Effectiveness of three-dimensional printed lumbar spine-model-based training for epidural anesthesia in novice anesthesiology residents

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Abstract
Background Epidural procedures have a steep learning curve and may raise patient-safety concerns during early anesthesiology training. We evaluated whether a low-cost, three-dimensional (3D) simulation model improves early procedural success and efficiency in novice trainees. Methods In this prospective randomized controlled study, 36 anesthesia residents were randomized into two groups. Group A received hands-on training on a 3D simulation model plus audiovisual teaching, whereas Group B received audiovisual teaching only. Performance was assessed at baseline (0 h), 3 h, and 6 h using procedural success, a checklist score, and a global rating scale; procedure time was recorded. Results Baseline success was comparable between groups. At 3 h and 6 h, Group A demonstrated a marked improvement, reaching a success rate of 94.4% at 6 h compared with 50.0% in Group B. Checklist scores did not differ at baseline (p = 0.888) but were significantly higher in Group A at 3 h and 6 h (both p < 0.001). Procedure time decreased significantly in Group A (from 149 ± 24 s to 107 ± 26 s, p < 0.001) versus a limited reduction in Group B (from 148 ± 26 s to 142 ± 22 s, p = 0.001). The model was inexpensive and feasible to produce (~ 6 h printing time; total cost ~$11.50/model). Conclusion Low-cost 3D model–assisted training improved short-term simulator-based epidural performance, checklist scores, GRS scores, and procedural efficiency among novice anesthesiology residents. These findings support the use of 3D printed models as an accessible hands-on adjunct to conventional audiovisual epidural anesthesia training. Further studies are needed to determine whether these improvements translate into long-term retention, clinical performance and patient outcomes.

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