Ke emi nei ke ʻoki kupapaʻu kuʻuna, ʻoiai ke kaulana nei ke ʻano plastination a me nā hiʻohiʻona paʻi 3D (3DP) ma ke ʻano he koho ʻē aʻe i nā ʻano aʻo anatomy kuʻuna. ʻAʻole maopopo i nā ikaika a me nā nāwaliwali o kēia mau mea hana hou a pehea lākou e hoʻopilikia ai i ka ʻike aʻo anatomy o nā haumāna, ʻo ia hoʻi nā waiwai kanaka e like me ka mahalo, ka mālama, a me ke aloha.
Ma hope koke iho o ke aʻo ʻana i ke keʻa ʻana i ka randomized, ua kono ʻia he 96 mau haumāna. Ua hoʻohana ʻia kahi hoʻolālā pragmatic e ʻimi i nā ʻike aʻo e hoʻohana ana 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 loiloi thematic inductive ma muli o 278 mau loiloi kikokikona manuahi (e pili ana i nā ikaika, nā nāwaliwali, nā wahi no ka hoʻomaikaʻi ʻana) a me nā palapala verbatim o nā hui kālele (n = 8) e pili ana i ke aʻo ʻana i ke anatomy me ka hoʻohana ʻana i kēia mau mea hana.
ʻEhā mau kumuhana i ʻike ʻia: ka ʻoiaʻiʻo i ʻike ʻia, ka hoʻomaopopo kumu a me ka paʻakikī, nā ʻano o ka mahalo a me ka mālama, ka multimodality, a me ke alakaʻi.
Ma keʻano laulā, ua manaʻo nā haumāna he ʻoi aku ka maoli o nā hāpana plastinated a no laila ua ʻoi aku ka mahalo a me ka mālama ʻia ma mua o nā kumu hoʻohālike 3DP, i maʻalahi ka hoʻohana a ʻoi aku ka kūpono no ke aʻo ʻana i ke anatomi kumu.
ʻO ke kūʻē ʻana o ke kanaka kahi ʻano aʻo maʻamau i hoʻohana ʻia i ka hoʻonaʻauao lapaʻau mai ke kenekulia 17 [1, 2]. Eia nō naʻe, ma muli o ke komo palena ʻia, nā kumukūʻai kiʻekiʻe o ka mālama ʻana i ke kupapaʻu [3, 4], ka emi nui ʻana o ka manawa hoʻomaʻamaʻa anatomy [1, 5], a me nā holomua ʻenehana [3, 6], ke emi nei nā haʻawina anatomy i aʻo ʻia me ka hoʻohana ʻana i nā ʻano dissection kuʻuna. Wehe kēia i nā mea hiki hou no ka noiʻi ʻana i nā ʻano aʻo a me nā mea hana hou, e like me nā specimens kanaka plastinated a me nā hiʻohiʻona 3D i paʻi ʻia (3DP) [6,7,8].
Loaʻa i kēlā me kēia o kēia mau mea hana nā pono a me nā hemahema. He maloʻo nā ʻano i hoʻopili ʻia, ʻaʻohe ʻala, maoli a ʻaʻole weliweli [9,10,11], e lilo ana lākou i mea kūpono no ke aʻo ʻana a me ka hoʻokomo ʻana i nā haumāna i ke aʻo ʻana a me ka hoʻomaopopo ʻana i ke anatomy. Eia nō naʻe, he paʻa lākou a ʻaʻole maʻalahi [10, 12], no laila ua manaʻo ʻia he paʻakikī ke hoʻoponopono a hiki i nā ʻano hohonu [9]. Ma ke ʻano o ke kumukūʻai, ʻoi aku ke kumukūʻai o nā laʻana plasticized e kūʻai a mālama 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 ana i nā haumāna e ʻike maʻalahi, hoʻokaʻawale a hoʻomanaʻo i nā ʻano koʻikoʻi, ʻoiai ʻaʻole like kēia me ka maoli ma mua o nā laʻana plasticized.
Ua nānā kekahi mau haʻawina i nā hopena aʻo/hana o nā ʻano mea hana anatomical like ʻole e like me nā specimens 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, ua ʻokoʻa nā hopena ma muli o ke koho ʻana o ka mea hana hoʻomaʻamaʻa i hoʻohana ʻia i nā hui kaohi a me ke komo ʻana, a me ka hilinaʻi ʻana i nā ʻāpana anatomical like ʻole [14, 22]. No ka laʻana, i ka wā e hoʻohana ʻia ai me ka dissection pulu [11, 15] a me nā papa autopsy [20], ua hōʻike nā haumāna i ka ʻoluʻolu aʻo kiʻekiʻe a me nā manaʻo e pili ana i nā specimens plastinated. Pēlā nō, ʻo ka hoʻohana ʻana i nā ʻano plastination e hōʻike ana 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]. Ua hōʻike ʻo Loke et al. (2017) i ka hoʻohana ʻana o ke kumu hoʻohālike 3DP e hoʻomaopopo i ka maʻi puʻuwai hānau i loko o kahi pediatrician [18]. Ua hōʻike kēia haʻawina ua ʻoi aku ka ʻoluʻolu o ka hui 3DP i ke aʻo ʻana, ʻoi aku ka maikaʻi o ka hoʻomaopopo ʻana i ka tetrad a Fallot, a me ka hiki ke hoʻomaikaʻi i ka mālama ʻana 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 me ka hoʻohana ʻana i nā hiʻohiʻona 3DP e hāʻawi i ka ʻoluʻolu aʻo like me nā kiʻi 2D [16, 17]. Ua hōʻike kēia mau haʻawina ua ʻoi aku ka maikaʻi o nā hiʻohiʻona 3DP ma mua o nā kiʻi 2D ma ke ʻano o ka ʻoluʻolu aʻo i ʻike ʻia e ka haumāna. Eia nō naʻe, ua kaupalena ʻia nā haʻawina e hoʻohālikelike pono ana i nā hiʻohiʻona 3DP multi-material me nā laʻana plasticized. Ua hoʻohana ʻo Mogali et al. (2021) i ke kumu hoʻohālike plastination me kāna mau hiʻohiʻona puʻuwai a me ka ʻāʻī 3DP a ua hōʻike i ka piʻi like o ka ʻike ma waena o nā hui kaohi a me nā hui hoʻokolohua [21].
