Ukuhlukaniswa kwezidumbu zendabuko kuyawohloka, kuyilapho amamodeli e-plastination kanye ne-3D printed (3DP) ethola ukuthandwa njengendlela ehlukile kunezindlela zokufundisa zendabuko ze-anatomy. Akucaci ukuthi yimaphi amandla nobuthakathaka bala mathuluzi amasha nokuthi angathinta kanjani ulwazi lokufunda kwe-anatomy lwabafundi, oluhlanganisa izindinganiso zobuntu ezifana nenhlonipho, ukunakekelwa, nozwela.
Ngemva nje kocwaningo oluhleliwe lwe-cross-over, kwamenywa abafundi abangu-96. Kwasetshenziswa umklamo osebenzayo ukuhlola okuhlangenwe nakho kokufunda kusetshenziswa amamodeli enhliziyo ahlanganiswe ngokwe-anatomiki kanye ne-3D (Isigaba 1, n=63) kanye nentamo (Isigaba 2, n=33). Ukuhlaziywa kwesihloko okuholelayo kwenziwa ngokusekelwe ekubuyekezweni kombhalo wamahhala okungu-278 (okubhekisela emandleni, ubuthakathaka, izindawo zokuthuthukisa) kanye nokulotshwa kwamagama aqondile kwamaqembu okugxila (n = 8) mayelana nokufunda i-anatomiki kusetshenziswa la mathuluzi.
Kwahlonzwa izingqikithi ezine: ubuqiniso obubonakalayo, ukuqonda okuyisisekelo kanye nobunzima, izimo zengqondo zenhlonipho nokunakekela, izindlela eziningi zokuphatha izinto, kanye nobuholi.
Ngokuvamile, abafundi babenomuzwa wokuthi amasampula afakwe ipulasitiki ayengokoqobo kakhulu ngakho-ke azizwa ehlonishwa futhi enakekelwa kakhulu kunamamodeli e-3DP, okulula ukuwasebenzisa futhi afaneleka kangcono ekufundeni ukwakheka komzimba okuyisisekelo.
Ukuhlolwa kwesidumbu somuntu kube yindlela ejwayelekile yokufundisa esetshenziswa emfundweni yezokwelapha kusukela ngekhulu le-17 [1, 2]. Kodwa-ke, ngenxa yokufinyeleleka okulinganiselwe, izindleko eziphezulu zokugcinwa kwesidumbu [3, 4], ukwehla okukhulu kwesikhathi sokuqeqeshwa kwe-anatomy [1, 5], kanye nentuthuko yezobuchwepheshe [3, 6], izifundo ze-anatomy ezifundiswa ngezindlela zendabuko zokuhlukanisa ziyancipha. Lokhu kuvula amathuba amasha okucwaninga izindlela ezintsha zokufundisa namathuluzi, njengezibonelo zabantu ezifakwe ipulasitiki kanye namamodeli aphrintiwe nge-3D (3DP) [6,7,8].
Ngayinye yalezi zixhobo inezinzuzo nezingozi. Amasampula afakwe acwebezelayo omile, awanaphunga, angokoqobo futhi awayona ingozi [9,10,11], okwenza abe afanele ukufundisa nokubandakanya abafundi esifundweni nasekuqondeni i-anatomy. Kodwa-ke, aqinile futhi awaguquguquki kangako [10, 12], ngakho-ke kucatshangwa ukuthi kunzima ukuwasebenzisa nokufinyelela izakhiwo ezijulile [9]. Ngokuphathelene nezindleko, amasampula epulasitiki ngokuvamile abiza kakhulu ukuwathenga nokunakekela kunamamodeli e-3DP [6,7,8]. Ngakolunye uhlangothi, amamodeli e-3DP avumela ukuthungwa okuhlukile [7, 13] nemibala [6, 14] futhi angabelwa izingxenye ezithile, okusiza abafundi ukuthi babone kalula, bahlukanise futhi bakhumbule izakhiwo ezibalulekile, yize lokhu kubonakala kungeyona into engokoqobo kunamasampula epulasitiki.
Izifundo eziningana zihlole imiphumela yokufunda/ukusebenza kwezinhlobo ezahlukene zezinsimbi zomzimba ezifana nezibonelo zepulasitiki, izithombe ze-2D, izingxenye ezimanzi, amatafula e-Anatomage (Anatomage Inc., San Jose, CA) kanye namamodeli e-3DP [11, 15, 16, 17, 18, 19, 20, 21]. Kodwa-ke, imiphumela yahluka kuye ngokukhetha ithuluzi lokuqeqesha elisetshenziswa emaqenjini okulawula nawokungenelela, kanye nokuya ngezifunda ezahlukene zomzimba [14, 22]. Isibonelo, uma kusetshenziswa kanye namatafula okuhlukanisa okumanzi [11, 15] kanye nokuhlolwa kwesidumbu [20], abafundi babike ukwaneliseka kokufunda okuphezulu kanye nesimo sengqondo mayelana nezibonelo zepulasitiki. Ngokufanayo, ukusetshenziswa kwamaphethini epulasitiki kukhombisa umphumela omuhle wolwazi lwabafundi oluqondile [23, 24].
