Ke emi nei ka ʻokiʻoki kuʻuna kuʻuna, ʻoiai ke kaulana nei nā kumu hoʻohālike plastination a me 3D paʻi (3DP) ma ke ʻano he ʻokoʻa i nā ʻano kumu aʻo anatomy.ʻAʻole maopopo i ka ikaika a me nā nāwaliwali o kēia mau mea hana hou a pehea e pili ai i ka ʻike aʻo anatomy o nā haumāna, e pili ana i nā waiwai kanaka e like me ka mahalo, mālama, a me ke aloha.
Ma hope koke iho o ka hoʻopaʻa ʻana i ke aʻo ʻana, ua kono ʻia nā haumāna 96.Ua hoʻohana ʻia kahi hoʻolālā pragmatic no ka ʻimi ʻana i nā ʻike aʻo me ka hoʻohana ʻana i nā hiʻohiʻona anatomically plasticized a me 3D o ka puʻuwai (Stage 1, n=63) a me ka ʻāʻī (Stage 2, n=33).Ua hana ʻia kahi ʻano loiloi inductive ma muli o 278 mau loiloi kikokikona manuahi (e pili ana i ka ikaika, nāwaliwali, nā wahi no ka hoʻomaikaʻi ʻana) a me nā transcripts verbatim o nā pūʻulu kiko (n = 8) e pili ana i ke aʻo ʻana i ka anatomi me ka hoʻohana ʻana i kēia mau mea hana.
ʻEhā mau kumuhana i ʻike ʻia: ʻike ʻia ka ʻoiaʻiʻo, ka ʻike kumu a me ka paʻakikī, nā manaʻo o ka mahalo a me ka mālama, multimodality, a me ke alakaʻi.
Ma keʻano laulā, ua manaʻo nā haumāna he ʻoi aku ka ʻoiaʻiʻo o nā mea i hoʻopili ʻia a no laila ua ʻoi aku ka mahalo a mālama ʻia ma mua o nā hiʻohiʻona 3DP, ʻoi aku ka maʻalahi o ka hoʻohana ʻana a ʻoi aku ka maikaʻi no ke aʻo ʻana i ka anatomia kumu.
ʻO ka autopsy kanaka kahi ʻano aʻo maʻamau i hoʻohana ʻia i ka hoʻonaʻauao olakino mai ka makahiki 17th [1, 2].Eia nō naʻe, ma muli o ka liʻiliʻi o ke komo ʻana, nā kumukūʻai kiʻekiʻe o ka mālama ʻana i nā cadaver [3, 4], kahi hōʻemi nui o ka manawa hoʻomaʻamaʻa anatomy [1, 5], a me ka holomua ʻenehana [3, 6], ua emi nā haʻawina anatomia i aʻo ʻia me ka hoʻohana ʻana i nā ʻano dissection kuʻuna. .Wehe kēia i nā mea hou no ka noiʻi ʻana i nā ʻano hana aʻo hou a me nā mea hana, e like me nā kiʻi kanaka plastinated a me nā hiʻohiʻona paʻi 3D (3DP) [6,7,8].
Loaʻa i kēlā me kēia o kēia mau mea hana nā pono a me nā pōʻino.He maloʻo, ʻaʻala ʻole, ʻoiaʻiʻo a ʻaʻole pōʻino [9,10,11].Eia nō naʻe, ʻoi aku ka paʻakikī a me ka liʻiliʻi o ka maʻalahi [10, 12], no laila ua manaʻo ʻia ʻoi aku ka paʻakikī o ka hana ʻana a hiki i nā hale hohonu [9].Ma ke ʻano o ke kumukūʻai, ʻoi aku ka maikaʻi o nā laʻana plasticized e kūʻai a mālama ʻia ma mua o nā hiʻohiʻona 3DP [6,7,8].Ma ka ʻaoʻao ʻē aʻe, ʻae nā hiʻohiʻona 3DP i nā ʻano like ʻole [7, 13] a me nā kala [6, 14] a hiki ke hāʻawi ʻia i nā ʻāpana kikoʻī, e kōkua i nā haumāna e ʻike maʻalahi, ʻokoʻa a hoʻomanaʻo i nā hale koʻikoʻi, ʻoiai ʻaʻole i ʻike ʻia kēia ma mua o ka plasticized. nā laʻana.
Ua nānā kekahi mau haʻawina i nā hopena aʻo / hana o nā ʻano mea hana anatomical e like me nā specimen plasticized, nā kiʻi 2D, nā ʻāpana pulu, nā papa Anatomage (Anatomage Inc., San Jose, CA) a me nā hiʻohiʻona 3DP [11, 15, 16, 17, 18, 19, 20, 21].Eia nō naʻe, ʻokoʻa nā hopena ma muli o ke koho ʻana o ka mea hana hoʻomaʻamaʻa i hoʻohana ʻia i nā pūʻulu hoʻomalu a me nā hui intervention, a me ka hilinaʻi ʻana i nā ʻāpana anatomical like ʻole [14, 22].No ka laʻana, ke hoʻohana pū ʻia me ka dissection pulu [11, 15] a me nā papa autopsy [20], hōʻike nā haumāna i ka hauʻoli aʻo kiʻekiʻe a me nā ʻano e pili ana i nā specimens plastinated.Pēlā nō, hōʻike ka hoʻohana ʻana i nā mamana plastina i ka hopena maikaʻi o ka ʻike pahuhopu o nā haumāna [23, 24].
