert scale. First, frequency distributions were examined to understand the proportion of participants selecting each response level. Then, to test the hypothesis that the median response for each survey item was significantly greater than a neutral value (3), a one-sample Wilcoxon Signed-Rank test was employed. This test is suitable for ordinal data and does not require a normal distribution assumption. For each item, the null hypothesis was that the median response equals 3, while the alternative hypothesis was that the median is greater than 3. Results The results of the survey from 40 respondents, comprising 10 medical professionals and 30 medical students, are shown in Table 2 . In general, 95% of respondents found that 3DPMs significantly improved the understanding of targeted anatomical structures (p-value < 0.001). Furthermore, 90% of respondents expressed interest in utilizing these 3DPMs in future studies (p-value < 0.001), underscoring the perceived value in medical education. Also, 65% of respondents showed willingness to purchase 3DPMs for personal learning (p-value = 0.001), highlighting the perceived educational benefits of these models. While 85% stated they are willing to participate in courses incorporating 3DPMs (p-value < 0.001), indicating a positive reception amongst respondents towards integrating this technology into educational curricula. Table 2 Results of Medical Education Survey 1: Strongly Disagree, 2: Disagree, 3: Neutral, 4: Agree, 5: Strongly Agree, MP: Medical Professionals (N = 10), MS: Medical Students (N = 30), T: Total (N = 40) Question 1 2 3 4 5 P-Value The 3D printed model helped me to better understand the targeted anatomy. MP 20% 0% 0% 10% 70% 0.066 MS 0% 0% 0% 30% 70% < .001 T 5% 0% 0% 25% 70% < .001 I would use a 3D printed model in the future. MP 20% 0% 0% 10% 70% 0.066 MS 0% 0% 6.7% 23.3% 70% < .001 T 5% 0% 5% 20% 70% < .001 I am willing to pay to acquire the 3D printed model for my own learning. MP 20% 0% 0% 20% 60% 0.085 MS 6.7% 13.3% 20% 26.7% 33.3% 0.007 T 10% 10% 15% 25% 40% 0.001 I am willing to participate in courses with 3D printed models in the future. MP 20% 0% 0% 10% 70% 0.066 MS 0% 0% 13.3% 33.3% 53.3% < .001 T 5% 0% 10% 27.5% 57.5% < .001 The use of the 3D printed model enhanced my ability to understand the surgical procedure. MP 10% 10% 10% 10% 60% 0.063 MS 0% 6.7% 13.3% 20% 60% < .001 T 2.5% 7.5% 12.5% 17.5% 60% < .001 The use of the 3D printed model enhanced my ability to retain information. MP 10% 10% 0% 10% 70% 0.030 MS 0% 0% 10% 36.7% 53.3% < .001 T 2.5% 2.5% 7.5% 30% 57.5 < .001 The use of the 3D printed model helped me reach the course's educational objectives. MP 20% 0% 0% 0% 80% 0.051 MS 0% 0% 20% 26.7% 53.3% < .001 T 5% 0% 15% 20% 60% < .001 The anatomical landmarks/features were easy to recognize using the provided 3D printed model. MP 10% 10% 10% 20% 50% 0.081 MS 0% 3.3% 10% 36.7% 50% < .001 T 2.5% 5% 10% 32.5% 50% < .001 The 3D printed model was detailed enough to be used in a simulation or a procedure. MP 10% 10% 30% 0% 50% 0.173 MS 0% 3.3% 13.3% 36.7% 46.7% < .001 T 2.5% 5% 17.5% 27.5% 47.5% < .001 The 3D printed model feels close to real cadaveric structure in the hand in terms of texture . MP 0% 10% 30% 20% 40% 0.029 MS 10% 16.7% 30% 20% 23.3% 0.213 T 7.5% 15% 30% 20% 27.5% 0.030 The 3D printed model feels close to real cadaveric structure in the hand in terms of weight . MP 0% 10% 40% 20% 30% 0.066 MS 6.7% 20% 30% 20% 70% 0.152 T 5% 17.5% 32.5% 20% 25% 0.030 The 3D printed model accurately reflected the anatomical structure in size . MP 0% 20% 10% 10% 60% 0.024 MS 0% 10% 30% 23.3% 36.7% < .001 T 0% 12.5% 25% 20% 42.5% < .001 The 3D printed model accurately reflected the anatomical structure in shape . MP 0% 20% 30% 0% 50% 0.087 MS 0% 0% 6.7% 46.7% 46.7% < .001 T 0% 5% 12.5% 35% 47.5% < .001 Additionally, 77.5% stated that the models enhanced the ability to understand surgical procedure (p-value < 0.001), and 87.5% reported improved retention of information upon using 3DPMs (p-value < 0.001). Furthermore, 80% believed that the models helped achieve the courses’ educational objectives (p-value < 0.001). A high percentage (82.5%) found it easy to recognize the landmarks on the 3DPM (p-value < 0.001), and 75% thought that the 3DPMs were sufficiently detailed for use in simulations or procedures (p-value < 0.001). Regarding the trueness of the 3DPMs itself, 47.5% agreed that the model feels comparable to the real cadaveric structure in the hand in terms of texture (p-value = 0.029), 45% agreed that it feels similar in terms of weight (p-value = 0.03), 62.5% agreed that it accurately represented the anatomical structure in size (p-value < 0.001), and 82.5% agreed that it reflects the structure in shape (p-value < 0.001). Among medical professionals, 80% agreed that the 3DPMs significantly improved the understanding of targeted anatomical structures (p-value = 0.066). Moreover, 80% of respondents indicated a willingness to consider 3DPMs in future instructional contexts (p-value = 0.066), highlighting the perceived educational value. Also, 80% of respondents indicated their willingness to pay to acquire 3DPMs for personal learning (p-value = 0.085). While 80% stated they are willing to participate in courses incorporating 3DPMs (p-value = 0.066), indicating a positive reception among medical professionals towards integrating 3DPMs into educational curricula. The survey presented that 70% agree that the model helped enhance the ability to understand the surgical procedure (p-value = 0.063). Also, 80% responded that the use of the 3DPMs enhanced the ability to retain information (p-value = 0.030) and reach the courses’ educational objectives (p-value = 0.051). Among the results, 70% answered that the landmarks were easy to recognize on the 3DPM (p-value = 0.081). However, only 50% thought that the 3DPM was detailed enough to be used in a simulation or a procedure (p-value = 0.173). Regarding the 3DPM itself, 60% reported that it feels similar to the real cadaveric structure in terms of texture (p-value = 0.029). Half of the participants found the weight to be comparable (p-value = 0.066). Seventy percent considered the size to accurately reflect the anatomical structure (p-value = 0.024), and 50% felt that the shape was a close match (p-value = 0.087). Among medical students, all answered that the model enhanced their understanding of the targeted anatomy (p-value < 0.001), and 93.3% would use a 3DPM in the future (p-value < 0.0001). On the other hand, only 50% are willing to pay to acquire a 3DPM (p-value = 0.007), while 20% neither agree nor disagree, and 20% are not willing to pay for it. In case of willingness to participate in courses consist of 3DPMs, 86.6% responded in agreement (p-value < 0.001), and 13.3% neither agree nor disagree. Additionally, 80% of students agree that the model helped enhance their ability to understand the surgical procedure (p-value < 0.001), and 90% reported that it enhanced their ability to retain information (p-value < 0.001). The 3DPM helped 80% of students to reach the course’s educational objectives (p-value < 0.001). Furthermore, 86.67% of students stated that anatomical landmarks were easy to recognize on the 3DPM (p-value < 0.001), and 83.34% thought the model was detailed enough for use in a simulation or a procedure (p-value < 0.001). In terms of model accuracy, 43.3% of students agreed that the 3DPM feels close to real cadaveric structure in terms of texture (p-value = 0.213) and weight (p-value = 0.152), 60% of them expressed that it reflects it in size (p-value < 0.001), and 93.34% confirmed that it reflects it in shape (p-value < 0.001). Measurements of real Javan Rusa deer (Rusa timorensis) antlers were compared with their 3DPMs, and the results are shown in Fig. 1 and Tables 3 and 4 . This revealed valuable insights into the accuracy of different scanning and reconstruction methods. Figure 1 illustrates the 3DPMs alongside the real bone, showing a close visual adaptation in overall shape. However, some defects are apparent in the 3D printed models. For example, in Fig. 1 .1, V3DP-1, compared to RB-1, exhibits printing defects and layer deformities on the distal side. This can also be shown in H3DP-2, displaying a visible staircasing effect. Measurements showed that printing horizontally resulted in a mean positive difference of + 3.01 mm for the length from the real bone measurements, with an accuracy of 93.41%. Whereas, for the base, there is a mean positive difference of + 1.07 mm for the base, with an accuracy of 90.47%. Similarly, with no significant difference, printing vertically yielded a mean positive difference of + 2.99 mm for the length from the real bone measurements, with an accuracy of 93.29%. In case of the base measurement, a mean positive difference of + 1.01 mm, with an accuracy of 90.67%. Table 3 Measurements of Real Bones and 3D Printed Bones (Length). Measurement 1 Measurement 2 Measurement 3 AVG MD %E RB-1 43.51 43.43 43.26 43.4 H3DP-1 45.84 45.78 45.81 45.81 2.41 5.55% V3DP-1 46.07 45.96 46.04 46.02 2.62 6.04% RB-2 43.02 43.06 42.99 43.02 H3DP-2 46.74 46.84 46.75 46.78 3.75 8.72% V3DP-2 46.92 46.85 46.86 46.88 3.85 8.95% RB-3 49.7 49.67 49.72 49.70 H3DP-3 52.36 52.33 52.33 52.34 2.64 5.32% V3DP-3 53.17 53.18 53.18 53.18 3.48 7.00% RB-4 42.96 42.87 42.81 42.88 H3DP-4 44.41 44.32 44.27 44.33 1.45 3.39% V3DP-4 44 44.38 44.14 44.17 1.29 3.02% RB-5 48.24 48.2 48.21 48.22 H3DP-5 51.74 51.75 51.72 51.74 3.52 7.30% V3DP-5 51.66 51.63 51.66 51.65 3.43 7.12% RB-6 46.38 46.33 46.28 46.33 H3DP-6 50.7 50.63 50.56 50.63 4.3 9.28% V3DP-6 49.87 50.25 50.13 50.08 3.75 8.10% AVG 3.04 6.65% AVG V3DP 2.99 6.71% AVG H3DP 3.01 6.59% RB: Real Bone, V3DP: Vertical 3D Printed, H3DP: Horizontal 3D Printed, MD: Mean Difference, and %E: Percentage of Error. Table 4: Measurements of Real Bones and 3D Printed Bones (Width). Measurement 1 Measurement 2 Measurement 3 AVG MD %E RB-1 10.47 10.45 10.45 10.46 H3DP-1 11.77 11.72 11.71 11.73 1.28 12.21% V3DP-1 11.54 11.46 11.51 11.50 1.05 10.01% RB-2 11.78 11.76 11.66 11.73 H3DP-2 12.36 12.34 12.32 12.34 0.61 5.17% V3DP-2 12.92 12.87 12.82 12.87 1.14 9.69% RB-3 10.15 10.15 10.16 10.15 H3DP-3 11.28 11.24 11.25 11.26 1.10 10.87% V3DP-3 11.29 11.42 11.41 11.37 1.22 12.02% RB-4 11.21 11.16 11.1 11.16 H3DP-4 12.29 12.29 12.27 12.28 1.13 10.10% V3DP-4 12.27 12.27 12.26 12.27 1.11 9.95% RB-5 11.9 11.91 11.9 11.90 H3DP-5 13.27 13.22 13.32 13.27 1.37 11.48% V3DP-5 12.92 12.97 12.95 12.95 1.04 8.76% RB-6 12.56 12.66 12.4 12.54 H3DP-6 13.56 13.41 13.42 13.46 0.92 7.36% V3DP-6 13.15 13.34 13.21 13.23 0.69 5.53% AVG 1.05 9.43% AVG V3DP 1.01 9.33% AVG H3DP 1.07 9.53% RB: Real Bone, V3DP: Vertical 3D Printed, H3DP: Horizontal 3D Printed, MD: Mean Difference, and %E: Percentage of Error . Discussion This research study investigated the impact of 3DP-EM on improving the learning outcomes of medical students and professionals and suggested a standardized methodology for creating and 3D printing medical models. The 3DPMs accuracy was also evaluated in comparison to CT images. The feedback from both the medical professionals and students indicated the positive impact of 3DP-EM on learning outcomes and information retention. The majority of the respondents agreed that 3DP-EM had a significant impact on their ability to understand and retain information. Additionally, this study showed the willingness to use 3DP-EM in the future. While there were some reservations on the realness of the 3DP-EM compared to cadavers, the overall response was positive. When it comes to paying for the model, a noteworthy difference in the responses of the two groups can be seen, which can be due to the difference in economic status between the two groups, as 80% of medical professionals were willing to pay, compared to only 50% of the students. The resulting p-values indicate that participants’ ratings were significantly higher than neutral, supporting the claim of strong positive agreement. The survey the evaluation, and consideration of medical models reinforce the need for standardization in this field. In a consultation with the professionals involved in the creation of 3DPMs, valuable insights were obtained regarding current practices and the challenges associated with model reconstruction. Despite a limited sample size of two respondents, their feedback was highly informative, shedding light on critical aspects of standardization in 3D printing for medical applications. One respondent stated that while the default software settings generally produce accurate models, the implementation of standardized methods could further enhance consistency and reduce inter-user variability. The other respondent took a more neutral stance on the adequacy of these defaults but agreed that establishing a standardized approach is essential for improving reproducibility and quality control in 3D model creation. A key finding from the survey was the emphasis on the impact of CT image resolution on the accuracy of 3DPMs. Both professionals stressed that optimizing CT resolution is a crucial step in ensuring high-quality reconstructions. While specific recommendations varied, one suggested using the highest megapixel resolution available for craniofacial reconstruction. Whereas the other proposed a resolution of 0.65 mm for soft tissue models. Overall, there was unanimous agreement on the necessity of defining resolution standards based on the anatomical structure being modeled. Beyond CT resolution, respondents also provided recommendations on additional parameters that should be standardized. These recommendations included layer height, with suggestions ranging from 0.1 mm to 0.15 mm, as well as material selection, where preferences varied between PLA, UV-curing resin, and PA 11 & PA 12 (Nylon), depending on the application. Infill percentages were also highlighted as an important factor, with suggested values ranging from 20–50%. Additional considerations for standardization included optimizing print speed and incorporating open-source machine learning tools to automate the conversion of DICOM files to STL, thereby improving workflow efficiency. These insights collectively underscore the imperative for explicit guidelines to ensure that all 3DP-EM consistently meet high-quality standards. For comparing the real bone structures to their 3D printed counterparts, measurements of both were taken. Data showed that both ways offer high accuracy, exceeding 90% in measurements, but with slight variations. Horizontal printing demonstrated a marginally higher accuracy in replicating the bone’s length, with a percentage error of about 0.12% lower than that of vertical printing. However, for the base measurement, horizontal printing was less accurate, exhibiting an error approximately 0.20% higher than vertical printing. Multiple studies in the dental field noted that print orientation significantly alters accuracy 36 – 41 , while a few found no significant difference 41 , 42 . ​This can differ depending on the complexity and nature of different structures, indicating that the printing orientation can influence the accuracy of the 3DP-EM. With proper printer calibration and support strategies, the differences can be minimized; nonetheless, when producing a model, one should consider which orientation will minimize distortions. For instance, to maintain anatomic symmetry or to ensure important surfaces are printed with the highest fidelity. While the findings of this study are promising, there are some limitations. Maintaining operator-dependent variations in segmentation and manual refinement processes could introduce biases that affect the reproducibility of the final 3DPMs, as one radiology review emphasized that the segmentation process is a major contributor to inaccuracies. The study was also limited to a single 3D printing technology (FDM) and material (PLA), which may not represent the full spectrum of available methods and materials. Future work should focus on expanding participant diversity and sample sizes, exploring alternative printing technologies and materials, and integrating automated segmentation techniques to minimize human error. Furthermore, multicenter studies and patient-specific evaluations are also recommended to validate and refine the proposed standardization protocols. Suggested Methodology for 3D Printing Educational Models (3DP-EM): Based on the study’s findings, the following methodology is proposed to achieve high-quality 3DP-EM. CT scans should be acquired with an image dimension of 512 x 512, an in-plane resolution of approximately 0.365 mm, and a slice thickness of 2 mm, with data stored as a short (16-bit) scalar type to capture the necessary anatomical details. Segmentation should be performed using software such as 3D Slicer (Brigham and Women’s Hospital, Harvard, Boston, Massachusetts) 35 , starting with appropriate thresholding—typically within a range suited to the specific scan—and refined manually to match the original anatomy closely. The resulting segmented images are then converted into a digital mesh using minimal smoothing to preserve fine details and exported in a format like STL or OBJ. For printing, an FDM technique is recommended, with a layer height set to 0.15 mm to ensure sufficient detail. A baseline infill of 20%, adjustable as needed to replicate the weight and internal texture of the anatomical structure. Both vertical and horizontal printing orientations should be evaluated, and rigorous post-processing, including the removal of support structures and precise dimensional verification using digital calipers (with measurements ideally within ± 2% of the original CT data), should be implemented. This comprehensive methodology is intended to ensure that 3DP-EM are produced with consistent accuracy and reproducibility for both educational and clinical applications 32 . Conclusion This study evaluated 3DP-EM in terms of accuracy and knowledge retention for users. The benefits of 3DP-EM in enhancing comprehension, retention, and surgical predictability have been highlighted, along with their potential to improve education and decision-making. Nonetheless, a significant obstacle in this field is the lack of standardization in model reconstruction and assessment, emphasizing the need for consistent practices to ensure accuracy and reproducibility. Feedback from the 3DP-EM survey demonstrated a strong positive impact on the learning outcomes for both medical professionals and students, with 80–100% of respondents indicating improved learning outcomes, averaging roughly an 86% overall positive response across key educational measures. The survey of professionals involved in the reconstruction of medical models emphasized the need for standardization in the field. Comparing real bone structures with their 3D printed counterparts, showed the effects of the CT image resolution, the segmentation skills, the slicing and 3D printing skills, and the post-processing on the model, indicating the need for a standardized method to convey the best result regardless of the person creating the 3DP-EM. This study proposed a standardized method for producing accurate, semi-realistic synthetic bone structures for educational use. Horizontal print orientation yielded better deviations; however, the printing of 3DPMs should be evaluated on a case-by-case basis. Abbreviations The following abbreviations are used in this manuscript : 3DP-EM 3D printed educational models RB Real bone V3DP Vertically 3F printed H3DP Horizontally 3D printed SLA Stereolithography STL Stereolithography SLS Selective laser sintering CT Computed tomography CMM Coordinate measuring machine DICOM Digital imaging and communications in medicine MRI Magnetic resonance imaging Declarations Acknowledgments Researchers would like to thank and acknowledge the Ongoing Research Funding program (ORF-2025-901), King Saud University, Riyadh, Saudi Arabia. Corresponding Author: Faisal S. Fakhouri 1 ( [email protected] ) Ethics Approval and Consent to Participate Institutional Review Board (IRB) approval has been received from Health Sciences Colleges Researches on Human Subjects, College of Medicine, King Saud University, Riyadh, Kingdom of Saudi Arabia. Consent for participation in the study’s surveys was obtained from all participants. Funding This study is funded by the Ongoing Research Funding program (ORF-2025-901), King Saud University, Riyadh, Saudi Arabia. Author’s Contribution: Faisal S. Fakhouri: conceptualization (lead), formal analysis (equal), investigation (equal), methodology (equal), project administration (lead), resources (equal), supervision (lead), validation (equal), writing – original draft (equal). Llama F. Alothman: conceptualization (supporting), data curation (lead), formal analysis (equal), investigation (equal), methodology (equal), resources (equal), software (lead), validation (equal), visualization (lead), writing – original draft (equal). Abdulaziz S. Fakhouri: funding acquisition (lead), writing – review & editing (equal). Ziyad M. Aloqala: writing – review & editing (equal). Abdulsalam A. Altamimi: writing – review & editing (equal). Soliman A. Alhudaithy: writing – review & editing (equal). References Tejo-Otero A, Buj-Corral I, Fenollosa-Artés F. 3D printing in medicine for preoperative surgical planning: a review. Ann Biomed Eng. 2020;48(2):536–55. 10.1007/S10439-019-02411-0 . Segaran N, Saini G, Mayer JL, et al. Application of 3D Printing in Preoperative Planning. J Clin Med. 2021;10(5):917. 10.3390/jcm10050917 . Matsumoto JS, Morris JM, Foley TA et al. Three-dimensional Physical Modeling: Applications and Experience at Mayo Clinic. RadioGraphics. 2015;35(7):1989–2006; 10.1148/rg.2015140260 Garcia J, Yang Z, Mongrain R, et al. 3D printing materials and their use in medical education: a review of current technology and trends for the future. BMJ Simul Technol Enhanc Learn. 2018;4(1):27–40. 