Amamodeli e-3DP avame ukusetshenziswa ukwengeza izindlela zokufundisa zendabuko [14,17,21]. ULoke et al. (2017) babike ngokusetshenziswa kwemodeli ye-3DP ukuqonda isifo senhliziyo esizalwa naso kudokotela wezingane [18]. Lolu cwaningo lubonise ukuthi iqembu le-3DP lalinokwaneliseka kokufunda okuphezulu, ukuqonda okungcono kwe-tetrad kaFallot, kanye nekhono elithuthukisiwe lokuphatha iziguli (ukuzikhandla) uma kuqhathaniswa neqembu lezithombe ze-2D. Ukufunda ukwakheka kwesihlahla semithambo yegazi kanye nokwakheka kwekhanda kusetshenziswa amamodeli e-3DP kunikeza ukwaneliseka kokufunda okufanayo njengezithombe ze-2D [16, 17]. Lezi zifundo zibonise ukuthi amamodeli e-3DP angcono kunezithombe ze-2D maqondana nokwaneliseka kokufunda okubonwa ngabafundi. Kodwa-ke, izifundo eziqhathanisa ngqo amamodeli e-3DP amaningi anezibonelo zepulasitiki zilinganiselwe. UMogali et al. (2021) basebenzise imodeli ye-plastination namamodeli ayo enhliziyo nentamo ye-3DP futhi babike ukwanda okufanayo kolwazi phakathi kwamaqembu okulawula nawokuhlola [21].
Kodwa-ke, kudingeka ubufakazi obengeziwe ukuze kutholakale ukuqonda okujulile kokuthi kungani ulwazi lokufunda lwabafundi luncike ekukhetheni izinsimbi zomzimba kanye nezingxenye ezahlukene zomzimba nezitho zomzimba [14, 22]. Izindinganiso zobuntu ziyisici esithakazelisayo esingathonya lo mbono. Lokhu kubhekisela ekuhlonipheni, ekunakekeleni, ekuzweleni nasekuzweleni okulindeleke kubafundi ababa odokotela [25, 26]. Izindinganiso zobuntu bezilokhu zifunwa ekuhlolweni kwezidumbu, njengoba abafundi befundiswa ukuzwelana nokunakekela izidumbu ezinikelwe, ngakho-ke ukutadisha i-anatomy bekulokhu kuthatha indawo ekhethekile [27, 28]. Kodwa-ke, lokhu akuvamile ukulinganiswa ekufakeni ipulasitiki kanye namathuluzi e-3DP. Ngokungafani nemibuzo yocwaningo lwe-Likert evaliwe, izindlela zokuqoqa idatha esezingeni eliphezulu njengezingxoxo zeqembu eligxile kanye nemibuzo yocwaningo evulekile inikeza ukuqonda ngemibono yabahlanganyeli ebhalwe ngokulandelana okungahleliwe ukuchaza umthelela wamathuluzi okufunda amasha kokuhlangenwe nakho kwabo kokufunda.
Ngakho-ke lolu cwaningo luhlose ukuphendula ukuthi abafundi babona kanjani i-anatomy ngendlela ehlukile uma benikezwa amathuluzi asethiwe (i-plastination) uma kuqhathaniswa nezithombe eziprintiwe ze-3D ezibonakalayo ukuze bafunde i-anatomy?
Ukuze baphendule imibuzo engenhla, abafundi banethuba lokuthola, ukuqoqa nokwabelana ngolwazi lwe-anatomical ngokusebenzisana kweqembu kanye nokubambisana. Lo mqondo uvumelana kahle nethiyori ye-constructivist, lapho abantu noma amaqembu omphakathi adala khona futhi abelane ngolwazi lwabo ngenkuthalo [29]. Ukuxhumana okunjalo (isibonelo, phakathi kontanga, phakathi kwabafundi nothisha) kuthinta ukwaneliseka kokufunda [30, 31]. Ngesikhathi esifanayo, ulwazi lokufunda lwabafundi luzothonywa yizici ezifana nokufunda okulula, indawo, izindlela zokufundisa, kanye nokuqukethwe kwezifundo [32]. Ngemva kwalokho, lezi zimfanelo zingathonya ukufunda kwabafundi kanye nokuqonda izihloko ezibathakazelisayo [33, 34]. Lokhu kungase kuhlobane nombono wethiyori we-pragmatic epistemology, lapho ukuvuna kokuqala noma ukwakheka kokuhlangenwe nakho komuntu siqu, ubuhlakani, kanye nezinkolelo kunganquma inkambo elandelayo yesenzo [35]. Indlela ye-pragmatic ihlelwe ngokucophelela ukuhlonza izihloko eziyinkimbinkimbi kanye nokulandelana kwazo ngezingxoxo kanye nokuhlola, kulandelwe ukuhlaziywa kwezihloko [36].
Amasampula ezidumbu avame ukubhekwa njengabeluleki abathule, njengoba ebhekwa njengezipho ezibalulekile zenzuzo yesayensi nobuntu, ekhuthaza inhlonipho nokubonga okuvela kubafundi kubanikeli babo [37, 38]. Izifundo zangaphambilini zibike amaphuzu afanayo noma aphezulu phakathi kweqembu lezidumbu/i-plastination kanye neqembu le-3DP [21, 39], kodwa bekungacaci ukuthi abafundi babelana ngolwazi olufanayo lokufunda, okuhlanganisa nezindinganiso zobuntu, phakathi kwamaqembu amabili. Ukuze kuqhutshekwe nocwaningo, lolu cwaningo lusebenzisa isimiso sokusebenza [36] ukuhlola ulwazi lokufunda kanye nezici zamamodeli e-3DP (umbala nokuthungwa) bese luqhathanisa namasampula e-plastinated ngokusekelwe kumpendulo yabafundi.