Hoʻohana pinepine ʻia nā hiʻohiʻona 3DP e hoʻohui i nā ʻano aʻo kuʻuna [14,17,21].ʻO Loke et al.(2017) i hōʻike i ka hoʻohana ʻana i ke kumu hoʻohālike 3DP e hoʻomaopopo i ka maʻi naʻau congenital i kahi pediatrician [18].Ua hōʻike kēia haʻawina i ka hui 3DP i ʻoi aku ka maikaʻi o ke aʻo ʻana, ʻoi aku ka maikaʻi o ka hoʻomaopopo ʻana i ka tetrad o Fallot, a me ka hoʻomaikaʻi ʻana i ka hiki ke hoʻokele i nā maʻi (self-efficacy) i hoʻohālikelike ʻia me ka hui kiʻi 2D.ʻO ke aʻo ʻana i ke anatomy o ka lāʻau vascular a me ke anatomy o ke poʻo e hoʻohana ana i nā hiʻohiʻona 3DP e hāʻawi i ka hauʻoli aʻo like me nā kiʻi 2D [16, 17].Ua hōʻike ʻia kēia mau haʻawina ʻoi aku ka maikaʻi o nā hiʻohiʻona 3DP ma mua o nā kiʻi 2D ma ke ʻano o ka hauʻoli aʻo i ʻike ʻia e nā haumāna.Eia naʻe, ua kaupalena ʻia nā haʻawina e hoʻohālikelike ana i nā hiʻohiʻona 3DP multi-material me nā laʻana plasticized.Mogali et al.(2021) hoʻohana i ka plastina model me kona 3DP puʻuwai a me ka ʻāʻī hoʻohālike a hōʻike i ka hoʻonui like o ka ʻike ma waena o ka mana a me nā hui hoʻokolohua [21].
Eia nō naʻe, pono nā hōʻike hou aʻe e loaʻa ai ka ʻike hohonu no ke kumu e hilinaʻi ai ka ʻike aʻo ʻana o nā haumāna i ke koho ʻana o nā mea hana anatomical a me nā ʻāpana like ʻole o ke kino a me nā ʻāpana [14, 22].ʻO nā waiwai kanaka he mea hoihoi e hiki ke hoʻololi i kēia ʻike.E pili ana kēia i ka mahalo, mālama, empathy a me ke aloha i manaʻo ʻia mai nā haumāna i lilo i kauka [25, 26].Ua ʻimi mau ʻia nā waiwai kanaka i loko o nā autopsies, no ka mea, ua aʻo ʻia nā haumāna e aloha a mālama i nā kupapaʻu i hāʻawi ʻia, a no laila ua noho mau ke aʻo ʻana i ka anatomy i kahi kūikawā [27, 28].Eia naʻe, ʻaʻole i ana ʻia kēia ma ka plasticizing a me nā mea hana 3DP.ʻAʻole like me nā nīnau noiʻi Likert i pani ʻia, ʻo nā ʻano o ka hōʻiliʻili ʻikepili qualitative e like me nā kūkākūkā pūʻulu kikoʻī a me nā nīnau noiʻi wehe ʻia e hāʻawi i ka ʻike i nā manaʻo o ka poʻe komo i kākau ʻia ma ke ʻano maʻamau e wehewehe i ka hopena o nā mea hana aʻo hou i kā lākou ʻike aʻo.
No laila, ua manaʻo kēia noiʻi e pane pehea e ʻokoʻa ai ka ʻike ʻana o nā haumāna i ka anatomia ke hāʻawi ʻia iā lākou nā mea hana hoʻonohonoho (plastination) me nā kiʻi paʻi 3D kino e aʻo ai i ka anatomi?
No ka pane ʻana i nā nīnau ma luna, loaʻa i nā haumāna ka manawa e loaʻa ai, hōʻiliʻili a kaʻana like i ka ʻike anatomical ma o ka launa pū ʻana a me ka hui pū ʻana.Ua ʻae maikaʻi kēia manaʻo me ka manaʻo constructivist, e like me ka mea e hana ikaika ai nā kānaka a i ʻole nā hui kaiaulu i kā lākou ʻike [29].ʻO ia mau pilina (no ka laʻana, ma waena o nā hoa, ma waena o nā haumāna a me nā kumu) pili i ka ʻoluʻolu o ke aʻo ʻana [30, 31].Ma ka manawa like, e hoʻopili ʻia ka ʻike aʻo ʻana o nā haumāna e nā mea e like me ka maʻalahi o ke aʻo ʻana, ka ʻona, nā ʻano aʻo, a me nā ʻike papa [32].Ma hope mai, hiki i kēia mau ʻano ke hoʻoikaika i ke aʻo ʻana o nā haumāna a me ka mākaukau o nā kumuhana hoihoi iā lākou [33, 34].Pili paha kēia i ka manaʻo kuʻuna o ka epistemology pragmatic, kahi i hiki ai i ka ʻohi mua a i ʻole ka hoʻokumu ʻana o ka ʻike pilikino, ka naʻauao, a me nā manaʻoʻiʻo e hiki ke hoʻoholo i ka hana aʻe [35].Hoʻolālā maikaʻi ʻia ke ala pragmatic e ʻike i nā kumuhana paʻakikī a me kā lākou kaʻina ma o nā nīnauele a me nā noiʻi, a ukali ʻia e ka loiloi thematic [36].
Manaʻo pinepine ʻia nā laʻana Cadaver he mau kumu aʻoaʻo leo ʻole, no ka mea, ʻike ʻia lākou he mau makana nui no ka pono o ka ʻepekema a me ke kanaka, e hōʻeuʻeu i ka mahalo a me ka mahalo mai nā haumāna i kā lākou mea hāʻawi [37, 38].Ua hōʻike mua nā haʻawina i nā helu like a ʻoi aku paha ma waena o ka hui cadaver/plastination a me ka hui 3DP [21, 39], akā ʻaʻole maopopo i ka like ʻana o nā haumāna i ka ʻike aʻo like, me nā waiwai kanaka, ma waena o nā hui ʻelua.No ka noiʻi hou aku, hoʻohana kēia haʻawina i ke kumu o ka pragmatism [36] e nānā i ka ʻike aʻo a me nā hiʻohiʻona o nā hiʻohiʻona 3DP (kala a me ke ʻano) a hoʻohālikelike iā lākou me nā laʻana plastinated e pili ana i ka manaʻo o nā haumāna.