10.1136/bmjstel-2017-000234 . Ogden KM, Aslan C, Ordway N, et al. Factors Affecting Dimensional Accuracy of 3-D Printed Anatomical Structures Derived from CT Data. J Digit Imaging. 2015;28(6):654–63. 10.1007/s10278-015-9803-7 . EARWAKER BARKERTM. Accuracy of stereolithographic models of human anatomy. Australas Radiol. 1994;38(2):106–11. 10.1111/j.1440-1673.1994.tb00146.x . Li KHC, Kui C, Lee EKM, et al. The role of 3D printing in anatomy education and surgical training: A narrative review. MedEdPublish. 2017;6:92. 10.15694/mep.2017.000092 . Baskaran V, Štrkalj G, Štrkalj M, et al. Current Applications and Future Perspectives of the Use of 3D Printing in Anatomical Training and Neurosurgery. Front Neuroanat. 2016;10. 10.3389/fnana.2016.00069 . Wu A-M, Shao Z-X, Wang J-S, et al. The Accuracy of a Method for Printing Three-Dimensional Spinal Models. PLoS ONE. 2015;10(4):e0124291. 10.1371/journal.pone.0124291 . Berry E, Brown JM, Connell M, et al. Preliminary experience with medical applications of rapid prototyping by selective laser sintering. Med Eng Phys. 1997;19(1):90–6. 10.1016/S1350-4533(96)00039-2 . Sun Z, Wong YH, Yeong CH. Patient-Specific 3D-Printed Low-Cost Models in Medical Education and Clinical Practice. Micromachines (Basel). 2023;14(2):464. 10.3390/mi14020464 . Salmi M, Paloheimo K-S, Tuomi J, et al. Accuracy of medical models made by additive manufacturing (rapid manufacturing). J Cranio-Maxillofacial Surg. 2013;41(7):603–9. 10.1016/j.jcms.2012.11.041 . George E, Liacouras P, Rybicki FJ et al. Measuring and Establishing the Accuracy and Reproducibility of 3D Printed Medical Models. RadioGraphics. 2017;37(5):1424–1450; 10.1148/rg.2017160165 Arrieta C, Uribe S, Ramos-Grez J, et al. Quantitative assessments of geometric errors for rapid prototyping in medical applications. Rapid Prototyp J. 2012;18(6):431–42. 10.1108/13552541211271974 . O’Brien EK, Wayne DB, Barsness KA, et al. Use of 3D Printing for Medical Education Models in Transplantation Medicine: a Critical Review. Curr Transpl Rep. 2016;3(1):109–19. 10.1007/s40472-016-0088-7 . Ionita CN, Mokin M, Varble N et al. Challenges and Limitations of Patient-Specific Vascular Phantom Fabrication Using 3D Polyjet Printing. (Molthen RC, Weaver JB. eds). 2014; p. 90380M; 10.1117/12.2042266 Vernon T, Peckham D. The benefits of 3D modelling and animation in medical teaching. J Audiov Media Med. 2002;25(4):142–8. 10.1080/0140511021000051117 . Vaccarezza M, Papa V. 3D printing: a valuable resource in human anatomy education. Anat Sci Int. 2015;90(1):64–5. 10.1007/s12565-014-0257-7 . McMenamin PG, Quayle MR, McHenry CR, et al. The production of anatomical teaching resources using three-dimensional (3D) printing technology. Anat Sci Educ. 2014;7(6):479–86. 10.1002/ase.1475 . Lim KHA, Loo ZY, Goldie SJ, et al. Use of 3D printed models in medical education: A randomized control trial comparing 3D prints versus cadaveric materials for learning external cardiac anatomy. Anat Sci Educ. 2016;9(3):213–21. 10.1002/ase.1573 . Salazar D, Thompson M, Rosen A, et al. Using 3D Printing to Improve Student Education of Complex Anatomy: a Systematic Review and Meta-analysis. Med Sci Educ. 2022;32(5):1209–18. 10.1007/s40670-022-01595-w . Bernhard J-C, Isotani S, Matsugasumi T, et al. Personalized 3D printed model of kidney and tumor anatomy: a useful tool for patient education. World J Urol. 2016;34(3):337–45. 10.1007/s00345-015-1632-2 . Segaran N, Saini G, Mayer JL, et al. Application of 3D Printing in Preoperative Planning. J Clin Med. 2021;10(5):917. 10.3390/jcm10050917 . You Y, Niu Y, Sun F, et al. Three-dimensional printing and 3D slicer powerful tools in understanding and treating neurosurgical diseases. Front Surg. 2022;9. 10.3389/fsurg.2022.1030081 . Shim KW. Medical Applications of 3D Printing and Standardization Issues. Brain Tumor Res Treat. 2023;11(3):159. 10.14791/btrt.2023.0001 . Huotilainen E, Jaanimets R, Valášek J, et al. Inaccuracies in additive manufactured medical skull models caused by the DICOM to STL conversion process. J Cranio-Maxillofacial Surg. 2014;42(5):e259–65. 10.1016/j.jcms.2013.10.001 . Ugidos Lozano MT, Haro FB, Ruggiero A, et al. Evaluation of the Applicability of 3d Models as Perceived by the Students of Health Sciences. J Med Syst. 2019;43(5):108. 10.1007/s10916-019-1238-0 . Schlegel L, Ho M, Fields JM, et al. Standardizing evaluation of patient-specific 3D printed models in surgical planning: development of a cross-disciplinary survey tool for physician and trainee feedback. BMC Med Educ. 2022;22(1). 10.1186/s12909-022-03581-7 . Garas M, Vaccarezza M, Newland G, et al. 3D-Printed specimens as a valuable tool in anatomy education: A pilot study. Annals Anat - Anatomischer Anzeiger. 2018;219:57–64. 10.1016/j.aanat.2018.05.006 . Smith CF, Tollemache N, Covill D, et al. Take away body parts! An investigation into the use of 3D-printed anatomical models in undergraduate anatomy education. Anat Sci Educ. 2018;11(1):44–53. 10.1002/ase.1718 . Aimar A, Palermo A, Innocenti B. The Role of 3D Printing in Medical Applications: A State of the Art. J Healthc Eng. 2019;2019:1–10. 10.1155/2019/5340616 . Spanier C, Schwahn C, Krey KF, et al. Fused filament fabrication (FFF): influence of layer height on forces and moments delivered by aligners—an in vitro study. Clin Oral Investig. 2023;27(5):2163–73. 10.1007/s00784-023-04912-8 . Allen S, Deba D. ON THE COMPUTATION OF PART ORIENTATION USING SUPPORT STRUCTURES IN LAYERED MANUFACTURING. 1994. Ramian J, Ramian J, Dziob D, Materials. 2021;14(22); 10.3390/ma14227070 Fedorov A, Beichel R, Kalpathy-Cramer J, et al. 3D Slicer as an image computing platform for the Quantitative Imaging Network. Magn Reson Imaging. 2012;30(9):1323–41. 10.1016/j.mri.2012.05.001 . Tongkitcharoen N, Manopattanakul S, Boonpratham S, et al. Comparison of dimensional accuracy of 3D printing model for clear aligner among various orientation types and hollow types. Clin Invest Orthod. 2023;82(4):177–93. 10.1080/27705781.2023.2251191 . Maneiro Lojo J, Alonso Pérez-Barquero J, García-Sala Bonmatí F, et al. Influence of print orientation on the accuracy (trueness and precision) of diagnostic casts manufactured with a daylight polymer printer. J Prosthet Dent. 2024;132(6):1314–22. 10.1016/j.prosdent.2023.01.033 . Ide Y, Nayar S, Logan H, et al. The effect of the angle of acuteness of additive manufactured models and the direction of printing on the dimensional fidelity: clinical implications. Odontology. 2017;105(1):108–15. 10.1007/s10266-016-0239-4 . Demirel M, Diken Türksayar AA, Donmez MB, et al. Effect of 3D printing technology and print orientation on the trueness of additively manufactured definitive casts with different tooth preparations. J Dent. 2024;148. 10.1016/j.jdent.2024.105244 . ElShebiny T, Matthaios S, Menezes LM, et al. Effect of printing technology, layer height, and orientation on assessment of 3D-printed models. J World Fed Orthod. 2024;13(4):169–74. 10.1016/j.ejwf.2024.03.006 . Alghauli MA, Almuzaini SA, Aljohani R, et al. Impact of 3D Printing Orientation on Accuracy, Properties, Cost, and Time Efficiency of Additively Manufactured Dental Models: A Systematic Review. BMC Oral Health. 2024;24(1). 10.1186/s12903-024-05365-5 . Lohfeld S, Belnap B, Retrouvey J-M, et al. Effect of Model Body Type and Print Angle on the Accuracy of 3D-Printed Orthodontic Models. Biomimetics. 2024;9(4):217. 10.3390/biomimetics9040217 . Additional Declarations No competing interests reported. Cite Share Download PDF Status: Posted Version 1 posted You are reading this latest preprint version Research Square lets you share your work early, gain feedback from the community, and start making changes to your manuscript prior to peer review in a journal. As a division of Research Square Company, we’re committed to making research communication faster, fairer, and more useful. We do this by developing innovative software and high quality services for the global research community. Our growing team is made up of researchers and industry professionals working together to solve the most critical problems facing scientific publishing. Also discoverable on Platform About Our Team In Review Editorial Policies Advisory Board Help Center Resources Author Services Accessibility API Access RSS feed Manage Cookie Preferences © Research Square 2026 | ISSN 2693-5015 (online) Privacy Policy Terms of Service Do Not Sell My Personal Information {"props":{"pageProps":{"initialData":{"identity":"rs-7545658","acceptedTermsAndConditions":true,"allowDirectSubmit":true,"archivedVersions":[],"articleType":"Research Article","associatedPublications":[],"authors":[{"id":545669417,"identity":"6b3f72c6-2316-411b-8e78-318c8c151995","order_by":0,"name":"Faisal S. Fakhouri","email":"data:image/png;base64,iVBORw0KGgoAAAANSUhEUgAAAZAAAAAyAQMAAABI0h/eAAAABlBMVEX///8AAABVwtN+AAAACXBIWXMAAA7EAAAOxAGVKw4bAAAA3klEQVRIiWNgGAWjYBAC9uYDzMwgBht7G1iAsYGQFp5jCVAtPMdI1cIgkUasFjbmx8YFFYfz+SSfJX/mYbCR3XCA/eEH/FrYjJNnnDls2SaddkyahyHNeMMBHmMJfFrs5RuMD/O2HTZgk05vY+ZhOJwI1MKAVwsPG/tniBbJ481Ah/0HamF//AO/Fh7jZLAWCbYDQIcdAGphMCNgC0+xMc+ZdAM2nrQ0yTkGycYzD/OYWRBw2GZpngprA/n2Y8Yf3lTYyfYdb398A58WNGAAxMwkqB8Fo2AUjIJRgB0AAAm6P/YxIpZ4AAAAAElFTkSuQmCC","orcid":"","institution":"King Saud University","correspondingAuthor":true,"prefix":"","firstName":"Faisal","middleName":"S.","lastName":"Fakhouri","suffix":""},{"id":545669418,"identity":"6b7028ee-9c14-48ee-8831-130d6eed2132","order_by":1,"name":"Llama F. Alothman","email":"","orcid":"","institution":"King Saud University","correspondingAuthor":false,"prefix":"","firstName":"Llama","middleName":"F.","lastName":"Alothman","suffix":""},{"id":545669419,"identity":"77339523-8b7a-4213-8668-d699bd9da2d6","order_by":2,"name":"Abdulaziz S. Fakhouri","email":"","orcid":"","institution":"King Saud University","correspondingAuthor":false,"prefix":"","firstName":"Abdulaziz","middleName":"S.","lastName":"Fakhouri","suffix":""},{"id":545669420,"identity":"8c9e1d25-5c21-4c81-931e-8c4e04d6948f","order_by":3,"name":"Ziyad M. Aloqala","email":"","orcid":"","institution":"King Saud University","correspondingAuthor":false,"prefix":"","firstName":"Ziyad","middleName":"M.","lastName":"Aloqala","suffix":""},{"id":545669421,"identity":"601bdcd2-2318-49da-9c26-c1a64f47e504","order_by":4,"name":"Abdulsalam A. Al-Tamimi","email":"","orcid":"","institution":"King Saud University","correspondingAuthor":false,"prefix":"","firstName":"Abdulsalam","middleName":"A.","lastName":"Al-Tamimi","suffix":""},{"id":545669422,"identity":"7a301924-d32d-444d-88ff-5d0bd687932b","order_by":5,"name":"Soliman A. Alhudaithy","email":"","orcid":"","institution":"King Saud University","correspondingAuthor":false,"prefix":"","firstName":"Soliman","middleName":"A.","lastName":"Alhudaithy","suffix":""}],"badges":[],"createdAt":"2025-09-05 15:38:18","currentVersionCode":1,"declarations":"","doi":"10.21203/rs.3.rs-7545658/v1","doiUrl":"https://doi.org/10.21203/rs.3.rs-7545658/v1","draftVersion":[],"editorialEvents":[],"editorialNote":"","failedWorkflow":false,"files":[{"id":96158726,"identity":"1ea0c6c4-2a1a-4dc6-8706-d34943e7d7e6","added_by":"auto","created_at":"2025-11-18 08:39:14","extension":"docx","order_by":0,"title":"","display":"","copyAsset":false,"role":"acdc-reference","size":827473,"visible":true,"origin":"","legend":"","description":"","filename":"TheValueof3DPrintedMedicalEducationalModels.docx","url":"https://assets-eu.researchsquare.com/files/rs-7545658/v1/56b4eb8684f84927e25c4a59.docx"},{"id":96158787,"identity":"69a01f4e-d0d1-4c8f-bc57-f9f7637f5c3a","added_by":"auto","created_at":"2025-11-18 08:39:20","extension":"json","order_by":1,"title":"","display":"","copyAsset":false,"role":"acdc-reference","size":6953,"visible":true,"origin":"","legend":"","description":"","filename":"5cf25bbd391c4db08b96d60d67de467d.json","url":"https://assets-eu.researchsquare.com/files/rs-7545658/v1/35a08da0e5c8fe0c623a92c0.json"},{"id":96158906,"identity":"83e8ee04-f031-4f0d-878b-de793e2c0b3a","added_by":"auto","created_at":"2025-11-18 08:39:32","extension":"xml","order_by":2,"title":"","display":"","copyAsset":false,"role":"acdc-reference","size":157642,"visible":true,"origin":"","legend":"","description":"","filename":"5cf25bbd391c4db08b96d60d67de467d1enriched.xml","url":"https://assets-eu.researchsquare.com/files/rs-7545658/v1/59042917899f09c3cfdfa3fa.xml"},{"id":96158792,"identity":"848902ab-3eac-4bb4-8e51-763501c345cc","added_by":"auto","created_at":"2025-11-18 08:39:21","extension":"png","order_by":3,"title":"","display":"","copyAsset":false,"role":"acdc-reference","size":164130,"visible":true,"origin":"","legend":"","description":"","filename":"floatimage1.png","url":"https://assets-eu.researchsquare.com/files/rs-7545658/v1/7022d2f25dbc3a093bb763df.png"},{"id":96158784,"identity":"327b1b3c-e6b1-4149-802b-58ac152b48c3","added_by":"auto","created_at":"2025-11-18 08:39:19","extension":"jpeg","order_by":4,"title":"","display":"","copyAsset":false,"role":"acdc-reference","size":46462,"visible":true,"origin":"","legend":"","description":"","filename":"floatimage10.jpeg","url":"https://assets-eu.researchsquare.com/files/rs-7545658/v1/0bc17104afcc7d9342f0e2e2.jpeg"},{"id":96158773,"identity":"21c8d577-a06d-434f-a9c2-4aafe9b95614","added_by":"auto","created_at":"2025-11-18 08:39:16","extension":"jpeg","order_by":5,"title":"","display":"","copyAsset":false,"role":"acdc-reference","size":46496,"visible":true,"origin":"","legend":"","description":"","filename":"floatimage11.jpeg","url":"https://assets-eu.researchsquare.com/files/rs-7545658/v1/764312793dc6b77b366b376a.jpeg"},{"id":96158914,"identity":"951220b0-c63c-4e23-b578-4d775779cbae","added_by":"auto","created_at":"2025-11-18 08:39:35","extension":"jpeg","order_by":6,"title":"","display":"","copyAsset":false,"role":"acdc-reference","size":46496,"visible":true,"origin":"","legend":"","description":"","filename":"floatimage11.jpeg","url":"https://assets-eu.researchsquare.com/files/rs-7545658/v1/06932ab4caea34a43fa0ec04.jpeg"},{"id":96249703,"identity":"39f46b70-d854-49ac-aabb-6bebd781b73a","added_by":"auto","created_at":"2025-11-19 07:36:02","extension":"jpeg","order_by":7,"title":"","display":"","copyAsset":false,"role":"acdc-reference","size":48277,"visible":true,"origin":"","legend":"","description":"","filename":"floatimage13.jpeg","url":"https://assets-eu.researchsquare.com/files/rs-7545658/v1/ce68749fe48d9891ed2a53a2.jpeg"},{"id":96158781,"identity":"b18be67d-bc8a-4dc6-b885-16e5cdbf330d","added_by":"auto","created_at":"2025-11-18 08:39:17","extension":"jpeg","order_by":8,"title":"","display":"","copyAsset":false,"role":"acdc-reference","size":48277,"visible":true,"origin":"","legend":"","description":"","filename":"floatimage13.jpeg","url":"https://assets-eu.researchsquare.com/files/rs-7545658/v1/1a4cad016cee7c9576cc31d8.jpeg"},{"id":96158793,"identity":"49233e67-e3f7-4369-8e21-0f483eeffd3d","added_by":"auto","created_at":"2025-11-18 08:39:21","extension":"jpeg","order_by":9,"title":"","display":"","copyAsset":false,"role":"acdc-reference","size":48277,"visible":true,"origin":"","legend":"","description":"","filename":"floatimage13.jpeg","url":"https://assets-eu.researchsquare.com/files/rs-7545658/v1/02b7007e29e1c680122ae2d4.jpeg"},{"id":96158807,"identity":"2f612f8b-586e-47ea-864e-e8a35955b094","added_by":"auto","created_at":"2025-11-18 08:39:25","extension":"jpeg","order_by":10,"title":"","display":"","copyAsset":false,"role":"acdc-reference","size":46187,"visible":true,"origin":"","legend":"","description":"","filename":"floatimage16.jpeg","url":"https://assets-eu.researchsquare.com/files/rs-7545658/v1/d501ba1e04428cf8701ed107.jpeg"},{"id":96251753,"identity":"fc656f12-beef-486a-bc01-c1e8417c1371","added_by":"auto","created_at":"2025-11-19 07:40:00","extension":"jpeg","order_by":11,"title":"","display":"","copyAsset":false,"role":"acdc-reference","size":46187,"visible":true,"origin":"","legend":"","description":"","filename":"floatimage16.jpeg","url":"https://assets-eu.researchsquare.com/files/rs-7545658/v1/990284fe16ddb669b876353b.jpeg"},{"id":96158877,"identity":"b31b37ab-5a4c-4adc-9c6c-44aa97333273","added_by":"auto","created_at":"2025-11-18 08:39:29","extension":"jpeg","order_by":12,"title":"","display":"","copyAsset":false,"role":"acdc-reference","size":46167,"visible":true,"origin":"","legend":"","description":"","filename":"floatimage18.jpeg","url":"https://assets-eu.researchsquare.com/files/rs-7545658/v1/22e07796a5b4cb17911e42d6.jpeg"},{"id":96158843,"identity":"f868056f-74b2-4c06-aaab-651b815c2eb2","added_by":"auto","created_at":"2025-11-18 08:39:27","extension":"png","order_by":13,"title":"","display":"","copyAsset":false,"role":"acdc-reference","size":164130,"visible":true,"origin":"","legend":"","description":"","filename":"floatimage1.png","url":"https://assets-eu.researchsquare.com/files/rs-7545658/v1/f765ebc87d196d1437f76af5.png"},{"id":96158776,"identity":"d4322c86-47ab-47f4-a676-d09c83cb4145","added_by":"auto","created_at":"2025-11-18 08:39:17","extension":"png","order_by":14,"title":"","display":"","copyAsset":false,"role":"acdc-reference","size":164130,"visible":true,"origin":"","legend":"","description":"","filename":"floatimage1.png","url":"https://assets-eu.researchsquare.com/files/rs-7545658/v1/787622d64fc58105e38c8aea.png"},{"id":96158879,"identity":"eb3fe134-5277-4eda-b967-80ff7b313178","added_by":"auto","created_at":"2025-11-18 08:39:29","extension":"jpeg","order_by":15,"title":"","display":"","copyAsset":false,"role":"acdc-reference","size":41404,"visible":true,"origin":"","legend":"","description":"","filename":"floatimage4.jpeg","url":"https://assets-eu.researchsquare.com/files/rs-7545658/v1/a2e3ed5eac40e8c7a01a2e89.jpeg"},{"id":96158727,"identity":"3bbf44a1-0b7d-4093-8726-1eb04db252b9","added_by":"auto","created_at":"2025-11-18 08:39:14","extension":"jpeg","order_by":16,"title":"","display":"","copyAsset":false,"role":"acdc-reference","size":41535,"visible":true,"origin":"","legend":"","description":"","filename":"floatimage5.jpeg","url":"https://assets-eu.researchsquare.com/files/rs-7545658/v1/3ea5186ecec7388717e9b6ab.jpeg"},{"id":96158774,"identity":"28d579e4-2194-4146-a184-fc8665e1d56f","added_by":"auto","created_at":"2025-11-18 08:39:16","extension":"jpeg","order_by":17,"title":"","display":"","copyAsset":false,"role":"acdc-reference","size":41414,"visible":true,"origin":"","legend":"","description":"","filename":"floatimage6.jpeg","url":"https://assets-eu.researchsquare.com/files/rs-7545658/v1/0dde46fb12902cd0e44cfefe.jpeg"},{"id":96249102,"identity":"27c712e9-8a36-48c8-84d2-a79ce96fa942","added_by":"auto","created_at":"2025-11-19 07:30:19","extension":"jpeg","order_by":18,"title":"","display":"","copyAsset":false,"role":"acdc-reference","size":38401,"visible":true,"origin":"","legend":"","description":"","filename":"floatimage7.jpeg","url":"https://assets-eu.researchsquare.com/files/rs-7545658/v1/8e9ec1e616c1ae3165001d1e.jpeg"},{"id":96158771,"identity":"ce7ed6cf-c2ce-4599-9010-485cb00acfee","added_by":"auto","created_at":"2025-11-18 08:39:16","extension":"jpeg","order_by":19,"title":"","display":"","copyAsset":false,"role":"acdc-reference","size":38401,"visible":true,"origin":"","legend":"","description":"","filename":"floatimage7.jpeg","url":"https://assets-eu.researchsquare.com/files/rs-7545658/v1/7c619d7e1e823ac27ab0d1fc.jpeg"},{"id":96158943,"identity":"7fe06f6c-2a1b-4e77-b0a7-fab7904d9a85","added_by":"auto","created_at":"2025-11-18 08:39:35","extension":"jpeg","order_by":20,"title":"","display":"","copyAsset":false,"role":"acdc-reference","size":38401,"visible":true,"origin":"","legend":"","description":"","filename":"floatimage7.jpeg","url":"https://assets-eu.researchsquare.com/files/rs-7545658/v1/0df1eab736d33ef0ca407c45.jpeg"},{"id":96158777,"identity":"37ad20a4-a1f5-4e34-bf06-c64f333ec6ac","added_by":"auto","created_at":"2025-11-18 08:39:17","extension":"png","order_by":21,"title":"","display":"","copyAsset":false,"role":"acdc-reference","size":33251,"visible":true,"origin":"","legend":"","description":"","filename":"Onlinefloatimage1.png","url":"https://assets-eu.researchsquare.com/files/rs-7545658/v1/818286b2d999c98dd0f93c4a.png"},{"id":96158964,"identity":"d3cb91eb-dc91-41e0-a9bc-8271da71b9dd","added_by":"auto","created_at":"2025-11-18 08:39:37","extension":"png","order_by":22,"title":"","display":"","copyAsset":false,"role":"acdc-reference","size":32883,"visible":true,"origin":"","legend":"","description":"","filename":"Onlinefloatimage10.png","url":"https://assets-eu.researchsquare.com/files/rs-7545658/v1/cdd7554296fc798368bce4d3.png"},{"id":96158796,"identity":"d0ff43bf-6ded-49f9-af5d-8706eee8a46c","added_by":"auto","created_at":"2025-11-18 08:39:22","extension":"png","order_by":23,"title":"","display":"","copyAsset":false,"role":"acdc-reference","size":32903,"visible":true,"origin":"","legend":"","description":"","filename":"Onlinefloatimage11.png","url":"https://assets-eu.researchsquare.com/files/rs-7545658/v1/e6305dbff8def4adbcf8fb5b.png"},{"id":96158830,"identity":"6054c383-c89e-4934-a0e7-50049ee5a7b5","added_by":"auto","created_at":"2025-11-18 08:39:27","extension":"png","order_by":24,"title":"","display":"","copyAsset":false,"role":"acdc-reference","size":32903,"visible":true,"origin":"","legend":"","description":"","filename":"Onlinefloatimage11.png","url":"https://assets-eu.researchsquare.com/files/rs-7545658/v1/929650ea3e806f4075249e2d.png"},{"id":96158783,"identity":"b4ab9209-e6b4-452b-8f38-b0d878221420","added_by":"auto","created_at":"2025-11-18 08:39:18","extension":"png","order_by":25,"title":"","display":"","copyAsset":false,"role":"acdc-reference","size":43486,"visible":true,"origin":"","legend":"","description":"","filename":"Onlinefloatimage13.png","url":"https://assets-eu.researchsquare.com/files/rs-7545658/v1/4899ad10f161784cbccec2d5.png"},{"id":96158875,"identity":"d3e91823-5585-43c0-a909-c90a121cb72d","added_by":"auto","created_at":"2025-11-18 