Eia nō naʻe, pono nā hōʻike hou aku e loaʻa ai kahi ʻike hohonu no ke kumu e hilinaʻi ai ka ʻike aʻo haumāna i ke koho ʻana o nā mea hana anatomical a me nā ʻāpana like ʻole o ke kino a me nā ʻōpū [14, 22]. ʻO nā waiwai humanist kahi ʻano hoihoi e hiki ke hoʻohuli i kēia ʻike. Pili kēia i ka mahalo, ka mālama, ke aloha a me ke aloha i manaʻo ʻia mai nā haumāna e lilo i mau kauka [25, 26]. Ua ʻimi mau ʻia nā waiwai humanistic i nā autopsies, ʻoiai ua aʻo ʻia nā haumāna e aloha a mālama i nā kupapaʻu i hāʻawi ʻia, a no laila ua noho mau ke aʻo ʻana o ke anatomy i kahi kūikawā [27, 28]. Eia naʻe, ʻaʻole i ana pinepine ʻia kēia i nā mea hana plasticizing a me 3DP. ʻAʻole e like me nā nīnau noiʻi Likert pani ʻia, ʻo nā ʻano hōʻiliʻili ʻikepili qualitative e like me nā kūkākūkā hui kālele a me nā nīnau noiʻi wehe ʻia e hāʻawi i ka ʻike i nā manaʻo o ka mea 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 i ke ʻano o ka ʻike ʻana o nā haumāna i ke anatomy ke hāʻawi ʻia lākou i nā mea hana i hoʻonohonoho ʻia (plastination) e hoʻohālikelike ʻia me nā kiʻi paʻi 3D kino e aʻo ai i ke anatomy?
No ka pane ʻana i nā nīnau i luna, loaʻa i nā haumāna ka manawa kūpono e loaʻa, hōʻiliʻili a kaʻana like i ka ʻike anatomical ma o ka launa pū ʻana o ka hui a me ka laulima ʻana. Kūlike kēia manaʻo me ke kumumanaʻo constructivist, e like me ka poʻe a i ʻole nā hui kaiaulu e hana ikaika a kaʻana like 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) e pili ana i ka ʻoluʻolu o ke aʻo ʻana [30, 31]. I ka manawa like, e hoʻopili ʻia ka ʻike aʻo o nā haumāna e nā mea e like me ka maʻalahi o ke aʻo ʻana, ke kaiapuni, nā ʻano aʻo, a me ka ʻike o ka papa [32]. Ma hope mai, hiki i kēia mau ʻano ke hoʻopili 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 theoretical o ka epistemology pragmatic, kahi e hiki ai i ka ʻohi mua a i ʻole ka hoʻokumu ʻana o ka ʻike pilikino, ka naʻauao, a me nā manaʻoʻiʻo ke hoʻoholo i ka hana aʻe [35]. Hoʻolālā pono ʻia ke ʻano 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].
Ua manaʻo pinepine ʻia nā hāpana kupapaʻu he mau kumu aʻoaʻo leo ʻole, no ka mea, ua ʻike ʻia lākou he mau makana koʻikoʻi no ka pono o ka ʻepekema a me ke kanaka, e hoʻoulu ana i ka mahalo a me ka mahalo mai nā haumāna i kā lākou poʻe hāʻawi [37, 38]. Ua hōʻike nā haʻawina mua i nā helu like a ʻoi aku paha ma waena o ka hui kupapaʻu/plastination a me ka hui 3DP [21, 39], akā ʻaʻole maopopo inā like ka ʻike aʻo ʻana o nā haumāna, me nā waiwai humanistic, ma waena o nā hui ʻelua. No ka noiʻi hou aku, hoʻohana kēia haʻawina i ke kumumanaʻo o ka pragmatism [36] e nānā i ka ʻike aʻo a me nā ʻano o nā hiʻohiʻona 3DP (kala a me ke ʻano) a hoʻohālikelike iā lākou me nā hāpana plastinated e pili ana i ka manaʻo o nā haumāna.
A laila hiki i nā manaʻo o nā haumāna ke hoʻohuli i nā hoʻoholo a nā kumu e pili ana i ke koho ʻana i nā mea hana anatomi kūpono e pili ana i ka mea kūpono a me ka mea ʻole no ke aʻo ʻana i ka anatomi. Hiki i kēia ʻike ke kōkua i nā kumu e ʻike i nā makemake o nā haumāna a hoʻohana i nā mea hana loiloi kūpono e hoʻomaikaʻi i kā lākou ʻike aʻo.