Hiki i nā manaʻo o nā haumāna ke hoʻoikaika i nā hoʻoholo a nā kumu e pili ana i ke koho ʻana i nā mea hana anatomia kūpono e pili ana i ka mea kūpono a maikaʻi ʻole no ke aʻo ʻana i ke anatomia.Hiki i kēia ʻike ke kōkua i nā kumu aʻo e ʻike i nā makemake o nā haumāna a hoʻohana i nā mea hana loiloi kūpono e hoʻomaikaʻi ai i kā lākou ʻike aʻo.
Ua manaʻo kēia haʻawina qualitative e ʻimi i nā mea a nā haumāna i manaʻo ai he ʻike aʻo koʻikoʻi me ka hoʻohana ʻana i nā laʻana naʻau a me ka ʻāʻī i hoʻohālikelike ʻia me nā hiʻohiʻona 3DP.Wahi a kahi noiʻi mua a Mogali et al.ma 2018, ua noʻonoʻo nā haumāna i nā specimens plastinated i ʻoi aku ka maoli ma mua o nā hiʻohiʻona 3DP [7].No laila, e manaʻo kākou:
Ma muli o ka hana ʻia ʻana o nā plastinations mai nā cadavers maoli, ua manaʻo ʻia nā haumāna e nānā i nā plastinations ʻoi aku ka maikaʻi ma mua o nā hiʻohiʻona 3DP ma ke ʻano o ka ʻoiaʻiʻo a me ka waiwai kanaka.
Ua pili kēia haʻawina qualitative i ʻelua mau noiʻi quantitative mua [21, 40] no ka mea, ua hōʻiliʻili ʻia nā ʻikepili i hōʻike ʻia ma nā haʻawina ʻekolu i ka manawa like mai ka laʻana like o nā haumāna.Ua hōʻike ka ʻatikala mua i nā ana pahuhopu like (nā helu hōʻike) ma waena o ka plastination a me nā pūʻulu 3DP [21], a ʻo ka ʻatikala ʻelua i hoʻohana i ka loiloi kumu e hoʻomohala i kahi mea hana psychometrically validated (ʻehā mau mea, 19 mau mea) e ana i nā kūkulu hoʻonaʻauao e like me ka hauʻoli aʻo. ka pono pono'ī, nā waiwai kanaka, a me nā palena media aʻo [40].Ua nānā kēia haʻawina i nā kūkākūkā pūʻulu haʻahaʻa kiʻekiʻe e ʻike i nā mea a nā haumāna e manaʻo nui ai i ke aʻo ʻana i ka anatomia me ka hoʻohana ʻana i nā specimens plastinated a me nā hiʻohiʻona paʻi 3D.No laila, ʻokoʻa kēia haʻawina mai nā ʻatikala ʻelua ma mua e pili ana i nā pahuhopu noiʻi/nā nīnau, ka ʻikepili, a me nā ʻano loiloi no ka loaʻa ʻana o ka ʻike i ka manaʻo maikaʻi o nā haumāna (nā manaʻo kikokikona manuahi a me ka kūkākūkā pūʻulu kikoʻī) ma ka hoʻohana ʻana i nā mea hana 3DP i hoʻohālikelike ʻia me nā laʻana plasticized.ʻO ke ʻano o ka hoʻopaʻa ʻana o kēia haʻawina i kahi nīnau noiʻi ʻē aʻe ma mua o nā ʻatikala ʻelua ma mua [21, 40].
Ma ke kula o ka mea kākau, ua hoʻohui ʻia ka anatomy i nā papa ʻōnaehana e like me ka cardiopulmonary, endocrinology, musculoskeletal, etc., i nā makahiki ʻelua o ka papahana Bachelor of Medicine and Bachelor of Surgery (MBBS) makahiki ʻelima.Hoʻohana pinepine ʻia nā hiʻohiʻona i hoʻopaʻa ʻia, nā kiʻi plastik, nā kiʻi lapaʻau, a me nā hiʻohiʻona 3D virtual ma kahi o ka dissection a i ʻole nā mea hoʻoheheʻe wai e kākoʻo i ka hana anatomy maʻamau.Hoʻololi nā kau haʻawina hui i nā haʻiʻōlelo kuʻuna i aʻo ʻia me ka nānā ʻana i ka hoʻohana ʻana i ka ʻike i loaʻa.Ma ka pau ʻana o kēlā me kēia ʻōnaehana ʻōnaehana, e lawe i kahi hoʻomaʻamaʻa anatomy formative online e loaʻa ana he 20 mau pane maikaʻi loa (SBA) e uhi ana i ka anatomy maʻamau, kiʻi, a me ka mōʻaukala.ʻO ka huina, ʻelima mau hoʻokolohua formative i mālama ʻia i ka wā o ka hoʻokolohua (ʻekolu i ka makahiki mua a ʻelua i ka makahiki ʻelua).ʻO ka loiloi kākau piha piha ʻana no nā makahiki 1 a me 2 e loaʻa ana ʻelua pepa, aia i kēlā me kēia me 120 SBA.Ua lilo ka Anatomy i ʻāpana o kēia mau loiloi a ʻo ka hoʻolālā loiloi e hoʻoholo i ka helu o nā nīnau anatomical e hoʻokomo ʻia.
No ka hoʻomaikaʻi ʻana i ka ratio haumāna-a-laʻi, ua aʻo ʻia nā hiʻohiʻona 3DP kūloko e pili ana i nā specimen plastinated no ke aʻo ʻana a me ke aʻo ʻana i ke anatomia.Hāʻawi kēia i kahi manawa e hoʻokumu ai i ka waiwai hoʻonaʻauao o nā hiʻohiʻona 3DP hou i hoʻohālikelike ʻia me nā specimens plastinated ma mua o ka hoʻokomo ʻia ʻana i loko o ka haʻawina anatomy.
