Although males typically outperform women on spatial tasks, we investigated whether structured training with 3D-printed heart models substantially reduces performance differences in echocardiographic education. A total of 144 medical students (95 female, 49 male) were enrolled in an interventional study via propensity score matching (n = 80: 40 female, 40 male). They received standardized echocardiography training with physical 3D models, tutoring, PowerPoint instruction, and self-directed practice. All measured outcomes showed significant improvements (p < 0.001) but no sex-related differences: 2D visualization (females: +2.30; males: +2.55; p = 0.738), 3D visualization (females: +3.52; males: +3.23; p = 0.661), and visual thinking (females: +5.83; males: +5.78; p = 0.961). Notably, females required more time before and after the intervention (post-test: f: 13.12±3.87 min vs. m: 10.69±3.86; p = 0.006) and rated spatial tasks as more difficult (f: 4.2±0.85 vs. m: 3.62±1.14; p = 0.0016). Yet they achieved identical objective results. Both groups rated the 3D models as highly effective (4.65 ± 0.86). These findings demonstrate that multi-modal anatomy training with physical 3D-printed models narrows sex differences in spatial learning outcomes and enables equitable development of anatomical visualization skills through appropriate educational scaffolding. However, process-related differences remain.
Salewski et al. (Sat,) studied this question.