Kei te heke haere te mahi tango tūpāpaku tuku iho, ā, kei te piki haere te rongonui o te whakamahi i te plastination me ngā tauira tānga 3D (3DP) hei huarahi kē atu ki ngā tikanga whakaako anatomy tuku iho. Kāore i te mārama he aha ngā kaha me ngā ngoikoretanga o ēnei taputapu hou, me pēhea hoki te pānga ki te wheako ako anatomy o ngā ākonga, tae atu ki ngā uara tangata pēnei i te whakaute, te manaaki, me te aroha.
I muri tonu i te rangahau whakawhiti matapōkere, i karangatia kia 96 ngā ākonga. I whakamahia he hoahoa mahi hei tūhura i ngā wheako ako mā te whakamahi i ngā tauira kirihou ā-tinana me ngā tauira 3D o te ngākau (Wāhanga 1, n=63) me te kaki (Wāhanga 2, n=33). I whakahaerehia he tātari kaupapa whakataki i runga i te 278 arotake tuhinga kore utu (e pā ana ki ngā kaha, ngā ngoikoretanga, ngā wāhi hei whakapai ake) me ngā tuhinga kupu-tika o ngā rōpū arotahi (n = 8) mō te ako i te ā-tinana mā te whakamahi i ēnei taputapu.
E whā ngā kaupapa i tautuhia: te pono e kitea ana, te māramatanga me te uauatanga taketake, ngā waiaro o te whakaute me te manaaki, te maha o ngā momo mahi, me te kaiārahi.
I te nuinga o te wā, i whakaaro ngā ākonga he pono ake ngā tauira kirihou, nō reira i nui ake te whakaute me te manaaki i a rātou i ngā tauira 3DP, he māmā ake te whakamahi, he pai ake hoki mō te ako i ngā hanganga taketake.
Ko te tātaritanga tupapaku he tikanga whakaako paerewa e whakamahia ana i roto i te mātauranga hauora mai i te rautau 17 [1, 2]. Heoi, nā te iti o te urunga atu, te nui o ngā utu tiaki tūpāpaku [3, 4], te whakaiti nui i te wā whakangungu hanganga tinana [1, 5], me ngā whanaketanga hangarau [3, 6], kei te heke haere ngā akoranga hanganga tinana e whakaakona ana mā te whakamahi i ngā tikanga tapahi tuku iho. Ka huaki ake tēnei i ngā huarahi hou mō te rangahau i ngā tikanga me ngā taputapu whakaako hou, pērā i ngā tauira tangata kua pania ki te kirihou me ngā tauira tānga 3D (3DP) [6,7,8].
He painga, he huakore hoki ō ia taputapu. He maroke, he kore kakara, he tūturu, ā, kāore e mōrearea ngā tauira kua whakakikoruatia [9,10,11], he mea pai mō te whakaako me te whakauru i ngā ākonga ki te ako me te mārama ki te hanganga tinana. Heoi, he pakari hoki, ā, he iti ake te ngāwari [10, 12], nō reira e whakaarohia ana he uaua ake te whakahaere me te toro atu ki ngā hanganga hohonu ake [9]. Mō te utu, he nui ake te utu mō te hoko me te tiaki i ngā tauira kirihou i ngā tauira 3DP [6,7,8]. I tētahi atu taha, ka taea e ngā tauira 3DP te whakamahi i ngā kakano rerekē [7, 13] me ngā tae [6, 14] ā, ka taea te tuku ki ngā wāhanga motuhake, e āwhina ana i ngā ākonga ki te tautuhi, ki te wehewehe me te maumahara ki ngā hanganga nui, ahakoa he ahua kāore i te tūturu tēnei i ngā tauira kirihou.
He maha ngā rangahau kua tirotiro i ngā putanga ako/mahi o ngā momo taputapu tinana pērā i ngā tauira kirihou, ngā whakaahua 2D, ngā wāhanga mākū, ngā ripanga Anatomage (Anatomage Inc., San Jose, CA) me ngā tauira 3DP [11, 15, 16, 17, 18, 19, 20, 21]. Heoi, he rerekē ngā hua i runga i te whiringa o te taputapu whakangungu i whakamahia i roto i ngā rōpū whakahaere me ngā rōpū wawaotanga, tae atu ki ngā rohe tinana rerekē [14, 22]. Hei tauira, i te wā e whakamahia ana me te tapahi mākū [11, 15] me ngā ripanga tātaritanga tūpāpaku [20], i kōrero ngā ākonga mō te pai ake o te ako me ngā waiaro ki ngā tauira kirihou. Waihoki, ko te whakamahinga o ngā tauira kirihou e whakaata ana i te hua pai o te mōhiotanga whāinga o ngā ākonga [23, 24].