08:39:29","extension":"png","order_by":26,"title":"","display":"","copyAsset":false,"role":"acdc-reference","size":43486,"visible":true,"origin":"","legend":"","description":"","filename":"Onlinefloatimage13.png","url":"https://assets-eu.researchsquare.com/files/rs-7545658/v1/914484126e6cdbedf37e2972.png"},{"id":96158789,"identity":"a41aaca5-1888-4909-b95a-1e9dcc0ca592","added_by":"auto","created_at":"2025-11-18 08:39:20","extension":"png","order_by":27,"title":"","display":"","copyAsset":false,"role":"acdc-reference","size":43486,"visible":true,"origin":"","legend":"","description":"","filename":"Onlinefloatimage13.png","url":"https://assets-eu.researchsquare.com/files/rs-7545658/v1/76b083078ed236a226608c25.png"},{"id":96158883,"identity":"e566d21e-33be-4b6e-8745-10691332437e","added_by":"auto","created_at":"2025-11-18 08:39:30","extension":"png","order_by":28,"title":"","display":"","copyAsset":false,"role":"acdc-reference","size":40416,"visible":true,"origin":"","legend":"","description":"","filename":"Onlinefloatimage16.png","url":"https://assets-eu.researchsquare.com/files/rs-7545658/v1/021e2e787220dcc3207c14cf.png"},{"id":96158788,"identity":"60fd251f-a390-4d93-a5e4-0bd430d22310","added_by":"auto","created_at":"2025-11-18 08:39:20","extension":"png","order_by":29,"title":"","display":"","copyAsset":false,"role":"acdc-reference","size":40416,"visible":true,"origin":"","legend":"","description":"","filename":"Onlinefloatimage16.png","url":"https://assets-eu.researchsquare.com/files/rs-7545658/v1/56d7662ae18738b0daf3bb80.png"},{"id":96158907,"identity":"eee4cd7a-6998-4450-b496-94760518f2eb","added_by":"auto","created_at":"2025-11-18 08:39:32","extension":"png","order_by":30,"title":"","display":"","copyAsset":false,"role":"acdc-reference","size":40340,"visible":true,"origin":"","legend":"","description":"","filename":"Onlinefloatimage18.png","url":"https://assets-eu.researchsquare.com/files/rs-7545658/v1/3d716980da937468a32be8a9.png"},{"id":96158779,"identity":"48c0006b-10bf-4d84-a823-60426c54b2be","added_by":"auto","created_at":"2025-11-18 08:39:17","extension":"png","order_by":31,"title":"","display":"","copyAsset":false,"role":"acdc-reference","size":33251,"visible":true,"origin":"","legend":"","description":"","filename":"Onlinefloatimage1.png","url":"https://assets-eu.researchsquare.com/files/rs-7545658/v1/a1c80a72888ed8d2d79cff04.png"},{"id":96158770,"identity":"3752c6b5-e787-4d3d-abaa-f78f3fefd460","added_by":"auto","created_at":"2025-11-18 08:39:15","extension":"png","order_by":32,"title":"","display":"","copyAsset":false,"role":"acdc-reference","size":33251,"visible":true,"origin":"","legend":"","description":"","filename":"Onlinefloatimage1.png","url":"https://assets-eu.researchsquare.com/files/rs-7545658/v1/04af8489448a2adaf7afd0f6.png"},{"id":96158873,"identity":"f6dc3ed3-9bba-4dc8-9158-6f3416a1a648","added_by":"auto","created_at":"2025-11-18 08:39:29","extension":"png","order_by":33,"title":"","display":"","copyAsset":false,"role":"acdc-reference","size":37133,"visible":true,"origin":"","legend":"","description":"","filename":"Onlinefloatimage4.png","url":"https://assets-eu.researchsquare.com/files/rs-7545658/v1/e3c20ec174d4dd57354a2af3.png"},{"id":96158952,"identity":"11c4402d-1fb9-49e9-89e2-d06cf18f6d64","added_by":"auto","created_at":"2025-11-18 08:39:36","extension":"png","order_by":34,"title":"","display":"","copyAsset":false,"role":"acdc-reference","size":37051,"visible":true,"origin":"","legend":"","description":"","filename":"Onlinefloatimage5.png","url":"https://assets-eu.researchsquare.com/files/rs-7545658/v1/eb175d291b7972099a6e3b99.png"},{"id":96158721,"identity":"033f399f-86a1-40d0-8ebe-080ed8e8b188","added_by":"auto","created_at":"2025-11-18 08:39:14","extension":"png","order_by":35,"title":"","display":"","copyAsset":false,"role":"acdc-reference","size":37095,"visible":true,"origin":"","legend":"","description":"","filename":"Onlinefloatimage6.png","url":"https://assets-eu.researchsquare.com/files/rs-7545658/v1/bcf04b8d5d632ca77d68e3ab.png"},{"id":96158769,"identity":"3ce38672-3d28-48e1-984b-0ca20c4eb2bd","added_by":"auto","created_at":"2025-11-18 08:39:15","extension":"png","order_by":36,"title":"","display":"","copyAsset":false,"role":"acdc-reference","size":32270,"visible":true,"origin":"","legend":"","description":"","filename":"Onlinefloatimage7.png","url":"https://assets-eu.researchsquare.com/files/rs-7545658/v1/21798f26484dbf2e04311e53.png"},{"id":96158772,"identity":"7299ba0a-d90a-49c0-a450-7180695e7c43","added_by":"auto","created_at":"2025-11-18 08:39:16","extension":"png","order_by":37,"title":"","display":"","copyAsset":false,"role":"acdc-reference","size":32270,"visible":true,"origin":"","legend":"","description":"","filename":"Onlinefloatimage7.png","url":"https://assets-eu.researchsquare.com/files/rs-7545658/v1/fab9ddbe747c63bbf78aad65.png"},{"id":96158778,"identity":"9e6ffc1c-9249-4863-a887-a3b2ebf82f50","added_by":"auto","created_at":"2025-11-18 08:39:17","extension":"png","order_by":38,"title":"","display":"","copyAsset":false,"role":"acdc-reference","size":32270,"visible":true,"origin":"","legend":"","description":"","filename":"Onlinefloatimage7.png","url":"https://assets-eu.researchsquare.com/files/rs-7545658/v1/99e69fd5073cd0b9720fcc90.png"},{"id":96158785,"identity":"940c0a2c-ca35-4461-bc64-604854664086","added_by":"auto","created_at":"2025-11-18 08:39:19","extension":"xml","order_by":39,"title":"","display":"","copyAsset":false,"role":"acdc-reference","size":159130,"visible":true,"origin":"","legend":"","description":"","filename":"5cf25bbd391c4db08b96d60d67de467d1structuring.xml","url":"https://assets-eu.researchsquare.com/files/rs-7545658/v1/8db90e4c44c03e319c7bccec.xml"},{"id":96158960,"identity":"9c4ede9c-d0cb-4967-a8f7-9522854eaa1b","added_by":"auto","created_at":"2025-11-18 08:39:36","extension":"html","order_by":40,"title":"","display":"","copyAsset":false,"role":"acdc-reference","size":165915,"visible":true,"origin":"","legend":"","description":"","filename":"earlyproof.html","url":"https://assets-eu.researchsquare.com/files/rs-7545658/v1/063a959466f775b5c9ae939c.html"},{"id":96158786,"identity":"72e25e3a-9cd5-4fd2-adcd-010453c93d1c","added_by":"auto","created_at":"2025-11-18 08:39:19","extension":"png","order_by":1,"title":"Figure 1","display":"","copyAsset":false,"role":"figure","size":199929,"visible":true,"origin":"","legend":"\u003cp\u003eJavan Rusa deer (Rusa timorensis) antlers real bones (RB), vertical 3D printed (V3DP), and horizontal 3D printed (H3DP) models.\u003c/p\u003e","description":"","filename":"1.png","url":"https://assets-eu.researchsquare.com/files/rs-7545658/v1/089162b8897669d9dc3c491f.png"},{"id":97201772,"identity":"2b435be2-b747-47ee-8a32-aa3b631f0d18","added_by":"auto","created_at":"2025-12-02 01:08:51","extension":"pdf","order_by":0,"title":"","display":"","copyAsset":false,"role":"manuscript-pdf","size":1307641,"visible":true,"origin":"","legend":"","description":"","filename":"manuscript.pdf","url":"https://assets-eu.researchsquare.com/files/rs-7545658/v1/6b3ca9fc-0af2-428b-8712-0a617d396e7c.pdf"}],"financialInterests":"No competing interests reported.","formattedTitle":"The Value and Standardization of 3D Printed Medical Educational Models","fulltext":[{"header":"Background","content":"\u003cp\u003eResearch and application in preoperative planning combined with medical education have grown extensively over the past two decades to minimize operative risk and maximize surgery success rates\u003csup\u003e\u003cspan citationid=\"CR1\" class=\"CitationRef\"\u003e1\u003c/span\u003e\u003c/sup\u003e. Traditional preoperative planning depends on medical imaging such as computed tomography (CT) and magnetic resonance imaging (MRI) and clinical experience, but the absence of physical interaction and limited spatial accuracy can impede surgeons' readiness, particularly in complex cases\u003csup\u003e\u003cspan citationid=\"CR2\" class=\"CitationRef\"\u003e2\u003c/span\u003e\u003c/sup\u003e. Although virtual three-dimensional (3D) imaging has shown beneficial results, it fails to represent the actual anatomical structures of the patient fully. These limitations have been addressed by one of the rapidly advancing technologies in the field of medical education and preoperative planning, namely additive manufacturing (3D printing). 3D printing significantly influenced medical education and revolutionized how surgeons plan and execute complex procedures\u003csup\u003e\u003cspan citationid=\"CR3\" class=\"CitationRef\"\u003e3\u003c/span\u003e\u003c/sup\u003e. One of the medical 3D printing applications is the creation of intricate, patient-specific anatomical models for educational purposes. These 3D printed educational models (3DP-EM) have great potential to improve academic and surgical outcomes\u003csup\u003e\u003cspan citationid=\"CR3\" class=\"CitationRef\"\u003e3\u003c/span\u003e,\u003cspan citationid=\"CR4\" class=\"CitationRef\"\u003e4\u003c/span\u003e\u003c/sup\u003e.\u003c/p\u003e\u003cp\u003eAs 3DP-EM emerges, the existing literature remains scarce; however, aspects like dimensional accuracy were addressed\u003csup\u003e\u003cspan additionalcitationids=\"CR6 CR7 CR8\" citationid=\"CR5\" class=\"CitationRef\"\u003e5\u003c/span\u003e\u0026ndash;\u003cspan citationid=\"CR9\" class=\"CitationRef\"\u003e9\u003c/span\u003e\u003c/sup\u003e. In 1994, a stereolithography (SLA) study demonstrated an accuracy rate between 97.7 and 99.12%\u003csup\u003e6\u003c/sup\u003e. Another study found that human skull models printed using selective laser sintering (SLS) differed by 0.5 mm to 1.05 mm compared to the computed tomography (CT) scans\u003csup\u003e\u003cspan citationid=\"CR10\" class=\"CitationRef\"\u003e10\u003c/span\u003e,\u003cspan citationid=\"CR11\" class=\"CitationRef\"\u003e11\u003c/span\u003e\u003c/sup\u003e. Recently, Salmi et al. evaluated models produced via a PolyJet 3D printer, with a dimensional error of only 0.18\u0026thinsp;\u0026plusmn;\u0026thinsp;0.12%\u003csup\u003e12\u003c/sup\u003e. The accuracy of 3D printed models (3DPMs) can be measured in different ways, such as comparing digital computer-aided design (CAD) models to 3D printed ones\u003csup\u003e\u003cspan citationid=\"CR13\" class=\"CitationRef\"\u003e13\u003c/span\u003e\u003c/sup\u003e. On the other hand, CT scans of the patient's imaging are compared to the 3DPMs \u003csup\u003e\u003cspan citationid=\"CR14\" class=\"CitationRef\"\u003e14\u003c/span\u003e\u003c/sup\u003e, using a coordinate measuring machine (CMM)\u003csup\u003e\u003cspan citationid=\"CR12\" class=\"CitationRef\"\u003e12\u003c/span\u003e\u003c/sup\u003e, either by referencing anatomical landmarks or by incorporating external landmarks such as spheres or tracking dots. Lastly, osteometric analysis is commonly used for bone models\u003csup\u003e\u003cspan citationid=\"CR7\" class=\"CitationRef\"\u003e7\u003c/span\u003e\u003c/sup\u003e.\u003c/p\u003e\u003cp\u003e3D printing allows creating patient-specific 3DP-EM with high accuracy\u003csup\u003e\u003cspan citationid=\"CR6\" class=\"CitationRef\"\u003e6\u003c/span\u003e,\u003cspan citationid=\"CR15\" class=\"CitationRef\"\u003e15\u003c/span\u003e\u003c/sup\u003e, with an average variance of \u0026plusmn;\u0026thinsp;120 \u0026micro;m in volume dimensions\u003csup\u003e\u003cspan citationid=\"CR16\" class=\"CitationRef\"\u003e16\u003c/span\u003e\u003c/sup\u003e. Also, 3DP-EMs have advantages over real structures as they do not decay, are easily accessible, and easily reproducible at a low cost\u003csup\u003e\u003cspan citationid=\"CR9\" class=\"CitationRef\"\u003e9\u003c/span\u003e,\u003cspan additionalcitationids=\"CR18\" citationid=\"CR17\" class=\"CitationRef\"\u003e17\u003c/span\u003e\u0026ndash;\u003cspan citationid=\"CR19\" class=\"CitationRef\"\u003e19\u003c/span\u003e\u003c/sup\u003e. A randomized controlled trial conducted in 2015 involving undergraduate medical students with no formal cardiac anatomy background \u003csup\u003e\u003cspan citationid=\"CR20\" class=\"CitationRef\"\u003e20\u003c/span\u003e\u003c/sup\u003e. The study revealed an increase of almost 42.16% in post-test scores for the group exclusively utilizing 3DP-EM, compared to only 21.9% and 20.01% for those relying on cadaveric materials or a combination of both, respectively\u003csup\u003e\u003cspan citationid=\"CR20\" class=\"CitationRef\"\u003e20\u003c/span\u003e\u003c/sup\u003e. In a recent study, students who learned with 3DP-EM scored 11% better compared to students who were taught with traditional methods\u003csup\u003e\u003cspan citationid=\"CR21\" class=\"CitationRef\"\u003e21\u003c/span\u003e\u003c/sup\u003e, indicating the efficacy of 3DP-EM in medical academia\u003csup\u003e\u003cspan citationid=\"CR20\" class=\"CitationRef\"\u003e20\u003c/span\u003e\u003c/sup\u003e., In a study focusing on patient education by Bernhard et al., the authors concluded that patients\u0026rsquo; understanding improved by 37.6% after viewing a 3DP-EM of their kidney\u003csup\u003e\u003cspan citationid=\"CR22\" class=\"CitationRef\"\u003e22\u003c/span\u003e\u003c/sup\u003e.\u003c/p\u003e\u003cp\u003eMultiple articles concluded that there is an absence of standardization for the creation and assessment of 3DPMMs\u003csup\u003e\u003cspan citationid=\"CR12\" class=\"CitationRef\"\u003e12\u003c/span\u003e,\u003cspan additionalcitationids=\"CR24\" citationid=\"CR23\" class=\"CitationRef\"\u003e23\u003c/span\u003e\u0026ndash;\u003cspan citationid=\"CR25\" class=\"CitationRef\"\u003e25\u003c/span\u003e\u003c/sup\u003e. In 2016, three institutes received identical data sets of Digital Imaging and Communications in Medicine (DICOM) and were asked to convert them into a 3D model with (.STL) file format using their preferred software. There were significant variations in the size and anatomical geometries of the final models\u003csup\u003e\u003cspan citationid=\"CR26\" class=\"CitationRef\"\u003e26\u003c/span\u003e\u003c/sup\u003e. This shows the need for standardization to improve model accuracy and reproducibility across different users.\u003c/p\u003e\u003cp\u003eVarious methodologies were employed to measure the value of 3DP-EM, such as surveys targeting medical practitioners and students. Questions directed to students include \u0026ldquo;Do you prefer 3D models of the bones to study anatomy?\u0026rdquo;\u003csup\u003e\u003cspan citationid=\"CR27\" class=\"CitationRef\"\u003e27\u003c/span\u003e\u003c/sup\u003e, \u0026ldquo;In the anatomy classes, with the choice of standard anatomical specimen (cadaver) and an accurately mapped 3D model, what would you choose?\u0026rdquo;\u003csup\u003e\u003cspan citationid=\"CR28\" class=\"CitationRef\"\u003e28\u003c/span\u003e\u003c/sup\u003e, \u0026ldquo;The model was useful for simulation teaching.\u0026rdquo;\u003csup\u003e\u003cspan citationid=\"CR28\" class=\"CitationRef\"\u003e28\u003c/span\u003e\u003c/sup\u003e. Other investigators employed quantitative approaches to assess the accuracy of 3DP-EM, as mentioned earlier; these methodologies include the application of volumetric intersection indexes\u003csup\u003e\u003cspan citationid=\"CR14\" class=\"CitationRef\"\u003e14\u003c/span\u003e\u003c/sup\u003e, osteometric analysis\u003csup\u003e\u003cspan citationid=\"CR7\" class=\"CitationRef\"\u003e7\u003c/span\u003e\u003c/sup\u003e, and the utilization of CMM\u003csup\u003e\u003cspan citationid=\"CR12\" class=\"CitationRef\"\u003e12\u003c/span\u003e\u003c/sup\u003e. In addition, some used comparative methods to evaluate results before and after the implementation of 3DP-EM, such as comparing students\u0026rsquo; test results before and after using 3DP-EM\u003csup\u003e\u003cspan citationid=\"CR20\" class=\"CitationRef\"\u003e20\u003c/span\u003e,\u003cspan citationid=\"CR29\" class=\"CitationRef\"\u003e29\u003c/span\u003e,\u003cspan citationid=\"CR30\" class=\"CitationRef\"\u003e30\u003c/span\u003e\u003c/sup\u003e.\u003c/p\u003e\u003cp\u003eTo date, and to our knowledge, the literature evaluating educational outcomes of 3DP-EM in a clear, structured, and analytically thorough way remains limited. In addition, there is a lack of standardized methods and processes to 3D print such medical models, leading to variations in the quality and size of the 3DP-EM \u003csup\u003e\u003cspan citationid=\"CR25\" class=\"CitationRef\"\u003e25\u003c/span\u003e,\u003cspan citationid=\"CR31\" class=\"CitationRef\"\u003e31\u003c/span\u003e\u003c/sup\u003e. Therefore, this study aims to first assess the efficacy of 3DP-EM in improving the learning outcomes of medical students and trainees. Second, suggest a standardized methodology for the creation of 3DP-EM, beginning at the first stages of CT and MRI image acquisition, image segmentation, 3D modeling, 3D printing, and post-processing. Finally, the 3DP-EM will be compared to the real structures.\u003c/p\u003e"},{"header":"Methods","content":"\u003cdiv id=\"Sec3\" class=\"Section2\"\u003e\u003ch2\u003eSurvey-Based Assessment\u003c/h2\u003e\u003cp\u003eAn institutional review board (IRB)-approved survey-based approach was employed to assess the effect of 3DP-EM on learning outcomes. Participants in this survey included 30 medical students and 10 medical practitioners taking medical educational courses. The survey focused on comprehension, knowledge retention, and overall educational experience, as shown in Table\u0026nbsp;\u003cspan refid=\"Tab1\" class=\"InternalRef\"\u003e1\u003c/span\u003e. The answers to the survey were based on a Likert scale (i.e., Strongly Agree, Agree, Neutral, Disagree, Strongly Disagree)\u003csup\u003e\u003cspan citationid=\"CR28\" class=\"CitationRef\"\u003e28\u003c/span\u003e\u003c/sup\u003e. Analysis of responses provided insights into the perceived benefits of 3DP-EM on learning outcomes.\u003c/p\u003e\u003cp\u003e\u003cdiv class=\"gridtable\"\u003e\u003ctable float=\"Yes\" id=\"Tab1\" border=\"1\"\u003e\u003ccaption language=\"En\"\u003e\u003cdiv class=\"CaptionNumber\"\u003eTable 1\u003c/div\u003e\u003cdiv class=\"CaptionContent\"\u003e\u003cp\u003e3D Printed Medical Education Questionnaire\u003c/p\u003e\u003c/div\u003e\u003c/caption\u003e\u003ccolgroup cols=\"1\"\u003e\u003cdiv align=\"left\" class=\"colspec\" colname=\"c1\" colnum=\"1\"\u003e\u003c/div\u003e\u003cthead\u003e\u003ctr\u003e\u003cth align=\"left\" colname=\"c1\"\u003e\u003cp\u003eMedical Education (targeted audience: medical students and practitioners)\u003c/p\u003e\u003c/th\u003e\u003c/tr\u003e\u003c/thead\u003e\u003ctbody\u003e\u003ctr\u003e\u003ctd align=\"left\" colname=\"c1\"\u003e\u003cp\u003e1. The 3D printed medical model helped me to better understand the targeted anatomy.\u003c/p\u003e\u003c/td\u003e\u003c/tr\u003e\u003ctr\u003e\u003ctd align=\"left\" colname=\"c1\"\u003e\u003cp\u003e2. I would use a 3D printed medical model in the future\u003csup\u003e\u003cspan citationid=\"CR28\" class=\"CitationRef\"\u003e28\u003c/span\u003e\u003c/sup\u003e.\u003c/p\u003e\u003c/td\u003e\u003c/tr\u003e\u003ctr\u003e\u003ctd align=\"left\" colname=\"c1\"\u003e\u003cp\u003e3. I am willing to pay to acquire the 3D printed medical model for my own learning.\u003c/p\u003e\u003c/td\u003e\u003c/tr\u003e\u003ctr\u003e\u003ctd align=\"left\" colname=\"c1\"\u003e\u003cp\u003e4. I am willing to participate in courses with 3D printed medical models in the future.\u003c/p\u003e\u003c/td\u003e\u003c/tr\u003e\u003ctr\u003e\u003ctd align=\"left\" colname=\"c1\"\u003e\u003cp\u003e5. The use of the 3D printed medical model enhanced my ability to understand the surgical procedure.\u003c/p\u003e\u003c/td\u003e\u003c/tr\u003e\u003ctr\u003e\u003ctd align=\"left\" colname=\"c1\"\u003e\u003cp\u003e6. The use of the 3D printed medical model enhanced my ability to retain information.\u003c/p\u003e\u003c/td\u003e\u003c/tr\u003e\u003ctr\u003e\u003ctd align=\"left\" colname=\"c1\"\u003e\u003cp\u003e7. The use of the 3D printed medical model helped me reach the course's educational objectives.\u003c/p\u003e\u003c/td\u003e\u003c/tr\u003e\u003ctr\u003e\u003ctd align=\"left\" colname=\"c1\"\u003e\u003cp\u003e8. The anatomical landmarks/features were easy to recognize using the provided 3D printed medical model.\u003c/p\u003e\u003c/td\u003e\u003c/tr\u003e\u003ctr\u003e\u003ctd align=\"left\" colname=\"c1\"\u003e\u003cp\u003e9. The 3D printed medical model was detailed enough to be used in a simulation or a procedure.\u003c/p\u003e\u003c/td\u003e\u003c/tr\u003e\u003ctr\u003e\u003ctd align=\"left\" colname=\"c1\"\u003e\u003cp\u003e10. The 3D printed medical model feels close to real cadaveric materials in the hand in terms of texture.\u003c/p\u003e\u003c/td\u003e\u003c/tr\u003e\u003ctr\u003e\u003ctd align=\"left\" colname=\"c1\"\u003e\u003cp\u003e11. The 3D printed medical model feels close to real cadaveric materials in the hand in terms of weight.\u003c/p\u003e\u003c/td\u003e\u003c/tr\u003e\u003ctr\u003e\u003ctd align=\"left\" colname=\"c1\"\u003e\u003cp\u003e12. The 3D printed medical model accurately reflected the anatomical structure in size\u003csup\u003e\u003cspan citationid=\"CR28\" class=\"CitationRef\"\u003e28\u003c/span\u003e\u003c/sup\u003e.\u003c/p\u003e\u003c/td\u003e\u003c/tr\u003e\u003ctr\u003e\u003ctd align=\"left\" colname=\"c1\"\u003e\u003cp\u003e13. The 3D printed medical model accurately reflected the anatomical structure in shape\u003csup\u003e\u003cspan citationid=\"CR28\" class=\"CitationRef\"\u003e28\u003c/span\u003e\u003c/sup\u003e.\u003c/p\u003e\u003c/td\u003e\u003c/tr\u003e\u003c/tbody\u003e\u003c/colgroup\u003e\u003c/table\u003e\u003c/div\u003e\u003c/p\u003e\u003cp\u003eTo help assess the extent of the lack of standardization for 3DP-EM, professionals were consulted and involved in the creation of the 3DPMs. Their insights about software and 3D printing preferences, and suggestions were gathered through structured questions. Additionally, they provided input on key factors affecting accuracy, such as CT resolution and 3D printing parameters. The responses will be analyzed to identify common practices, challenges, and areas where standardization is crucial for maintaining quality in 3DP-EM.