I loko o kēia haʻawina, ua hana ʻia ka tomography computed (CT) (64-slice Somatom Definition Flash CT scanner, Siemens Healthcare, Erlangen, Kelemānia) ma nā hiʻohiʻona plastik o ka puʻuwai (hoʻokahi puʻuwai holoʻokoʻa a hoʻokahi puʻuwai i ka pauku keʻa) a me ke poʻo a me ka ʻāʻī ( hoʻokahi holoʻokoʻa a hoʻokahi midsagittal plane head-neck) (Fig. 1).Ua loaʻa a hoʻouka ʻia nā kiʻi Digital Imaging and Communications in Medicine (DICOM) i 3D Slicer (versions 4.8.1 a me 4.10.2, Harvard Medical School, Boston, Massachusetts) no ka hoʻokaʻawale ʻana i ke ʻano e like me nā ʻiʻo, nā ʻaʻa, nā aʻalolo, a me nā iwi. .Ua hoʻoili ʻia nā faila i hoʻokaʻawale ʻia i loko o Materialize Magics (Version 22, Materialize NV, Leuven, Belgium) no ka wehe ʻana i nā pūpū leo, a mālama ʻia nā kiʻi paʻi ma ke ʻano STL, a laila hoʻoili ʻia i kahi paʻi Objet 500 Connex3 Polyjet (Stratasys, Eden. Prairie, MN) e hana i nā hiʻohiʻona anatomical 3D.ʻO nā resins Photopolymerizable a me nā elastomers māmā (VeroYellow, VeroMagenta a me TangoPlus) e paʻakikī i ka papa ma lalo o ka hana a UV radiation, e hāʻawi ana i kēlā me kēia ʻano anatomical kona ʻano a me kona kala.
Nā mea hana aʻo Anatomy i hoʻohana ʻia i kēia haʻawina.Hema: Neck;ʻākau: paʻi ʻia a me ka puʻuwai paʻi 3D.
Eia kekahi, ua koho ʻia ka aorta piʻi a me ka ʻōnaehana coronary mai ke ʻano o ka puʻuwai holoʻokoʻa, a ua kūkulu ʻia nā scaffolds kumu e hoʻopili ai i ke kumu hoʻohālike (version 22, Materialize NV, Leuven, Belgium).Ua paʻi ʻia ke kŘkohu ma kahi paʻi paʻi Raise3D Pro2 (Raise3D Technologies, Irvine, CA) me ka hoʻohana ʻana i ka filament thermoplastic polyurethane (TPU).No ka hōʻike ʻana i nā aʻa o ke kumu hoʻohālike, pono e wehe ʻia nā mea kākoʻo TPU i paʻi ʻia a pena ʻia nā kīʻaha koko me ka acrylic ʻulaʻula.
Ua loaʻa i nā haumāna Bachelor of Medicine makahiki mua ma ka Lee Kong Chiang Faculty of Medicine i ka makahiki kula 2020-2021 (n = 163, 94 kāne a me 69 wahine) i kono leka uila e komo i kēia noiʻi ma ke ʻano he hana manawaleʻa.Ua hana ʻia ka hoʻokolohua ʻokoʻa i hoʻopaʻa ʻia i ʻelua mau pae, ʻo ka mua me ka ʻoki puʻuwai a laila me ka ʻoki ʻāʻī.Aia he ʻeono pule holoi ma waena o nā pae ʻelua e hōʻemi i nā hopena i koe.Ma nā pae ʻelua, makapō nā haumāna i ke aʻo ʻana i nā kumuhana a me nā haʻawina hui.ʻAʻole ʻoi aku ma mua o ʻeono mau kānaka i loko o kahi hui.Ua loaʻa i nā haumāna i loaʻa nā laʻana plastinated ma ka ʻanuʻu mua i nā hiʻohiʻona 3DP ma ka lua.Ma kēlā me kēia pae, loaʻa i nā hui ʻelua kahi haʻiʻōlelo hoʻomaka (30 mau minuke) mai kahi ʻaoʻao ʻekolu (kumu kiʻekiʻe) a ukali ʻia e ka hoʻopaʻa ʻana iā ia iho (50 mau minuke) me ka hoʻohana ʻana i nā mea hana a me nā palapala hāʻawi.
Hoʻohana ʻia ka papa helu helu COREQ (Comprehensive Criteria for Qualitative Research Reporting) e alakaʻi i ka noiʻi qualitative.
Hāʻawi nā haumāna i nā manaʻo e pili ana i ka mea aʻo noiʻi ma o kahi noiʻi i loaʻa i ʻekolu mau nīnau wehe e pili ana i ko lākou ikaika, nāwaliwali, a me nā manawa kūpono no ka hoʻomohala ʻana.Ua hāʻawi nā mea pane he 96 i nā pane manuahi.A laila, ʻewalu mau haumāna manawaleʻa (n = 8) i komo i ka pūʻulu manaʻo.Ua mālama ʻia nā nīnauele ma ka Anatomy Training Center (kahi i hana ʻia ai nā hoʻokolohua) a ua alakaʻi ʻia e Investigator 4 (Ph.D.), he kumu aʻoaʻo kāne non-anatomy me ka ʻoi aku o 10 mau makahiki o ka hoʻomaʻamaʻa TBL, akā ʻaʻole i komo i ka hui noiʻi. hoʻonaʻauao.ʻAʻole ʻike nā haumāna i nā ʻano pilikino o ka poʻe noiʻi (a i ʻole ka hui noiʻi) ma mua o ka hoʻomaka ʻana o ke aʻo ʻana, akā ua hōʻike ka palapala ʻae iā lākou i ke kumu o ke aʻo ʻana.ʻO ka mea noiʻi 4 a me nā haumāna wale nō i komo i ka hui.Ua wehewehe ka mea noiʻi i ka hui kikoʻī i nā haumāna a nīnau iā lākou inā makemake lākou e komo.Ua kaʻana like lākou i ko lākou ʻike no ke aʻo ʻana i ka paʻi 3D a me ka plastination a ua hauʻoli loa lākou.Ua nīnau ka mea kōkua i ʻeono mau nīnau alakaʻi no ka paipai ʻana i nā haumāna e hoʻoikaika i ka hana (Mahele Pākuʻi 1).ʻO nā laʻana e pili ana i ke kūkākūkā ʻana i nā ʻano o nā mea hana anatomical e hoʻoikaika i ke aʻo ʻana a me ke aʻo ʻana, a me ke kuleana o ka empathy i ka hana ʻana me ia mau hiʻohiʻona."Pehea ʻoe e wehewehe ai i kou ʻike no ke aʻo ʻana i ka anatomia me ka hoʻohana ʻana i nā specimens plastinated a me nā kope paʻi 3D?"ʻo ia ka nīnau mua o ka nīnauele.Ua wehe ʻia nā nīnau a pau, e ʻae ana i nā mea hoʻohana e pane i nā nīnau me ka ʻole o nā ʻāpana ʻokoʻa, e ʻae i ka ʻike hou ʻana a me ka hoʻokō ʻana i nā pilikia me nā mea hana aʻo.ʻAʻole i loaʻa i nā poʻe i hoʻopaʻa ʻia nā manaʻo a i ʻole ka nānā ʻana i nā hopena.ʻO ke ʻano manawaleʻa o ke aʻo ʻana i pale i ka saturation ʻikepili.Ua hoʻopaʻa ʻia ke kamaʻilio holoʻokoʻa no ka nānā ʻana.