ʻO ka pahuhopu o kēia haʻawina qualitative e ʻimi i nā mea a nā haumāna e manaʻo ai he ʻike aʻo koʻikoʻi me ka hoʻohana ʻana i nā laʻana puʻuwai a me ka ʻāʻī plasticized i hoʻohālikelike ʻia me nā hiʻohiʻona 3DP. Wahi a kahi noiʻi mua na Mogali et al. i ka makahiki 2018, ua manaʻo nā haumāna he ʻoi aku ka maoli o nā laʻana plastinated ma mua o nā hiʻohiʻona 3DP [7]. No laila e manaʻo kākou:
No ka mea ua hana ʻia nā plastinations mai nā kupapaʻu maoli, ua manaʻo ʻia nā haumāna e nānā i nā plastinations me ka maikaʻi aʻe ma mua o nā kumu hoʻohālike 3DP e pili ana i ka ʻoiaʻiʻo a me ka waiwai kanaka.
Pili kēia haʻawina qualitative i ʻelua mau haʻawina quantitative ma mua [21, 40] no ka mea ua hōʻiliʻili ʻia ka ʻikepili i hōʻike ʻia ma nā haʻawina ʻekolu mai ka laʻana like o nā haumāna i komo. Ua hōʻike ka ʻatikala mua i nā ana like like (nā helu hoʻāʻo) ma waena o nā hui plastination a me 3DP [21], a ua hoʻohana ka ʻatikala ʻelua i ka loiloi kumu e hoʻomohala i kahi mea hana i hōʻoia ʻia e ka psychometrically (ʻehā mau kumu, 19 mau mea) e ana i nā kūkulu hoʻonaʻauao e like me ka ʻoluʻolu o ke aʻo ʻana, ka pono ponoʻī, nā waiwai humanistic, a me nā palena o ka media aʻo [40]. Ua nānā kēia haʻawina i nā kūkākūkā hui wehe a me ka hui kālele kiʻekiʻe e ʻike i nā mea a nā haumāna e manaʻo ai he mea nui i ke aʻo ʻana i ke anatomy 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/nīnau, ʻikepili, a me nā ʻano loiloi e loaʻa ai ka ʻike i ka manaʻo o nā haumāna qualitative (nā manaʻo kikokikona manuahi a me ke kūkākūkā hui kālele) ma ka hoʻohana ʻana i nā mea hana 3DP i hoʻohālikelike ʻia me nā laʻana plasticized. ʻO ke ʻano kēia, ua hoʻoponopono maoli ka haʻawina o kēia manawa i kahi nīnau noiʻi ʻokoʻa ma mua o nā ʻatikala ʻelua ma mua [21, 40].
Ma ke kula o ka mea kākau, ua hoʻohui ʻia ke anatomy i loko o nā papa hana ʻōnaehana e like me ka cardiopulmonary, endocrinology, musculoskeletal, a pēlā aku, i nā makahiki ʻelua mua o ka papahana ʻelima makahiki Bachelor of Medicine a me Bachelor of Surgery (MBBS). Hoʻohana pinepine ʻia nā ʻāpana plastered, nā hiʻohiʻona plastic, nā kiʻi lapaʻau, a me nā hiʻohiʻona 3D virtual ma kahi o ka dissection a i ʻole nā ʻāpana dissection pulu e kākoʻo i ka hana anatomy laulā. Hoʻololi nā hālāwai aʻo hui i nā haʻiʻōlelo kuʻuna i aʻo ʻia me ka nānā ʻana i ka hoʻopili ʻana o ka ʻike i loaʻa. I ka hopena o kēlā me kēia module ʻōnaehana, e lawe i kahi hoʻokolohua hoʻomaʻamaʻa anatomy formative pūnaewele e komo pū ana me 20 mau pane maikaʻi loa (SBAs) e uhi ana i ke anatomy laulā, ke kiʻi ʻana, a me ka histology. Ma ka huina, ua mālama ʻia ʻelima mau hoʻokolohua formative i ka wā o ka hoʻokolohua (ʻekolu i ka makahiki mua a ʻelua i ka makahiki ʻelua). ʻO ka loiloi kākau piha i hui pū ʻia no nā Makahiki 1 a me 2 e komo pū ana me ʻelua mau pepa, aia i kēlā me kēia he 120 SBAs. Lilo ke Anatomy i ʻāpana o kēia mau loiloi a hoʻoholo ka hoʻolālā loiloi i ka helu o nā nīnau anatomical e hoʻokomo ʻia.
I mea e hoʻomaikaʻi ai i ka lakio o ka haumāna-i-laʻana, ua aʻo ʻia nā kumu hoʻohālike 3DP kūloko e pili ana i nā laʻana plastinated no ke aʻo ʻana a me ke aʻo ʻana i ke anatomia. Hāʻawi kēia i kahi manawa kūpono e hoʻokumu i ka waiwai hoʻonaʻauao o nā kumu hoʻohālike 3DP hou i hoʻohālikelike ʻia me nā laʻana plastinated ma mua o ko lākou hoʻokomo kūhelu ʻia ʻana i loko o ka papa hana anatomia.
