区域切除の理解を深めるための3D実体モデルを用いた医学教育

Educational Impact of Using Three-dimentional Models for Preoperative Simulation of Segmentectomy for Medical Students

近年，相次いで肺癌に対する縮小切除の良好な治療成績1，2）が報告された．特に縮小切除のうち小型肺癌に対する区域切除の重要性が認識され，その手術の適応が増加していると推察される．このため今後，区域切除は呼吸器外科研修のみならず医学教育においても必要な知識になる可能性がある．一方，肺区域の解剖は複雑で，呼吸器外科をめざす研修医，専攻医にとって十分に理解するには時間が必要である．まして医学生の短い実習期間内では十分な指導や教育はむずかしい．医学教育における解剖学の重要性は論を俟たず，最近では解剖学のよりよい理解のために有用なツールやウェブサイトも公表されているものの，医学生が区域切除に興味をもち，かつ理解することはきわめて困難である．

Background：Lung segment anatomy is complex and difficult for medical students to comprehend, so education is a challenging issue. Three-dimensional （3D） models may be a more effective teaching tool for medical students. We evaluated the usefulness of 3D models in education for segmentectomy.

Methods：Sixty-six students who participated in clinical training for thoracic surgery from November 2020 to March 2022 were included in the study. Computed tomography （CT） images, 3D-CT images, and 3D models were used to investigate students’ level of understanding for each lung segment. Levels of understanding were assessed using a questionnaire administered using the interview method. The results of the questionnaire were tabulated and analyzed using the Kruskal-Wallis test.

Results：The response rate was 100％. Comprehension scores for all questions were highest for 3D models, followed by 3D-CT and CT. These results suggest that use of a 3D entity model may have a high educational effect.

Conclusion：Although it is unclear whether students’ comprehension was directly related to their understanding of correct anatomy, our results suggest that 3D models may be an effective way for medical students to understand lung segmentectomy.