ʻO ka hoʻopaʻa ʻana o ka pūʻulu manaʻo (35 mau minuke) ua unuhi ʻia a hoʻopau ʻia (ua hoʻohana ʻia nā pseudonyms).Eia hou, ua hōʻiliʻili ʻia nā nīnau nīnau puka.Ua lawe ʻia nā transcripts a me nā nīnau noiʻi i loko o kahi pālahalaha Microsoft Excel (Microsoft Corporation, Redmond, WA) no ka triangulation data a me ka hōʻuluʻulu ʻana e nānā i nā hopena like ʻole a i ʻole nā hopena hou [41].Hana ʻia kēia ma o ka theoretical thematic analysis [41, 42].Hoʻohui ʻia nā pane kikokikona a kēlā me kēia haumāna i ka huina o nā pane.ʻO ia hoʻi, e mālama ʻia nā manaʻo me nā ʻōlelo he nui.E nānā ʻole ʻia nā pane me ka ʻole, ʻaʻohe a ʻaʻohe manaʻo.ʻEkolu mau mea noiʻi (he wahine noiʻi me ka Ph.D., he wahine noiʻi me ke kēkelē laepua, a he kōkua kāne me ke kēkelē laepua ma ka ʻenekinia a me 1-3 makahiki o ka ʻike noiʻi ma ka hoʻonaʻauao olakino) hoʻopili kūʻokoʻa i ka ʻikepili i kūkulu ʻole ʻia.Hoʻohana ʻekolu mea polokalamu polokalamu i nā papa kiʻi kiʻi maoli e hoʻokaʻawale i nā memo post-it e pili ana i nā mea like a me nā ʻokoʻa.Ua alakaʻi ʻia kekahi mau kau e hoʻonohonoho a hui pū i nā code ma o ka systematic and iterative pattern recognition, kahi i hui pū ʻia ai nā code e ʻike ai i nā subtopics (nā ʻano kikoʻī a i ʻole nā hiʻohiʻona maʻamau e like me nā ʻano maikaʻi a maikaʻi ʻole o nā mea hana aʻo) a laila i hoʻokumu ʻia i nā kumuhana overarching [41].No ka loaʻa ʻana o ka manaʻo, ua ʻae kahi kanaka noiʻi kāne 6 (Ph.D.) me 15 mau makahiki o ke aʻo ʻana i ka anatomia i nā kumuhana hope loa.
E like me ka Declaration of Helsinki, ua loiloi ka Institutional Review Board o Nanyang Technological University (IRB) (2019-09-024) i ka protocol study a loaʻa i nā ʻae kūpono.Hāʻawi ka poʻe i komo i ka ʻae ʻike a hoʻomaopopo ʻia i ko lākou kuleana e haʻalele i ke komo ʻana i kēlā me kēia manawa.
He kanaiwakumamāono makahiki mua nā haumāna lāʻau lapaʻau i hāʻawi ʻia i ka ʻae ʻike piha, nā ʻikepili kumu e like me ke kāne a me ka makahiki, a ʻaʻole hoʻi i hoʻomaʻamaʻa mua ʻia i ka anatomia.ʻO ka Phase I (naʻau) a me ka Phase II (ka wehe ʻana i ka ʻāʻī) i komo pū me 63 (33 kāne a me 30 wahine) a me 33 mau mea komo (18 kāne a me 15 wahine).ʻO ko lākou mau makahiki mai ka 18 a hiki i ka 21 makahiki (mean ± standard deviation: 19.3 ± 0.9) makahiki.Ua pane nā haumāna a pau he 96 i ka nīnau nīnau (ʻaʻohe haʻalele), a he 8 mau haumāna i komo i nā pūʻulu kiko.He 278 mau manaʻo wehe e pili ana i nā pono, nā mea ʻino, a me nā pono no ka hoʻomaikaʻi ʻana.ʻAʻohe mea like ʻole ma waena o ka ʻikepili i kālailai ʻia a me ka hōʻike o nā ʻike.
I loko o nā kūkākūkā a me nā pane noiʻi, ʻehā mau kumuhana i puka mai: ʻike ʻia ka ʻoiaʻiʻo, ka ʻike kumu a me ka paʻakikī, nā ʻano o ka mahalo a me ka mālama ʻana, multimodality, a me ke alakaʻi (Figure 2).Ua wehewehe ʻia kēlā me kēia kumuhana ma lalo nei.