He maha ngā wā ka whakamahia ngā tauira 3DP hei tāpiri i ngā tikanga whakaako tuku iho [14,17,21]. I kōrero a Loke et al. (2017) mō te whakamahinga o te tauira 3DP hei mārama ki te mate manawa whānau i roto i te tākuta tamariki [18]. I whakaatuhia e tēnei rangahau he nui ake te pai o te ako a te rōpū 3DP, he pai ake te mārama ki te tetrad a Fallot, ā, he pai ake te kaha ki te whakahaere i ngā tūroro (te whai mana-whaiaro) ki te whakaritea ki te rōpū whakaahua 2D. Mā te ako i te hanganga o te rākau toto me te hanganga o te angaanga mā te whakamahi i ngā tauira 3DP ka rite te pai o te ako ki ngā whakaahua 2D [16, 17]. Kua whakaatuhia e ēnei rangahau he pai ake ngā tauira 3DP i ngā whakaahua 2D e pā ana ki te pai o te ako a ngā ākonga. Heoi, he iti noa ngā rangahau e whakataurite ana i ngā tauira 3DP maha-rauemi me ngā tauira kirihou. I whakamahia e Mogali et al. (2021) te tauira plastination me āna tauira ngākau me te kaki 3DP, ā, i kōrerohia he pikinga rite tonu o te mōhiotanga i waenga i ngā rōpū mana whakahaere me ngā rōpū whakamātautau [21].
Heoi anō, me nui ake ngā taunakitanga hei mārama ake i te take e whakawhirinaki ai te wheako ako a ngā ākonga ki te whiriwhiri i ngā taputapu anatomical me ngā wāhanga rerekē o te tinana me ngā okana [14, 22]. He āhuatanga whakamere ngā uara tangata ka taea te awe i tēnei tirohanga. E pā ana tēnei ki te whakaute, te manaaki, te aroha me te ngākau aroha e tumanakohia ana mai i ngā ākonga e noho hei tākuta [25, 26]. Ko ngā uara tangata kua rapua i roto i ngā tātaritanga tupapaku, i te mea ka akohia ngā ākonga ki te aroha me te tiaki i ngā tūpāpaku i tukuna, nō reira kua noho tonu te ako i te anatomical i tētahi wāhi motuhake [27, 28]. Heoi anō, he onge te ine i tēnei i roto i ngā taputapu kirihou me te 3DP. He rerekē ki ngā pātai rangahau Likert kati-mutunga, ko ngā tikanga kohikohi raraunga kounga pērā i ngā kōrero rōpū arotahi me ngā pātai rangahau tuwhera ka whakarato i te māramatanga ki ngā kōrero a ngā kaiuru i tuhia i roto i tētahi raupapa matapōkere hei whakamārama i te pānga o ngā taputapu ako hou ki ō rātou wheako ako.
Nō reira, ko te whāinga o tēnei rangahau he whakautu i ngā rerekētanga o te tirohanga a ngā ākonga ki te hanganga tinana ina hoatu he taputapu kua whakaritea (plastination) ki a rātou, me ngā whakaahua tūturu kua tāia ki te 3D hei ako i te hanganga tinana?
Hei whakautu i ngā pātai o runga ake nei, ka whai wāhi ngā ākonga ki te whiwhi, ki te kohikohi me te tohatoha i ngā mōhiotanga hanganga tinana mā te taunekeneke me te mahi tahi a te rōpū. He pai te whakaae o tēnei ariā ki te ariā hangahanga, e ai ki te ariā hangahanga, e hanga kaha ana, e tohatoha ana hoki ngā tāngata takitahi, ngā rōpū pāpori rānei i ō rātou mōhiotanga [29]. Ka pāngia te pai o te ako e ēnei taunekeneke (hei tauira, i waenga i ngā hoa, i waenga i ngā ākonga me ngā kaiako) [30, 31]. I taua wā anō, ka pāngia hoki te wheako ako o ngā ākonga e ngā āhuatanga pēnei i te wātea o te ako, te taiao, ngā tikanga whakaako, me ngā ihirangi akoranga [32]. Nō muri mai, ka taea e ēnei āhuatanga te awe i te ako a ngā ākonga me te mōhio ki ngā kaupapa e pārekareka ana ki a rātou [33, 34]. Tērā pea e pā ana tēnei ki te tirohanga ariā o te epistemology mahi, ko te kotinga tuatahi, ko te whakatakotoranga rānei o ngā wheako whaiaro, te mātauranga, me ngā whakapono ka taea te whakatau i te huarahi mahi e whai ake nei [35]. Ka whakamaheretia marietia te huarahi mahi hei tautuhi i ngā kaupapa uaua me tō rātou raupapatanga mā roto i ngā uiui me ngā rangahau, ā, ka whai ake ko te tātari kaupapa [36].
He maha ngā wā ka kiia ngā tauira tūpāpaku he kaiārahi puku, nā te mea e kitea ana rātou he koha nui hei painga mō te pūtaiao me te tangata, e whakaoho ana i te whakaute me te whakawhetai mai i ngā ākonga ki ā rātou kaituku [37, 38]. Kua pūrongohia e ngā rangahau o mua he rite, he teitei ake rānei ngā kaute whāinga i waenga i te rōpū tūpāpaku/plastination me te rōpū 3DP [21, 39], engari kāore i te mārama mēnā he rite te wheako ako a ngā ākonga, tae atu ki ngā uara tangata, i waenga i ngā rōpū e rua. Mō ētahi atu rangahau, ka whakamahia e tēnei rangahau te mātāpono o te pragmatism [36] hei tirotiro i te wheako ako me ngā āhuatanga o ngā tauira 3DP (tae me te kakano) me te whakataurite ki ngā tauira plastinated i runga i ngā urupare a ngā ākonga.
