Evaluating the educational impact of tomography-based high-resolution 3D-printed distal radius fracture models

BACKGROUND: Distal radius fractures (DRFs) are among the most common orthopedic injuries and are often challenging for students to fully understand when taught using only 2D radiographs or healthy models. This study aimed to evaluate the educational impact of tomography-based 3DP DRF models on medical students' knowledge acquisition and anatomical understanding compared with conventional teaching methods. METHODS: The study was designed as a parallel-group, single-blinded prospective randomized controlled trial conducted over two days of structured education. Ninety-four second year physiotherapy students (19.62 ± 1.2 years; 45 F, 49 M) were enrolled and randomly assigned into intervention (n = 47) and control (n = 47) groups. The intervention group received tomography-based fracture 3DP training, while the control group received a healthy 3D-printed model. Primary outcomes included theoretical knowledge (MCQs) and practical case-solving. Secondary outcomes were Test-Taking Motivation Questionnaire (TTMQ); Test Anxiety Inventory (TAI), puzzle assembly time, satisfaction, and willingness-to-recommend ratings. Assessments were conducted pre- and post-training, with knowledge retention re-assessed at one month after education. Statistical analyses were performed using independent samples t-tests and chi-square tests for between-group comparisons, paired t-tests for within-group changes. RESULTS: The intervention group included 47 students (19.51 ± 1.1 years; 36 F, 11 M), while the control group consisted of 47 students (19.74 ± 1.3 years; 33 F, 14 M). Demographic characteristics were similar between the groups. In the 3D group, theoretical knowledge scores improved (50.68 45.34, 55.93, p < .001), TTMQ scores increased (28.06 24.22, 31.91, p < .001), and TAI scores decreased (-10.89 -14.33, - 7.46, p < .001). Similarly, in the control group, theoretical knowledge scores improved (49.46 44.86, 54.03, p < .001), TTMQ scores increased (21.60 17.13, 26.06, p < .001), and TAI scores decreased (-9.70 -14.35, - 5.05, p < .001). Post-training comparisons showed that the intervention group achieved significantly higher scores in case-solving (-18.55 -23.87, - 13.23, p < .001), MCQ performance (4.17 0.15, 8.18, p = .042), puzzle assembly time (11.34 4.24, 18.44, p = .002), TTMQ (8.04 3.20, 12.87, p = .030), and TAI (-4.42 -7.54, - 1.30, p = .030). No significant between-group differences were observed for color recognition (p = .301), weight identification (p = .161), detail recognition (p = .669), or knowledge retention (p = .160). CONCLUSIONS: Within the limits of this study, tomography-based fracture-specific 3D printed models led to greater improvements in knowledge, motivation, reduced anxiety, and better practical performance compared with conventional teaching methods. These models showed educational benefits; further research is needed to confirm long-term and clinical impacts. TRIAL REGISTRATION: clinicaltrials.gov NCT06061003 24/09/2023.