Imibono yabafundi ingabe isithonya izinqumo zothisha mayelana nokukhetha amathuluzi okwakheka komzimba afanele ngokusekelwe kulokho okusebenzayo nokungaphumeleli ekufundiseni ukwakheka komzimba. Lolu lwazi lungasiza othisha ukuhlonza okuthandwa ngabafundi nokusebenzisa amathuluzi okuhlaziya afanele ukuthuthukisa ulwazi lwabo lokufunda.
Lolu cwaningo olunemininingwane luhlose ukuhlola lokho abafundi abakubheka njengolwazi olubalulekile lokufunda besebenzisa amasampula enhliziyo nentamo enziwe ngepulasitiki uma kuqhathaniswa namamodeli e-3DP. Ngokusho kocwaningo lokuqala olwenziwe nguMogali et al. ngo-2018, abafundi babheka amasampula enziwe ngepulasitiki njengangokoqobo kakhulu kunamamodeli e-3DP [7]. Ngakho ake sithi:
Njengoba ukufakelwa kwepulasitiki kwadalwa ngezidumbu zangempela, abafundi kwakulindeleke ukuthi babheke ukufakelwa kwepulasitiki ngendlela enhle kakhulu kunamamodeli e-3DP maqondana nobuqiniso kanye nenani lobuntu.
Lolu cwaningo lwekhwalithi luhlobene nezifundo ezimbili zangaphambilini zezibalo [21, 40] ngoba idatha eyethulwe kuzo zonke izifundo ezintathu yaqoqwa ngesikhathi esisodwa kusuka kusampula efanayo yabafundi abahlanganyeli. Isihloko sokuqala sibonise izilinganiso ezifanayo zenhloso (amaphuzu okuhlola) phakathi kwe-plastination namaqembu e-3DP [21], kanti isihloko sesibili sisebenzise ukuhlaziywa kwezinto ukuthuthukisa ithuluzi eliqinisekisiwe ngokwengqondo (izici ezine, izinto ezingu-19) ukukala izakhiwo zemfundo njengokwaneliseka kokufunda, ukuzikhandla, izindinganiso zobuntu, kanye nemikhawulo yemidiya yokufunda [40]. Lolu cwaningo luhlole izingxoxo zeqembu ezivulekile nezigxile ezisezingeni eliphezulu ukuthola ukuthi yini abafundi abayibheka njengebalulekile lapho befunda i-anatomy besebenzisa amasampula e-plastinated namamodeli aphrintiwe nge-3D. Ngakho-ke, lolu cwaningo luhlukile ezihlokweni ezimbili zangaphambilini ngokwemigomo/imibuzo yocwaningo, idatha, kanye nezindlela zokuhlaziya ukuze bathole ukuqonda ngempendulo yabafundi yekhwalithi (amazwana ombhalo wamahhala kanye nengxoxo yeqembu lokugxila) ekusetshenzisweni kwamathuluzi e-3DP uma kuqhathaniswa namasampula epulasitiki. Lokhu kusho ukuthi lolu cwaningo lwamanje luxazulula ngokuyisisekelo umbuzo wocwaningo ohlukile kunezihloko ezimbili zangaphambilini [21, 40].
Esikhungweni sombhali, i-anatomy ihlanganiswe nezifundo zesistimu ezifana ne-cardiopulmonary, i-endocrinology, i-musculoskeletal, njll., eminyakeni emibili yokuqala yohlelo lweminyaka emihlanu lwe-Bachelor of Medicine kanye ne-Bachelor of Surgery (MBBS). Amasampula afakwe iplasta, amamodeli epulasitiki, izithombe zezokwelapha, kanye namamodeli e-3D abonakalayo avame ukusetshenziswa esikhundleni samasampula okuhlukaniswa noma okumanzi ukuze kusekelwe umkhuba wokwakheka komzimba ojwayelekile. Izikhathi zokufunda zeqembu zithatha indawo yezinkulumo zendabuko ezifundiswa ngokugxila ekusetshenzisweni kolwazi olutholiwe. Ekupheleni kwemodyuli ngayinye yesistimu, thatha isivivinyo sokuzijwayeza i-anatomy esiku-inthanethi esihlanganisa izimpendulo ezingu-20 ezinhle kakhulu (ama-SBA) ezihlanganisa i-anatomy ejwayelekile, izithombe, kanye ne-histology. Sekukonke, kwenziwa izivivinyo ezinhlanu zokwakheka ngesikhathi sokuhlolwa (ezintathu ngonyaka wokuqala kanye nezimbili ngonyaka wesibili). Ukuhlolwa okubhaliwe okuphelele okuhlanganisiwe kweNyaka 1 nowesi-2 kufaka amaphepha amabili, ngalinye liqukethe ama-SBA angu-120. I-Anatomy iba yingxenye yalezi zivivinyo futhi uhlelo lokuhlola lunquma inani lemibuzo ye-anatomy okufanele ifakwe.
Ukuze kuthuthukiswe isilinganiso somfundi nesampula, kwafundwa amamodeli angaphakathi e-3DP asekelwe kumasampula afakwe ipulasitiki ukuze kufundiswe futhi kufundwe ukwakheka komzimba. Lokhu kunikeza ithuba lokusungula inani lemfundo lamamodeli amasha e-3DP uma kuqhathaniswa namasampula afakwe ipulasitiki ngaphambi kokuba afakwe ngokusemthethweni kuhlelo lokufunda ukwakheka komzimba.