Ka taea e ngā tirohanga a ngā ākonga te awe i ngā whakatau a ngā kaiako mō te whiriwhiri i ngā taputapu hanganga tinana e tika ana, i runga i ngā mea e whai hua ana, e kore rānei e whai hua mō te whakaako hanganga tinana. Ka taea hoki e ēnei mōhiohio te āwhina i ngā kaiako ki te tautuhi i ngā manakohanga a ngā ākonga me te whakamahi i ngā taputapu tātari tika hei whakapai ake i ō rātou wheako ako.
Ko te whāinga o tēnei rangahau kounga he tūhura i ngā mea e whakaarohia ana e ngā ākonga he wheako ako nui mā te whakamahi i ngā tauira ngākau me te kaki kua whakakirikiritia ki te whakataurite ki ngā tauira 3DP. E ai ki tētahi rangahau tuatahi nā Mogali et al. i te tau 2018, i whakaaro ngā ākonga he pono ake ngā tauira kua whakakirikiritia ki te tauira 3DP [7]. Nō reira, me kī tātou:
I te mea i hangaia ngā plastination mai i ngā tūpāpaku tūturu, i tumanakohia kia pai ake te tirohanga a ngā ākonga ki ngā plastination i ngā tauira 3DP, e ai ki te pono me te uara tangata.
E pā ana tēnei rangahau kounga ki ngā rangahau tauanga e rua o mua [21, 40] nā te mea i kohia ngā raraunga i whakaaturia i roto i ngā rangahau e toru i te wā kotahi mai i te tauira kotahi o ngā ākonga whai wāhi. I whakaatuhia e te tuhinga tuatahi ngā inenga whāinga ōrite (ngā kaute whakamātautau) i waenga i ngā rōpū plastination me te 3DP [21], ā, i whakamahia e te tuhinga tuarua te tātaritanga tauwehe hei whakawhanake i tētahi taputapu kua whakamanahia e te hinengaro (ngā tauwehe e whā, ngā tūemi 19) hei ine i ngā hanganga mātauranga pēnei i te makona ki te ako, te whai mana ki a ia anō, ngā uara tangata, me ngā herenga pāpāho ako [40]. I tirotirohia e tēnei rangahau ngā kōrerorero rōpū tuwhera me te arotahi kounga teitei hei rapu i ngā mea e whakaarohia ana e ngā ākonga he mea nui i te wā e ako ana i te hanganga tinana mā te whakamahi i ngā tauira plastinated me ngā tauira tānga 3D. Nō reira, he rerekē tēnei rangahau i ngā tuhinga e rua o mua e pā ana ki ngā whāinga/pātai rangahau, ngā raraunga, me ngā tikanga tātari hei whiwhi māramatanga ki ngā urupare ākonga kounga (ngā kōrero tuhinga kore utu me te kōrerorero rōpū arotahi) mō te whakamahinga o ngā taputapu 3DP ki te whakataurite ki ngā tauira kirihou. Ko te tikanga o tēnei rangahau he rerekē te whakaoti rapanga rangahau a tēnei rangahau i ngā tuhinga e rua o mua [21, 40].
I te whare wānanga o te kaituhi, ka whakauruhia te anatomy ki roto i ngā akoranga pūnaha pēnei i te cardiopulmonary, endocrinology, musculoskeletal, me ētahi atu, i roto i ngā tau tuatahi e rua o te kaupapa Bachelor of Medicine me te Bachelor of Surgery (MBBS) e rima tau te roa. Ko ngā tauira kua pania ki te paraharaha, ngā tauira kirihou, ngā whakaahua hauora, me ngā tauira 3D mariko ka whakamahia pinepine hei whakakapi i ngā tauira wetewete, wetewete rānei hei tautoko i te mahi anatomy whānui. Ka whakakapia ngā kauhau tuku iho e whakaakona ana e ngā wā ako rōpū me te arotahi ki te whakamahi i ngā mātauranga kua riro mai. I te mutunga o ia kōwae pūnaha, tangohia he whakamātautau mahi anatomy whakawhanake ipurangi kei roto ko te 20 ngā whakautu pai takitahi (SBA) e kapi ana i te anatomy whānui, te whakaahua, me te histology. I te katoa, e rima ngā whakamātautau whakawhanake i whakahaerehia i te wā o te whakamātautau (e toru i te tau tuatahi, e rua i te tau tuarua). Ko te aromatawai tuhituhi whānui mō ngā Tau 1 me te 2 kei roto ko ngā pepa e rua, ia ia he 120 SBA. Ka uru te anatomy ki roto i ēnei aromatawai, ā, ka whakatauhia e te mahere aromatawai te maha o ngā pātai anatomy hei whakauru.
Hei whakapai ake i te ōwehenga tauira-ki-tauira, i akohia ngā tauira 3DP ā-roto i runga i ngā tauira kirihou hei whakaako me te ako i te hanganga tinana. Mā tēnei ka whai wāhi ki te whakatū i te uara mātauranga o ngā tauira 3DP hou ki te whakataurite ki ngā tauira kirihou i mua i te whakaurunga ōkawa ki te marautanga hanganga tinana.