\u003c/p\u003e\u003c/div\u003e\n\u003ch3\u003eSuggested 3DPMs Standardization\u003c/h3\u003e\n\u003cp\u003eThe following parameters represent the minimum standards for producing high-quality 3D printed educational medical models. First, the CT scan should be acquired with an image dimension of 512 x 512 pixels and a slice count that preserves anatomical detail, using an in-plane resolution of approximately 0.365 mm and a slice thickness of 2 mm, stored as a short (16-bit) scalar type to capture the necessary grayscale variations for accurate segmentation. During model reconstruction, minimal smoothing should be applied to retain the anatomical fidelity of the model, with the resulting mesh exported in a format like (.STL) or (.OBJ). For the printing process, a layer height of 0.15 mm is recommended to balance detail with print efficiency\u003csup\u003e\u003cspan citationid=\"CR32\" class=\"CitationRef\"\u003e32\u003c/span\u003e\u003c/sup\u003e.\u003c/p\u003e\u003cp\u003eThe infill percentage should be carefully chosen not only to ensure structural integrity but also to best represent the weight and internal feel of the real anatomical part. In previous experiments, the Gyroid lattice structure with 30% infill can serve as a baseline, as it can be adjusted as needed to mimic the density and tactile characteristics of the original tissue. Consideration should also be given to print orientation; vertical printing may be favored for long structures to minimize warping, and horizontal printing can be beneficial for stable base support\u003csup\u003e\u003cspan citationid=\"CR33\" class=\"CitationRef\"\u003e33\u003c/span\u003e,\u003cspan citationid=\"CR34\" class=\"CitationRef\"\u003e34\u003c/span\u003e\u003c/sup\u003e. Finally, dimensional deviation comparisons between the printed models and the original CT data must remain within an acceptable range (ideally within \u0026plusmn;\u0026thinsp;2%) to ensure the accuracy and reliability of the models for both educational and clinical applications. These settings can serve as the baseline minimum standard to ensure that 3DPMs accurately replicate the original anatomical structures while maintaining consistency and quality for educational and clinical applications.\u003c/p\u003e\u003cp\u003e\u003cspan type=\"ItalicUnderline\" class=\"ItalicUnderline\" name=\"Emphasis\"\u003e3D Printed Educational Model (3DP-EM) acquisition and fabrication\u003c/span\u003e\u003c/p\u003e\u003cp\u003eA Siemens Healthineers (Somatom Force Eco, Erlangen, Germany) scanner was used to scan the six different Javan Rusa deer (Rusa timorensis) antlers to create a 3DPM using 3D Slicer 5.1.6 software (Brigham and Women\u0026rsquo;s Hospital, Harvard, Boston, Massachusetts)\u003csup\u003e\u003cspan citationid=\"CR35\" class=\"CitationRef\"\u003e35\u003c/span\u003e\u003c/sup\u003e, an open-source image processing software for research use. Image segmentation was performed by first selecting the appropriate threshold, ranging from \u0026minus;\u0026thinsp;500 to 2634 and then from \u0026minus;\u0026thinsp;500 to 3070, depending on the scan intensity range for each structure. The segments were then manually adjusted to match the scan closely.\u003c/p\u003e\u003cp\u003eThe 3DPMs were 3D printed using a fused deposition modeling (FDM) technique by using a Creality Ender 3 S-1 Pro (Creality, China) 3D Printer and SunCubic polylactic acid (PLA) filament (SunCubic, China). Printing parameters considered two orientations (vertically 90 and horizontally 0), a layer height of 0.15 mm, with a 0.4 mm standard nozzle, at 200\u0026deg;C, with a bed temperature of 60\u0026deg;C. #####. Each bone structure had a specific infill ranging from 70\u0026ndash;100% infill to match the weight of the real bone. After 3D printing the bones, the models were manually measured using a vernier digital caliper and were compared with the measurements of the real bones. Each measurement was repeated three times. Two points of measurement were taken: the length of the bone (from the tip to the base) and a second measurement at around 3.5 mm from the base. Then, the average of these values was calculated. Finally, the results were compared to the CT scans to assess the accuracy of the 3DPM.\u003c/p\u003e\u003cdiv id=\"Sec5\" class=\"Section2\"\u003e\u003ch2\u003eStatistical Analysis\u003c/h2\u003e\u003cp\u003eSurvey responses were collected on an ordinal Likert scale. First, frequency distributions were examined to understand the proportion of participants selecting each response level. Then, to test the hypothesis that the median response for each survey item was significantly greater than a neutral value (3), a one-sample Wilcoxon Signed-Rank test was employed. This test is suitable for ordinal data and does not require a normal distribution assumption. For each item, the null hypothesis was that the median response equals 3, while the alternative hypothesis was that the median is greater than 3.\u003c/p\u003e\u003c/div\u003e"},{"header":"Results","content":"\u003cp\u003eThe results of the survey from 40 respondents, comprising 10 medical professionals and 30 medical students, are shown in Table\u0026nbsp;\u003cspan refid=\"Tab2\" class=\"InternalRef\"\u003e2\u003c/span\u003e. In general, 95% of respondents found that 3DPMs significantly improved the understanding of targeted anatomical structures (p-value\u0026thinsp;\u0026lt;\u0026thinsp;0.001). Furthermore, 90% of respondents expressed interest in utilizing these 3DPMs in future studies (p-value\u0026thinsp;\u0026lt;\u0026thinsp;0.001), underscoring the perceived value in medical education. Also, 65% of respondents showed willingness to purchase 3DPMs for personal learning (p-value\u0026thinsp;=\u0026thinsp;0.001), highlighting the perceived educational benefits of these models. While 85% stated they are willing to participate in courses incorporating 3DPMs (p-value\u0026thinsp;\u0026lt;\u0026thinsp;0.001), indicating a positive reception amongst respondents towards integrating this technology into educational curricula.\u003c/p\u003e\u003cp\u003e\u003cdiv class=\"gridtable\"\u003e\u003ctable float=\"Yes\" id=\"Tab2\" border=\"1\"\u003e\u003ccaption language=\"En\"\u003e\u003cdiv class=\"CaptionNumber\"\u003eTable 2\u003c/div\u003e\u003cdiv class=\"CaptionContent\"\u003e\u003cp\u003eResults of Medical Education Survey 1: Strongly Disagree, 2: Disagree, 3: Neutral, 4: Agree, 5: Strongly Agree, MP: Medical Professionals (N\u0026thinsp;=\u0026thinsp;10), MS: Medical Students (N\u0026thinsp;=\u0026thinsp;30), T: Total (N\u0026thinsp;=\u0026thinsp;40)\u003c/p\u003e\u003c/div\u003e\u003c/caption\u003e\u003ccolgroup cols=\"8\"\u003e\u003cdiv align=\"left\" class=\"colspec\" colname=\"c1\" colnum=\"1\"\u003e\u003c/div\u003e\u003cdiv align=\"left\" class=\"colspec\" colname=\"c2\" colnum=\"2\"\u003e\u003c/div\u003e\u003cdiv align=\"left\" class=\"colspec\" colname=\"c3\" colnum=\"3\"\u003e\u003c/div\u003e\u003cdiv align=\"left\" class=\"colspec\" colname=\"c4\" colnum=\"4\"\u003e\u003c/div\u003e\u003cdiv align=\"left\" class=\"colspec\" colname=\"c5\" colnum=\"5\"\u003e\u003c/div\u003e\u003cdiv align=\"left\" class=\"colspec\" colname=\"c6\" colnum=\"6\"\u003e\u003c/div\u003e\u003cdiv align=\"left\" class=\"colspec\" colname=\"c7\" colnum=\"7\"\u003e\u003c/div\u003e\u003cdiv align=\"char\" char=\".\" class=\"colspec\" colname=\"c8\" colnum=\"8\"\u003e\u003c/div\u003e\u003cthead\u003e\u003ctr\u003e\u003cth align=\"left\" colname=\"c1\"\u003e\u003cp\u003eQuestion\u003c/p\u003e\u003c/th\u003e\u003cth align=\"left\" colname=\"c2\"\u003e\u0026nbsp;\u003c/th\u003e\u003cth align=\"left\" colname=\"c3\"\u003e\u003cp\u003e1\u003c/p\u003e\u003c/th\u003e\u003cth align=\"left\" colname=\"c4\"\u003e\u003cp\u003e2\u003c/p\u003e\u003c/th\u003e\u003cth align=\"left\" colname=\"c5\"\u003e\u003cp\u003e3\u003c/p\u003e\u003c/th\u003e\u003cth align=\"left\" colname=\"c6\"\u003e\u003cp\u003e4\u003c/p\u003e\u003c/th\u003e\u003cth align=\"left\" colname=\"c7\"\u003e\u003cp\u003e5\u003c/p\u003e\u003c/th\u003e\u003cth align=\"left\" colname=\"c8\"\u003e\u003cp\u003eP-Value\u003c/p\u003e\u003c/th\u003e\u003c/tr\u003e\u003c/thead\u003e\u003ctbody\u003e\u003ctr\u003e\u003ctd align=\"left\" colname=\"c1\" morerows=\"2\" rowspan=\"3\"\u003e\u003cp\u003eThe 3D printed model helped me to better understand the targeted anatomy.\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c2\"\u003e\u003cp\u003e\u003cb\u003eMP\u003c/b\u003e\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c3\"\u003e\u003cp\u003e20%\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c4\"\u003e\u003cp\u003e0%\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c5\"\u003e\u003cp\u003e0%\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c6\"\u003e\u003cp\u003e10%\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c7\"\u003e\u003cp\u003e70%\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"char\" char=\".\" colname=\"c8\"\u003e\u003cp\u003e0.066\u003c/p\u003e\u003c/td\u003e\u003c/tr\u003e\u003ctr\u003e\u003ctd align=\"left\" colname=\"c2\"\u003e\u003cp\u003e\u003cb\u003eMS\u003c/b\u003e\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c3\"\u003e\u003cp\u003e0%\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c4\"\u003e\u003cp\u003e0%\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c5\"\u003e\u003cp\u003e0%\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c6\"\u003e\u003cp\u003e30%\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c7\"\u003e\u003cp\u003e70%\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"char\" char=\".\" colname=\"c8\"\u003e\u003cp\u003e\u0026lt;\u0026thinsp;.001\u003c/p\u003e\u003c/td\u003e\u003c/tr\u003e\u003ctr\u003e\u003ctd align=\"left\" colname=\"c2\"\u003e\u003cp\u003e\u003cb\u003eT\u003c/b\u003e\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c3\"\u003e\u003cp\u003e5%\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c4\"\u003e\u003cp\u003e0%\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c5\"\u003e\u003cp\u003e0%\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c6\"\u003e\u003cp\u003e25%\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c7\"\u003e\u003cp\u003e70%\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"char\" char=\".\" colname=\"c8\"\u003e\u003cp\u003e\u0026lt;\u0026thinsp;.001\u003c/p\u003e\u003c/td\u003e\u003c/tr\u003e\u003ctr\u003e\u003ctd align=\"left\" colname=\"c1\" morerows=\"2\" rowspan=\"3\"\u003e\u003cp\u003eI would use a 3D printed model in the future.\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c2\"\u003e\u003cp\u003e\u003cb\u003eMP\u003c/b\u003e\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c3\"\u003e\u003cp\u003e20%\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c4\"\u003e\u003cp\u003e0%\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c5\"\u003e\u003cp\u003e0%\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c6\"\u003e\u003cp\u003e10%\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c7\"\u003e\u003cp\u003e70%\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"char\" char=\".\" colname=\"c8\"\u003e\u003cp\u003e0.066\u003c/p\u003e\u003c/td\u003e\u003c/tr\u003e\u003ctr\u003e\u003ctd align=\"left\" colname=\"c2\"\u003e\u003cp\u003e\u003cb\u003eMS\u003c/b\u003e\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c3\"\u003e\u003cp\u003e0%\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c4\"\u003e\u003cp\u003e0%\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c5\"\u003e\u003cp\u003e6.7%\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c6\"\u003e\u003cp\u003e23.3%\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c7\"\u003e\u003cp\u003e70%\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"char\" char=\".\" colname=\"c8\"\u003e\u003cp\u003e\u0026lt;\u0026thinsp;.001\u003c/p\u003e\u003c/td\u003e\u003c/tr\u003e\u003ctr\u003e\u003ctd align=\"left\" colname=\"c2\"\u003e\u003cp\u003e\u003cb\u003eT\u003c/b\u003e\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c3\"\u003e\u003cp\u003e5%\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c4\"\u003e\u003cp\u003e0%\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c5\"\u003e\u003cp\u003e5%\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c6\"\u003e\u003cp\u003e20%\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c7\"\u003e\u003cp\u003e70%\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"char\" char=\".\" colname=\"c8\"\u003e\u003cp\u003e\u0026lt;\u0026thinsp;.001\u003c/p\u003e\u003c/td\u003e\u003c/tr\u003e\u003ctr\u003e\u003ctd align=\"left\" colname=\"c1\" morerows=\"2\" rowspan=\"3\"\u003e\u003cp\u003eI am willing to pay to acquire the 3D printed model for my own learning.\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c2\"\u003e\u003cp\u003e\u003cb\u003eMP\u003c/b\u003e\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c3\"\u003e\u003cp\u003e20%\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c4\"\u003e\u003cp\u003e0%\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c5\"\u003e\u003cp\u003e0%\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c6\"\u003e\u003cp\u003e20%\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c7\"\u003e\u003cp\u003e60%\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"char\" char=\".\" colname=\"c8\"\u003e\u003cp\u003e0.085\u003c/p\u003e\u003c/td\u003e\u003c/tr\u003e\u003ctr\u003e\u003ctd align=\"left\" colname=\"c2\"\u003e\u003cp\u003e\u003cb\u003eMS\u003c/b\u003e\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c3\"\u003e\u003cp\u003e6.7%\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c4\"\u003e\u003cp\u003e13.3%\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c5\"\u003e\u003cp\u003e20%\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c6\"\u003e\u003cp\u003e26.7%\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c7\"\u003e\u003cp\u003e33.3%\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"char\" char=\".\" colname=\"c8\"\u003e\u003cp\u003e0.007\u003c/p\u003e\u003c/td\u003e\u003c/tr\u003e\u003ctr\u003e\u003ctd align=\"left\" colname=\"c2\"\u003e\u003cp\u003e\u003cb\u003eT\u003c/b\u003e\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c3\"\u003e\u003cp\u003e10%\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c4\"\u003e\u003cp\u003e10%\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c5\"\u003e\u003cp\u003e15%\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c6\"\u003e\u003cp\u003e25%\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c7\"\u003e\u003cp\u003e40%\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"char\" char=\".\" colname=\"c8\"\u003e\u003cp\u003e0.001\u003c/p\u003e\u003c/td\u003e\u003c/tr\u003e\u003ctr\u003e\u003ctd align=\"left\" colname=\"c1\" morerows=\"2\" rowspan=\"3\"\u003e\u003cp\u003eI am willing to participate in courses with 3D printed models in the future.\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c2\"\u003e\u003cp\u003e\u003cb\u003eMP\u003c/b\u003e\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c3\"\u003e\u003cp\u003e20%\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c4\"\u003e\u003cp\u003e0%\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c5\"\u003e\u003cp\u003e0%\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c6\"\u003e\u003cp\u003e10%\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c7\"\u003e\u003cp\u003e70%\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"char\" char=\".\" colname=\"c8\"\u003e\u003cp\u003e0.066\u003c/p\u003e\u003c/td\u003e\u003c/tr\u003e\u003ctr\u003e\u003ctd align=\"left\" colname=\"c2\"\u003e\u003cp\u003e\u003cb\u003eMS\u003c/b\u003e\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c3\"\u003e\u003cp\u003e0%\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c4\"\u003e\u003cp\u003e0%\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c5\"\u003e\u003cp\u003e13.3%\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c6\"\u003e\u003cp\u003e33.3%\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c7\"\u003e\u003cp\u003e53.3%\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"char\" char=\".\" colname=\"c8\"\u003e\u003cp\u003e\u0026lt;\u0026thinsp;.001\u003c/p\u003e\u003c/td\u003e\u003c/tr\u003e\u003ctr\u003e\u003ctd align=\"left\" colname=\"c2\"\u003e\u003cp\u003e\u003cb\u003eT\u003c/b\u003e\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c3\"\u003e\u003cp\u003e5%\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c4\"\u003e\u003cp\u003e0%\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c5\"\u003e\u003cp\u003e10%\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c6\"\u003e\u003cp\u003e27.5%\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c7\"\u003e\u003cp\u003e57.5%\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"char\" char=\".\" colname=\"c8\"\u003e\u003cp\u003e\u0026lt;\u0026thinsp;.001\u003c/p\u003e\u003c/td\u003e\u003c/tr\u003e\u003ctr\u003e\u003ctd align=\"left\" colname=\"c1\" morerows=\"2\" rowspan=\"3\"\u003e\u003cp\u003eThe use of the 3D printed model enhanced my ability to understand the surgical procedure.\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c2\"\u003e\u003cp\u003e\u003cb\u003eMP\u003c/b\u003e\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c3\"\u003e\u003cp\u003e10%\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c4\"\u003e\u003cp\u003e10%\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c5\"\u003e\u003cp\u003e10%\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c6\"\u003e\u003cp\u003e10%\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c7\"\u003e\u003cp\u003e60%\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"char\" char=\".\" colname=\"c8\"\u003e\u003cp\u003e0.063\u003c/p\u003e\u003c/td\u003e\u003c/tr\u003e\u003ctr\u003e\u003ctd align=\"left\" colname=\"c2\"\u003e\u003cp\u003e\u003cb\u003eMS\u003c/b\u003e\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c3\"\u003e\u003cp\u003e0%\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c4\"\u003e\u003cp\u003e6.7%\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c5\"\u003e\u003cp\u003e13.3%\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c6\"\u003e\u003cp\u003e20%\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c7\"\u003e\u003cp\u003e60%\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"char\" char=\".\" colname=\"c8\"\u003e\u003cp\u003e\u0026lt;\u0026thinsp;.001\u003c/p\u003e\u003c/td\u003e\u003c/tr\u003e\u003ctr\u003e\u003ctd align=\"left\" colname=\"c2\"\u003e\u003cp\u003e\u003cb\u003eT\u003c/b\u003e\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c3\"\u003e\u003cp\u003e2.5%\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c4\"\u003e\u003cp\u003e7.5%\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c5\"\u003e\u003cp\u003e12.5%\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c6\"\u003e\u003cp\u003e17.5%\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c7\"\u003e\u003cp\u003e60%\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"char\" char=\".\" colname=\"c8\"\u003e\u003cp\u003e\u0026lt;\u0026thinsp;.001\u003c/p\u003e\u003c/td\u003e\u003c/tr\u003e\u003ctr\u003e\u003ctd align=\"left\" colname=\"c1\" morerows=\"2\" rowspan=\"3\"\u003e\u003cp\u003eThe use of the 3D printed model enhanced my ability to retain information.\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c2\"\u003e\u003cp\u003e\u003cb\u003eMP\u003c/b\u003e\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c3\"\u003e\u003cp\u003e10%\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c4\"\u003e\u003cp\u003e10%\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c5\"\u003e\u003cp\u003e0%\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c6\"\u003e\u003cp\u003e10%\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c7\"\u003e\u003cp\u003e70%\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"char\" char=\".\" colname=\"c8\"\u003e\u003cp\u003e0.030\u003c/p\u003e\u003c/td\u003e\u003c/tr\u003e\u003ctr\u003e\u003ctd align=\"left\" colname=\"c2\"\u003e\u003cp\u003e\u003cb\u003eMS\u003c/b\u003e\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c3\"\u003e\u003cp\u003e0%\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c4\"\u003e\u003cp\u003e0%\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c5\"\u003e\u003cp\u003e10%\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c6\"\u003e\u003cp\u003e36.7%\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c7\"\u003e\u003cp\u003e53.3%\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"char\" char=\".\" colname=\"c8\"\u003e\u003cp\u003e\u0026lt;\u0026thinsp;.001\u003c/p\u003e\u003c/td\u003e\u003c/tr\u003e\u003ctr\u003e\u003ctd align=\"left\" colname=\"c2\"\u003e\u003cp\u003e\u003cb\u003eT\u003c/b\u003e\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c3\"\u003e\u003cp\u003e2.5%\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c4\"\u003e\u003cp\u003e2.5%\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c5\"\u003e\u003cp\u003e7.5%\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c6\"\u003e\u003cp\u003e30%\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c7\"\u003e\u003cp\u003e57.5\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"char\" char=\".\" colname=\"c8\"\u003e\u003cp\u003e\u0026lt;\u0026thinsp;.001\u003c/p\u003e\u003c/td\u003e\u003c/tr\u003e\u003ctr\u003e\u003ctd align=\"left\" colname=\"c1\" morerows=\"2\" rowspan=\"3\"\u003e\u003cp\u003eThe use of the 3D printed model helped me reach the course's educational objectives.\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c2\"\u003e\u003cp\u003e\u003cb\u003eMP\u003c/b\u003e\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c3\"\u003e\u003cp\u003e20%\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c4\"\u003e\u003cp\u003e0%\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c5\"\u003e\u003cp\u003e0%\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c6\"\u003e\u003cp\u003e0%\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c7\"\u003e\u003cp\u003e80%\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"char\" char=\".