Kulolu cwaningo, i-computed tomography (CT) (i-64-slice Somatom Definition Flash CT scanner, Siemens Healthcare, Erlangen, Germany) yenziwe kumamodeli epulasitiki enhliziyo (inhliziyo eyodwa ephelele nenhliziyo eyodwa esigabeni esiphambeneyo) kanye nekhanda nentamo (eyodwa ephelele nenye i-midsagittal plane head-neck) (Isithombe 1). Izithombe ze-Digital Imaging and Communications in Medicine (DICOM) zatholakala futhi zalayishwa ku-3D Slicer (izinguqulo 4.8.1 kanye no-4.10.2, Harvard Medical School, eBoston, eMassachusetts) ukuze kuhlukaniswe isakhiwo ngohlobo olufana nemisipha, imithambo yegazi, imizwa, namathambo. Amafayela ahlukaniswe alayishwa ku-Materialize Magics (Inguqulo 22, Materialize NV, eLeuven, eBelgium) ukuze kususwe amagobolondo omsindo, kanti amamodeli okuphrinta alondolozwa ngefomethi ye-STL, abese edluliselwa kuphrinta ye-Objet 500 Connex3 Polyjet (Stratasys, Eden Prairie, MN) ukuze kudalwe amamodeli e-anatomical e-3D. Ama-resin angena ku-photopolymer kanye nama-elastomer abonakalayo (i-VeroYellow, i-VeroMagenta kanye ne-TangoPlus) aqinisa ungqimba ngengqimba ngaphansi kwesenzo somsebe we-UV, enikeza isakhiwo ngasinye sokwakheka kokwakheka kwaso ukuthungwa nombala waso.
Amathuluzi okutadisha i-anatomy asetshenziswe kulolu cwaningo. Kwesobunxele: Intamo; kwesokudla: inhliziyo eqoshiwe kanye nenhliziyo ephrintiwe nge-3D.
Ngaphezu kwalokho, i-ascending aorta kanye nesistimu ye-coronary kwakhethwa kumodeli yenhliziyo yonke, kwathi kwakhiwa izisekelo eziyisisekelo ukuze zinamathele kumodeli (inguqulo 22, i-Materialize NV, i-Leuven, i-Belgium). Imodeli yanyatheliswa kuphrinta ye-Raise3D Pro2 (i-Raise3D Technologies, i-Irvine, i-CA) kusetshenziswa i-thermoplastic polyurethane (TPU) filament. Ukuze kuboniswe imithambo yemodeli, izinto ezisekelayo ze-TPU ezinyathelisiwe kwadingeka zisuswe futhi imithambo yegazi ipendwe nge-acrylic ebomvu.
Abafundi be-Bachelor of Medicine bonyaka wokuqala e-Lee Kong Chiang Faculty of Medicine ngonyaka wezifundo ka-2020-2021 (n = 163, abesilisa abangu-94 nabesifazane abangu-69) bathole isimemo se-imeyili sokubamba iqhaza kulolu cwaningo njengomsebenzi wokuzithandela. Ukuhlolwa okungahleliwe kwe-cross-over kwenziwa ngezigaba ezimbili, okokuqala ngokusikwa kwenhliziyo bese kuba nokusikwa kwentamo. Kunesikhathi sokuhlanza amasonto ayisithupha phakathi kwezigaba ezimbili ukunciphisa imiphumela eseleyo. Kuzo zombili izigaba, abafundi babengaboni ngezihloko zokufunda kanye nemisebenzi yeqembu. Abantu abangengaphezu kwabayisithupha eqenjini. Abafundi abathole amasampula e-plastinated esinyathelweni sokuqala bathole amamodeli e-3DP esinyathelweni sesibili. Esigabeni ngasinye, womabili amaqembu athola inkulumo yokwethula (imizuzu engama-30) evela kumuntu wesithathu (uthisha omkhulu) kulandele ukuzifundela (imizuzu engama-50) kusetshenziswa amathuluzi okuzifundela kanye nezincwajana ezinikeziwe.
Uhlu lokuhlola lwe-COREQ (Imigomo Ephelele Yokubika Ucwaningo Lwekhwalithi) lusetshenziselwa ukuqondisa ucwaningo lwekhwalithi.
Abafundi banikeze impendulo ngezinto zokufunda zocwaningo ngokusebenzisa inhlolovo eyayihlanganisa imibuzo emithathu evulekile mayelana namandla abo, ubuthakathaka babo, kanye namathuba okuthuthuka. Bonke abaphenduli abangu-96 banikeze izimpendulo zamahhala. Ngemuva kwalokho abafundi abayisishiyagalombili abazithandelayo (n = 8) bahlanganyela eqenjini lokugxila. Izingxoxo zenziwa e-Anatomy Training Center (lapho kwenziwa khona izivivinyo) futhi zenziwa nguMphenyi 4 (Ph.D.), umfundisi wesilisa ongeyena usosayensi wokwakheka komzimba onolwazi olungaphezu kweminyaka eyi-10 lokusiza nge-TBL, kodwa engahilelekile ekuqeqeshweni kweqembu locwaningo. Abafundi babengazazi izici zomuntu siqu zabacwaningi (noma iqembu locwaningo) ngaphambi kokuqala kocwaningo, kodwa ifomu lemvume labazisa ngenhloso yocwaningo. Umcwaningi 4 nabafundi kuphela abahlanganyele eqenjini lokugxila. Umcwaningi uchaze iqembu lokugxila kubafundi futhi wababuza ukuthi bangathanda yini ukuhlanganyela. Babelane ngolwazi lwabo lokufunda ukuphrinta kwe-3D kanye nokufakelwa kwepulasitiki futhi babenomdlandla omkhulu. Umgqugquzeli ubuze imibuzo eyisithupha eholayo ukukhuthaza abafundi ukuthi basebenze (Izinto Ezingeziwe 1). Izibonelo zifaka phakathi ingxoxo ngezici zezinsimbi zomzimba ezikhuthaza ukufunda nokufunda, kanye nendima yozwela ekusebenzeni ngezibonelo ezinjalo. “Ungaluchaza kanjani ulwazi lwakho lokufunda nge-anatomy usebenzisa izibonelo ze-plastinated kanye namakhophi anyathelisiwe e-3D?” kwakuwumbuzo wokuqala wengxoxo. Yonke imibuzo ivulekile, ivumela abasebenzisi ukuphendula imibuzo ngokukhululeka ngaphandle kwezindawo ezibandlululayo, okuvumela ukuthi kutholakale idatha entsha kanye nezinselele okufanele zinqotshwe ngamathuluzi okufunda. Abahlanganyeli abazange bathole ukuqoshwa kwamazwana noma ukuhlaziywa kwemiphumela. Uhlobo lokuzithandela locwaningo lugweme ukugcwala kwedatha. Yonke ingxoxo iqoshwe ukuze ihlaziywe.