I roto i tēnei rangahau, i whakahaerehia te tomography rorohiko (CT) (64-poro Somatom Definition Flash CT scanner, Siemens Healthcare, Erlangen, Tiamana) ki ngā tauira kirihou o te ngākau (kotahi te ngākau katoa me te kotahi te ngākau i te wāhanga whakawhiti) me te upoko me te kaki (kotahi te katoa me te kotahi te papa waenga-whakawhiti upoko-kaki) (Pikitia 1). I kohia ngā whakaahua Digital Imaging and Communications in Medicine (DICOM) ā, i utaina ki roto i te 3D Slicer (putanga 4.8.1 me te 4.10.2, Harvard Medical School, Boston, Massachusetts) mō te wehewehe hanganga mā te momo pēnei i ngā uaua, ngā uaua, ngā io, me ngā wheua. I utaina ngā kōnae wehewehe ki roto i te Materialize Magics (Putanga 22, Materialize NV, Leuven, Belgium) hei tango i ngā anga haruru, ā, i tiakina ngā tauira tā ki te hōputu STL, kātahi ka whakawhitia ki tētahi pūreretā Objet 500 Connex3 Polyjet (Stratasys, Eden Prairie, MN) hei hanga tauira hanganga 3D. Ka whakapakeketia ngā kapia photopolymerizable me ngā elastomers mārama (VeroYellow, VeroMagenta me TangoPlus) papatahi i raro i te mahi a te hihi UV, ka hoatu ki ia hanganga tinana tōna ake kakano me te tae.
Ngā taputapu ako hanganga tinana i whakamahia i roto i tēnei rangahau. Mauī: Kaki; matau: ngākau whakakikoruatia me te tānga 3D.
Hei tāpiritanga, i tīpakohia te aorta piki me te pūnaha coronary mai i te tauira ngākau katoa, ā, i hangaia ngā tūāpapa turanga hei tāpiri atu ki te tauira (putanga 22, Materialize NV, Leuven, Belgium). I tāia te tauira ki runga i te pūreretā Raise3D Pro2 (Raise3D Technologies, Irvine, CA) mā te whakamahi i te miro polyurethane thermoplastic (TPU). Hei whakaatu i ngā uaua o te tauira, me tango te rauemi tautoko TPU kua tāia, ā, me peita ngā oko toto ki te kiriaku whero.
I whiwhi ngā ākonga tau tuatahi o te Tohu Paetahi Rongoā i te Whare Wānanga Rongoā o Lee Kong Chiang i te tau mātauranga 2020-2021 (n = 163, 94 tāne me 69 wāhine) i tētahi īmēra pōwhiri kia whai wāhi atu ki tēnei rangahau hei mahi tūao. I whakahaerehia te whakamātautau whakawhiti matapōkere i roto i ngā wāhanga e rua, tuatahi me te tapahi i te ngākau, kātahi me te tapahi i te kaki. E ono wiki te wā horoi i waenganui i ngā wāhanga e rua hei whakaiti i ngā pānga toenga. I ngā wāhanga e rua, i matapo ngā ākonga ki ngā kaupapa ako me ngā mahi rōpū. Kāore i neke atu i te ono tāngata i roto i te rōpū. Ko ngā ākonga i whiwhi tauira kirihou i te taahiraa tuatahi i whiwhi tauira 3DP i te taahiraa tuarua. I ia wāhanga, ka whiwhi ngā rōpū e rua i tētahi kauhau whakataki (30 meneti) mai i tētahi atu rōpū (kaiako matua) ā, muri iho ko te ako-whaiaro (50 meneti) mā te whakamahi i ngā taputapu ako-whaiaro me ngā pepa tohatoha kua whakaratohia.
Ka whakamahia te rārangi arowhai COREQ (Paearu Whānui mō te Pūrongo Rangahau Kounga) hei ārahi i te rangahau kounga.
I tukuna e ngā ākonga he urupare mō ngā rauemi ako rangahau mā roto i tētahi rangahau i whakaurua ai ngā pātai tuwhera e toru mō ō rātou kaha, ngoikoretanga, me ngā whai wāhitanga mō te whanaketanga. I homai e ngā kaiwhakautu 96 katoa he whakautu kore-whakautu. Kātahi ka uru atu ngā ākonga tūao tokowaru (n = 8) ki te rōpū arotahi. I whakahaerehia ngā uiuinga ki te Pokapū Whakangungu Anatomy (te wāhi i whakahaerehia ai ngā whakamātautau) ā, i whakahaerehia e te Kairangahau 4 (Ph.D.), he kaiako tāne ehara i te tohunga anatomy me te neke atu i te 10 tau o te wheako whakahaere TBL, engari kāore i uru ki te whakangungu a te tīma rangahau. Kāore ngā ākonga i te mōhio ki ngā āhuatanga whaiaro o ngā kairangahau (me te rōpū rangahau) i mua i te tīmatanga o te rangahau, engari i whakamōhiotia rātou e te puka whakaae mō te kaupapa o te rangahau. Ko te kairangahau 4 me ngā ākonga anake i uru ki te rōpū arotahi. I whakaahuahia e te kairangahau te rōpū arotahi ki ngā ākonga, ā, i pātai atu mēnā e hiahia ana rātou ki te whai wāhi. I whakapuakihia e rātou ō rātou wheako ki te ako i te tā 3D me te plastination, ā, i tino hihiri rātou. E ono ngā pātai ārahi a te kaiārahi hei whakatenatena i ngā ākonga ki te mahi (Rauemi Tāpiri 1). Ko ētahi tauira ko te matapaki i ngā āhuatanga o ngā taputapu hanganga tinana e whakatairanga ana i te ako me te ako, me te tūranga o te aroha ki te mahi me ēnei tauira. "Me pēhea e whakaahua ai koe i tō wheako ki te ako i te hanganga tinana mā te whakamahi i ngā tauira kirihou me ngā kape tānga 3D?" ko te pātai tuatahi o te uiui. He tuwhera ngā pātai katoa, e āhei ai ngā kaiwhakamahi ki te whakautu noa i ngā pātai me te kore he wāhi whakaaro kore, e āhei ai te kimi raraunga hou me te wikitoria i ngā wero mā ngā taputapu ako. Kāore i whiwhi ngā kaiuru i te tuhi o ngā kōrero, i te tātari rānei i ngā hua. Nā te āhua tūao o te rangahau i karo i te kī o ngā raraunga. I rīpenehia te kōrero katoa hei tātari.
