An activity theory approach to analysing student learning of human anatomy using a 3D-printed model and a digital resource
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Author(s)
Lee, Jason Wen Yau
Low, Li Xiang Tessa
Ong, Dennis Wenhui
Bello, Fernando
Soh, Reuben Chee Cheong
Type
Journal Article
Abstract
Introduction
The availability of different tools for teaching and learning has made it challenging for educators to determine which tools are more effective and appropriate for helping students achieve learning outcomes. This is particularly evident in teaching human anatomy, where a range of modalities is used to complement cadaveric dissection. Despite the positive reception of these tools, their impact on learning outcomes remains uncertain. To address this issue, we utilise the Activity Theory Framework to analyse students’ interaction with two tools – a 3D-printed (3DP) model and a digital resource (DR) – to answer two clinical questions relating to the lower spine.
Method
This study took place in a graduate medical school in Singapore. Forty-six students voluntarily signed up for the session. They were grouped in small teams of between 4 and 6 students, and interactions were video recorded. Using a cross-over design, five groups answered a clinical scenario using a 3DP lumbar spine model, while the other five groups used the DR. The teams then swapped the 3DP with the DR and vice versa to answer a second clinical scenario of similar difficulty.
Results
There was no significant performance difference in terms of scores. Using a case study approach, we found that students engaged in more authentic discussions using the 3DP compared to the DR. Despite having access to the system early in the semester, students appeared unfamiliar with using the DR, struggling initially to navigate the software. We found the 3DP model encouraged collaborative discussion as students could physically use it as a tool for discussion by pointing and manipulating the different components in three dimensions, which could not be done with the DR as it operates on a two-dimensional screen.
Conclusion
This study used activity theory to understand the impact of two educational tools on learning. Activity theory allowed a better understanding of tools’ dynamics in learning when looking beyond score performance. We found that 3DP better encouraged collaboration among students than DR. Educators must consider the ease of use of the learning tools when designing activities so that learners will utilise the system’s affordances.
The availability of different tools for teaching and learning has made it challenging for educators to determine which tools are more effective and appropriate for helping students achieve learning outcomes. This is particularly evident in teaching human anatomy, where a range of modalities is used to complement cadaveric dissection. Despite the positive reception of these tools, their impact on learning outcomes remains uncertain. To address this issue, we utilise the Activity Theory Framework to analyse students’ interaction with two tools – a 3D-printed (3DP) model and a digital resource (DR) – to answer two clinical questions relating to the lower spine.
Method
This study took place in a graduate medical school in Singapore. Forty-six students voluntarily signed up for the session. They were grouped in small teams of between 4 and 6 students, and interactions were video recorded. Using a cross-over design, five groups answered a clinical scenario using a 3DP lumbar spine model, while the other five groups used the DR. The teams then swapped the 3DP with the DR and vice versa to answer a second clinical scenario of similar difficulty.
Results
There was no significant performance difference in terms of scores. Using a case study approach, we found that students engaged in more authentic discussions using the 3DP compared to the DR. Despite having access to the system early in the semester, students appeared unfamiliar with using the DR, struggling initially to navigate the software. We found the 3DP model encouraged collaborative discussion as students could physically use it as a tool for discussion by pointing and manipulating the different components in three dimensions, which could not be done with the DR as it operates on a two-dimensional screen.
Conclusion
This study used activity theory to understand the impact of two educational tools on learning. Activity theory allowed a better understanding of tools’ dynamics in learning when looking beyond score performance. We found that 3DP better encouraged collaboration among students than DR. Educators must consider the ease of use of the learning tools when designing activities so that learners will utilise the system’s affordances.
Date Issued
2025-04-16
Date Acceptance
2025-04-11
Citation
BMC Medical Education, 2025, 25
ISSN
1472-6920
Publisher
BMC
Journal / Book Title
BMC Medical Education
Volume
25
Copyright Statement
© The Author(s) 2025. Open Access This article is licensed under a Creative Commons Attribution-NonCommercial-NoDerivatives 4.0 International License, which permits any non-commercial use, sharing, distribution and reproduction in any medium or format, as long as you give appropriate credit to the original author(s) and the source, provide a link to the Creative Commons licence, and indicate if you modified the licensed material. You do not have permission under this licence to share adapted material derived from this article or parts of it. The images or other third party material in this article are included in the article’s Creative Commons licence, unless indicated otherwise in a credit line to the material. If material is not included in the article’s Creative Commons licence and your intended use is not permitted by statutory regulation or exceeds the permitted use, you will need to obtain permission directly from the copyright holder. To view a copy of this licence, visit http://creativecommons.org/licenses/by-nc-nd/4.0/.
Identifier
10.1186/s12909-025-07172-0
Subjects
Digital learning resource
Anatomy education
Cultural-historical activity theory (CHAT)
3D-printing
Anatomy education
Fused deposition modelling (FDM)
Mixed-method research
Case study
Publication Status
Published
Article Number
553
Date Publish Online
2025-04-16