Ukuqoshwa kweqembu lokugxila (imizuzu engama-35) kubhalwe ngokwezwi nezwi futhi kwasuswa ubuntu (kusetshenziswe amagama angamanga). Ngaphezu kwalokho, kwaqoqwa imibuzo yemibuzo evulekile. Ama-transcript eqembu lokugxila kanye nemibuzo yocwaningo yangeniswa kuspredishithi se-Microsoft Excel (Microsoft Corporation, Redmond, WA) ukuze kuhlukaniswe idatha kanye nokuhlanganiswa ukuze kuhlolwe imiphumela efanayo noma ehambisanayo noma imiphumela emisha [41]. Lokhu kwenziwa ngokuhlaziywa kwethiyori [41, 42]. Izimpendulo zombhalo zomfundi ngamunye zengezwa enanini eliphelele lezimpendulo. Lokhu kusho ukuthi imibono equkethe imisho eminingi izophathwa njengeyodwa. Izimpendulo ezingenayo i-nil, akukho noma akukho amathegi okuphawula azonakwa. Abacwaningi abathathu (umcwaningi wesifazane one-Ph.D., umcwaningi wesifazane oneziqu ze-master, kanye nomsizi wesilisa oneziqu ze-bachelor kwezobunjiniyela kanye neminyaka eyi-1-3 yesipiliyoni socwaningo kwezemfundo yezokwelapha) babhala idatha engahlelekile ngokuzimela. Abahleli bezinhlelo abathathu basebenzisa amaphedi okudweba angempela ukuze bahlukanise amanothi e-post-it ngokusekelwe ekufaneni nasekuhlukeni. Kwenziwe izikhathi eziningana ukuze kuhlelwe futhi kuqoqwe amakhodi ngokusebenzisa ukuqashelwa kwephethini okuhlelekile nokuphindaphindwayo, lapho amakhodi aqoqwa ukuze kuhlonzwe izihloko ezincane (izici ezithile noma ezijwayelekile njengezimfanelo ezinhle nezimbi zamathuluzi okufunda) okwabe sekwakha izindikimba ezibanzi [41]. Ukuze kufinyelelwe esivumelwaneni, umcwaningi wesilisa oyisi-6 (Ph.D.) oneminyaka engu-15 yesipiliyoni ekufundiseni i-anatomy wavuma izifundo zokugcina.
Ngokuvumelana neSimemezelo saseHelsinki, iBhodi Lokubuyekeza Lezikhungo laseNanyang Technological University (IRB) (2019-09-024) lihlole inqubo yocwaningo futhi lathola izimvume ezidingekayo. Abahlanganyeli banikeze imvume enolwazi futhi baziswa ngelungelo labo lokuhoxa ekuhlanganyeleni nganoma yisiphi isikhathi.
Abafundi bezokwelapha abangaphansi kweminyaka engu-96 ababhalisele unyaka wokuqala banikeze imvume egcwele enolwazi, izibalo zabantu eziyisisekelo njengobulili nobudala, futhi bamemezela ukuthi abazange baqeqeshwe ngokusemthethweni ngaphambilini nge-anatomy. Isigaba I (inhliziyo) kanye neSigaba II (ukusikwa kwentamo) kwakubandakanya abahlanganyeli abangu-63 (amadoda angu-33 nabesifazane abangu-30) kanye nabahlanganyeli abangu-33 (amadoda angu-18 nabesifazane abangu-15), ngokulandelana. Ubudala babo babusukela eminyakeni engu-18 kuya kwengu-21 (isilinganiso ± ukuphambuka okujwayelekile: iminyaka engu-19.3 ± 0.9). Bonke abafundi abangu-96 baphendule imibuzo (akukho ukuyeka), kanti abafundi abangu-8 bahlanganyele emaqenjini okugxila. Kwakukhona imibono evulekile engu-278 mayelana nezinzuzo, izinkinga, kanye nezidingo zokuthuthukiswa. Kwakungekho ukungahambisani phakathi kwedatha ehlaziyiwe kanye nombiko wemiphumela.
Kuzo zonke izingxoxo zamaqembu okugxila kanye nezimpendulo zocwaningo, kwavela izingqikithi ezine: ubuqiniso obubonakalayo, ukuqonda okuyisisekelo kanye nobunzima, izimo zengqondo zenhlonipho nokunakekela, izindlela eziningi, kanye nobuholi (Isithombe 2). Isihloko ngasinye sichazwe ngokuningiliziwe ngezansi.