Ma kēia haʻawina, ua hana ʻia ka computed tomography (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 ma ke ʻano ʻoki) a me ke poʻo a me ka ʻāʻī (hoʻokahi holoʻokoʻa a hoʻokahi midsagittal plane head-neck) (Kiʻi 1). Ua loaʻa nā kiʻi Digital Imaging and Communications in Medicine (DICOM) a ua hoʻouka ʻia i loko o 3D Slicer (nā mana 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 aʻa, nā aʻalolo, a me nā iwi. Ua hoʻouka ʻia nā faila i māhele ʻia i loko o Materialize Magics (Version 22, Materialize NV, Leuven, Belgium) e wehe i nā pūpū walaʻau, a ua mālama ʻia nā hiʻohiʻona paʻi ma ke ʻano STL, a laila ua hoʻoili ʻia i kahi mīkini paʻi Objet 500 Connex3 Polyjet (Stratasys, Eden Prairie, MN) e hana i nā hiʻohiʻona anatomical 3D. Hoʻopaʻakikī nā resins photopolymerizable a me nā elastomers moakaka (VeroYellow, VeroMagenta a me TangoPlus) papa ma ka papa ma lalo o ka hana a ka kukuna UV, e hāʻawi ana i kēlā me kēia ʻano anatomical i kona ʻano a me ke kala ponoʻī.
Nā mea hana noiʻi anatomia i hoʻohana ʻia ma kēia noiʻi. Hema: ʻĀʻī; ʻākau: puʻuwai i hoʻopili ʻia a paʻi ʻia me 3D.
Eia kekahi, ua koho ʻia ka aorta piʻi aʻe a me ka ʻōnaehana coronary mai ke kumu hoʻohālike puʻuwai holoʻokoʻa, a ua kūkulu ʻia nā scaffolds kumu e hoʻopili i ke kumu hoʻohālike (mana 22, Materialize NV, Leuven, Belgium). Ua paʻi ʻia ke kumu hoʻohālike ma kahi mīkini 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 ka 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 ke Kulanui ʻo Lee Kong Chiang i ka makahiki kula 2020-2021 (n = 163, 94 kāne a me 69 wahine) kahi leka uila e komo i kēia haʻawina ma ke ʻano he hana manawaleʻa. Ua hana ʻia ka hoʻokolohua cross-over randomized i ʻelua mau pae, ʻo ka mua me ka ʻoki ʻana i ka puʻuwai a laila me ka ʻoki ʻana i ka ʻāʻī. Aia kahi manawa holoi ʻeono pule ma waena o nā pae ʻelua e hōʻemi i nā hopena koena. Ma nā pae ʻelua, ua makapō nā haumāna i nā kumuhana aʻo a me nā haʻawina hui. ʻAʻole i ʻoi aku ma mua o ʻeono mau kānaka i loko o kahi hui. ʻO nā haumāna i loaʻa nā laʻana plastinated i ka pae mua i loaʻa nā hiʻohiʻona 3DP i ka pae ʻelua. Ma kēlā me kēia pae, loaʻa i nā hui ʻelua kahi haʻiʻōlelo hoʻolauna (30 mau minuke) mai kahi ʻaoʻao ʻekolu (kumu kiʻekiʻe) a ukali ʻia e ke aʻo ponoʻī (50 mau minuke) me ka hoʻohana ʻana i nā mea hana aʻo ponoʻī i hāʻawi ʻia a me nā pepa hāʻawi.
Hoʻohana ʻia ka papa inoa COREQ (Comprehensive Criteria for Qualitative Research Reporting) e alakaʻi i ka noiʻi qualitative.
Ua hāʻawi nā haumāna i nā manaʻo no nā mea aʻo noiʻi ma o kahi noiʻi i hoʻokomo i ʻekolu mau nīnau hāmama e pili ana i ko lākou mau ikaika, nāwaliwali, a me nā manawa kūpono no ka hoʻomohala ʻana. Ua hāʻawi nā mea pane he 96 a pau i nā pane manuahi. A laila, ua komo nā haumāna manawaleʻa ʻewalu (n = 8) i ka hui kūkākūkā. Ua mālama ʻia nā nīnauele ma ke Kikowaena Hoʻomaʻamaʻa Anatomy (kahi i mālama ʻia ai nā hoʻokolohua) a ua mālama ʻia e ka Mea Noiʻi 4 (Ph.D.), he kumu aʻo kāne ʻaʻole anatomical me ka ʻoi aku o 10 mau makahiki o ka ʻike kōkua TBL, akā ʻaʻole i komo i ke aʻo ʻana o ka hui noiʻi. ʻAʻole ʻike nā haumāna i nā ʻano pilikino o nā mea noiʻi (a me ka hui noiʻi) ma mua o ka hoʻomaka ʻana o ke aʻo ʻana, akā ua hoʻomaopopo ka palapala ʻae iā lākou i ke kumu o ke aʻo ʻana. ʻO ka mea noiʻi 4 wale nō a me nā haumāna i komo i ka hui kūkākūkā. Ua wehewehe ka mea noiʻi i ka hui kūkākūkā i nā haumāna a nīnau iā lākou inā makemake lākou e komo. Ua kaʻana like lākou i ko lākou ʻike o ke aʻo ʻana i ka paʻi 3D a me ka plastination a ua hoihoi loa lākou. Ua nīnau ka mea kōkua i ʻeono mau nīnau alakaʻi e paipai i nā haumāna e hana ma o (Mea Hoʻohui 1). ʻO nā hiʻohiʻona e komo pū ana me ke kūkākūkā ʻana i nā ʻano o nā mea hana anatomical e paipai ana i ke aʻo ʻana a me ke aʻo ʻana, a me ke kuleana o ke aloha i ka hana ʻana me ia mau specimens. "Pehea ʻoe e wehewehe ai i kou ʻike o ke aʻo ʻana i ke anatomy me ka hoʻohana ʻana i nā specimens plastinated a me nā kope paʻi 3D?" ʻo ia ka nīnau mua o ka ninaninau. Ua wehe ʻia nā nīnau a pau, e ʻae ana i nā mea hoʻohana e pane manuahi i nā nīnau me ka ʻole o nā wahi i manaʻo ʻole ʻia, e ʻae ana i ka ʻikepili hou e ʻike ʻia a me nā pilikia e lanakila me nā mea hana aʻo. ʻAʻole i loaʻa i nā mea komo ka hoʻopaʻa ʻana o nā manaʻo a i ʻole ka nānā ʻana i nā hopena. ʻO ke ʻano manawaleʻa o ke aʻo ʻana i pale aku i ka saturation o ka ʻikepili. Ua hoʻopaʻa ʻia ke kamaʻilio holoʻokoʻa no ka nānā ʻana.