\" colname=\"c8\"\u003e\u003cp\u003e0.051\u003c/p\u003e\u003c/td\u003e\u003c/tr\u003e\u003ctr\u003e\u003ctd align=\"left\" colname=\"c2\"\u003e\u003cp\u003e\u003cb\u003eMS\u003c/b\u003e\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c3\"\u003e\u003cp\u003e0%\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c4\"\u003e\u003cp\u003e0%\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c5\"\u003e\u003cp\u003e20%\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c6\"\u003e\u003cp\u003e26.7%\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c7\"\u003e\u003cp\u003e53.3%\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"char\" char=\".\" colname=\"c8\"\u003e\u003cp\u003e\u0026lt;\u0026thinsp;.001\u003c/p\u003e\u003c/td\u003e\u003c/tr\u003e\u003ctr\u003e\u003ctd align=\"left\" colname=\"c2\"\u003e\u003cp\u003e\u003cb\u003eT\u003c/b\u003e\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c3\"\u003e\u003cp\u003e5%\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c4\"\u003e\u003cp\u003e0%\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c5\"\u003e\u003cp\u003e15%\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c6\"\u003e\u003cp\u003e20%\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c7\"\u003e\u003cp\u003e60%\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"char\" char=\".\" colname=\"c8\"\u003e\u003cp\u003e\u0026lt;\u0026thinsp;.001\u003c/p\u003e\u003c/td\u003e\u003c/tr\u003e\u003ctr\u003e\u003ctd align=\"left\" colname=\"c1\" morerows=\"2\" rowspan=\"3\"\u003e\u003cp\u003eThe anatomical landmarks/features were easy to recognize using the provided 3D printed model.\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c2\"\u003e\u003cp\u003e\u003cb\u003eMP\u003c/b\u003e\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c3\"\u003e\u003cp\u003e10%\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c4\"\u003e\u003cp\u003e10%\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c5\"\u003e\u003cp\u003e10%\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c6\"\u003e\u003cp\u003e20%\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c7\"\u003e\u003cp\u003e50%\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"char\" char=\".\" colname=\"c8\"\u003e\u003cp\u003e0.081\u003c/p\u003e\u003c/td\u003e\u003c/tr\u003e\u003ctr\u003e\u003ctd align=\"left\" colname=\"c2\"\u003e\u003cp\u003e\u003cb\u003eMS\u003c/b\u003e\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c3\"\u003e\u003cp\u003e0%\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c4\"\u003e\u003cp\u003e3.3%\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c5\"\u003e\u003cp\u003e10%\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c6\"\u003e\u003cp\u003e36.7%\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c7\"\u003e\u003cp\u003e50%\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"char\" char=\".\" colname=\"c8\"\u003e\u003cp\u003e\u0026lt;\u0026thinsp;.001\u003c/p\u003e\u003c/td\u003e\u003c/tr\u003e\u003ctr\u003e\u003ctd align=\"left\" colname=\"c2\"\u003e\u003cp\u003e\u003cb\u003eT\u003c/b\u003e\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c3\"\u003e\u003cp\u003e2.5%\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c4\"\u003e\u003cp\u003e5%\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c5\"\u003e\u003cp\u003e10%\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c6\"\u003e\u003cp\u003e32.5%\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c7\"\u003e\u003cp\u003e50%\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"char\" char=\".\" colname=\"c8\"\u003e\u003cp\u003e\u0026lt;\u0026thinsp;.001\u003c/p\u003e\u003c/td\u003e\u003c/tr\u003e\u003ctr\u003e\u003ctd align=\"left\" colname=\"c1\" morerows=\"2\" rowspan=\"3\"\u003e\u003cp\u003eThe 3D printed model was detailed enough to be used in a simulation or a procedure.\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c2\"\u003e\u003cp\u003e\u003cb\u003eMP\u003c/b\u003e\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c3\"\u003e\u003cp\u003e10%\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c4\"\u003e\u003cp\u003e10%\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c5\"\u003e\u003cp\u003e30%\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c6\"\u003e\u003cp\u003e0%\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c7\"\u003e\u003cp\u003e50%\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"char\" char=\".\" colname=\"c8\"\u003e\u003cp\u003e0.173\u003c/p\u003e\u003c/td\u003e\u003c/tr\u003e\u003ctr\u003e\u003ctd align=\"left\" colname=\"c2\"\u003e\u003cp\u003e\u003cb\u003eMS\u003c/b\u003e\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c3\"\u003e\u003cp\u003e0%\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c4\"\u003e\u003cp\u003e3.3%\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c5\"\u003e\u003cp\u003e13.3%\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c6\"\u003e\u003cp\u003e36.7%\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c7\"\u003e\u003cp\u003e46.7%\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"char\" char=\".\" colname=\"c8\"\u003e\u003cp\u003e\u0026lt;\u0026thinsp;.001\u003c/p\u003e\u003c/td\u003e\u003c/tr\u003e\u003ctr\u003e\u003ctd align=\"left\" colname=\"c2\"\u003e\u003cp\u003e\u003cb\u003eT\u003c/b\u003e\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c3\"\u003e\u003cp\u003e2.5%\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c4\"\u003e\u003cp\u003e5%\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c5\"\u003e\u003cp\u003e17.5%\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c6\"\u003e\u003cp\u003e27.5%\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c7\"\u003e\u003cp\u003e47.5%\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"char\" char=\".\" colname=\"c8\"\u003e\u003cp\u003e\u0026lt;\u0026thinsp;.001\u003c/p\u003e\u003c/td\u003e\u003c/tr\u003e\u003ctr\u003e\u003ctd align=\"left\" colname=\"c1\" morerows=\"2\" rowspan=\"3\"\u003e\u003cp\u003eThe 3D printed model feels close to real cadaveric structure in the hand in terms of \u003cem\u003etexture\u003c/em\u003e.\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c2\"\u003e\u003cp\u003e\u003cb\u003eMP\u003c/b\u003e\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c3\"\u003e\u003cp\u003e0%\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c4\"\u003e\u003cp\u003e10%\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c5\"\u003e\u003cp\u003e30%\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c6\"\u003e\u003cp\u003e20%\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c7\"\u003e\u003cp\u003e40%\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"char\" char=\".\" colname=\"c8\"\u003e\u003cp\u003e0.029\u003c/p\u003e\u003c/td\u003e\u003c/tr\u003e\u003ctr\u003e\u003ctd align=\"left\" colname=\"c2\"\u003e\u003cp\u003e\u003cb\u003eMS\u003c/b\u003e\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c3\"\u003e\u003cp\u003e10%\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c4\"\u003e\u003cp\u003e16.7%\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c5\"\u003e\u003cp\u003e30%\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c6\"\u003e\u003cp\u003e20%\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c7\"\u003e\u003cp\u003e23.3%\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"char\" char=\".\" colname=\"c8\"\u003e\u003cp\u003e0.213\u003c/p\u003e\u003c/td\u003e\u003c/tr\u003e\u003ctr\u003e\u003ctd align=\"left\" colname=\"c2\"\u003e\u003cp\u003e\u003cb\u003eT\u003c/b\u003e\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c3\"\u003e\u003cp\u003e7.5%\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c4\"\u003e\u003cp\u003e15%\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c5\"\u003e\u003cp\u003e30%\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c6\"\u003e\u003cp\u003e20%\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c7\"\u003e\u003cp\u003e27.5%\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"char\" char=\".\" colname=\"c8\"\u003e\u003cp\u003e0.030\u003c/p\u003e\u003c/td\u003e\u003c/tr\u003e\u003ctr\u003e\u003ctd align=\"left\" colname=\"c1\" morerows=\"2\" rowspan=\"3\"\u003e\u003cp\u003eThe 3D printed model feels close to real cadaveric structure in the hand in terms of \u003cem\u003eweight\u003c/em\u003e.\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c2\"\u003e\u003cp\u003e\u003cb\u003eMP\u003c/b\u003e\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c3\"\u003e\u003cp\u003e0%\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c4\"\u003e\u003cp\u003e10%\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c5\"\u003e\u003cp\u003e40%\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c6\"\u003e\u003cp\u003e20%\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c7\"\u003e\u003cp\u003e30%\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"char\" char=\".\" colname=\"c8\"\u003e\u003cp\u003e0.066\u003c/p\u003e\u003c/td\u003e\u003c/tr\u003e\u003ctr\u003e\u003ctd align=\"left\" colname=\"c2\"\u003e\u003cp\u003e\u003cb\u003eMS\u003c/b\u003e\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c3\"\u003e\u003cp\u003e6.7%\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c4\"\u003e\u003cp\u003e20%\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c5\"\u003e\u003cp\u003e30%\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c6\"\u003e\u003cp\u003e20%\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c7\"\u003e\u003cp\u003e70%\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"char\" char=\".\" colname=\"c8\"\u003e\u003cp\u003e0.152\u003c/p\u003e\u003c/td\u003e\u003c/tr\u003e\u003ctr\u003e\u003ctd align=\"left\" colname=\"c2\"\u003e\u003cp\u003e\u003cb\u003eT\u003c/b\u003e\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c3\"\u003e\u003cp\u003e5%\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c4\"\u003e\u003cp\u003e17.5%\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c5\"\u003e\u003cp\u003e32.5%\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c6\"\u003e\u003cp\u003e20%\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c7\"\u003e\u003cp\u003e25%\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"char\" char=\".\" colname=\"c8\"\u003e\u003cp\u003e0.030\u003c/p\u003e\u003c/td\u003e\u003c/tr\u003e\u003ctr\u003e\u003ctd align=\"left\" colname=\"c1\" morerows=\"2\" rowspan=\"3\"\u003e\u003cp\u003eThe 3D printed model accurately reflected the anatomical structure in \u003cem\u003esize\u003c/em\u003e.\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c2\"\u003e\u003cp\u003e\u003cb\u003eMP\u003c/b\u003e\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c3\"\u003e\u003cp\u003e0%\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c4\"\u003e\u003cp\u003e20%\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c5\"\u003e\u003cp\u003e10%\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c6\"\u003e\u003cp\u003e10%\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c7\"\u003e\u003cp\u003e60%\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"char\" char=\".\" colname=\"c8\"\u003e\u003cp\u003e0.024\u003c/p\u003e\u003c/td\u003e\u003c/tr\u003e\u003ctr\u003e\u003ctd align=\"left\" colname=\"c2\"\u003e\u003cp\u003e\u003cb\u003eMS\u003c/b\u003e\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c3\"\u003e\u003cp\u003e0%\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c4\"\u003e\u003cp\u003e10%\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c5\"\u003e\u003cp\u003e30%\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c6\"\u003e\u003cp\u003e23.3%\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c7\"\u003e\u003cp\u003e36.7%\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"char\" char=\".\" colname=\"c8\"\u003e\u003cp\u003e\u0026lt;\u0026thinsp;.001\u003c/p\u003e\u003c/td\u003e\u003c/tr\u003e\u003ctr\u003e\u003ctd align=\"left\" colname=\"c2\"\u003e\u003cp\u003e\u003cb\u003eT\u003c/b\u003e\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c3\"\u003e\u003cp\u003e0%\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c4\"\u003e\u003cp\u003e12.5%\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c5\"\u003e\u003cp\u003e25%\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c6\"\u003e\u003cp\u003e20%\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c7\"\u003e\u003cp\u003e42.5%\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"char\" char=\".\" colname=\"c8\"\u003e\u003cp\u003e\u0026lt;\u0026thinsp;.001\u003c/p\u003e\u003c/td\u003e\u003c/tr\u003e\u003ctr\u003e\u003ctd align=\"left\" colname=\"c1\" morerows=\"2\" rowspan=\"3\"\u003e\u003cp\u003eThe 3D printed model accurately reflected the anatomical structure in \u003cem\u003eshape\u003c/em\u003e.\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c2\"\u003e\u003cp\u003e\u003cb\u003eMP\u003c/b\u003e\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c3\"\u003e\u003cp\u003e0%\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c4\"\u003e\u003cp\u003e20%\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c5\"\u003e\u003cp\u003e30%\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c6\"\u003e\u003cp\u003e0%\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c7\"\u003e\u003cp\u003e50%\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"char\" char=\".\" colname=\"c8\"\u003e\u003cp\u003e0.087\u003c/p\u003e\u003c/td\u003e\u003c/tr\u003e\u003ctr\u003e\u003ctd align=\"left\" colname=\"c2\"\u003e\u003cp\u003e\u003cb\u003eMS\u003c/b\u003e\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c3\"\u003e\u003cp\u003e0%\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c4\"\u003e\u003cp\u003e0%\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c5\"\u003e\u003cp\u003e6.7%\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c6\"\u003e\u003cp\u003e46.7%\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c7\"\u003e\u003cp\u003e46.7%\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"char\" char=\".\" colname=\"c8\"\u003e\u003cp\u003e\u0026lt;\u0026thinsp;.001\u003c/p\u003e\u003c/td\u003e\u003c/tr\u003e\u003ctr\u003e\u003ctd align=\"left\" colname=\"c2\"\u003e\u003cp\u003e\u003cb\u003eT\u003c/b\u003e\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c3\"\u003e\u003cp\u003e0%\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c4\"\u003e\u003cp\u003e5%\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c5\"\u003e\u003cp\u003e12.5%\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c6\"\u003e\u003cp\u003e35%\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c7\"\u003e\u003cp\u003e47.5%\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"char\" char=\".\" colname=\"c8\"\u003e\u003cp\u003e\u0026lt;\u0026thinsp;.001\u003c/p\u003e\u003c/td\u003e\u003c/tr\u003e\u003c/tbody\u003e\u003c/colgroup\u003e\u003c/table\u003e\u003c/div\u003e\u003c/p\u003e\u003cp\u003eAdditionally, 77.5% stated that the models enhanced the ability to understand surgical procedure (p-value\u0026thinsp;\u0026lt;\u0026thinsp;0.001), and 87.5% reported improved retention of information upon using 3DPMs (p-value\u0026thinsp;\u0026lt;\u0026thinsp;0.001). Furthermore, 80% believed that the models helped achieve the courses\u0026rsquo; educational objectives (p-value\u0026thinsp;\u0026lt;\u0026thinsp;0.001). A high percentage (82.5%) found it easy to recognize the landmarks on the 3DPM (p-value\u0026thinsp;\u0026lt;\u0026thinsp;0.001), and 75% thought that the 3DPMs were sufficiently detailed for use in simulations or procedures (p-value\u0026thinsp;\u0026lt;\u0026thinsp;0.001). Regarding the trueness of the 3DPMs itself, 47.5% agreed that the model feels comparable to the real cadaveric structure in the hand in terms of texture (p-value\u0026thinsp;=\u0026thinsp;0.029), 45% agreed that it feels similar in terms of weight (p-value\u0026thinsp;=\u0026thinsp;0.03), 62.5% agreed that it accurately represented the anatomical structure in size (p-value\u0026thinsp;\u0026lt;\u0026thinsp;0.001), and 82.5% agreed that it reflects the structure in shape (p-value\u0026thinsp;\u0026lt;\u0026thinsp;0.001).\u003c/p\u003e\u003cp\u003eAmong medical professionals, 80% agreed that the 3DPMs significantly improved the understanding of targeted anatomical structures (p-value\u0026thinsp;=\u0026thinsp;0.066). Moreover, 80% of respondents indicated a willingness to consider 3DPMs in future instructional contexts (p-value\u0026thinsp;=\u0026thinsp;0.066), highlighting the perceived educational value. Also, 80% of respondents indicated their willingness to pay to acquire 3DPMs for personal learning (p-value\u0026thinsp;=\u0026thinsp;0.085). While 80% stated they are willing to participate in courses incorporating 3DPMs (p-value\u0026thinsp;=\u0026thinsp;0.066), indicating a positive reception among medical professionals towards integrating 3DPMs into educational curricula. The survey presented that 70% agree that the model helped enhance the ability to understand the surgical procedure (p-value\u0026thinsp;=\u0026thinsp;0.063). Also, 80% responded that the use of the 3DPMs enhanced the ability to retain information (p-value\u0026thinsp;=\u0026thinsp;0.030) and reach the courses\u0026rsquo; educational objectives (p-value\u0026thinsp;=\u0026thinsp;0.051).\u003c/p\u003e\u003cp\u003eAmong the results, 70% answered that the landmarks were easy to recognize on the 3DPM (p-value\u0026thinsp;=\u0026thinsp;0.081). However, only 50% thought that the 3DPM was detailed enough to be used in a simulation or a procedure (p-value\u0026thinsp;=\u0026thinsp;0.173). Regarding the 3DPM itself, 60% reported that it feels similar to the real cadaveric structure in terms of texture (p-value\u0026thinsp;=\u0026thinsp;0.029). Half of the participants found the weight to be comparable (p-value\u0026thinsp;=\u0026thinsp;0.066). Seventy percent considered the size to accurately reflect the anatomical structure (p-value\u0026thinsp;=\u0026thinsp;0.024), and 50% felt that the shape was a close match (p-value\u0026thinsp;=\u0026thinsp;0.087).\u003c/p\u003e\u003cp\u003eAmong medical students, all answered that the model enhanced their understanding of the targeted anatomy (p-value\u0026thinsp;\u0026lt;\u0026thinsp;0.001), and 93.3% would use a 3DPM in the future (p-value\u0026thinsp;\u0026lt;\u0026thinsp;0.0001). On the other hand, only 50% are willing to pay to acquire a 3DPM (p-value\u0026thinsp;=\u0026thinsp;0.007), while 20% neither agree nor disagree, and 20% are not willing to pay for it. In case of willingness to participate in courses consist of 3DPMs, 86.6% responded in agreement (p-value\u0026thinsp;\u0026lt;\u0026thinsp;0.001), and 13.3% neither agree nor disagree. Additionally, 80% of students agree that the model helped enhance their ability to understand the surgical procedure (p-value\u0026thinsp;\u0026lt;\u0026thinsp;0.001), and 90% reported that it enhanced their ability to retain information (p-value\u0026thinsp;\u0026lt;\u0026thinsp;0.001). The 3DPM helped 80% of students to reach the course\u0026rsquo;s educational objectives (p-value\u0026thinsp;\u0026lt;\u0026thinsp;0.001).\u003c/p\u003e\u003cp\u003eFurthermore, 86.67% of students stated that anatomical landmarks were easy to recognize on the 3DPM (p-value\u0026thinsp;\u0026lt;\u0026thinsp;0.001), and 83.34% thought the model was detailed enough for use in a simulation or a procedure (p-value\u0026thinsp;\u0026lt;\u0026thinsp;0.001). In terms of model accuracy, 43.3% of students agreed that the 3DPM feels close to real cadaveric structure in terms of texture (p-value\u0026thinsp;=\u0026thinsp;0.213) and weight (p-value\u0026thinsp;=\u0026thinsp;0.152), 60% of them expressed that it reflects it in size (p-value\u0026thinsp;\u0026lt;\u0026thinsp;0.001), and 93.34% confirmed that it reflects it in shape (p-value\u0026thinsp;\u0026lt;\u0026thinsp;0.001).\u003c/p\u003e\u003cp\u003eMeasurements of real Javan Rusa deer (Rusa timorensis) antlers were compared with their 3DPMs, and the results are shown in Fig.\u0026nbsp;\u003cspan refid=\"Fig1\" class=\"InternalRef\"\u003e1\u003c/span\u003e and Tables\u0026nbsp;\u003cspan refid=\"Tab3\" class=\"InternalRef\"\u003e3\u003c/span\u003e and \u003cspan refid=\"Tab4\" class=\"InternalRef\"\u003e4\u003c/span\u003e. This revealed valuable insights into the accuracy of different scanning and reconstruction methods. Figure\u0026nbsp;\u003cspan refid=\"Fig1\" class=\"InternalRef\"\u003e1\u003c/span\u003e illustrates the 3DPMs alongside the real bone, showing a close visual adaptation in overall shape. However, some defects are apparent in the 3D printed models. For example, in Fig.\u0026nbsp;\u003cspan refid=\"Fig1\" class=\"InternalRef\"\u003e1\u003c/span\u003e.1, V3DP-1, compared to RB-1, exhibits printing defects and layer deformities on the distal side. This can also be shown in H3DP-2, displaying a visible staircasing effect. Measurements showed that printing horizontally resulted in a mean positive difference of +\u0026thinsp;3.01 mm for the length from the real bone measurements, with an accuracy of 93.41%. Whereas, for the base, there is a mean positive difference of +\u0026thinsp;1.07 mm for the base, with an accuracy of 90.47%. Similarly, with no significant difference, printing vertically yielded a mean positive difference of +\u0026thinsp;2.99 mm for the length from the real bone measurements, with an accuracy of 93.29%. In case of the base measurement, a mean positive difference of +\u0026thinsp;1.01 mm, with an accuracy of 90.67%.\u003c/p\u003e\u003cp\u003e\u003c/p\u003e\u003cp\u003e\u003cdiv class=\"gridtable\"\u003e\u003ctable float=\"Yes\" id=\"Tab3\" border=\"1\"\u003e\u003ccaption language=\"En\"\u003e\u003cdiv class=\"CaptionNumber\"\u003eTable 3\u003c/div\u003e\u003cdiv class=\"CaptionContent\"\u003e\u003cp\u003eMeasurements of Real Bones and 3D Printed Bones (Length).