# Come out of Your Shell—A Comparative Pilot Study for Teaching the Central Plastrotomy in Chelonians Using a 3D-Printed Simulator and a Virtual 3D Simulation

## TL;DR

This study compares a 3D-printed simulator and a virtual 3D simulation for teaching a complex turtle surgery called plastrotomy, finding both useful but the simulator more effective.

## Contribution

The study introduces a 3D-printed simulator as a novel teaching tool for central plastrotomy in chelonians.

## Key findings

- The 3D-printed simulator was rated as a suitable and promising teaching device for plastrotomy in chelonians.
- Students using the simulator performed better in practical exams and self-assessment than those using the virtual simulation.
- Veterinary practitioners found the 3D-printed simulator suitable for practicing plastrotomy.

## Abstract

A plastrotomy is a complex surgery technique applied to chelonians (turtles and tortoises). Training in practical skills is critical to master this surgery. Thus, a three-dimensional (3D)-printed simulator and a virtual 3D simulation were designed. Both were tested for their suitability as learning resources in three settings. An objective examination and subjective self-assessment of the student’s skills were conducted alongside an evaluation process of the respective resources. Moreover, veterinary practitioners evaluated the 3D-printed simulator. Both resources were assessed as suitable training devices for a plastrotomy in chelonians. The 3D-printed simulator scored better in all three settings; however, the majority of these findings were not significant. The pilot study indicates that a 3D-printed chelonian simulator is a novel approach with promising potential for practicing surgical access to the coelomic cavity in chelonians.

A pilot study was conducted with 5th–8th semester students comparing a 3D-printed simulator and a virtual 3D simulation. This study’s aim was the comparison of these two resources in three different settings. Assessment of the resources’ suitability as teaching devices for performing a central plastrotomy in chelonians took place. One group used the simulator, while the other group used the simulation to practice this method in a preparation course. Afterwards, the practical skills of 28 students were validated in an objective structured clinical examination (OSCE). The students evaluated their respective resources (simulator and simulation). Additionally, 10 practicing veterinarians evaluated the simulator and rated its fidelity as suitable for practicing a plastrotomy. Furthermore, the self-efficacy of the two student groups was compared with each other. An increase in subjective self-assessment of skills in both groups was identified. Students trained on the simulator achieved better results in the OSCE and self-assessment of skills than those trained with the simulation. However, the differences between the groups regarding these aspects were mostly not significant. This study indicates that a 3D-printed chelonian simulator serves as an appropriate teaching device for veterinary students and is a useful addition to established teaching methods, like using cadavers.