ʻO nā kumumanaʻo ʻehā—ʻoiaʻiʻo i ʻike ʻia, ka ʻike kumu a me ka paʻakikī, ka mahalo a me ka mālama ʻana, a me ka makemake i ka media aʻo ʻana—ua hoʻokumu ʻia i ka loiloi kumuhana o nā nīnau noiʻi wehe a me nā kūkākūkā hui.ʻO nā mea i loko o ka pahu polū a me ka melemele e hōʻike ana i nā waiwai o ka hāpana paʻa a me ke kumu hoʻohālike 3DP.3DP = paʻi 3D
Ua manaʻo nā haumāna he ʻoi aku ka ʻoiaʻiʻo o nā mea i hoʻopaʻa ʻia, ʻoi aku ka ʻike o nā kala kūlohelohe i nā mea make maoli, a ʻoi aku ka maikaʻi o nā kikoʻī anatomical ma mua o nā hiʻohiʻona 3DP.No ka laʻana, ʻoi aku ka koʻikoʻi o ka orientation fiber muscle i nā laʻana plasticized i hoʻohālikelike ʻia me nā hiʻohiʻona 3DP.Hōʻike ʻia kēia ʻokoʻa ma ka ʻōlelo ma lalo nei.
… kikoʻī loa a pololei, e like me ke kanaka maoli (mea komo C17; loiloi plastination free-form).”
Ua ʻike nā haumāna he mea pono nā mea hana 3DP no ke aʻo ʻana i ke anatomy kumu a me ka loiloi ʻana i nā hiʻohiʻona macroscopic nui, ʻoiai ʻo nā kiʻi palaki i kūpono no ka hoʻonui hou ʻana i ko lākou ʻike a me ka hoʻomaopopo ʻana i nā hale anatomical paʻakikī a me nā ʻāpana.Ua manaʻo nā haumāna ʻoiai ʻo nā mea kani ʻelua he kope pololei o kekahi i kekahi, ua nalowale lākou i ka ʻike waiwai i ka wā e hana ana me nā hiʻohiʻona 3DP i hoʻohālikelike ʻia me nā laʻana plastinated.Ua wehewehe ʻia kēia ma ka ʻōlelo ma lalo nei.
“… aia kekahi mau pilikia e like me… nā kikoʻī liʻiliʻi e like me ka fossa ovale… ma ke ʻano maʻamau hiki ke hoʻohana ʻia kahi hiʻohiʻona 3D o ka puʻuwai… no ka ʻāʻī, malia paha e aʻo wau i ke kumu hoʻohālike me ka hilinaʻi (ke komo pū ʻana PA1; 3DP, kūkākūkā pūʻulu koʻikoʻi”) .
“Hiki ke ʻike ʻia nā hale nui… ma ke kikoʻī, pono nā ʻano hiʻohiʻona 3DP no ke aʻo ʻana, no ka laʻana, nā hale ʻoi aʻe (a) mea nui a maʻalahi hoʻi e ʻike ʻia e like me nā ʻiʻo a me nā ʻōkana… ʻO ka hui PA3; 3DP.
Ua hōʻike nui nā haumāna i ka mahalo a me ka hopohopo no nā mea hoʻohālike i hoʻopaʻa ʻia, akā hopohopo pū kekahi i ka luku ʻana o ka hale ma muli o kona palupalu a me ka ʻole o ka maʻalahi.ʻO ka mea ʻē aʻe, ua hoʻohui nā haumāna i kā lākou ʻike hana ma ka ʻike ʻana e hiki ke hana hou ʻia nā hiʻohiʻona 3DP inā pōʻino.
… ʻoi aku ka makaʻala o mākou i nā ʻano hoʻohālike (participant PA2; plastination, focus group discussion)”.
“…no nā mea hoʻohālike plastina, ua like ia…he mea i mālama ʻia no ka manawa lōʻihi.Inā wau i hōʻino iā ia… Manaʻo wau ua ʻike mākou ua ʻoi aku ka nui o ka pōʻino no ka mea he moʻolelo kona (ke komo pū ʻana i ka PA3; plastination, focus group discussion).
"Hiki ke hana ʻia nā kiʻi paʻi 3D me ka wikiwiki a me ka maʻalahi… e hiki ai i nā poʻe he nui a hoʻomaʻamaʻa i nā hiʻohiʻona 3D me ka ʻole e kaʻana like i nā laʻana (mea kōkua I38; 3DP, loiloi kikokikona manuahi).
"...me nā hiʻohiʻona 3D hiki iā mākou ke pāʻani a puni me ka hopohopo nui e pili ana i ka hoʻopōʻino ʻana iā lākou, e like me ka hōʻino ʻana i nā laʻana… (Ke komo pū ʻana PA2; 3DP, kūkākūkā pūʻulu kikoʻī).
Wahi a nā haumāna, ua kaupalena ʻia ka helu o nā mea hoʻohālike i hoʻopaʻa ʻia, a paʻakikī ke komo ʻana i nā hale hohonu ma muli o ko lākou paʻakikī.No ke kumu hoʻohālike 3DP, manaʻolana lākou e hoʻomaʻemaʻe hou i nā kikoʻī anatomical ma o ka hoʻopili ʻana i ke kumu hoʻohālike i nā wahi hoihoi no ke aʻo pilikino.Ua ʻae nā haumāna e hiki ke hoʻohana ʻia nā hiʻohiʻona plasticized a me 3DP i hui pū ʻia me nā ʻano mea hana aʻo ʻē aʻe e like me ka papa Anatomage e hoʻonui i ke aʻo ʻana.
"ʻAʻole ʻike maikaʻi ʻia kekahi mau hale kūloko hohonu (mea komo C14; plastination, ʻōlelo manuahi)."
"Malia paha he mea hoʻohui maikaʻi loa nā papa autopsy a me nā ʻano hana ʻē aʻe (member C14; plastination, free text review).
"Ma ka hōʻoia ʻana i ka kikoʻī ʻana o nā hiʻohiʻona 3D, hiki iā ʻoe ke loaʻa nā hiʻohiʻona ʻokoʻa e nānā ana i nā wahi like ʻole a me nā ʻano like ʻole, e like me nā aʻalolo a me nā kīʻaha koko (mea komo I26; 3DP, loiloi kikokikona manuahi).