I tuhia te rekoata rōpū arotahi (35 meneti) ki te kupu, ā, i tangohia te tuakiri (i whakamahia ngā ingoa huna). Hei tāpiri, i kohia ngā pātai pātai tuwhera. I kawemai ngā tuhinga rōpū arotahi me ngā pātai rangahau ki roto i te ripanga Microsoft Excel (Microsoft Corporation, Redmond, WA) mō te tapatoru raraunga me te whakakotahi hei tirotiro i ngā hua rite, ōrite rānei, ngā hua hou rānei [41]. Ka mahia tēnei mā te tātari kaupapa ariā [41, 42]. Ka tāpirihia ngā whakautu tuhinga a ia ākonga ki te tapeke o ngā whakautu. Ko te tikanga ka kiia ngā kōrero kei roto he rerenga maha hei kotahi. Ka kore e arohia ngā whakautu me te kore, te kore rānei he tohu kōrero. Tokotoru ngā kairangahau (he kairangahau wahine me te tohu Ph.D., he kairangahau wahine me te tohu māhita, me te kaiawhina tāne me te tohu paetahi i roto i te hangarau me te 1–3 tau o te wheako rangahau i roto i te mātauranga hauora) i whakakōwae takitahi i ngā raraunga kore hanganga. Tokotoru ngā kaihōtaka e whakamahi ana i ngā papa tuhi tūturu hei whakarōpū i ngā tuhipoka pou-i runga i ngā āhuatanga ōrite me ngā rerekētanga. He maha ngā wā i whakahaerehia hei whakarite me te whakarōpū i ngā waehere mā te mōhiotanga tauira pūnaha me te auau, ā, i reira ka whakarōpūhia ngā waehere hei tautuhi i ngā kaupapa iti (ngā āhuatanga motuhake, whānui rānei pērā i ngā āhuatanga pai me ngā āhuatanga kino o ngā taputapu ako) kātahi ka hanga kaupapa whānui [41]. Hei whakatutuki i te whakaae, i whakaaetia e tētahi kairangahau tāne tokoono (Ph.D.) me te 15 tau o te wheako ki te whakaako i te hanganga tinana ngā kaupapa whakamutunga.
E ai ki te Whakapuakitanga o Helsinki, i arotakehia e te Poari Arotake Whare Wānanga o Te Whare Wānanga Hangarau o Nanyang (IRB) (2019-09-024) te kaupapa rangahau, ā, i whiwhi i ngā whakaaetanga e tika ana. I whakaae ngā kaiuru me te whai whakaaro, ā, i whakamōhiotia rātou mō tō rātou tika ki te whakakore i te whai wāhi i ngā wā katoa.
E iwa tekau mā ono ngā ākonga hauora tau tuatahi i whakaae katoa mai, me ngā āhuatanga taketake pēnei i te ira tangata me te tau, ā, i kī kāore he whakangungu ōkawa i mua i roto i te hanganga tinana. Ko te Wāhanga I (ngākau) me te Wāhanga II (te tapahi kaki) i uru atu ki te 63 ngā kaiuru (33 ngā tāne me te 30 ngā wāhine) me te 33 ngā kaiuru (18 ngā tāne me te 15 ngā wāhine). Ko ō rātou tau i waenga i te 18 ki te 21 tau (te toharite ± te paerewa rerekētanga: 19.3 ± 0.9) tau. I whakautua e ngā ākonga 96 katoa te pātai (kāore he ākonga i whakarērea), ā, e waru ngā ākonga i uru ki ngā rōpū arotahi. E 278 ngā kōrero tuwhera mō ngā painga, ngā huakore, me ngā hiahia mō te whakapai ake. Kāore he rerekētanga i waenga i ngā raraunga i tātarihia me te pūrongo o ngā kitenga.