Ua kākau pololei ʻia ka hoʻopaʻa leo ʻana o ka hui kālele (35 mau minuke) a ua hoʻokaʻawale ʻia ke ʻano pilikino (ua hoʻohana ʻia nā inoa kapakapa). Eia kekahi, ua hōʻiliʻili ʻia nā nīnau nīnau hāmama. Ua lawe ʻia nā palapala a me nā nīnau noiʻi o ka hui kālele i loko o kahi pālahalaha Microsoft Excel (Microsoft Corporation, Redmond, WA) no ka triangulation ʻikepili a me ka hōʻuluʻulu ʻana e nānā i nā hopena like a kūlike paha a i ʻole nā hopena hou [41]. Hana ʻia kēia ma o ka loiloi thematic theoretical [41, 42]. Hoʻohui ʻia nā pane kikokikona a kēlā me kēia haumāna i ka huina o nā pane. ʻO ke ʻano kēia e mālama ʻia nā manaʻo e loaʻa ana nā ʻōlelo he nui ma ke ʻano he hoʻokahi. ʻO nā pane me ka nil, ʻaʻohe a ʻaʻohe paha nā lepili manaʻo e nānā ʻole ʻia. ʻEkolu mau mea noiʻi (he wahine noiʻi me ka Ph.D., he wahine noiʻi me ke kēkelē laepua, a me ke kōkua kāne me ke kēkelē laepua ma ke ʻenekinia a me 1-3 mau makahiki o ka ʻike noiʻi ma ka hoʻonaʻauao lapaʻau) i hoʻopili kūʻokoʻa i ka ʻikepili i hoʻonohonoho ʻole ʻia. Hoʻohana ʻekolu mau mea papahana i nā pads kaha kiʻi maoli e hoʻokaʻawale i nā memo post-it ma muli o nā ʻano like a me nā ʻokoʻa. Ua mālama ʻia kekahi mau hālāwai e hoʻonohonoho a hoʻohui i nā code ma o ka ʻike ʻana i nā ʻano hoʻohālike ʻōnaehana a me ka iterative, kahi i hoʻohui ʻia ai nā code e ʻike i nā kumuhana liʻiliʻi (nā ʻano kikoʻī a laulā paha e like me nā ʻano maikaʻi a maikaʻi ʻole o nā mea hana aʻo) a laila hoʻokumu i nā kumuhana nui [41]. No ka hiki ʻana i ka ʻaelike, ua ʻae ʻia e kahi mea noiʻi kāne 6 (Ph.D.) me 15 mau makahiki o ka ʻike i ke aʻo ʻana i ke anatomy nā kumuhana hope loa.
E like me ka Hōʻike a Helsinki, ua loiloi ka Papa Loiloi ʻAhahui o ke Kulanui ʻenehana ʻo Nanyang (IRB) (2019-09-024) i ke kaʻina hana noiʻi a ua loaʻa iā lākou nā ʻae e pono ai. Ua ʻae nā mea komo i ka ʻike maopopo a ua hoʻomaopopo ʻia lākou i ko lākou kuleana e haʻalele i ke komo ʻana i kēlā me kēia manawa.
Ua hāʻawi nā haumāna lapaʻau makahiki mua he kanaiwakūmāono i ka ʻae piha ʻana, nā demographics kumu e like me ke kāne a me ka makahiki, a ua haʻi aku ʻaʻohe aʻo kūhelu mua ma ke anatomy. ʻO ka Māhele I (puʻuwai) a me ka Māhele II (ʻoki ʻāʻī) ua pili i 63 mau mea komo (33 kāne a me 30 wahine) a me 33 mau mea komo (18 kāne a me 15 wahine), kēlā me kēia. ʻO ko lākou mau makahiki mai 18 a 21 mau makahiki (awelika ± ʻokoʻa maʻamau: 19.3 ± 0.9) mau makahiki. Ua pane nā haumāna 96 a pau i ka nīnau nīnau (ʻaʻohe haʻalele ʻana), a ua komo nā haumāna 8 i nā hui kālele. He 278 mau manaʻo hāmama e pili ana i nā pono, nā pōʻino, a me nā pono no ka hoʻomaikaʻi ʻana. ʻAʻohe kūlike ʻole ma waena o ka ʻikepili i kālailai ʻia a me ka hōʻike o nā ʻike.
Ma loko o nā kūkākūkā hui kūkākūkā a me nā pane noiʻi, ua puka mai nā kumumanaʻo ʻehā: ka ʻoiaʻiʻo i ʻike ʻia, ka hoʻomaopopo kumu a me ka paʻakikī, nā ʻano o ka mahalo a me ka mālama, ka multimodality, a me ke alakaʻi (Kiʻi 2). Ua wehewehe ʻia kēlā me kēia kumuhana ma nā kikoʻī ma lalo nei.