Manaʻo nā haumāna e hoʻokomo i kahi hōʻike no ke kumu e wehewehe i ke ʻano o ka hoʻohana pono ʻana i ke kumu hoʻohālike, a i ʻole ke alakaʻi hou ʻana i nā kiʻi hoʻohālike i hoʻopaʻa ʻia e hoʻomaʻamaʻa i ke aʻo ʻana a me ka hoʻomaopopo ʻana i nā memo haʻiʻōlelo, ʻoiai ua ʻae lākou ua hoʻolālā ʻia ke aʻo ʻana no ke aʻo ponoʻī.
“Mahalo au i ke ʻano kūʻokoʻa o ka noiʻi… malia paha e hāʻawi ʻia nā alakaʻi hou aʻe ma ke ʻano o nā kiʻi paheʻe a i ʻole kekahi mau memo…
"Hiki i ka poʻe loea maʻiʻo a i ʻole ka loaʻa ʻana o nā mea hana ʻike ʻē aʻe e like me ka animation a i ʻole wikiō ke kōkua iā mākou e hoʻomaopopo maikaʻi i ke ʻano o nā hiʻohiʻona 3D (lala C38; nā loiloi kikokikona manuahi ma ka laulā).
Ua nīnau ʻia nā haumāna lapaʻau makahiki mua e pili ana i kā lākou ʻike aʻo a me ka maikaʻi o nā laʻana 3D i paʻi ʻia a paʻi ʻia.E like me ka mea i manaʻo ʻia, ua ʻike nā haumāna i ʻoi aku ka ʻoiaʻiʻo a me ka pololei o nā laʻana plasticized ma mua o nā mea i paʻi ʻia 3D.Ua hōʻoia ʻia kēia mau hopena e kahi noiʻi mua [7].No ka mea, ua hana ʻia nā moʻolelo mai nā kupapaʻu i hāʻawi ʻia, he ʻoiaʻiʻo lākou.ʻOiai he kope 1:1 ia o kahi mea hoʻohālike i hoʻopaʻa ʻia me nā ʻano morphological like [8], ua manaʻo ʻia ka ʻano paʻi 3D i hoʻokumu ʻia i ka polymer i ʻoi aku ka ʻoiaʻiʻo a me ka liʻiliʻi o ka ʻoiaʻiʻo, ʻoi aku ka nui o nā haumāna i loaʻa nā kikoʻī e like me nā kihi o ka fossa oval. ʻAʻole ʻike ʻia ma ke ʻano 3DP o ka puʻuwai i hoʻohālikelike ʻia me ke kumu hoʻohālike plastinated.Ma muli paha o ka maikaʻi o ke kiʻi CT, ʻaʻole e ʻae i ka wehewehe ʻana i nā palena.No laila, paʻakikī ka hoʻokaʻawale ʻana i ia mau hale i ka polokalamu hoʻokaʻawale, e pili ana i ke kaʻina paʻi 3D.Hiki i kēia ke hāpai i nā kānalua e pili ana i ka hoʻohana ʻana i nā mea hana 3DP no ka mea e hopohopo nei lākou e nalowale ka ʻike koʻikoʻi inā ʻaʻole hoʻohana ʻia nā mea hana maʻamau e like me ka plasticized samples.Hiki i nā haumāna ke makemake i ka hoʻomaʻamaʻa ʻana i ke kaʻina hana pono ke hoʻohana i nā hiʻohiʻona kūpono [43].Ua like nā hopena o kēia manawa me nā haʻawina mua i ʻike ʻia ʻaʻole i loaʻa i nā hiʻohiʻona plastic [44] a me 3DP samples ka pololei o nā laʻana maoli [45].
I mea e hoʻomaikaʻi ai i ka hiki ʻana o nā haumāna a no laila e ʻoluʻolu nā haumāna, pono e noʻonoʻo ʻia ke kumukūʻai a me ka loaʻa ʻana o nā mea hana.Kākoʻo nā hopena i ka hoʻohana ʻana i nā hiʻohiʻona 3DP no ka loaʻa ʻana o ka ʻike anatomical ma muli o kā lākou hana kumu kūʻai kūpono [6, 21].Ua kūlike kēia me kahi noiʻi mua i hōʻike i ka hoʻohālikelike ʻana i ka hana o nā hiʻohiʻona plasticized a me nā hiʻohiʻona 3DP [21].Manaʻo nā haumāna he ʻoi aku ka maikaʻi o nā hiʻohiʻona 3DP no ke aʻo ʻana i nā manaʻo anatomical maʻamau, nā ʻōkana, a me nā hiʻohiʻona, ʻoiai ʻoi aku ka kūpono o nā specimens plastinated no ke aʻo ʻana i ka anatomical paʻakikī.Eia hou, ua paipai nā haumāna i ka hoʻohana ʻana i nā hiʻohiʻona 3DP i hui pū me nā specimens cadaver a me nā ʻenehana hou e hoʻomaikaʻi i ka ʻike o nā haumāna i ke anatomia.Nui nā ala e hōʻike ai i ka mea hoʻokahi, e like me ka palapala ʻana i ke anatomy o ka puʻuwai me ka hoʻohana ʻana i nā cadavers, paʻi 3D, scan maʻi, a me nā hiʻohiʻona 3D virtual.ʻO kēia ala multi-modal e hiki ai i nā haumāna ke hōʻike i ke anatomy ma nā ʻano like ʻole, e kamaʻilio i nā mea a lākou i aʻo ai ma nā ʻano like ʻole, a hoʻokomo i nā haumāna i nā ʻano like ʻole [44].Ua hōʻike ʻia ka noiʻi ʻana i nā mea aʻo maoli e like me nā mea hana cadaver hiki ke paʻakikī no kekahi mau haumāna e pili ana i ka ukana cognitive e pili ana i ke aʻo ʻana i ke anatomy [46].He mea koʻikoʻi ka hoʻomaopopo ʻana i ka hopena o ka haʻahaʻa cognitive i ke aʻo ʻana o nā haumāna a me ka hoʻohana ʻana i nā ʻenehana e hōʻemi i ka ukana cognitive e hana i kahi ʻano aʻo maikaʻi aʻe [47, 48].Ma mua o ka hoʻolauna ʻana i nā haumāna i nā mea cadaveric, hiki i nā hiʻohiʻona 3DP ke hana pono e hōʻike i nā ʻano kumu a koʻikoʻi o ke anatomy i mea e hōʻemi ai i ka ukana naʻau a hoʻonui i ke aʻo ʻana.Eia kekahi, hiki i nā haumāna ke lawe i nā hiʻohiʻona 3DP i ka home no ka loiloi i hui pū ʻia me nā puke aʻo a me nā haʻawina a hoʻonui i ke aʻo ʻana o ka anatomy ma waho o ka lab [45].Eia naʻe, ʻaʻole i hoʻokō ʻia ka hana o ka wehe ʻana i nā ʻāpana 3DP ma ke keʻena o ka mea kākau.
