The educational value of 3D printed models in surgical airway skills teaching for medical students

Introduction: Using 3D models to help with surgical skill acquisition has been shown to improve both confidence and technical skills ¹. However, surgical education has historically utilised animal tissues or human cadaveric specimens, both of which are associated with high financial cost and limited accessibility due to specialist facilities². This research evaluated the use of three- dimensional (3D) printed airway models as an accessible alternative for teaching surgical airway management to postgraduate medical students.

Methodology: A multidisciplinary team (MDT) of ear, nose and throat (ENT) surgeons and anaesthetists (n=9) delivered a practical workshop to 20 postgraduate medical students (n=20). Students were taught how to perform surgical airway procedures, including tracheostomy and emergency cricothyrotomy, using 3D-printed airway models. Students received hands-on practice on the models in a small group setting, under clinician guidance. To assess the value of the 3D models, pre- and post-workshop surveys were utilised, including qualitative and quantitative components. Questions were designed to assess changes in students’ knowledge and confidence of surgical airway management, as well as their perceptions of the models themselves.

Results: Overall 100% of participants rated the course as excellent (n=20). The data indicates that medical student knowledge of surgical airways improved; for example the number of students correctly able to identify signs of early airway obstruction increased from 40% pre course to 85% post course. Similarly, confidence levels in airway management increased substantially: prior to the course 95% of attendees rated feeling either ‘unsure’, ‘low confidence’ or ‘not at all confident’; whereas 90% felt ‘confident’ following the course.

Regarding the 3D printed models, 85% of delegates ‘strongly agreed’ that the models helped them achieve their learning goals and allowed them to perform key steps in performing tracheostomy and cricothyroidotomy. In addition to the quantitative data collected, thematic analysis was performed on qualitative responses: students highlighted the value of hands-on experience, a lack of previous exposure to airway management through their training, and a wish for further teaching in a ‘workshop/MDT’ style.

In addition, clinician feedback was collected and with 100% of clinicians agreeing that it was beneficial having both ENT and Anaesthetics present. 100% of clinicians also ‘agreed’ or ‘strongly agreed’ that the models allowed them to demonstrate the key stages in a tracheostomy and cricothyroidotomy.

Discussion: Overall, this initial workshop supports the educational value of 3D printed models within surgical airway teaching. The model is comparatively much cheaper and easily reproducible compared to current alternatives. In addition it provides opportunity for students to fine- tune their skills in a realistic and stress-free environment. Drawbacks include clinician feedback surrounding realism of tissue feel with the 3D materials used, which the authors aim to improve. In addition this study supports airway workshops with a multidisciplinary faculty, which was perceived favourably by both clinicians and students. Future aims include validation of the models with further workshops and a larger dataset. In addition models could be used to teach resident doctors in specialities such as A&E, ENT and Anaesthetics.