I roto i ngā kōrero a te rōpū arotahi me ngā whakautu rangahau, e whā ngā kaupapa i puta ake: te pono e kitea ana, te māramatanga taketake me te uauatanga, ngā waiaro o te whakaute me te manaaki, te maha o ngā momo mahi, me te kaiārahi (Pikitia 2). Ka whakamāramahia ia kaupapa ki raro nei.
Ko ngā kaupapa e whā—te pono e kitea ana, te māramatanga me te uauatanga taketake, te whakaute me te manaaki, me te hiahia ki ngā pāpāho ako—e ahu mai ana i te tātari kaupapa o ngā pātai rangahau tuwhera me ngā kōrerorero rōpū arotahi. Ko ngā huānga i roto i ngā pouaka kikorangi me te kōwhai e tohu ana i ngā āhuatanga o te tauira whakakikoruatia me te tauira 3DP. 3DP = tānga 3D
I whakaaro ngā ākonga he pono ake ngā tauira kirihou, he rite ake ngā tae tūturu ki ngā tūpāpaku tūturu, ā, he pai ake ngā taipitopito tinana i ngā tauira 3DP. Hei tauira, he nui ake te kitea o te takotoranga o te muka uaua i roto i ngā tauira kirihou ki ngā tauira 3DP. E whakaatuhia ana tēnei rerekētanga i roto i te kōrero i raro nei.
"...tino taipitopito, ā, he tika hoki, pērā i te tangata tūturu (kaiuru C17; arotakenga plastination āhua-kore)."
I kite ngā ākonga he pai ngā taputapu 3DP mō te ako i te hanganga tinana taketake me te aromatawai i ngā āhuatanga nui o te tinana, engari he pai ngā tauira kirihou hei whakawhānui ake i ō rātou mōhiotanga me te māramatanga ki ngā hanganga me ngā rohe uaua o te tinana. I whakaaro ngā ākonga ahakoa he rite tonu ngā taputapu e rua tetahi ki tetahi, i ngaro i a rātou ngā mōhiohio whai hua i te wā e mahi ana me ngā tauira 3DP ki te whakataurite ki ngā tauira kirihou. Ka whakamāramahia tēnei i roto i te kōrero i raro nei.
"...i kitea ētahi uauatanga pērā i... ngā taipitopito iti pērā i te fossa ovale... i te nuinga o te wā ka taea te whakamahi i te tauira 3D o te ngākau... mō te kaki, tera pea ka ako au i te tauira plastination me te maia ake (kaiuru PA1; 3DP, kōrero rōpū arotahi”).
"...ka kitea ngā hanganga whānui... i roto i ngā taipitopito, he pai ngā tauira 3DP mō te ako, hei tauira, ngā hanganga matotoru (me) ngā mea nunui ake, ngāwari te tautuhi pērā i ngā uaua me ngā whekau... pea (mō) te hunga kāore pea e uru atu ki ngā tauira kirihou (kaiuru PA3; 3DP, kōrero rōpū arotahi)".
I nui ake te whakaute me te āwangawanga o ngā ākonga mō ngā tauira kua whakapūmautia, engari i āwangawanga anō hoki rātou mō te whakangaromanga o te hanganga nā tōna ngoikore me te kore ngāwari. I tua atu, i tāpiri atu ngā ākonga ki ō rātou wheako mahi mā te mōhio ka taea te tārua i ngā tauira 3DP mēnā ka pakaru.
"... he nui ake tō mātou tupato ki ngā tauira plastination (kaiuru PA2; plastination, kōrero rōpū arotahi)".
"...mō ngā tauira plastination, he rite ki...he mea kua roa e tiakina ana. Mena i pakaru e au...ki taku whakaaro e mōhio ana tātou he kino rawa atu te āhua nā te mea he hītori tōna (kaiuru PA3; plastination, kōrero rōpū arotahi)."
"Ka taea te hanga i ngā tauira tānga-3D i roto i te tere me te ngāwari...ka taea ai e te tini o te tangata te uru atu ki ngā tauira 3D, ā, ka taea hoki te ako me te kore e hiahia ki te tohatoha tauira (kaitākoha I38; 3DP, arotake tuhinga kore utu)."
"...mā ngā tauira 3D ka taea e tātou te tākaro noa me te kore e manukanuka nui mō te kino o aua tauira, pērā i te kino o ngā tauira... (kaiuru PA2; 3DP, kōrero rōpū arotahi)."
E ai ki ngā ākonga, he iti noa te maha o ngā tauira kua whakapūkaratia, ā, he uaua te uru atu ki ngā hanganga hohonu ake nā te pakari o aua hanganga. Mō te tauira 3DP, e tumanako ana rātou ki te whakapai ake i ngā taipitopito hanganga tinana mā te whakarite i te tauira ki ngā wāhi e hiahiatia ana mō te ako whaiaro. I whakaae ngā ākonga ka taea te whakamahi i ngā tauira whakapūkaratia me te 3DP me ētahi atu momo taputapu whakaako pērā i te ripanga Anatomage hei whakarei ake i te ako.
"Kāore e tino kitea ana ētahi hanganga hōhonu o roto (kaiuru C14; plastination, kōrero āhua-kore)."
"Tērā pea he tāpiri tino whai hua ngā ripanga tātaritanga tūpāpaku me ētahi atu tikanga (mema C14; plastination, arotake tuhinga kore utu)."