Izindikimba ezine—ubuqiniso obubonwayo, ukuqonda okuyisisekelo kanye nobunzima, inhlonipho nokunakekela, kanye nokukhetha kwemidiya yokufunda—kusekelwe ekuhlaziyweni kwezihloko kwemibuzo yocwaningo oluvulekile kanye nezingxoxo zamaqembu okugxila. Izinto ezisebhokisini eliluhlaza okwesibhakabhaka neliphuzi zimele izakhiwo zesampula efakwe ipulasitiki kanye nemodeli ye-3DP, ngokulandelana. I-3DP = Ukuphrinta kwe-3D
Abafundi babenomuzwa wokuthi amasampula afakwe ipulasitiki ayengokoqobo kakhudlwana, ayenemibala yemvelo emele kakhulu izidumbu zangempela, futhi enemininingwane emihle kakhulu yomzimba kunamamodeli e-3DP. Isibonelo, ukuqondiswa kwe-muscle fiber kugqame kakhulu kumasampula enziwe ngepulasitiki uma kuqhathaniswa namamodeli e-3DP. Lo mehluko uboniswe esitatimendeni esingezansi.
"...kunemininingwane eminingi futhi kunembile, njengokuvela kumuntu wangempela (umhlanganyeli we-C17; isibuyekezo se-free-form plastination)."
Abafundi baphawule ukuthi amathuluzi e-3DP ayewusizo ekufundeni i-anatomy eyisisekelo nokuhlola izici ezinkulu ze-macroscopic, kuyilapho amasampula epulasitiki ayelungele ukwandisa ulwazi lwabo nokuqonda izakhiwo eziyinkimbinkimbi ze-anatomy nezindawo. Abafundi babe nomuzwa wokuthi yize zombili izinsimbi zazifana ncamashi nomunye nomunye, babelahlekelwa ulwazi olubalulekile lapho besebenza ngamamodeli e-3DP uma kuqhathaniswa namasampula e-plastinated. Lokhu kuchazwe esitatimendeni esingezansi.
“…kwakukhona ubunzima obufana… nemininingwane emincane efana ne-fossa ovale… ngokuvamile imodeli yenhliziyo ye-3D ingasetshenziswa… entanyeni, mhlawumbe ngizofunda imodeli ye-plastination ngokuzethemba (umhlanganyeli we-PA1; i-3DP, ingxoxo yeqembu lokugxila”).
"...izakhiwo eziphelele zingabonakala... ngokuningiliziwe, amasampula e-3DP awusizo ekutadisheni, isibonelo, izakhiwo eziqinile (kanye) nezinto ezinkulu, ezibonakala kalula njengemisipha nezitho zomzimba... mhlawumbe (kubantu) abangase bangakwazi ukufinyelela amasampula afakwe ipulasitiki (umhlanganyeli we-PA3; i-3DP, ingxoxo yeqembu lokugxila)".
Abafundi babonise inhlonipho nokukhathazeka okwengeziwe ngamasampula afakwe ipulasitiki, kodwa futhi babekhathazekile ngokubhujiswa kwesakhiwo ngenxa yobuthakathaka baso kanye nokuntuleka kokuguquguquka. Ngokuphambene nalokho, abafundi banezela kokuhlangenwe nakho kwabo okusebenzayo ngokuqaphela ukuthi amamodeli e-3DP angakhiqizwa kabusha uma onakele.
"... sivame futhi ukuqaphela kakhulu ngamaphethini okufakelwa ipulasitiki (umhlanganyeli we-PA2; ukufakwa kwepulasitiki, ingxoxo yeqembu eligxile)".
"...kumasampula e-plastination, kufana nokuthi... into ebilokhu igcinwe isikhathi eside. Uma ngiyilimaza... Ngicabanga ukuthi siyazi ukuthi ibukeka njengomonakalo omkhulu ngoba inomlando (umhlanganyeli we-PA3; i-plastination, ingxoxo yeqembu eligxile)."
"Amamodeli aphrintiwe nge-3D angakhiqizwa ngokushesha nangokulula... okwenza amamodeli e-3D atholakale kubantu abaningi futhi kube lula ukufunda ngaphandle kokwabelana ngamasampula (umhlinzeki we-I38; i-3DP, ukubuyekezwa kombhalo wamahhala)."
“…ngamamodeli e-3D singadlala kancane ngaphandle kokukhathazeka kakhulu ngokuwalimaza, njengokulimaza amasampula… (umhlanganyeli we-PA2; i-3DP, ingxoxo yeqembu lokugxila).”
Ngokusho kwabafundi, inani lamasampula afakwe ipulasitiki lilinganiselwe, futhi ukufinyelela ezakhiweni ezijulile kunzima ngenxa yokuqina kwazo. Kumodeli ye-3DP, banethemba lokuqhubeka nokulungisa imininingwane yokwakheka komzimba ngokushintsha imodeli ibe yizindawo ezithakazelisayo zokufunda komuntu siqu. Abafundi bavumile ukuthi amamodeli enziwe ngepulasitiki kanye ne-3DP angasetshenziswa kanye nezinye izinhlobo zamathuluzi okufundisa njengethebula le-Anatomage ukuthuthukisa ukufunda.
"Ezinye izakhiwo zangaphakathi ezijulile azibonakali kahle (umhlanganyeli C14; ukufakelwa kwepulasitiki, ukuphawula okukhululekile)."