\u003c/p\u003e\u003c/div\u003e\u003c/caption\u003e\u003ccolgroup cols=\"7\"\u003e\u003cdiv align=\"left\" class=\"colspec\" colname=\"c1\" colnum=\"1\"\u003e\u003c/div\u003e\u003cdiv align=\"left\" class=\"colspec\" colname=\"c2\" colnum=\"2\"\u003e\u003c/div\u003e\u003cdiv align=\"left\" class=\"colspec\" colname=\"c3\" colnum=\"3\"\u003e\u003c/div\u003e\u003cdiv align=\"left\" class=\"colspec\" colname=\"c4\" colnum=\"4\"\u003e\u003c/div\u003e\u003cdiv align=\"left\" class=\"colspec\" colname=\"c5\" colnum=\"5\"\u003e\u003c/div\u003e\u003cdiv align=\"left\" class=\"colspec\" colname=\"c6\" colnum=\"6\"\u003e\u003c/div\u003e\u003cdiv align=\"left\" class=\"colspec\" colname=\"c7\" colnum=\"7\"\u003e\u003c/div\u003e\u003cthead\u003e\u003ctr\u003e\u003cth align=\"left\" colname=\"c1\"\u003e\u0026nbsp;\u003c/th\u003e\u003cth align=\"left\" colname=\"c2\"\u003e\u003cp\u003eMeasurement 1\u003c/p\u003e\u003c/th\u003e\u003cth align=\"left\" colname=\"c3\"\u003e\u003cp\u003eMeasurement 2\u003c/p\u003e\u003c/th\u003e\u003cth align=\"left\" colname=\"c4\"\u003e\u003cp\u003eMeasurement 3\u003c/p\u003e\u003c/th\u003e\u003cth align=\"left\" colname=\"c5\"\u003e\u003cp\u003eAVG\u003c/p\u003e\u003c/th\u003e\u003cth align=\"left\" colname=\"c6\"\u003e\u003cp\u003eMD\u003c/p\u003e\u003c/th\u003e\u003cth align=\"left\" colname=\"c7\"\u003e\u003cp\u003e%E\u003c/p\u003e\u003c/th\u003e\u003c/tr\u003e\u003c/thead\u003e\u003ctbody\u003e\u003ctr\u003e\u003ctd align=\"left\" colname=\"c1\"\u003e\u003cp\u003eRB-1\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c2\"\u003e\u003cp\u003e43.51\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c3\"\u003e\u003cp\u003e43.43\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c4\"\u003e\u003cp\u003e43.26\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c5\"\u003e\u003cp\u003e43.4\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colspan=\"2\" nameend=\"c7\" namest=\"c6\"\u003e\u0026nbsp;\u003c/td\u003e\u003c/tr\u003e\u003ctr\u003e\u003ctd align=\"left\" colname=\"c1\"\u003e\u003cp\u003eH3DP-1\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c2\"\u003e\u003cp\u003e45.84\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c3\"\u003e\u003cp\u003e45.78\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c4\"\u003e\u003cp\u003e45.81\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c5\"\u003e\u003cp\u003e45.81\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c6\"\u003e\u003cp\u003e2.41\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c7\"\u003e\u003cp\u003e5.55%\u003c/p\u003e\u003c/td\u003e\u003c/tr\u003e\u003ctr\u003e\u003ctd align=\"left\" colname=\"c1\"\u003e\u003cp\u003eV3DP-1\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c2\"\u003e\u003cp\u003e46.07\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c3\"\u003e\u003cp\u003e45.96\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c4\"\u003e\u003cp\u003e46.04\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c5\"\u003e\u003cp\u003e46.02\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c6\"\u003e\u003cp\u003e2.62\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c7\"\u003e\u003cp\u003e6.04%\u003c/p\u003e\u003c/td\u003e\u003c/tr\u003e\u003ctr\u003e\u003ctd align=\"left\" colname=\"c1\"\u003e\u003cp\u003eRB-2\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c2\"\u003e\u003cp\u003e43.02\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c3\"\u003e\u003cp\u003e43.06\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c4\"\u003e\u003cp\u003e42.99\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c5\"\u003e\u003cp\u003e43.02\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colspan=\"2\" nameend=\"c7\" namest=\"c6\"\u003e\u0026nbsp;\u003c/td\u003e\u003c/tr\u003e\u003ctr\u003e\u003ctd align=\"left\" colname=\"c1\"\u003e\u003cp\u003eH3DP-2\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c2\"\u003e\u003cp\u003e46.74\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c3\"\u003e\u003cp\u003e46.84\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c4\"\u003e\u003cp\u003e46.75\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c5\"\u003e\u003cp\u003e46.78\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c6\"\u003e\u003cp\u003e3.75\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c7\"\u003e\u003cp\u003e8.72%\u003c/p\u003e\u003c/td\u003e\u003c/tr\u003e\u003ctr\u003e\u003ctd align=\"left\" colname=\"c1\"\u003e\u003cp\u003eV3DP-2\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c2\"\u003e\u003cp\u003e46.92\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c3\"\u003e\u003cp\u003e46.85\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c4\"\u003e\u003cp\u003e46.86\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c5\"\u003e\u003cp\u003e46.88\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c6\"\u003e\u003cp\u003e3.85\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c7\"\u003e\u003cp\u003e8.95%\u003c/p\u003e\u003c/td\u003e\u003c/tr\u003e\u003ctr\u003e\u003ctd align=\"left\" colname=\"c1\"\u003e\u003cp\u003eRB-3\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c2\"\u003e\u003cp\u003e49.7\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c3\"\u003e\u003cp\u003e49.67\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c4\"\u003e\u003cp\u003e49.72\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c5\"\u003e\u003cp\u003e49.70\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colspan=\"2\" nameend=\"c7\" namest=\"c6\"\u003e\u0026nbsp;\u003c/td\u003e\u003c/tr\u003e\u003ctr\u003e\u003ctd align=\"left\" colname=\"c1\"\u003e\u003cp\u003eH3DP-3\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c2\"\u003e\u003cp\u003e52.36\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c3\"\u003e\u003cp\u003e52.33\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c4\"\u003e\u003cp\u003e52.33\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c5\"\u003e\u003cp\u003e52.34\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c6\"\u003e\u003cp\u003e2.64\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c7\"\u003e\u003cp\u003e5.32%\u003c/p\u003e\u003c/td\u003e\u003c/tr\u003e\u003ctr\u003e\u003ctd align=\"left\" colname=\"c1\"\u003e\u003cp\u003eV3DP-3\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c2\"\u003e\u003cp\u003e53.17\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c3\"\u003e\u003cp\u003e53.18\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c4\"\u003e\u003cp\u003e53.18\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c5\"\u003e\u003cp\u003e53.18\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c6\"\u003e\u003cp\u003e3.48\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c7\"\u003e\u003cp\u003e7.00%\u003c/p\u003e\u003c/td\u003e\u003c/tr\u003e\u003ctr\u003e\u003ctd align=\"left\" colname=\"c1\"\u003e\u003cp\u003eRB-4\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c2\"\u003e\u003cp\u003e42.96\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c3\"\u003e\u003cp\u003e42.87\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c4\"\u003e\u003cp\u003e42.81\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c5\"\u003e\u003cp\u003e42.88\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colspan=\"2\" nameend=\"c7\" namest=\"c6\"\u003e\u0026nbsp;\u003c/td\u003e\u003c/tr\u003e\u003ctr\u003e\u003ctd align=\"left\" colname=\"c1\"\u003e\u003cp\u003eH3DP-4\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c2\"\u003e\u003cp\u003e44.41\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c3\"\u003e\u003cp\u003e44.32\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c4\"\u003e\u003cp\u003e44.27\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c5\"\u003e\u003cp\u003e44.33\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c6\"\u003e\u003cp\u003e1.45\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c7\"\u003e\u003cp\u003e3.39%\u003c/p\u003e\u003c/td\u003e\u003c/tr\u003e\u003ctr\u003e\u003ctd align=\"left\" colname=\"c1\"\u003e\u003cp\u003eV3DP-4\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c2\"\u003e\u003cp\u003e44\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c3\"\u003e\u003cp\u003e44.38\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c4\"\u003e\u003cp\u003e44.14\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c5\"\u003e\u003cp\u003e44.17\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c6\"\u003e\u003cp\u003e1.29\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c7\"\u003e\u003cp\u003e3.02%\u003c/p\u003e\u003c/td\u003e\u003c/tr\u003e\u003ctr\u003e\u003ctd align=\"left\" colname=\"c1\"\u003e\u003cp\u003eRB-5\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c2\"\u003e\u003cp\u003e48.24\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c3\"\u003e\u003cp\u003e48.2\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c4\"\u003e\u003cp\u003e48.21\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c5\"\u003e\u003cp\u003e48.22\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colspan=\"2\" nameend=\"c7\" namest=\"c6\"\u003e\u0026nbsp;\u003c/td\u003e\u003c/tr\u003e\u003ctr\u003e\u003ctd align=\"left\" colname=\"c1\"\u003e\u003cp\u003eH3DP-5\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c2\"\u003e\u003cp\u003e51.74\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c3\"\u003e\u003cp\u003e51.75\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c4\"\u003e\u003cp\u003e51.72\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c5\"\u003e\u003cp\u003e51.74\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c6\"\u003e\u003cp\u003e3.52\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c7\"\u003e\u003cp\u003e7.30%\u003c/p\u003e\u003c/td\u003e\u003c/tr\u003e\u003ctr\u003e\u003ctd align=\"left\" colname=\"c1\"\u003e\u003cp\u003eV3DP-5\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c2\"\u003e\u003cp\u003e51.66\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c3\"\u003e\u003cp\u003e51.63\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c4\"\u003e\u003cp\u003e51.66\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c5\"\u003e\u003cp\u003e51.65\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c6\"\u003e\u003cp\u003e3.43\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c7\"\u003e\u003cp\u003e7.12%\u003c/p\u003e\u003c/td\u003e\u003c/tr\u003e\u003ctr\u003e\u003ctd align=\"left\" colname=\"c1\"\u003e\u003cp\u003eRB-6\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c2\"\u003e\u003cp\u003e46.38\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c3\"\u003e\u003cp\u003e46.33\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c4\"\u003e\u003cp\u003e46.28\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c5\"\u003e\u003cp\u003e46.33\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colspan=\"2\" nameend=\"c7\" namest=\"c6\"\u003e\u0026nbsp;\u003c/td\u003e\u003c/tr\u003e\u003ctr\u003e\u003ctd align=\"left\" colname=\"c1\"\u003e\u003cp\u003eH3DP-6\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c2\"\u003e\u003cp\u003e50.7\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c3\"\u003e\u003cp\u003e50.63\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c4\"\u003e\u003cp\u003e50.56\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c5\"\u003e\u003cp\u003e50.63\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c6\"\u003e\u003cp\u003e4.3\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c7\"\u003e\u003cp\u003e9.28%\u003c/p\u003e\u003c/td\u003e\u003c/tr\u003e\u003ctr\u003e\u003ctd align=\"left\" colname=\"c1\"\u003e\u003cp\u003eV3DP-6\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c2\"\u003e\u003cp\u003e49.87\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c3\"\u003e\u003cp\u003e50.25\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c4\"\u003e\u003cp\u003e50.13\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c5\"\u003e\u003cp\u003e50.08\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c6\"\u003e\u003cp\u003e3.75\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c7\"\u003e\u003cp\u003e8.10%\u003c/p\u003e\u003c/td\u003e\u003c/tr\u003e\u003ctr\u003e\u003ctd align=\"left\" colspan=\"5\" nameend=\"c5\" namest=\"c1\"\u003e\u003cp\u003eAVG\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c6\"\u003e\u003cp\u003e3.04\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c7\"\u003e\u003cp\u003e6.65%\u003c/p\u003e\u003c/td\u003e\u003c/tr\u003e\u003ctr\u003e\u003ctd align=\"left\" colspan=\"5\" nameend=\"c5\" namest=\"c1\"\u003e\u003cp\u003eAVG V3DP\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c6\"\u003e\u003cp\u003e2.99\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c7\"\u003e\u003cp\u003e6.71%\u003c/p\u003e\u003c/td\u003e\u003c/tr\u003e\u003ctr\u003e\u003ctd align=\"left\" colspan=\"5\" nameend=\"c5\" namest=\"c1\"\u003e\u003cp\u003eAVG H3DP\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c6\"\u003e\u003cp\u003e3.01\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c7\"\u003e\u003cp\u003e6.59%\u003c/p\u003e\u003c/td\u003e\u003c/tr\u003e\u003ctr\u003e\u003ctd align=\"left\" colspan=\"7\" nameend=\"c7\" namest=\"c1\"\u003e\u003cp\u003eRB: Real Bone, V3DP: Vertical 3D Printed, H3DP: Horizontal 3D Printed, MD: Mean Difference, and %E: Percentage of Error.\u003c/p\u003e\u003c/td\u003e\u003c/tr\u003e\u003c/tbody\u003e\u003c/colgroup\u003e\u003c/table\u003e\u003c/div\u003e\u003c/p\u003e\n\u003cp\u003e\u003cstrong\u003eTable 4:\u0026nbsp;\u003c/strong\u003eMeasurements of Real Bones and 3D Printed Bones (Width).\u003c/p\u003e\n\u003ctable border=\"1\" cellspacing=\"0\" cellpadding=\"0\" width=\"101%\"\u003e\n \u003ctbody\u003e\n \u003ctr\u003e\n \u003ctd style=\"width: 11px;\"\u003e\n \u003cp\u003e\u003cstrong\u003e\u0026nbsp;\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 20px;\"\u003e\n \u003cp\u003e\u003cstrong\u003eMeasurement 1\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 20px;\"\u003e\n \u003cp\u003e\u003cstrong\u003eMeasurement 2\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 20px;\"\u003e\n \u003cp\u003e\u003cstrong\u003eMeasurement 3\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 8px;\"\u003e\n \u003cp\u003e\u003cstrong\u003eAVG\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 8px;\"\u003e\n \u003cp\u003e\u003cstrong\u003eMD\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 11px;\"\u003e\n \u003cp\u003e\u003cstrong\u003e%E\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd style=\"width: 11px;\"\u003e\n \u003cp\u003e\u003cstrong\u003eRB-1\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 20px;\"\u003e\n \u003cp\u003e10.47\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 20px;\"\u003e\n \u003cp\u003e10.45\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 20px;\"\u003e\n \u003cp\u003e10.45\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 8px;\"\u003e\n \u003cp\u003e10.46\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd colspan=\"2\" style=\"width: 19px;\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd style=\"width: 11px;\"\u003e\n \u003cp\u003e\u003cstrong\u003eH3DP-1\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 20px;\"\u003e\n \u003cp\u003e11.77\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 20px;\"\u003e\n \u003cp\u003e11.72\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 20px;\"\u003e\n \u003cp\u003e11.71\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 8px;\"\u003e\n \u003cp\u003e11.73\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 8px;\"\u003e\n \u003cp\u003e1.28\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 11px;\"\u003e\n \u003cp\u003e12.21%\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd style=\"width: 11px;\"\u003e\n \u003cp\u003e\u003cstrong\u003eV3DP-1\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 20px;\"\u003e\n \u003cp\u003e11.54\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 20px;\"\u003e\n \u003cp\u003e11.46\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 20px;\"\u003e\n \u003cp\u003e11.51\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 8px;\"\u003e\n \u003cp\u003e11.50\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 8px;\"\u003e\n \u003cp\u003e1.05\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 11px;\"\u003e\n \u003cp\u003e10.01%\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd style=\"width: 11px;\"\u003e\n \u003cp\u003e\u003cstrong\u003eRB-2\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 20px;\"\u003e\n \u003cp\u003e11.78\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 20px;\"\u003e\n \u003cp\u003e11.76\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 20px;\"\u003e\n \u003cp\u003e11.66\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 8px;\"\u003e\n \u003cp\u003e11.73\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd colspan=\"2\" style=\"width: 19px;\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd style=\"width: 11px;\"\u003e\n \u003cp\u003e\u003cstrong\u003eH3DP-2\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 20px;\"\u003e\n \u003cp\u003e12.36\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 20px;\"\u003e\n \u003cp\u003e12.34\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 20px;\"\u003e\n \u003cp\u003e12.32\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 8px;\"\u003e\n \u003cp\u003e12.34\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 8px;\"\u003e\n \u003cp\u003e0.61\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 11px;\"\u003e\n \u003cp\u003e5.17%\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd style=\"width: 11px;\"\u003e\n \u003cp\u003e\u003cstrong\u003eV3DP-2\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 20px;\"\u003e\n \u003cp\u003e12.92\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 20px;\"\u003e\n \u003cp\u003e12.87\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 20px;\"\u003e\n \u003cp\u003e12.82\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 8px;\"\u003e\n \u003cp\u003e12.87\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 8px;\"\u003e\n \u003cp\u003e1.14\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 11px;\"\u003e\n \u003cp\u003e9.69%\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd style=\"width: 11px;\"\u003e\n \u003cp\u003e\u003cstrong\u003eRB-3\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 20px;\"\u003e\n \u003cp\u003e10.15\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 20px;\"\u003e\n \u003cp\u003e10.15\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 20px;\"\u003e\n \u003cp\u003e10.16\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 8px;\"\u003e\n \u003cp\u003e10.15\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd colspan=\"2\" style=\"width: 19px;\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd style=\"width: 11px;\"\u003e\n \u003cp\u003e\u003cstrong\u003eH3DP-3\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 20px;\"\u003e\n \u003cp\u003e11.28\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 20px;\"\u003e\n \u003cp\u003e11.24\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 20px;\"\u003e\n \u003cp\u003e11.25\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 8px;\"\u003e\n \u003cp\u003e11.26\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 8px;\"\u003e\n \u003cp\u003e1.10\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 11px;\"\u003e\n \u003cp\u003e10.87%\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd style=\"width: 11px;\"\u003e\n \u003cp\u003e\u003cstrong\u003eV3DP-3\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 20px;\"\u003e\n \u003cp\u003e11.29\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 20px;\"\u003e\n \u003cp\u003e11.42\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 20px;\"\u003e\n \u003cp\u003e11.41\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 8px;\"\u003e\n \u003cp\u003e11.37\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 8px;\"\u003e\n \u003cp\u003e1.22\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 11px;\"\u003e\n \u003cp\u003e12.02%\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd style=\"width: 11px;\"\u003e\n \u003cp\u003e\u003cstrong\u003eRB-4\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 20px;\"\u003e\n \u003cp\u003e11.21\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 20px;\"\u003e\n \u003cp\u003e11.16\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 20px;\"\u003e\n \u003cp\u003e11.1\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 8px;\"\u003e\n \u003cp\u003e11.16\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd colspan=\"2\" style=\"width: 19px;\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd style=\"width: 11px;\"\u003e\n \u003cp\u003e\u003cstrong\u003eH3DP-4\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 20px;\"\u003e\n \u003cp\u003e12.29\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 20px;\"\u003e\n \u003cp\u003e12.29\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 20px;\"\u003e\n \u003cp\u003e12.27\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 8px;\"\u003e\n \u003cp\u003e12.28\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 8px;\"\u003e\n \u003cp\u003e1.13\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 11px;\"\u003e\n \u003cp\u003e10.10%\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd style=\"width: 11px;\"\u003e\n \u003cp\u003e\u003cstrong\u003eV3DP-4\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 20px;\"\u003e\n \u003cp\u003e12.27\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 20px;\"\u003e\n \u003cp\u003e12.27\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 20px;\"\u003e\n \u003cp\u003e12.26\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 8px;\"\u003e\n \u003cp\u003e12.27\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 8px;\"\u003e\n \u003cp\u003e1.11\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 11px;\"\u003e\n \u003cp\u003e9.95%\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd style=\"width: 11px;\"\u003e\n \u003cp\u003e\u003cstrong\u003eRB-5\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 20px;\"\u003e\n \u003cp\u003e11.9\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 