"Mā te whakarite kia tino taipitopito ngā tauira 3D, ka taea e koe te hanga tauira motuhake e arotahi ana ki ngā wāhi rerekē me ngā āhuatanga rerekē, pērā i ngā io me ngā uaua toto (kaiuru I26; 3DP, arotake tuhinga kore utu)."
I kī atu hoki ngā ākonga kia whakaurua he whakaaturanga mā te kaiako hei whakamārama me pēhea te whakamahi tika i te tauira, me ētahi atu aratohu rānei mō ngā tauira whakaahua kua tāpirihia he whakamārama hei whakahaere i te ako me te māramatanga i roto i ngā tuhipoka kauhau, ahakoa i whakaae rātou i hangaia te rangahau mō te ako-whaiaro.
"...E mihi ana ahau ki te momo rangahau motuhake...tērā pea ka taea te whakarato atu i ētahi atu aratohu mā roto i te ahua o ngā kiriata kua tāia, ētahi tuhipoka rānei...(kaiuru C02; ngā kōrero kuputuhi kore utu whānui)."
"Mā ngā tohunga ihirangi, mā ngā taputapu tirohanga anō hoki pērā i te pakiwaituhi, te ataata rānei, ka taea e tātou te mārama ake ki te hanganga o ngā tauira 3D (mema C38; arotake tuhinga kore utu whānui)."
I pātaihia ngā ākonga hauora tau tuatahi mō ā rātou wheako ako me te kounga o ngā tauira tānga-3D me ngā tauira kirihou. E ai ki te whakaaro, i kitea e ngā ākonga he pono ake, he tika ake hoki ngā tauira kirihou i ngā tauira tānga-3D. Kua whakaūhia ēnei hua e tētahi rangahau tuatahi [7]. Nā te mea i hangaia ngā tuhinga mai i ngā tūpāpaku i kohaina, he pono. Ahakoa he tauira 1:1 o tētahi tauira kirihou me ngā āhuatanga āhua rite [8], i kiia te tauira tānga-3D polymer he iti ake te pono, he iti ake hoki te pono, inā koa mō ngā ākonga kāore i kitea ngā taipitopito pēnei i ngā taha o te fossa porotītaha i roto i te tauira 3DP o te ngākau ki te tauira kirihou. Tērā pea nā te kounga o te ahua CT tēnei, kāore e taea te tautuhi mārama i ngā rohe. Nō reira, he uaua ki te wehewehe i aua hanganga i roto i te pūmanawa wehewehe, e pā ana ki te tukanga tānga-3D. Ka ara ake pea ngā feaa mō te whakamahinga o ngā taputapu 3DP nā te mea e wehi ana rātou ka ngaro te mōhiotanga nui mēnā kāore e whakamahia ngā taputapu paerewa pēnei i ngā tauira kirihou. Tērā pea ka kitea e ngā ākonga e hiahia ana ki te whakangungu pokanga he mea tika kia whakamahia ngā tauira mahi [43]. He rite tonu ngā hua o nāianei ki ngā rangahau o mua i kitea ai kāore i te tika ngā tauira kirihou [44] me ngā tauira 3DP ki ngā tauira tūturu [45].
Hei whakapai ake i te urunga atu o ngā ākonga, ā, nō reira, me whai whakaaro hoki ki te utu me te wātea o ngā taputapu. E tautoko ana ngā hua i te whakamahinga o ngā tauira 3DP hei whiwhi mātauranga hanganga tinana nā te mea he iti te utu o tā rātou hanga [6, 21]. He rite tēnei ki tētahi rangahau o mua i whakaatu i te mahi whāinga rite tonu o ngā tauira kirihou me ngā tauira 3DP [21]. I whakaaro ngā ākonga he pai ake ngā tauira 3DP mō te ako i ngā ariā hanganga tinana taketake, ngā okana, me ngā āhuatanga, ko ngā tauira kirihou he pai ake mō te ako i te hanganga tinana uaua. Hei tāpiri, i tautoko ngā ākonga i te whakamahinga o ngā tauira 3DP me ngā tauira tūpāpaku o nāianei me ngā hangarau hou hei whakapai ake i te māramatanga o ngā ākonga ki te hanganga tinana. He maha ngā huarahi hei whakaatu i te mea kotahi, pērā i te mahere i te hanganga tinana o te ngākau mā te whakamahi i ngā tūpāpaku, te tā 3D, ngā matawai tūroro, me ngā tauira 3D mariko. Mā tēnei huarahi maha-ahurea ka taea e ngā ākonga te whakaatu i te hanganga tinana i ngā huarahi rerekē, te whakapuaki i tā rātou i ako ai i ngā huarahi rerekē, me te whakauru i ngā ākonga i ngā huarahi rerekē [44]. Kua whakaatuhia e te rangahau he uaua pea ngā rauemi ako pono pērā i ngā taputapu tūpāpaku mō ētahi ākonga e pā ana ki te kawenga hinengaro e pā ana ki te ako hanganga tinana [46]. He mea nui te mārama ki te pānga o te kawenga hinengaro ki te ako a ngā ākonga, me te whakamahi i ngā hangarau hei whakaiti i te kawenga hinengaro kia pai ake ai te taiao ako [47, 48]. I mua i te whakauru i ngā rauemi tūpāpaku ki ngā ākonga, he tikanga whai hua pea ngā tauira 3DP hei whakaatu i ngā āhuatanga taketake me ngā āhuatanga nui o te hanganga tinana hei whakaiti i te kawenga hinengaro me te whakarei ake i te ako. Hei tāpiri, ka taea e ngā ākonga te kawe i ngā tauira 3DP ki te kāinga hei arotake me ngā pukapuka ako me ngā rauemi kauhau, me te whakawhānui ake i te ako i te hanganga tinana ki tua atu i te taiwhanga [45]. Heoi, kāore anō kia whakatinanahia te mahi tango i ngā wāhanga 3DP i roto i te whare wānanga o te kaituhi.