ʻO nā kumumanaʻo ʻehā—ka ʻoiaʻiʻo i ʻike ʻia, ka hoʻomaopopo kumu a me ka paʻakikī, ka mahalo a me ka mālama, a me ka makemake no nā mea hoʻolaha aʻo—ua hoʻokumu ʻia ma ka loiloi kumuhana o nā nīnau noiʻi hāmama a me nā kūkākūkā hui kālele. Hōʻike nā mea i loko o nā pahu polū a me ka melemele i nā waiwai o ka laʻana i hoʻopili ʻia a me ke kumu hoʻohālike 3DP. 3DP = paʻi 3D
Ua manaʻo nā haumāna he ʻoi aku ka maoli o nā ʻāpana i hoʻopili ʻia me ka plastination, he mau kala kūlohelohe e hōʻike ana i nā kupapaʻu maoli, a he ʻoi aku ka maikaʻi o nā kikoʻī anatomical ma mua o nā hiʻohiʻona 3DP. No ka laʻana, ʻoi aku ka ʻike ʻia o ke kuhikuhi ʻana o ka 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 hoʻi, e like me ke kanaka maoli (mea komo C17; loiloi plastination ʻano manuahi)."
Ua ʻike nā haumāna he 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 specimens plasticized he kūpono no ka hoʻonui hou ʻana i ko lākou ʻike a me ka hoʻomaopopo ʻana i nā ʻano anatomical paʻakikī a me nā ʻāpana. Ua manaʻo nā haumāna ʻoiai he mau kope pololei nā mea hana ʻelua o kekahi i kekahi, ua nele 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.
"...ua loaʻa kekahi mau pilikia e like me... nā kikoʻī liʻiliʻi e like me ka fossa ovale... ma ke ʻano laulā hiki ke hoʻohana ʻia kahi kumu hoʻohālike 3D o ka puʻuwai... no ka ʻāʻī, malia paha e aʻo wau i ke kumu hoʻohālike plastination me ka hilinaʻi nui (mea komo PA1; 3DP, kūkākūkā hui kikoʻī").
"...hiki ke ʻike ʻia nā ʻano nui... ma ke kikoʻī, he mea pono nā hiʻohiʻona 3DP no ke aʻo ʻana, no ka laʻana, nā ʻano ʻoi aku ka paʻakikī (a) nā mea nui a maʻalahi hoʻi e ʻike e like me nā ʻiʻo a me nā ʻōpū... malia paha (no) ka poʻe i loaʻa ʻole ke komo ʻana i nā hiʻohiʻona plastinated (mea komo PA3; 3DP, kūkākūkā hui kālele)".
Ua hōʻike aku nā haumāna i ka mahalo a me ka hopohopo no nā ʻāpana i hoʻopili ʻia i ka plastination, akā ua hopohopo pū lākou no ka luku ʻia ʻana o ke ʻano ma muli o kona palupalu a me ka nele o ka maʻalahi. Ma ke ʻano ʻē, ua hoʻohui nā haumāna i ko lākou ʻike hana ma ka ʻike ʻana e hiki ke hana hou ʻia nā hiʻohiʻona 3DP inā hōʻino ʻia.
"... ʻoi aku ko mākou akahele me nā ʻano plastination (mea komo PA2; plastination, kūkākūkā hui kālele)".
"...no nā hāpana plastination, ua like ia me...kahi mea i mālama ʻia no ka manawa lōʻihi. Inā ua hōʻino wau iā ia... manaʻo wau ua ʻike mākou he ʻoi aku ka nui o ka pōʻino no ka mea he mōʻaukala kona (mea komo PA3; plastination, kūkākūkā hui kālele)."
"Hiki ke hana ʻia nā hiʻohiʻona paʻi 3D me ka wikiwiki a me ka maʻalahi ... e hoʻolilo ana i nā hiʻohiʻona 3D i mea hiki i nā poʻe he nui ke komo a hoʻomaʻalahi i ke aʻo ʻana me ka ʻole o ka kaʻana like ʻana 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 ʻole e pili ana i ka hōʻino ʻana iā lākou, e like me ka hōʻino ʻana i nā laʻana... (mea komo PA2; 3DP, kūkākūkā hui kālele)."
Wahi a nā haumāna, ua kaupalena ʻia ka nui o nā ʻano plastinated, a he paʻakikī ke komo ʻana i nā ʻano hohonu ma muli o ko lākou paʻakikī. No ke kumu hoʻohālike 3DP, ke manaʻolana nei lākou e hoʻomaikaʻi hou aku i nā kikoʻī anatomical ma o ka hoʻopilikino ʻana i ke kumu hoʻohālike i nā wahi hoihoi no ke aʻo pilikino. Ua ʻae nā haumāna e hiki ke hoʻohana ʻia nā kumu hoʻohālike plasticized a me 3DP me nā ʻano mea hana aʻo ʻē aʻe e like me ka papa Anatomage e hoʻomaikaʻi i ke aʻo ʻana.
"ʻAʻole ʻike maikaʻi ʻia kekahi mau ʻano hohonu o loko (mea komo C14; plastination, ʻōlelo ʻano manuahi)."
"Malia paha he mea pono loa nā papa autopsy a me nā ʻano hana ʻē aʻe (lālā C14; plastination, loiloi kikokikona manuahi)."
"Ma ka hōʻoia ʻana ua kikoʻī maikaʻi ʻia nā hiʻohiʻona 3D, hiki iā ʻoe ke loaʻa nā hiʻohiʻona kaʻawale e kālele 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)."