20px;\"\u003e\n \u003cp\u003e11.91\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 20px;\"\u003e\n \u003cp\u003e11.9\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 8px;\"\u003e\n \u003cp\u003e11.90\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd colspan=\"2\" style=\"width: 19px;\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd style=\"width: 11px;\"\u003e\n \u003cp\u003e\u003cstrong\u003eH3DP-5\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 20px;\"\u003e\n \u003cp\u003e13.27\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 20px;\"\u003e\n \u003cp\u003e13.22\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 20px;\"\u003e\n \u003cp\u003e13.32\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 8px;\"\u003e\n \u003cp\u003e13.27\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 8px;\"\u003e\n \u003cp\u003e1.37\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 11px;\"\u003e\n \u003cp\u003e11.48%\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd style=\"width: 11px;\"\u003e\n \u003cp\u003e\u003cstrong\u003eV3DP-5\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 20px;\"\u003e\n \u003cp\u003e12.92\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 20px;\"\u003e\n \u003cp\u003e12.97\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 20px;\"\u003e\n \u003cp\u003e12.95\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 8px;\"\u003e\n \u003cp\u003e12.95\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 8px;\"\u003e\n \u003cp\u003e1.04\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 11px;\"\u003e\n \u003cp\u003e8.76%\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd style=\"width: 11px;\"\u003e\n \u003cp\u003e\u003cstrong\u003eRB-6\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 20px;\"\u003e\n \u003cp\u003e12.56\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 20px;\"\u003e\n \u003cp\u003e12.66\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 20px;\"\u003e\n \u003cp\u003e12.4\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 8px;\"\u003e\n \u003cp\u003e12.54\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd colspan=\"2\" style=\"width: 19px;\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd style=\"width: 11px;\"\u003e\n \u003cp\u003e\u003cstrong\u003eH3DP-6\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 20px;\"\u003e\n \u003cp\u003e13.56\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 20px;\"\u003e\n \u003cp\u003e13.41\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 20px;\"\u003e\n \u003cp\u003e13.42\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 8px;\"\u003e\n \u003cp\u003e13.46\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 8px;\"\u003e\n \u003cp\u003e0.92\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 11px;\"\u003e\n \u003cp\u003e7.36%\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd style=\"width: 11px;\"\u003e\n \u003cp\u003e\u003cstrong\u003eV3DP-6\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 20px;\"\u003e\n \u003cp\u003e13.15\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 20px;\"\u003e\n \u003cp\u003e13.34\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 20px;\"\u003e\n \u003cp\u003e13.21\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 8px;\"\u003e\n \u003cp\u003e13.23\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 8px;\"\u003e\n \u003cp\u003e0.69\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 11px;\"\u003e\n \u003cp\u003e5.53%\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd colspan=\"5\" valign=\"top\" style=\"width: 80px;\"\u003e\n \u003cp\u003e\u003cstrong\u003eAVG\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 8px;\"\u003e\n \u003cp\u003e1.05\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 11px;\"\u003e\n \u003cp\u003e9.43%\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd colspan=\"5\" valign=\"top\" style=\"width: 80px;\"\u003e\n \u003cp\u003e\u003cstrong\u003eAVG V3DP\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 8px;\"\u003e\n \u003cp\u003e1.01\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 11px;\"\u003e\n \u003cp\u003e9.33%\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd colspan=\"5\" valign=\"top\" style=\"width: 80px;\"\u003e\n \u003cp\u003e\u003cstrong\u003eAVG H3DP\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 8px;\"\u003e\n \u003cp\u003e1.07\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 11px;\"\u003e\n \u003cp\u003e9.53%\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd colspan=\"7\" valign=\"top\" style=\"width: 100px;\"\u003e\n \u003cp\u003e\u003cstrong\u003eRB: Real Bone, V3DP: Vertical 3D Printed, H3DP: Horizontal 3D Printed, MD: Mean Difference,\u003c/strong\u003e \u003cstrong\u003eand %E: Percentage of Error\u003c/strong\u003e.\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003c/tbody\u003e\n\u003c/table\u003e"},{"header":"Discussion","content":"\u003cp\u003eThis research study investigated the impact of 3DP-EM on improving the learning outcomes of medical students and professionals and suggested a standardized methodology for creating and 3D printing medical models. The 3DPMs accuracy was also evaluated in comparison to CT images.\u003c/p\u003e\u003cp\u003eThe feedback from both the medical professionals and students indicated the positive impact of 3DP-EM on learning outcomes and information retention. The majority of the respondents agreed that 3DP-EM had a significant impact on their ability to understand and retain information. Additionally, this study showed the willingness to use 3DP-EM in the future. While there were some reservations on the realness of the 3DP-EM compared to cadavers, the overall response was positive. When it comes to paying for the model, a noteworthy difference in the responses of the two groups can be seen, which can be due to the difference in economic status between the two groups, as 80% of medical professionals were willing to pay, compared to only 50% of the students. The resulting p-values indicate that participants\u0026rsquo; ratings were significantly higher than neutral, supporting the claim of strong positive agreement. The survey the evaluation, and consideration of medical models reinforce the need for standardization in this field.\u003c/p\u003e\u003cp\u003eIn a consultation with the professionals involved in the creation of 3DPMs, valuable insights were obtained regarding current practices and the challenges associated with model reconstruction. Despite a limited sample size of two respondents, their feedback was highly informative, shedding light on critical aspects of standardization in 3D printing for medical applications. One respondent stated that while the default software settings generally produce accurate models, the implementation of standardized methods could further enhance consistency and reduce inter-user variability. The other respondent took a more neutral stance on the adequacy of these defaults but agreed that establishing a standardized approach is essential for improving reproducibility and quality control in 3D model creation. A key finding from the survey was the emphasis on the impact of CT image resolution on the accuracy of 3DPMs.\u003c/p\u003e\u003cp\u003eBoth professionals stressed that optimizing CT resolution is a crucial step in ensuring high-quality reconstructions. While specific recommendations varied, one suggested using the highest megapixel resolution available for craniofacial reconstruction. Whereas the other proposed a resolution of 0.65 mm for soft tissue models. Overall, there was unanimous agreement on the necessity of defining resolution standards based on the anatomical structure being modeled.\u003c/p\u003e\u003cp\u003eBeyond CT resolution, respondents also provided recommendations on additional parameters that should be standardized. These recommendations included layer height, with suggestions ranging from 0.1 mm to 0.15 mm, as well as material selection, where preferences varied between PLA, UV-curing resin, and PA 11 \u0026amp; PA 12 (Nylon), depending on the application. Infill percentages were also highlighted as an important factor, with suggested values ranging from 20\u0026ndash;50%. Additional considerations for standardization included optimizing print speed and incorporating open-source machine learning tools to automate the conversion of DICOM files to STL, thereby improving workflow efficiency. These insights collectively underscore the imperative for explicit guidelines to ensure that all 3DP-EM consistently meet high-quality standards.\u003c/p\u003e\u003cp\u003eFor comparing the real bone structures to their 3D printed counterparts, measurements of both were taken. Data showed that both ways offer high accuracy, exceeding 90% in measurements, but with slight variations. Horizontal printing demonstrated a marginally higher accuracy in replicating the bone\u0026rsquo;s length, with a percentage error of about 0.12% lower than that of vertical printing. However, for the base measurement, horizontal printing was less accurate, exhibiting an error approximately 0.20% higher than vertical printing. Multiple studies in the dental field noted that print orientation significantly alters accuracy\u003csup\u003e\u003cspan additionalcitationids=\"CR37 CR38 CR39 CR40\" citationid=\"CR36\" class=\"CitationRef\"\u003e36\u003c/span\u003e\u0026ndash;\u003cspan citationid=\"CR41\" class=\"CitationRef\"\u003e41\u003c/span\u003e\u003c/sup\u003e, while a few found no significant difference\u003csup\u003e\u003cspan citationid=\"CR41\" class=\"CitationRef\"\u003e41\u003c/span\u003e,\u003cspan citationid=\"CR42\" class=\"CitationRef\"\u003e42\u003c/span\u003e\u003c/sup\u003e. ​This can differ depending on the complexity and nature of different structures, indicating that the printing orientation can influence the accuracy of the 3DP-EM. With proper printer calibration and support strategies, the differences can be minimized; nonetheless, when producing a model, one should consider which orientation will minimize distortions. For instance, to maintain anatomic symmetry or to ensure important surfaces are printed with the highest fidelity.\u003c/p\u003e\u003cp\u003eWhile the findings of this study are promising, there are some limitations. Maintaining operator-dependent variations in segmentation and manual refinement processes could introduce biases that affect the reproducibility of the final 3DPMs, as one radiology review emphasized that the segmentation process is a major contributor to inaccuracies. The study was also limited to a single 3D printing technology (FDM) and material (PLA), which may not represent the full spectrum of available methods and materials. Future work should focus on expanding participant diversity and sample sizes, exploring alternative printing technologies and materials, and integrating automated segmentation techniques to minimize human error. Furthermore, multicenter studies and patient-specific evaluations are also recommended to validate and refine the proposed standardization protocols.\u003c/p\u003e\u003cdiv id=\"Sec8\" class=\"Section2\"\u003e\u003ch2\u003eSuggested Methodology for 3D Printing Educational Models (3DP-EM):\u003c/h2\u003e\u003cp\u003eBased on the study\u0026rsquo;s findings, the following methodology is proposed to achieve high-quality 3DP-EM. CT scans should be acquired with an image dimension of 512 x 512, an in-plane resolution of approximately 0.365 mm, and a slice thickness of 2 mm, with data stored as a short (16-bit) scalar type to capture the necessary anatomical details. Segmentation should be performed using software such as 3D Slicer (Brigham and Women\u0026rsquo;s Hospital, Harvard, Boston, Massachusetts)\u003csup\u003e\u003cspan citationid=\"CR35\" class=\"CitationRef\"\u003e35\u003c/span\u003e\u003c/sup\u003e, starting with appropriate thresholding\u0026mdash;typically within a range suited to the specific scan\u0026mdash;and refined manually to match the original anatomy closely.\u003c/p\u003e\u003cp\u003eThe resulting segmented images are then converted into a digital mesh using minimal smoothing to preserve fine details and exported in a format like STL or OBJ. For printing, an FDM technique is recommended, with a layer height set to 0.15 mm to ensure sufficient detail. A baseline infill of 20%, adjustable as needed to replicate the weight and internal texture of the anatomical structure. Both vertical and horizontal printing orientations should be evaluated, and rigorous post-processing, including the removal of support structures and precise dimensional verification using digital calipers (with measurements ideally within \u0026plusmn;\u0026thinsp;2% of the original CT data), should be implemented. This comprehensive methodology is intended to ensure that 3DP-EM are produced with consistent accuracy and reproducibility for both educational and clinical applications\u003csup\u003e\u003cspan citationid=\"CR32\" class=\"CitationRef\"\u003e32\u003c/span\u003e\u003c/sup\u003e.\u003c/p\u003e\u003c/div\u003e"},{"header":"Conclusion","content":"\u003cp\u003eThis study evaluated 3DP-EM in terms of accuracy and knowledge retention for users. The benefits of 3DP-EM in enhancing comprehension, retention, and surgical predictability have been highlighted, along with their potential to improve education and decision-making. Nonetheless, a significant obstacle in this field is the lack of standardization in model reconstruction and assessment, emphasizing the need for consistent practices to ensure accuracy and reproducibility.\u003c/p\u003e\u003cp\u003eFeedback from the 3DP-EM survey demonstrated a strong positive impact on the learning outcomes for both medical professionals and students, with 80\u0026ndash;100% of respondents indicating improved learning outcomes, averaging roughly an 86% overall positive response across key educational measures. The survey of professionals involved in the reconstruction of medical models emphasized the need for standardization in the field. Comparing real bone structures with their 3D printed counterparts, showed the effects of the CT image resolution, the segmentation skills, the slicing and 3D printing skills, and the post-processing on the model, indicating the need for a standardized method to convey the best result regardless of the person creating the 3DP-EM. This study proposed a standardized method for producing accurate, semi-realistic synthetic bone structures for educational use. Horizontal print orientation yielded better deviations; however, the printing of 3DPMs should be evaluated on a case-by-case basis.\u003c/p\u003e"},{"header":"Abbreviations","content":"\u003cp\u003eThe following abbreviations are used in this manuscript\u003cspan dir=\"RTL\"\u003e:\u003c/span\u003e\u003c/p\u003e\u003cdiv class=\"gridtable\"\u003e\u003ctable float=\"No\" id=\"Tabb\" border=\"1\"\u003e\u003ccolgroup cols=\"2\"\u003e\u003cdiv align=\"left\" class=\"colspec\" colname=\"c1\" colnum=\"1\"\u003e\u003c/div\u003e\u003cdiv align=\"left\" class=\"colspec\" colname=\"c2\" colnum=\"2\"\u003e\u003c/div\u003e\u003cthead\u003e\u003ctr\u003e\u003cth align=\"left\" colname=\"c1\"\u003e\u003cdiv class=\"SimplePara\"\u003e3DP-EM\u003c/div\u003e\u003c/th\u003e\u003cth align=\"left\" colname=\"c2\"\u003e\u003cdiv class=\"SimplePara\"\u003e3D printed educational models\u003c/div\u003e\u003c/th\u003e\u003c/tr\u003e\u003c/thead\u003e\u003ctbody\u003e\u003ctr\u003e\u003ctd align=\"left\" colname=\"c1\"\u003e\u003cdiv class=\"SimplePara\"\u003eRB\u003c/div\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c2\"\u003e\u003cdiv class=\"SimplePara\"\u003eReal bone\u003c/div\u003e\u003c/td\u003e\u003c/tr\u003e\u003ctr\u003e\u003ctd align=\"left\" colname=\"c1\"\u003e\u003cdiv class=\"SimplePara\"\u003eV3DP\u003c/div\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c2\"\u003e\u003cdiv class=\"SimplePara\"\u003eVertically 3F printed\u003c/div\u003e\u003c/td\u003e\u003c/tr\u003e\u003ctr\u003e\u003ctd align=\"left\" colname=\"c1\"\u003e\u003cdiv class=\"SimplePara\"\u003eH3DP\u003c/div\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c2\"\u003e\u003cdiv class=\"SimplePara\"\u003eHorizontally 3D printed\u003c/div\u003e\u003c/td\u003e\u003c/tr\u003e\u003ctr\u003e\u003ctd align=\"left\" colname=\"c1\"\u003e\u003cdiv class=\"SimplePara\"\u003eSLA\u003c/div\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c2\"\u003e\u003cdiv class=\"SimplePara\"\u003eStereolithography\u003c/div\u003e\u003c/td\u003e\u003c/tr\u003e\u003ctr\u003e\u003ctd align=\"left\" colname=\"c1\"\u003e\u003cdiv class=\"SimplePara\"\u003eSTL\u003c/div\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c2\"\u003e\u003cdiv class=\"SimplePara\"\u003eStereolithography\u003c/div\u003e\u003c/td\u003e\u003c/tr\u003e\u003ctr\u003e\u003ctd align=\"left\" colname=\"c1\"\u003e\u003cdiv class=\"SimplePara\"\u003eSLS\u003c/div\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c2\"\u003e\u003cdiv class=\"SimplePara\"\u003eSelective laser sintering\u003c/div\u003e\u003c/td\u003e\u003c/tr\u003e\u003ctr\u003e\u003ctd align=\"left\" colname=\"c1\"\u003e\u003cdiv class=\"SimplePara\"\u003eCT\u003c/div\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c2\"\u003e\u003cdiv class=\"SimplePara\"\u003eComputed tomography\u003c/div\u003e\u003c/td\u003e\u003c/tr\u003e\u003ctr\u003e\u003ctd align=\"left\" colname=\"c1\"\u003e\u003cdiv class=\"SimplePara\"\u003eCMM\u003c/div\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c2\"\u003e\u003cdiv class=\"SimplePara\"\u003eCoordinate measuring machine\u003c/div\u003e\u003c/td\u003e\u003c/tr\u003e\u003ctr\u003e\u003ctd align=\"left\" colname=\"c1\"\u003e\u003cdiv class=\"SimplePara\"\u003eDICOM\u003c/div\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c2\"\u003e\u003cdiv class=\"SimplePara\"\u003eDigital imaging and communications in medicine\u003c/div\u003e\u003c/td\u003e\u003c/tr\u003e\u003ctr\u003e\u003ctd align=\"left\" colname=\"c1\"\u003e\u003cdiv class=\"SimplePara\"\u003eMRI\u003c/div\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c2\"\u003e\u003cdiv class=\"SimplePara\"\u003eMagnetic resonance imaging\u003c/div\u003e\u003c/td\u003e\u003c/tr\u003e\u003c/tbody\u003e\u003c/colgroup\u003e\u003c/table\u003e\u003c/div\u003e\u003cbr/\u003e"},{"header":"Declarations","content":"\u003cp\u003e\u003cstrong\u003eAcknowledgments\u003c/strong\u003e\u003c/p\u003e\n\u003cp\u003eResearchers would like to thank and acknowledge the Ongoing Research Funding program (ORF-2025-901), King Saud University, Riyadh,\u0026nbsp;Saudi\u0026nbsp;Arabia.\u003c/p\u003e\n\u003cp\u003e\u003cstrong\u003eCorresponding Author:\u0026nbsp;\u003c/strong\u003eFaisal S. Fakhouri\u003csup\u003e1\u003c/sup\u003e ([email protected])\u003c/p\u003e\n\u003cp\u003e\u003cstrong\u003eEthics Approval and Consent to Participate\u003c/strong\u003e\u003c/p\u003e\n\u003cp\u003eInstitutional Review Board (IRB) approval has been received from Health Sciences Colleges Researches on Human Subjects, College of Medicine, King Saud University, Riyadh, Kingdom of Saudi Arabia. Consent for participation in the study’s surveys was obtained from all participants.\u0026nbsp;\u003c/p\u003e\n\u003cp\u003e\u003cstrong\u003eFunding\u003c/strong\u003e\u003c/p\u003e\n\u003cp\u003eThis study is funded by the Ongoing Research Funding program (ORF-2025-901), King Saud University, Riyadh,\u0026nbsp;Saudi\u0026nbsp;Arabia.\u003c/p\u003e\n\u003cp\u003e\u003cstrong\u003eAuthor’s Contribution:\u003c/strong\u003e\u003c/p\u003e\n\u003cp\u003eFaisal S. Fakhouri: conceptualization (lead), formal analysis (equal), investigation (equal), methodology (equal), project administration (lead), resources (equal), supervision (lead), validation (equal), writing – original draft (equal). Llama F. Alothman: conceptualization (supporting), data curation (lead), formal analysis (equal), investigation (equal), methodology (equal), resources (equal), software (lead), validation (equal), visualization (lead), writing – original draft (equal). Abdulaziz S. Fakhouri: funding acquisition (lead), writing – review \u0026amp; editing (equal). Ziyad M. Aloqala: writing – review \u0026amp; editing (equal). Abdulsalam A. Altamimi: writing – review \u0026amp; editing (equal). Soliman A. Alhudaithy: writing – review \u0026amp; editing (equal).\u003c/p\u003e"},{"header":"References","content":"\u003col\u003e\u003cli\u003e\u003cspan\u003eTejo-Otero A, Buj-Corral I, Fenollosa-Art\u0026eacute;s F. 3D printing in medicine for preoperative surgical planning: a review. Ann Biomed Eng. 2020;48(2):536\u0026ndash;55. \u003cspan class=\"ExternalRef\"\u003e\u003cspan class=\"RefSource\"\u003e10.1007/S10439-019-02411-0\u003c/span\u003e\u003cspan address=\"10.1007/S10439-019-02411-0\" targettype=\"DOI\" class=\"RefTarget\"\u003e\u003c/span\u003e\u003c/span\u003e.\u003c/span\u003e\u003c/li\u003e\u003cli\u003e\u003cspan\u003eSegaran N, Saini G, Mayer JL, et al. Application of 3D Printing in Preoperative Planning. J Clin Med. 2021;10(5):917. \u003cspan class=\"ExternalRef\"\u003e\u003cspan class=\"RefSource\"\u003e10.3390/jcm10050917\u003c/span\u003e\u003cspan address=\"10.3390/jcm10050917\" targettype=\"DOI\" class=\"RefTarget\"\u003e\u003c/span\u003e\u003c/span\u003e.\u003c/span\u003e\u003c/li\u003e\u003cli\u003e\u003cspan\u003eMatsumoto JS, Morris JM, Foley TA et al. Three-dimensional Physical Modeling: Applications and Experience at Mayo Clinic. RadioGraphics. 2015;35(7):1989\u0026ndash;2006; \u003cspan class=\"ExternalRef\"\u003e\u003cspan class=\"RefSource\"\u003e10.1148/rg.2015140260\u003c/span\u003e\u003cspan address=\"10.1148/rg.2015140260\" targettype=\"DOI\" class=\"RefTarget\"\u003e\u003c/span\u003e\u003c/span\u003e\u003c/span\u003e\u003c/li\u003e\u003cli\u003e\u003cspan\u003eGarcia J, Yang Z, Mongrain R, et al. 3D printing materials and their use in medical education: a review of current technology and trends for the future. BMJ Simul Technol Enhanc Learn. 