I roto i tēnei rangahau, he nui ake te whakaute o ngā tauira plastinated i ngā tauira 3DP. He rite tonu tēnei whakatau ki ngā rangahau o mua e whakaatu ana ko ngā tauira tūpāpaku hei "tūroro tuatahi" e whakahau ana i te whakaute me te aroha, engari kāore ngā tauira horihori [49]. He piripono, he tūturu hoki te kiko tangata plastinated tūturu. Mā te whakamahinga o ngā rauemi tūpāpaku ka taea e ngā ākonga te whakawhanake i ngā kaupapa tangata me ngā tikanga matatika [50]. Hei tāpiri, ko ngā tirohanga a ngā ākonga ki ngā tauira plastination ka pāngia pea e tō rātou mōhiotanga e tipu haere ana ki ngā kaupapa koha tūpāpaku me/ranei te tukanga plastination. Ko te plastination he koha tūpāpaku e whai ana i te aroha, te whakamoemiti me te whakawhetai e pā ana ki ngā ākonga mō ā rātou kaituku [10, 51]. Ko ēnei āhuatanga e wehewehe ana i ngā nēhi tangata, ā, ki te whakatipuria, ka taea te āwhina i a rātou ki te ahu whakamua i roto i te ngaio mā te maioha me te aroha ki ngā tūroro [25, 37]. He rite tēnei ki ngā kaiako wahangu e whakamahi ana i te wetewete tangata mākū [37,52,53]. Nā te mea i kohaina ngā tauira mō te plastination mai i ngā tūpāpaku, i tirohia rātou he kaiako wahangu e ngā ākonga, ā, i whiwhi i te whakaute mō tēnei taputapu whakaako hou. Ahakoa e mōhio ana rātou he mea hanga ngā tauira 3DP e ngā mīhini, e pai tonu ana rātou ki te whakamahi. E māharahara ana ia rōpū kei te manaakitia, ā, ka ata whakahaerea te tauira kia mau tonu tōna āhua. Tērā pea kua mōhio kē ngā ākonga kei te hangaia ngā tauira 3DP mai i ngā raraunga tūroro mō ngā kaupapa mātauranga. I te whare wānanga o te kaituhi, i mua i te tīmatanga o te ako ā-ture mō te hanganga tinana, ka tukuna he akoranga hanganga tinana whakataki mō te hītori o te hanganga tinana, ā, muri iho ka oati ngā ākonga. Ko te kaupapa matua o te oati he whakatō ki roto i ngā ākonga te māramatanga ki ngā uara tangata, te whakaute ki ngā taputapu hanganga tinana, me te ngaiotanga. Mā te whakakotahitanga o ngā taputapu hanganga tinana me te whakapau kaha ka āwhina i te whakatō i te wairua manaaki, te whakaute, me te whakamahara pea i ngā ākonga ki ō rātou kawenga ā muri ake nei ki ngā tūroro [54].
Mō ngā whakapainga ā muri ake nei i roto i ngā taputapu ako, i whakaurua e ngā ākonga o ngā rōpū plastination me te 3DP te wehi o te whakangaromanga o te hanganga ki roto i tā rātou whai wāhi me te ako. Heoi, i whakaatuhia ngā āwangawanga mō te pakaru o te hanganga o ngā tauira whakakikoruatia i roto i ngā kōrerorero rōpū arotahi. Kua whakaūhia tēnei kitenga e ngā rangahau o mua mō ngā tauira kirihou [9, 10]. He mea tika ngā whakarerekētanga hanganga, inā koa ngā tauira kaki, hei tūhura i ngā hanganga hohonu ake me te mārama ki ngā whanaungatanga ā-wāhi toru-ahu. Mā te whakamahi i ngā mōhiohio pā (pā) me te tirohanga ka āwhina i ngā ākonga ki te hanga i tētahi pikitia hinengaro taipitopito me te tino o ngā wāhanga anatomical toru-ahu [55]. Kua whakaatuhia e ngā rangahau ka taea e te whakarerekētanga pā o ngā mea tinana te whakaiti i te kawenga hinengaro me te arahi ki te māramatanga me te pupuri i ngā mōhiohio [55]. Kua whakaarohia ko te tāpiri i ngā tauira 3DP ki ngā tauira kirihou ka taea te whakapai ake i te taunekeneke a ngā ākonga me ngā tauira me te kore e wehi kei pakaru ngā hanganga.
Wā tuku: Hurae-21-2023