Ma kēia noiʻi ʻana, ʻoi aku ka mahalo ʻia o nā laʻana plastinated ma mua o 3DP replicas.Ua kūlike kēia hopena me ka noiʻi mua e hōʻike ana i nā ʻano cadaveric e like me ka "maʻi mua" e kauoha i ka mahalo a me ka empathy, ʻoiai ʻaʻole nā model artificial [49].ʻO ka ʻiʻo kanaka i hoʻopaʻa ʻia maoli he pili a ʻoiaʻiʻo.ʻO ka hoʻohana ʻana i nā mea cadaveric e hiki ai i nā haumāna ke hoʻomohala i nā manaʻo kanaka a me ka pono [50].Eia kekahi, hiki ke hoʻopili ʻia ka manaʻo o nā haumāna i nā ʻano plastina e ko lākou ʻike ulu ʻana i nā papahana hāʻawi cadaver a/a i ʻole ke kaʻina hana plastina.Hāʻawi ʻia ka Plastination i nā cadavers e like me ke aloha, ka mahalo a me ka mahalo a nā haumāna i manaʻo ai no kā lākou mea hāʻawi [10, 51].Hoʻokaʻawale kēia mau hiʻohiʻona i nā kahu hānai kanaka a, inā hoʻoulu ʻia, hiki ke kōkua iā lākou e holomua i ka ʻoihana ma o ka mahalo a me ke aloha ʻana i nā maʻi [25, 37].Hoʻohālikelike kēia i nā kumu aʻo leo ʻole e hoʻohana ana i ka dissection wet human dissection [37,52,53].Ma muli o ka hāʻawi ʻia ʻana o nā mea hoʻohālike no ka hoʻomaʻemaʻe ʻana mai nā kupapaʻu, ua manaʻo ʻia lākou he kumu aʻo leo leo e nā haumāna, i loaʻa ai ka mahalo no kēia mea hana aʻo hou.ʻOiai ua ʻike lākou ua hana ʻia nā hiʻohiʻona 3DP e nā mīkini, hauʻoli lākou i ka hoʻohana ʻana iā lākou.Manaʻo kēlā me kēia hui i ka mālama ʻia a mālama ʻia ke kumu hoʻohālike e mālama pono i kona kūpaʻa.Ua ʻike paha nā haumāna ua hana ʻia nā hiʻohiʻona 3DP mai ka ʻikepili maʻi no nā kumu hoʻonaʻauao.Ma ke kula o ka mea kākau, ma mua o ka hoʻomaka ʻana o nā haumāna i ke aʻo ʻana i ke anatomy, ua hāʻawi ʻia kahi papa anatomy hoʻomaka e pili ana i ka mōʻaukala anatomy, a laila hoʻohiki nā haumāna.ʻO ke kumu nui o ka hoʻohiki ʻana, ʻo ia ka hoʻoulu ʻana i nā haumāna i ka ʻike o ka waiwai kanaka, ka mahalo i nā mea hana anatomical, a me ka ʻoihana.ʻO ka hui pū ʻana o nā mea anatomical a me ka hoʻokō hiki ke kōkua i ka hoʻoulu ʻana i ke ʻano o ka mālama, mahalo, a hoʻomanaʻo paha i nā haumāna i kā lākou kuleana i ka wā e hiki mai ana i nā maʻi [54].
E pili ana i ka hoʻomaikaʻi ʻana i ka wā e hiki mai ana i nā mea hana aʻo, ua hoʻokomo nā haumāna mai nā pūʻulu plastination a me 3DP i ka makaʻu o ka luku ʻana i ka hale i ko lākou komo ʻana a me ke aʻo ʻana.Eia nō naʻe, ua hōʻike ʻia nā hopohopo e pili ana i ka hoʻohaunaele ʻana i ke ʻano o nā mea hoʻohālike i hoʻopaʻa ʻia i ka wā o nā kūkākūkā hui.Ua hōʻoia ʻia kēia ʻike e nā noiʻi mua ma nā ʻano plasticized [9, 10].Pono nā hoʻololi ʻana i ke kūkulu ʻana, ʻoi aku ka nui o nā ʻāʻī, e ʻimi i nā hale hohonu a hoʻomaopopo i ka pilina spatial ʻekolu.ʻO ka hoʻohana ʻana i ka tactile (tactile) a me ka ʻike ʻike e kōkua i nā haumāna e hana i kahi kiʻi noʻonoʻo kikoʻī a piha o nā ʻāpana anatomical ʻekolu-dimensional [55].Ua hōʻike nā haʻawina e hiki ke hoʻemi i ka haʻahaʻa cognitive a me ka hoʻomaopopo ʻana i ka ʻike [55].Ua manaʻo ʻia ʻo ka hoʻohui ʻana i nā hiʻohiʻona 3DP me nā hiʻohiʻona plasticized hiki ke hoʻomaikaʻi i ka launa pū ʻana o nā haumāna me nā hiʻohiʻona me ka makaʻu ʻole e hōʻino i nā hale.
Ka manawa hoʻouna: Iulai-21-2023