2018;4(1):27\u0026ndash;40. \u003cspan class=\"ExternalRef\"\u003e\u003cspan class=\"RefSource\"\u003e10.1136/bmjstel-2017-000234\u003c/span\u003e\u003cspan address=\"10.1136/bmjstel-2017-000234\" targettype=\"DOI\" class=\"RefTarget\"\u003e\u003c/span\u003e\u003c/span\u003e.\u003c/span\u003e\u003c/li\u003e\u003cli\u003e\u003cspan\u003eOgden KM, Aslan C, Ordway N, et al. Factors Affecting Dimensional Accuracy of 3-D Printed Anatomical Structures Derived from CT Data. J Digit Imaging. 2015;28(6):654\u0026ndash;63. \u003cspan class=\"ExternalRef\"\u003e\u003cspan class=\"RefSource\"\u003e10.1007/s10278-015-9803-7\u003c/span\u003e\u003cspan address=\"10.1007/s10278-015-9803-7\" targettype=\"DOI\" class=\"RefTarget\"\u003e\u003c/span\u003e\u003c/span\u003e.\u003c/span\u003e\u003c/li\u003e\u003cli\u003e\u003cspan\u003eEARWAKER BARKERTM. Accuracy of stereolithographic models of human anatomy. Australas Radiol. 1994;38(2):106\u0026ndash;11. \u003cspan class=\"ExternalRef\"\u003e\u003cspan class=\"RefSource\"\u003e10.1111/j.1440-1673.1994.tb00146.x\u003c/span\u003e\u003cspan address=\"10.1111/j.1440-1673.1994.tb00146.x\" targettype=\"DOI\" class=\"RefTarget\"\u003e\u003c/span\u003e\u003c/span\u003e.\u003c/span\u003e\u003c/li\u003e\u003cli\u003e\u003cspan\u003eLi KHC, Kui C, Lee EKM, et al. The role of 3D printing in anatomy education and surgical training: A narrative review. MedEdPublish. 2017;6:92. \u003cspan class=\"ExternalRef\"\u003e\u003cspan class=\"RefSource\"\u003e10.15694/mep.2017.000092\u003c/span\u003e\u003cspan address=\"10.15694/mep.2017.000092\" targettype=\"DOI\" class=\"RefTarget\"\u003e\u003c/span\u003e\u003c/span\u003e.\u003c/span\u003e\u003c/li\u003e\u003cli\u003e\u003cspan\u003eBaskaran V, Štrkalj G, Štrkalj M, et al. Current Applications and Future Perspectives of the Use of 3D Printing in Anatomical Training and Neurosurgery. Front Neuroanat. 2016;10. \u003cspan class=\"ExternalRef\"\u003e\u003cspan class=\"RefSource\"\u003e10.3389/fnana.2016.00069\u003c/span\u003e\u003cspan address=\"10.3389/fnana.2016.00069\" targettype=\"DOI\" class=\"RefTarget\"\u003e\u003c/span\u003e\u003c/span\u003e.\u003c/span\u003e\u003c/li\u003e\u003cli\u003e\u003cspan\u003eWu A-M, Shao Z-X, Wang J-S, et al. The Accuracy of a Method for Printing Three-Dimensional Spinal Models. PLoS ONE. 2015;10(4):e0124291. \u003cspan class=\"ExternalRef\"\u003e\u003cspan class=\"RefSource\"\u003e10.1371/journal.pone.0124291\u003c/span\u003e\u003cspan address=\"10.1371/journal.pone.0124291\" targettype=\"DOI\" class=\"RefTarget\"\u003e\u003c/span\u003e\u003c/span\u003e.\u003c/span\u003e\u003c/li\u003e\u003cli\u003e\u003cspan\u003eBerry E, Brown JM, Connell M, et al. Preliminary experience with medical applications of rapid prototyping by selective laser sintering. Med Eng Phys. 1997;19(1):90\u0026ndash;6. \u003cspan class=\"ExternalRef\"\u003e\u003cspan class=\"RefSource\"\u003e10.1016/S1350-4533(96)00039-2\u003c/span\u003e\u003cspan address=\"10.1016/S1350-4533(96)00039-2\" targettype=\"DOI\" class=\"RefTarget\"\u003e\u003c/span\u003e\u003c/span\u003e.\u003c/span\u003e\u003c/li\u003e\u003cli\u003e\u003cspan\u003eSun Z, Wong YH, Yeong CH. Patient-Specific 3D-Printed Low-Cost Models in Medical Education and Clinical Practice. Micromachines (Basel). 2023;14(2):464. \u003cspan class=\"ExternalRef\"\u003e\u003cspan class=\"RefSource\"\u003e10.3390/mi14020464\u003c/span\u003e\u003cspan address=\"10.3390/mi14020464\" targettype=\"DOI\" class=\"RefTarget\"\u003e\u003c/span\u003e\u003c/span\u003e.\u003c/span\u003e\u003c/li\u003e\u003cli\u003e\u003cspan\u003eSalmi M, Paloheimo K-S, Tuomi J, et al. Accuracy of medical models made by additive manufacturing (rapid manufacturing). J Cranio-Maxillofacial Surg. 2013;41(7):603\u0026ndash;9. \u003cspan class=\"ExternalRef\"\u003e\u003cspan class=\"RefSource\"\u003e10.1016/j.jcms.2012.11.041\u003c/span\u003e\u003cspan address=\"10.1016/j.jcms.2012.11.041\" targettype=\"DOI\" class=\"RefTarget\"\u003e\u003c/span\u003e\u003c/span\u003e.\u003c/span\u003e\u003c/li\u003e\u003cli\u003e\u003cspan\u003eGeorge E, Liacouras P, Rybicki FJ et al. Measuring and Establishing the Accuracy and Reproducibility of 3D Printed Medical Models. RadioGraphics. 2017;37(5):1424\u0026ndash;1450; \u003cspan class=\"ExternalRef\"\u003e\u003cspan class=\"RefSource\"\u003e10.1148/rg.2017160165\u003c/span\u003e\u003cspan address=\"10.1148/rg.2017160165\" targettype=\"DOI\" class=\"RefTarget\"\u003e\u003c/span\u003e\u003c/span\u003e\u003c/span\u003e\u003c/li\u003e\u003cli\u003e\u003cspan\u003eArrieta C, Uribe S, Ramos-Grez J, et al. Quantitative assessments of geometric errors for rapid prototyping in medical applications. Rapid Prototyp J. 2012;18(6):431\u0026ndash;42. \u003cspan class=\"ExternalRef\"\u003e\u003cspan class=\"RefSource\"\u003e10.1108/13552541211271974\u003c/span\u003e\u003cspan address=\"10.1108/13552541211271974\" targettype=\"DOI\" class=\"RefTarget\"\u003e\u003c/span\u003e\u003c/span\u003e.\u003c/span\u003e\u003c/li\u003e\u003cli\u003e\u003cspan\u003eO\u0026rsquo;Brien EK, Wayne DB, Barsness KA, et al. Use of 3D Printing for Medical Education Models in Transplantation Medicine: a Critical Review. Curr Transpl Rep. 2016;3(1):109\u0026ndash;19. \u003cspan class=\"ExternalRef\"\u003e\u003cspan class=\"RefSource\"\u003e10.1007/s40472-016-0088-7\u003c/span\u003e\u003cspan address=\"10.1007/s40472-016-0088-7\" targettype=\"DOI\" class=\"RefTarget\"\u003e\u003c/span\u003e\u003c/span\u003e.\u003c/span\u003e\u003c/li\u003e\u003cli\u003e\u003cspan\u003eIonita CN, Mokin M, Varble N et al. Challenges and Limitations of Patient-Specific Vascular Phantom Fabrication Using 3D Polyjet Printing. (Molthen RC, Weaver JB. eds). 2014; p. 90380M; \u003cspan class=\"ExternalRef\"\u003e\u003cspan class=\"RefSource\"\u003e10.1117/12.2042266\u003c/span\u003e\u003cspan address=\"10.1117/12.2042266\" targettype=\"DOI\" class=\"RefTarget\"\u003e\u003c/span\u003e\u003c/span\u003e\u003c/span\u003e\u003c/li\u003e\u003cli\u003e\u003cspan\u003eVernon T, Peckham D. The benefits of 3D modelling and animation in medical teaching. J Audiov Media Med. 2002;25(4):142\u0026ndash;8. \u003cspan class=\"ExternalRef\"\u003e\u003cspan class=\"RefSource\"\u003e10.1080/0140511021000051117\u003c/span\u003e\u003cspan address=\"10.1080/0140511021000051117\" targettype=\"DOI\" class=\"RefTarget\"\u003e\u003c/span\u003e\u003c/span\u003e.\u003c/span\u003e\u003c/li\u003e\u003cli\u003e\u003cspan\u003eVaccarezza M, Papa V. 3D printing: a valuable resource in human anatomy education. Anat Sci Int. 2015;90(1):64\u0026ndash;5. \u003cspan class=\"ExternalRef\"\u003e\u003cspan class=\"RefSource\"\u003e10.1007/s12565-014-0257-7\u003c/span\u003e\u003cspan address=\"10.1007/s12565-014-0257-7\" targettype=\"DOI\" class=\"RefTarget\"\u003e\u003c/span\u003e\u003c/span\u003e.\u003c/span\u003e\u003c/li\u003e\u003cli\u003e\u003cspan\u003eMcMenamin PG, Quayle MR, McHenry CR, et al. The production of anatomical teaching resources using three-dimensional (3D) printing technology. Anat Sci Educ. 2014;7(6):479\u0026ndash;86. \u003cspan class=\"ExternalRef\"\u003e\u003cspan class=\"RefSource\"\u003e10.1002/ase.1475\u003c/span\u003e\u003cspan address=\"10.1002/ase.1475\" targettype=\"DOI\" class=\"RefTarget\"\u003e\u003c/span\u003e\u003c/span\u003e.\u003c/span\u003e\u003c/li\u003e\u003cli\u003e\u003cspan\u003eLim KHA, Loo ZY, Goldie SJ, et al. Use of 3D printed models in medical education: A randomized control trial comparing 3D prints versus cadaveric materials for learning external cardiac anatomy. Anat Sci Educ. 2016;9(3):213\u0026ndash;21. \u003cspan class=\"ExternalRef\"\u003e\u003cspan class=\"RefSource\"\u003e10.1002/ase.1573\u003c/span\u003e\u003cspan address=\"10.1002/ase.1573\" targettype=\"DOI\" class=\"RefTarget\"\u003e\u003c/span\u003e\u003c/span\u003e.\u003c/span\u003e\u003c/li\u003e\u003cli\u003e\u003cspan\u003eSalazar D, Thompson M, Rosen A, et al. Using 3D Printing to Improve Student Education of Complex Anatomy: a Systematic Review and Meta-analysis. Med Sci Educ. 2022;32(5):1209\u0026ndash;18. \u003cspan class=\"ExternalRef\"\u003e\u003cspan class=\"RefSource\"\u003e10.1007/s40670-022-01595-w\u003c/span\u003e\u003cspan address=\"10.1007/s40670-022-01595-w\" targettype=\"DOI\" class=\"RefTarget\"\u003e\u003c/span\u003e\u003c/span\u003e.\u003c/span\u003e\u003c/li\u003e\u003cli\u003e\u003cspan\u003eBernhard J-C, Isotani S, Matsugasumi T, et al. Personalized 3D printed model of kidney and tumor anatomy: a useful tool for patient education. World J Urol. 2016;34(3):337\u0026ndash;45. \u003cspan class=\"ExternalRef\"\u003e\u003cspan class=\"RefSource\"\u003e10.1007/s00345-015-1632-2\u003c/span\u003e\u003cspan address=\"10.1007/s00345-015-1632-2\" targettype=\"DOI\" class=\"RefTarget\"\u003e\u003c/span\u003e\u003c/span\u003e.\u003c/span\u003e\u003c/li\u003e\u003cli\u003e\u003cspan\u003eSegaran N, Saini G, Mayer JL, et al. Application of 3D Printing in Preoperative Planning. J Clin Med. 2021;10(5):917. \u003cspan class=\"ExternalRef\"\u003e\u003cspan class=\"RefSource\"\u003e10.3390/jcm10050917\u003c/span\u003e\u003cspan address=\"10.3390/jcm10050917\" targettype=\"DOI\" class=\"RefTarget\"\u003e\u003c/span\u003e\u003c/span\u003e.\u003c/span\u003e\u003c/li\u003e\u003cli\u003e\u003cspan\u003eYou Y, Niu Y, Sun F, et al. Three-dimensional printing and 3D slicer powerful tools in understanding and treating neurosurgical diseases. Front Surg. 2022;9. \u003cspan class=\"ExternalRef\"\u003e\u003cspan class=\"RefSource\"\u003e10.3389/fsurg.2022.1030081\u003c/span\u003e\u003cspan address=\"10.3389/fsurg.2022.1030081\" targettype=\"DOI\" class=\"RefTarget\"\u003e\u003c/span\u003e\u003c/span\u003e.\u003c/span\u003e\u003c/li\u003e\u003cli\u003e\u003cspan\u003eShim KW. Medical Applications of 3D Printing and Standardization Issues. Brain Tumor Res Treat. 2023;11(3):159. \u003cspan class=\"ExternalRef\"\u003e\u003cspan class=\"RefSource\"\u003e10.14791/btrt.2023.0001\u003c/span\u003e\u003cspan address=\"10.14791/btrt.2023.0001\" targettype=\"DOI\" class=\"RefTarget\"\u003e\u003c/span\u003e\u003c/span\u003e.\u003c/span\u003e\u003c/li\u003e\u003cli\u003e\u003cspan\u003eHuotilainen E, Jaanimets R, Val\u0026aacute;šek J, et al. Inaccuracies in additive manufactured medical skull models caused by the DICOM to STL conversion process. J Cranio-Maxillofacial Surg. 2014;42(5):e259\u0026ndash;65. \u003cspan class=\"ExternalRef\"\u003e\u003cspan class=\"RefSource\"\u003e10.1016/j.jcms.2013.10.001\u003c/span\u003e\u003cspan address=\"10.1016/j.jcms.2013.10.001\" targettype=\"DOI\" class=\"RefTarget\"\u003e\u003c/span\u003e\u003c/span\u003e.\u003c/span\u003e\u003c/li\u003e\u003cli\u003e\u003cspan\u003eUgidos Lozano MT, Haro FB, Ruggiero A, et al. Evaluation of the Applicability of 3d Models as Perceived by the Students of Health Sciences. J Med Syst. 2019;43(5):108. \u003cspan class=\"ExternalRef\"\u003e\u003cspan class=\"RefSource\"\u003e10.1007/s10916-019-1238-0\u003c/span\u003e\u003cspan address=\"10.1007/s10916-019-1238-0\" targettype=\"DOI\" class=\"RefTarget\"\u003e\u003c/span\u003e\u003c/span\u003e.\u003c/span\u003e\u003c/li\u003e\u003cli\u003e\u003cspan\u003eSchlegel L, Ho M, Fields JM, et al. Standardizing evaluation of patient-specific 3D printed models in surgical planning: development of a cross-disciplinary survey tool for physician and trainee feedback. BMC Med Educ. 2022;22(1). \u003cspan class=\"ExternalRef\"\u003e\u003cspan class=\"RefSource\"\u003e10.1186/s12909-022-03581-7\u003c/span\u003e\u003cspan address=\"10.1186/s12909-022-03581-7\" targettype=\"DOI\" class=\"RefTarget\"\u003e\u003c/span\u003e\u003c/span\u003e.\u003c/span\u003e\u003c/li\u003e\u003cli\u003e\u003cspan\u003eGaras M, Vaccarezza M, Newland G, et al. 3D-Printed specimens as a valuable tool in anatomy education: A pilot study. Annals Anat - Anatomischer Anzeiger. 2018;219:57\u0026ndash;64. \u003cspan class=\"ExternalRef\"\u003e\u003cspan class=\"RefSource\"\u003e10.1016/j.aanat.2018.05.006\u003c/span\u003e\u003cspan address=\"10.1016/j.aanat.2018.05.006\" targettype=\"DOI\" class=\"RefTarget\"\u003e\u003c/span\u003e\u003c/span\u003e.\u003c/span\u003e\u003c/li\u003e\u003cli\u003e\u003cspan\u003eSmith CF, Tollemache N, Covill D, et al. Take away body parts! An investigation into the use of 3D-printed anatomical models in undergraduate anatomy education. Anat Sci Educ. 2018;11(1):44\u0026ndash;53. \u003cspan class=\"ExternalRef\"\u003e\u003cspan class=\"RefSource\"\u003e10.1002/ase.1718\u003c/span\u003e\u003cspan address=\"10.1002/ase.1718\" targettype=\"DOI\" class=\"RefTarget\"\u003e\u003c/span\u003e\u003c/span\u003e.\u003c/span\u003e\u003c/li\u003e\u003cli\u003e\u003cspan\u003eAimar A, Palermo A, Innocenti B. The Role of 3D Printing in Medical Applications: A State of the Art. J Healthc Eng. 2019;2019:1\u0026ndash;10. \u003cspan class=\"ExternalRef\"\u003e\u003cspan class=\"RefSource\"\u003e10.1155/2019/5340616\u003c/span\u003e\u003cspan address=\"10.1155/2019/5340616\" targettype=\"DOI\" class=\"RefTarget\"\u003e\u003c/span\u003e\u003c/span\u003e.\u003c/span\u003e\u003c/li\u003e\u003cli\u003e\u003cspan\u003eSpanier C, Schwahn C, Krey KF, et al. Fused filament fabrication (FFF): influence of layer height on forces and moments delivered by aligners\u0026mdash;an in vitro study. Clin Oral Investig. 2023;27(5):2163\u0026ndash;73. \u003cspan class=\"ExternalRef\"\u003e\u003cspan class=\"RefSource\"\u003e10.1007/s00784-023-04912-8\u003c/span\u003e\u003cspan address=\"10.1007/s00784-023-04912-8\" targettype=\"DOI\" class=\"RefTarget\"\u003e\u003c/span\u003e\u003c/span\u003e.\u003c/span\u003e\u003c/li\u003e\u003cli\u003e\u003cspan\u003eAllen S, Deba D. ON THE COMPUTATION OF PART ORIENTATION USING SUPPORT STRUCTURES IN LAYERED MANUFACTURING. 1994.\u003c/span\u003e\u003c/li\u003e\u003cli\u003e\u003cspan\u003eRamian J, Ramian J, Dziob D, Materials. 2021;14(22); \u003cspan class=\"ExternalRef\"\u003e\u003cspan class=\"RefSource\"\u003e10.3390/ma14227070\u003c/span\u003e\u003cspan address=\"10.3390/ma14227070\" targettype=\"DOI\" class=\"RefTarget\"\u003e\u003c/span\u003e\u003c/span\u003e\u003c/span\u003e\u003c/li\u003e\u003cli\u003e\u003cspan\u003eFedorov A, Beichel R, Kalpathy-Cramer J, et al. 3D Slicer as an image computing platform for the Quantitative Imaging Network. Magn Reson Imaging. 2012;30(9):1323\u0026ndash;41. \u003cspan class=\"ExternalRef\"\u003e\u003cspan class=\"RefSource\"\u003e10.1016/j.mri.2012.05.001\u003c/span\u003e\u003cspan address=\"10.1016/j.mri.2012.05.001\" targettype=\"DOI\" class=\"RefTarget\"\u003e\u003c/span\u003e\u003c/span\u003e.\u003c/span\u003e\u003c/li\u003e\u003cli\u003e\u003cspan\u003eTongkitcharoen N, Manopattanakul S, Boonpratham S, et al. Comparison of dimensional accuracy of 3D printing model for clear aligner among various orientation types and hollow types. Clin Invest Orthod. 2023;82(4):177\u0026ndash;93. \u003cspan class=\"ExternalRef\"\u003e\u003cspan class=\"RefSource\"\u003e10.1080/27705781.2023.2251191\u003c/span\u003e\u003cspan address=\"10.1080/27705781.2023.2251191\" targettype=\"DOI\" class=\"RefTarget\"\u003e\u003c/span\u003e\u003c/span\u003e.\u003c/span\u003e\u003c/li\u003e\u003cli\u003e\u003cspan\u003eManeiro Lojo J, Alonso P\u0026eacute;rez-Barquero J, Garc\u0026iacute;a-Sala Bonmat\u0026iacute; F, et al. Influence of print orientation on the accuracy (trueness and precision) of diagnostic casts manufactured with a daylight polymer printer. J Prosthet Dent. 2024;132(6):1314\u0026ndash;22. \u003cspan class=\"ExternalRef\"\u003e\u003cspan class=\"RefSource\"\u003e10.1016/j.prosdent.2023.01.033\u003c/span\u003e\u003cspan address=\"10.1016/j.prosdent.2023.01.033\" targettype=\"DOI\" class=\"RefTarget\"\u003e\u003c/span\u003e\u003c/span\u003e.\u003c/span\u003e\u003c/li\u003e\u003cli\u003e\u003cspan\u003eIde Y, Nayar S, Logan H, et al. The effect of the angle of acuteness of additive manufactured models and the direction of printing on the dimensional fidelity: clinical implications. Odontology. 2017;105(1):108\u0026ndash;15. \u003cspan class=\"ExternalRef\"\u003e\u003cspan class=\"RefSource\"\u003e10.1007/s10266-016-0239-4\u003c/span\u003e\u003cspan address=\"10.1007/s10266-016-0239-4\" targettype=\"DOI\" class=\"RefTarget\"\u003e\u003c/span\u003e\u003c/span\u003e.\u003c/span\u003e\u003c/li\u003e\u003cli\u003e\u003cspan\u003eDemirel M, Diken T\u0026uuml;rksayar AA, Donmez MB, et al. Effect of 3D printing technology and print orientation on the trueness of additively manufactured definitive casts with different tooth preparations. J Dent. 2024;148. \u003cspan class=\"ExternalRef\"\u003e\u003cspan class=\"RefSource\"\u003e10.1016/j.jdent.2024.105244\u003c/span\u003e\u003cspan address=\"10.1016/j.jdent.2024.105244\" targettype=\"DOI\" class=\"RefTarget\"\u003e\u003c/span\u003e\u003c/span\u003e.\u003c/span\u003e\u003c/li\u003e\u003cli\u003e\u003cspan\u003eElShebiny T, Matthaios S, Menezes LM, et al. Effect of printing technology, layer height, and orientation on assessment of 3D-printed models. J World Fed Orthod. 2024;13(4):169\u0026ndash;74. \u003cspan class=\"ExternalRef\"\u003e\u003cspan class=\"RefSource\"\u003e10.1016/j.ejwf.2024.03.006\u003c/span\u003e\u003cspan address=\"10.1016/j.ejwf.2024.03.006\" targettype=\"DOI\" class=\"RefTarget\"\u003e\u003c/span\u003e\u003c/span\u003e.\u003c/span\u003e\u003c/li\u003e\u003cli\u003e\u003cspan\u003eAlghauli MA, Almuzaini SA, Aljohani R, et al. Impact of 3D Printing Orientation on Accuracy, Properties, Cost, and Time Efficiency of Additively Manufactured Dental Models: A Systematic Review. BMC Oral Health. 2024;24(1). \u003cspan class=\"ExternalRef\"\u003e\u003cspan class=\"RefSource\"\u003e10.1186/s12903-024-05365-5\u003c/span\u003e\u003cspan address=\"10.1186/s12903-024-05365-5\" targettype=\"DOI\" class=\"RefTarget\"\u003e\u003c/span\u003e\u003c/span\u003e.\u003c/span\u003e\u003c/li\u003e\u003cli\u003e\u003cspan\u003eLohfeld S, Belnap B, Retrouvey J-M, et al. Effect of Model Body Type and Print Angle on the Accuracy of 3D-Printed Orthodontic Models. Biomimetics. 2024;9(4):217. \u003cspan class=\"ExternalRef\"\u003e\u003cspan class=\"RefSource\"\u003e10.3390/biomimetics9040217\u003c/span\u003e\u003cspan address=\"10.3390/biomimetics9040217\" targettype=\"DOI\" class=\"RefTarget\"\u003e\u003c/span\u003e\u003c/span\u003e.\u003c/span\u003e\u003c/li\u003e\u003c/ol\u003e"}],"fulltextSource":"","fullText":"","funders":[],"hasAdminPriorityOnWorkflow":false,"hasManuscriptDocX":true,"hasOptedInToPreprint":true,"hasPassedJournalQc":"","hasAnyPriority":false,"hideJournal":true,"highlight":"","institution":"","isAcceptedByJournal":false,"isAuthorSuppliedPdf":false,"isDeskRejected":"","isHiddenFromSearch":false,"isInQc":false,"isInWorkflow":false,"isPdf":false,"isPdfUpToDate":true,"isWithdrawnOrRetracted":false,"journal":{"display":true,"email":"[email protected]","identity":"researchsquare","isNatureJournal":false,"hasQc":true,"allowDirectSubmit":true,"externalIdentity":"","sideBox":"","snPcode":"","submissionUrl":"/submission","title":"Research Square","twitterHandle":"researchsquare","acdcEnabled":true,"dfaEnabled":false,"editorialSystem":"","reportingPortfolio":"","inReviewEnabled":false,"inReviewRevisionsEnabled":true},"keywords":"3D printing, Additive Manufacturing, Education, Medical Education","lastPublishedDoi":"10.21203/rs.3.rs-7545658/v1","lastPublishedDoiUrl":"https://doi.org/10.21203/rs.3.rs-7545658/v1","license":{"name":"CC BY 4.0","url":"https://creativecommons.org/licenses/by/4.0/"},"manuscriptAbstract":"\u003cp\u003eThe rapid advancements in 3D printing technology have transformed the field of medical education and presurgical planning. Given the novelty of this area, the literature is limited regarding end-users' feedback on how they benefited from the models. Thus, this study aimed to evaluate the impact of 3D printed educational models (3DP-EM) on educational outcomes from the end-user perspective. Surveys were conducted to assess the views of medical professionals and students on the effectiveness of 3DP-EM in enhancing their understanding of anatomical structures and surgical procedures. Results indicatsed that the use of 3DP-EM significantly improved the respondents\u0026rsquo; understanding and retention of medical concepts (p\u0026thinsp;\u0026lt;\u0026thinsp;0.001). Due to the positive effects of 3DP-EM on the end-users, there is a need for standardization of the 3D printing process for such models to ensure their accuracy and reproducibility.\u003c/p\u003e","manuscriptTitle":"The Value and Standardization of 3D Printed Medical Educational Models","msid":"","msnumber":"","nonDraftVersions":[{"code":1,"date":"2025-11-18 08:38:35","doi":"10.21203/rs.3.rs-7545658/v1","editorialEvents":[{"type":"communityComments","content":0}],"status":"published","journal":{"display":true,"email":"[email protected]","identity":"researchsquare","isNatureJournal":false,"hasQc":true,"allowDirectSubmit":true,"externalIdentity":"","sideBox":"","snPcode":"","submissionUrl":"/submission","title":"Research Square","twitterHandle":"researchsquare","acdcEnabled":true,"dfaEnabled":false,"editorialSystem":"","reportingPortfolio":"","inReviewEnabled":false,"inReviewRevisionsEnabled":true}}],"origin":"","ownerIdentity":"051af264-0ab9-4560-96b1-a702f85ec714","owner":[],"postedDate":"November 18th, 2025","published":true,"recentEditorialEvents":[],"rejectedJournal":[],"revision":"","amendment":"","status":"posted","subjectAreas":[],"tags":[],"updatedAt":"2025-12-02T01:08:18+00:00","versionOfRecord":[],"versionCreatedAt":"2025-11-18 08:38:35","video":"","vorDoi":"","vorDoiUrl":"","workflowStages":[]},"version":"v1","identity":"rs-7545658","journalConfig":"researchsquare"},"__N_SSP":true},"page":"/article/[identity]/[[...version]]","query":{"redirect":"/article/rs-7545658","identity":"rs-7545658","version":["v1"]},"buildId":"8U1c8b4HqxoKbykW_rLl7","isFallback":false,"isExperimentalCompile":false,"dynamicIds":[84888],"gssp":true,"scriptLoader":[]}