Ua manaʻo pū nā haumāna e hoʻokomo i kahi hōʻike no ke kumu e wehewehe pehea e hoʻohana pono ai i ke kumu hoʻohālike, a i ʻole ke alakaʻi hou aku e pili ana i nā kiʻi laʻana i hōʻike ʻia e hoʻomaʻalahi i ke aʻo ʻana a me ka hoʻomaopopo ʻana i nā memo haʻiʻōlelo, ʻoiai ua ʻae lākou ua hoʻolālā kūikawā ʻia ke aʻo ʻana no ke aʻo ponoʻī.
"...Mahalo wau i ke ʻano noiʻi kūʻokoʻa...malia paha e hiki ke hāʻawi ʻia aku nā alakaʻi hou aʻe ma ke ʻano o nā kiʻi paʻi a i ʻole kekahi mau memo...(mea komo C02; nā manaʻo kikokikona manuahi ma ke ʻano laulā)."
"Hiki i nā loea ʻike a i ʻole ka loaʻa ʻana o nā mea hana ʻike maka hou e like me ka animation a i ʻole wikiō ke kōkua iā mākou e hoʻomaopopo maikaʻi i ke ʻano o nā hiʻohiʻona 3D (lālā C38; nā loiloi kikokikona manuahi ma ke ʻano laulā)."
Ua nīnau ʻia nā haumāna lapaʻau makahiki mua e pili ana i kā lākou ʻike aʻo a me ke ʻano o nā laʻana i paʻi ʻia a me nā plasticized 3D. E like me ka mea i manaʻo ʻia, ua ʻike nā haumāna he ʻoi aku ka maoli a me ka pololei o nā laʻana plasticized ma mua o nā mea i paʻi ʻia ma 3D. Ua hōʻoia ʻia kēia mau hopena e kahi noiʻi mua [7]. ʻOiai ua hana ʻia nā moʻolelo mai nā kupapaʻu i hāʻawi ʻia, he ʻoiaʻiʻo lākou. ʻOiai he kope 1:1 ia o kahi laʻana plastinated me nā ʻano morphological like [8], ua manaʻo ʻia ke kumu hoʻohālike 3D i paʻi ʻia ma muli o ka polymer he mea maoli ʻole a ʻaʻole maoli, ʻoi aku hoʻi i nā haumāna i ʻike ʻole ʻia nā kikoʻī e like me nā kihi o ka fossa oval i ke kumu hoʻohālike 3DP o ka puʻuwai i hoʻohālikelike ʻia me ke kumu hoʻohālike plastinated. Hiki paha kēia ma muli o ke ʻano o ke kiʻi CT, ʻaʻole ia e ʻae i ka wehewehe maopopo ʻana o nā palena. No laila, he paʻakikī ke hoʻokaʻawale i kēlā mau ʻano i loko o ka polokalamu segmentation, kahi e hoʻopilikia ai i ke kaʻina hana paʻi 3D. Hiki i kēia ke hoʻāla i nā kānalua e pili ana i ka hoʻohana ʻana i nā mea hana 3DP no ka mea makaʻu lākou e nalowale ka ʻike koʻikoʻi inā ʻaʻole hoʻohana ʻia nā mea hana maʻamau e like me nā laʻana plasticized. Hiki i nā haumāna e makemake ana i ke aʻo ʻoki kino ke ʻike he mea pono ke hoʻohana i nā kumu hoʻohālike hana [43]. Ua like nā hopena o kēia manawa me nā haʻawina mua i ʻike ʻia ʻaʻole i loaʻa i nā kumu hoʻohālike plastik [44] a me nā laʻana 3DP ka pololei o nā laʻana maoli [45].
I mea e hoʻomaikaʻi ai i ka hiki ʻana o nā haumāna a no laila ka ʻoluʻolu o 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 ʻana i ke kumukūʻai kūpono [6, 21]. He kūlike kēia me kahi noiʻi mua i hōʻike i ka hana hoʻohālikelike o nā hiʻohiʻona plasticized a me nā hiʻohiʻona 3DP [21]. Manaʻo nā haumāna he ʻoi aku ka pono o nā hiʻohiʻona 3DP no ke aʻo ʻana i nā manaʻo anatomical kumu, nā ʻōpū, a me nā hiʻohiʻona, ʻoiai ʻoi aku ka kūpono o nā specimens plastinated no ke aʻo ʻana i ka anatomy paʻakikī. Eia kekahi, ua kākoʻo nā haumāna i ka hoʻohana ʻana i nā hiʻohiʻona 3DP me nā specimens cadaver e kū nei a me ka ʻenehana hou e hoʻomaikaʻi i ka ʻike o nā haumāna i ka anatomy. Nui nā ala e hōʻike ai i ka mea like, e like me ke kaha kiʻi ʻana i ka anatomy o ka puʻuwai me ka hoʻohana ʻana i nā cadavers, ka paʻi 3D, nā scans maʻi, a me nā hiʻohiʻona 3D virtual. ʻAe kēia ʻano multi-modal i nā haumāna e hōʻike i ka 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 ma nā ʻano like ʻole [44]. Ua hōʻike ʻia ka noiʻi he paʻakikī nā mea aʻo maoli e like me nā mea hana cadaver no kekahi mau haumāna e pili ana i ka ukana cognitive e pili ana i ke aʻo ʻana i ka anatomy [46]. He mea koʻikoʻi ka hoʻomaopopo ʻana i ka hopena o ka ukana noʻonoʻo i ke aʻo ʻana o nā haumāna a me ka hoʻopili ʻana i nā ʻenehana e hōʻemi i ka ukana noʻonoʻo 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 lilo i ala pono e hōʻike i nā ʻano kumu a koʻikoʻi o ke anatomy i mea e hōʻemi ai i ka ukana noʻonoʻo a hoʻonui i ke aʻo ʻana. Eia kekahi, hiki i nā haumāna ke lawe i nā hiʻohiʻona 3DP i ka home no ka loiloi ʻana me nā puke aʻo a me nā mea haʻiʻōlelo a hoʻonui i ke aʻo ʻana o ke anatomy ma waho o ka lab [45]. Eia naʻe, ʻaʻole i hoʻokō ʻia ka hana o ka wehe ʻana i nā ʻāpana 3DP ma ka hale o ka mea kākau.