"Mhlawumbe amatafula okuhlolwa kwesidumbu kanye nezinye izindlela kungaba yinto ewusizo kakhulu (ilungu C14; ukufakelwa kwepulasitiki, ukubuyekezwa kombhalo wamahhala)."
"Ngokuqinisekisa ukuthi amamodeli e-3D anemininingwane emihle, ungaba namamodeli ahlukene agxile ezindaweni ezahlukene kanye nezici ezahlukene, njengemizwa kanye nemithambo yegazi (umhlanganyeli I26; 3DP, ukubuyekezwa kombhalo wamahhala)."
Abafundi baphinde basikisela ukuthi kufakwe umboniso ukuze uthisha achaze ukuthi angayisebenzisa kanjani kahle imodeli, noma isiqondiso esengeziwe ngezithombe zesampula ezibhalwe phansi ukuze kube lula ukutadisha nokuqonda kumanothi esifundo, yize bevumile ukuthi isifundo senzelwe ngqo ukuzifundela.
"...Ngiyazisa indlela yokucwaninga ezimele... mhlawumbe isiqondiso esengeziwe singanikezwa ngesimo samaslayidi aphrintiwe noma amanye amanothi... (umhlanganyeli C02; imibono yamahhala yombhalo jikelele)."
"Ochwepheshe bokuqukethwe noma ukuba namathuluzi engeziwe okubonakalayo njenge-animation noma ividiyo kungasisiza siqonde kangcono isakhiwo samamodeli e-3D (ilungu le-C38; ukubuyekezwa kombhalo wamahhala ngokujwayelekile)."
Abafundi bezokwelapha bonyaka wokuqala babuzwe ngolwazi lwabo lokufunda kanye nekhwalithi yamasampula anyatheliswe nge-3D naphrintiwe ngepulasitiki. Njengoba bekulindelekile, abafundi bathole ukuthi amasampula aphrintiwe ngepulasitiki angokoqobo futhi anembile kunalawo aphrintiwe nge-3D. Le miphumela iqinisekiswa ucwaningo lokuqala [7]. Njengoba amarekhodi enziwe ngezidumbu ezinikelwe, ayiqiniso. Nakuba kwakuyikhophi engu-1:1 yesampula ephrintiwe ngepulasitiki enezici ezifanayo zesimo [8], imodeli ephrintiwe nge-3D esekelwe ku-polymer ibhekwa njengengangokoqobo futhi ingabi ngokoqobo kangako, ikakhulukazi kubafundi lapho imininingwane efana nemiphetho ye-oval fossa yayingabonakali khona kumodeli ye-3DP yenhliziyo uma kuqhathaniswa nemodeli ephrintiwe ngepulasitiki. Lokhu kungase kube ngenxa yekhwalithi yesithombe se-CT, engavumeli ukucaciswa okucacile kwemingcele. Ngakho-ke, kunzima ukuhlukanisa izakhiwo ezinjalo kusofthiwe yokuhlukanisa, okuthinta inqubo yokunyathelisa ye-3D. Lokhu kungaphakamisa ukungabaza mayelana nokusetshenziswa kwamathuluzi e-3DP njengoba besaba ukuthi ulwazi olubalulekile luzolahleka uma amathuluzi ajwayelekile afana namasampula aphrintiwe ngepulasitiki engasetshenziswa. Abafundi abanesifiso sokuqeqeshwa kokuhlinzwa bangase bakuthole kudingekile ukusebenzisa amamodeli asebenzayo [43]. Imiphumela yamanje ifana nezifundo zangaphambilini ezithole ukuthi amamodeli epulasitiki [44] kanye namasampula e-3DP awanakho ukunemba kwamasampula angempela [45].
Ukuze kuthuthukiswe ukufinyeleleka kwabafundi ngakho-ke ukwaneliseka kwabafundi, izindleko kanye nokutholakala kwamathuluzi kumele kucatshangelwe. Imiphumela isekela ukusetshenziswa kwamamodeli e-3DP ukuthola ulwazi lwe-anatomical ngenxa yokwenziwa kwawo okungabizi kakhulu [6, 21]. Lokhu kuhambisana nesifundo sangaphambilini esabonisa ukusebenza okufana kwenhloso yamamodeli epulasitiki namamodeli e-3DP [21]. Abafundi babenomuzwa wokuthi amamodeli e-3DP ayewusizo kakhulu ekutadisheni imiqondo eyisisekelo ye-anatomical, izitho, kanye nezici, kuyilapho amasampula epulasitiki ayefaneleka kakhulu ekutadisheni i-anatomy eyinkimbinkimbi. Ngaphezu kwalokho, abafundi bakhuthaza ukusetshenziswa kwamamodeli e-3DP kanye namasampula esidumbu akhona kanye nobuchwepheshe besimanje ukuze kuthuthukiswe ukuqonda kwabafundi nge-anatomy. Izindlela eziningi zokumelela into efanayo, njengokumaka i-anatomy yenhliziyo usebenzisa izidumbu, ukuphrinta kwe-3D, ukuskena kweziguli, kanye namamodeli e-3D abonakalayo. Le ndlela yezindlela eziningi ivumela abafundi ukuthi babonise i-anatomy ngezindlela ezahlukene, baxhumane ngalokho abakufundile ngezindlela ezahlukene, futhi bahlanganyele abafundi ngezindlela ezahlukene [44]. Ucwaningo lukhombisile ukuthi izinto zokufunda zangempela njengamathuluzi esidumbu zingaba yinselele kwabanye abafundi maqondana nomthwalo wokuqonda ohlobene ne-anatomy yokufunda [46]. Ukuqonda umthelela womthwalo wokuqonda ekufundeni kwabafundi nokusebenzisa ubuchwepheshe ukunciphisa umthwalo wokuqonda ukudala indawo yokufunda engcono kubalulekile [47, 48]. Ngaphambi kokwethula abafundi ezintweni ezifile, amamodeli e-3DP angaba yindlela ewusizo yokubonisa izici eziyisisekelo nezibalulekile ze-anatomy ukuze kuncishiswe umthwalo wokuqonda futhi kuthuthukiswe ukufunda. Ngaphezu kwalokho, abafundi bangayisa amamodeli e-3DP ekhaya ukuze abuyekezwe ngokuhlanganiswa nezincwadi zezifundo nezinto zokufundisa futhi bandise ukutadisha i-anatomy ngale kwelebhu [45]. Kodwa-ke, umkhuba wokususa izingxenye ze-3DP awukaqaliswa esikhungweni sombhali.