Ma kēia haʻawina, ua ʻoi aku ka mahalo ʻia o nā laʻana plastinated ma mua o nā replicas 3DP. Kūlike kēia hopena me ka noiʻi mua e hōʻike ana i nā specimens cadaveric ma ke ʻano he "maʻi mua" e kauoha i ka mahalo a me ke aloha, ʻoiai ʻaʻole nā mea hoʻohālike artificial [49]. He pilikino a maoli ka ʻiʻo kanaka plastinated maoli. ʻO ka hoʻohana ʻana i nā mea cadaveric e hiki ai i nā haumāna ke hoʻomohala i nā manaʻo humanistic a me nā pono [50]. Eia kekahi, hiki ke hoʻopilikia ʻia ka ʻike o nā haumāna i nā ʻano plastination e ko lākou ʻike ulu ʻana i nā papahana hāʻawi cadaver a/a i ʻole ke kaʻina hana plastination. ʻO ka plastination he mau cadavers i hāʻawi ʻia e hoʻohālike i ke aloha, ka mahalo a me ka mahalo a nā haumāna e manaʻo ai no kā lākou mea hāʻawi [10, 51]. Hoʻokaʻawale kēia mau ʻano i nā kahu hānai humanistic a, inā i mahi ʻia, hiki ke kōkua iā lākou e holomua ma ke ʻano ʻoihana ma ka mahalo a me ke aloha me nā maʻi [25, 37]. Ua like kēia me nā kumu aʻo leo ʻole e hoʻohana ana i ka dissection kanaka pulu [37,52,53]. ʻOiai ua hāʻawi ʻia nā specimens no ka plastination mai nā cadavers, ua manaʻo ʻia lākou he mau kumu aʻo leo ʻole e nā haumāna, kahi 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 mau lākou i ka hoʻohana ʻana iā lākou. Manaʻo kēlā me kēia hui ua mālama ʻia a ua mālama pono ʻia ke kumu hoʻohālike e mālama i kona kūpaʻa. Ua ʻike mua paha nā haumāna ua hana ʻia nā hiʻohiʻona 3DP mai ka ʻikepili o ka mea maʻi no nā kumu hoʻonaʻauao. Ma ke kula o ka mea kākau, ma mua o ka hoʻomaka ʻana o nā haumāna i ke aʻo kūhelu ʻana i ka anatomy, hāʻawi ʻia kahi papa anatomy hoʻolauna ma ka mōʻaukala o ka anatomy, a ma hope o ka hoʻohiki ʻana o nā haumāna. ʻO ke kumu nui o ka hoʻohiki ʻana, ʻo ia ke hoʻokomo i loko o nā haumāna i ka ʻike o nā pono kanaka, ka mahalo i nā mea hana anatomical, a me ka ʻoihana. ʻO ka hui pū ʻana o nā mea hana anatomical a me ke kūpaʻa e hiki ke kōkua i ka hoʻokomo ʻana i kahi manaʻo o ka mālama, ka mahalo, a me ka hoʻomanaʻo ʻana paha i nā haumāna i kā lākou mau kuleana e hiki mai ana i nā mea maʻi [54].
E pili ana i nā hoʻomaikaʻi ʻana i nā mea hana aʻo e hiki mai ana, ua hoʻokomo nā haumāna mai nā hui plastination a me 3DP i ka makaʻu o ka luku ʻia ʻana o ke ʻano i kā lākou komo ʻana a me ke aʻo ʻana. Eia nō naʻe, ua hōʻike ʻia nā hopohopo e pili ana i ka hoʻopilikia ʻana o ke ʻano o nā specimens i hoʻopili ʻia i ka wā o nā kūkākūkā hui. Ua hōʻoia ʻia kēia ʻike e nā haʻawina mua ma nā laʻana plasticized [9, 10]. Pono nā hoʻoponopono ʻano, ʻoiai nā hiʻohiʻona ʻāʻī, e ʻimi i nā ʻano hohonu a hoʻomaopopo i nā pilina spatial ʻekolu-dimensional. ʻO ka hoʻohana ʻana i ka ʻike tactile (tactile) a me ka ʻike maka 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 i ka hoʻoponopono tactile o nā mea kino ke hōʻemi i ka ukana cognitive a alakaʻi i ka hoʻomaopopo maikaʻi ʻana a me ka mālama ʻana i ka ʻike [55]. Ua manaʻo ʻia e hiki i ka hoʻohui ʻana i nā hiʻohiʻona 3DP me nā specimens plasticized ke hoʻomaikaʻi i ka launa pū ʻana o nā haumāna me nā specimens me ka makaʻu ʻole e hōʻino i nā ʻano.
Ka manawa hoʻouna: Iulai-21-2023