Kulolu cwaningo, amasampula enziwe ngepulasitiki ahlonishwa kakhulu kunezikopi ze-3DP. Lesi siphetho sihambisana nocwaningo lwangaphambilini olubonisa ukuthi amasampula esidumbu "njengesiguli sokuqala" adinga inhlonipho nozwela, kuyilapho amamodeli okwenziwa engawadingi [49]. Izicubu zomuntu ezinziwe ngepulasitiki zingokoqobo futhi zingokoqobo. Ukusetshenziswa kwezinto zesidumbu kuvumela abafundi ukuthi bathuthukise imibono yobuntu kanye neyokuziphatha [50]. Ngaphezu kwalokho, imibono yabafundi ngamaphethini epulasitiki ingase ithintwe ulwazi lwabo olukhulayo ngezinhlelo zokunikela ngesidumbu kanye/noma inqubo yepulasitiki. Ipulasitiki iyizidumbu ezinikelwayo ezilingisa uzwela, ukunconywa kanye nokubonga abafundi abakuzwayo ngabanikeli babo [10, 51]. Lezi zici zihlukanisa abahlengikazi abanomusa futhi, uma zihlakulelwa, zingabasiza bathuthuke ngokomsebenzi ngokwazisa nokuzwelana neziguli [25, 37]. Lokhu kufana nabafundisi abathule abasebenzisa ukuhlukaniswa kwabantu okumanzi [37,52,53]. Njengoba amasampula epulasitiki anikelwa ezidumbu, abafundi bawabheka njengabafundisi abathule, okwathola inhlonipho ngaleli thuluzi elisha lokufundisa. Ngisho noma bazi ukuthi amamodeli e-3DP enziwa yimishini, basakujabulela ukuwasebenzisa. Iqembu ngalinye lizizwa linakekelwe futhi imodeli iphathwa ngokucophelela ukuze kulondolozwe ubuqotho bayo. Abafundi bangase bazi kakade ukuthi amamodeli e-3DP adalwe ngedatha yesiguli ngezinjongo zemfundo. Esikhungweni sombhali, ngaphambi kokuba abafundi baqale isifundo esisemthethweni se-anatomy, kunikezwa isifundo sokuqala se-anatomy ngomlando we-anatomy, ngemva kwalokho abafundi bafunga. Inhloso eyinhloko yesifungo ukugxilisa kubafundi ukuqonda izindinganiso zobuntu, inhlonipho yezinsimbi zomzimba, kanye nobungcweti. Ukuhlanganiswa kwezinsimbi zomzimba kanye nokuzibophezela kungasiza ekugxiliseni umuzwa wokunakekela, inhlonipho, futhi mhlawumbe kukhumbuze abafundi ngemithwalo yabo yemfanelo yesikhathi esizayo ezigulini [54].
Ngokuphathelene nokuthuthukiswa kwesikhathi esizayo kwamathuluzi okufunda, abafundi abavela emaqenjini e-plastination kanye ne-3DP bafaka ukwesaba ukubhujiswa kwesakhiwo ekuhlanganyeleni nasekufundeni kwabo. Kodwa-ke, ukukhathazeka mayelana nokuphazamiseka kwesakhiwo samasampula afakwe amapulangwe kwagqanyiswa ngesikhathi sezingxoxo zeqembu lokugxila. Lokhu kuqashelwa kuqinisekiswa yizifundo zangaphambilini kumasampula enziwe ngepulasitiki [9, 10]. Ukuphathwa kwesakhiwo, ikakhulukazi amamodeli entamo, kuyadingeka ukuhlola izakhiwo ezijulile nokuqonda ubudlelwano bendawo obunezinhlangothi ezintathu. Ukusetshenziswa kolwazi oluthintayo (oluthintayo) nolwazi olubonakalayo kusiza abafundi bakhe isithombe sengqondo esiningiliziwe nesiphelele sezingxenye zomzimba ezinobukhulu obuthathu [55]. Izifundo zibonise ukuthi ukuphathwa kwezinto ezibonakalayo okuthintekayo kunganciphisa umthwalo wokuqonda futhi kuholele ekuqondeni nasekugcinweni kolwazi okungcono [55]. Kuphakanyiswe ukuthi ukwengeza amamodeli e-3DP ngamasampula enziwe ngepulasitiki kungathuthukisa ukusebenzisana kwabafundi namasampula ngaphandle kokwesaba ukulimaza izakhiwo.
Isikhathi sokuthunyelwe: Julayi-21-2023