Embracing 3D printing in emergency medicine training in Africa

Abstract

Africa's emergency medicine training faces challenges of limited resources, inadequate simulation tools, and few locally relevant training models. This article explores how three-dimensional (3D) printing can help address these gaps by enabling the creation of affordable, customizable models for procedural skills and simulation-based education. We discuss the context of emergency medicine training in Africa, where limited access to high-fidelity manikins and other teaching aids hampers skills acquisition. The model printing format may be of limited applicability in the context of dynamic simulations, where the model is required to interact and perform a function, versus static simulation, with the emphasis on identification and directed procedures. We highlight illustrative use cases, including a 3D-printed airway management manikin and a basic suturing practice pad, to demonstrate the technology’s potential for hands-on learning. Key benefits of integrating 3D printing into training programs are examined, such as improved access to simulation, better local adaptability, and increased opportunity for producing affordable task trainers that are suited for hands-on emergency procedures. We also acknowledge challenges, from startup costs and infrastructure needs to the learning curve of 3D printers and suggest practical steps for implementation. This commentary encourages educators and institutions in Africa to explore 3D printing for education, and we envision it becoming integral to emergency medicine training across the continent; fostering skill development, self-sufficiency, and ultimately improving patient care.

African Relevance

• •3D printing allows low-cost local production of simulation models, directly addressing the scarcity of training equipment in many African institutions.
• •3D printing allows educators to customize anatomical and procedural trainers to mirror regional disease patterns and patient demographics.
• •3D printing allows training programs to foster self-sufficiency and collaboration, reducing reliance on imported equipment and expanding hands-on emergency skills training in resource-limited and rural settings.

Introduction

Emergency medicine (EM) training programs in Africa often operate under limited resources and infrastructure. Many countries have recently established EM as a specialty and face shortages of trained faculty, insufficient equipment for hands-on training, and under-resourced clinical training sites [4]. Simulation-based education, a core component of modern EM training, is not yet widespread in the region [5,6]. High-fidelity manikins and commercial task trainers are expensive and often beyond the budget of training institutions [1]. Even when simulators are available, they tend to be concentrated in a few urban centres, leaving many trainees in rural settings without opportunities to practice critical emergency procedures in a safe environment.

A scoping review of simulation in developing countries highlighted several barriers to adoption [7]; lack of contextually relevant curricula, a shortage of simulation educators, and the high cost of manikins. Additionally, instructors and learners may feel anxious performing in simulations, highlighting the need to build a more familiar simulation culture through increased exposure. Despite these challenges, there is strong interest among African educators and trainees to use more simulation, recognizing its value for improving clinical skills and patient safety [7]. The key question is how to expand access to simulation and procedural training in a sustainable, cost-effective way suited to the African context.

3D printing for simulation and procedural training

Three-dimensional printing (additive manufacturing) creates objects layer by layer from digital designs. It has emerged as a promising tool to enhance medical education worldwide and is especially relevant for resource-limited settings [3]. Using materials like plastics or resins, 3D printers can produce anatomically accurate models, simulators, and even functional device components. This capability has been used to make realistic replicas of human anatomy, giving trainees hands-on experience with models derived from real patient data. Emergency medicine researchers have 3D-printed airway manikins based on patient CT scans, recreating a difficult airway that standard manikins cannot replicate [8]. Such models allow learners to practice intubation techniques on anatomy that closely mimics actual patients, including variations in size and structure.

3D-printed models have shown most promise in procedural and simulation-based training, particularly where hands-on skill acquisition is essential [3]. The technology enables customization: educators can design models to reflect local disease patterns or specific training needs. For instance, pathology common in Africa could be modelled and printed for simulation scenarios. 3D printing also supports distributed manufacturing of teaching tools: digital design files can be shared and printed locally, reducing reliance on costly imports [3]. This means a remote training program with a printer and materials can produce its own task trainers on-demand instead of waiting for international shipments. In this way, 3D printing acts as a technology equalizer, allowing institutions to create teaching aids on-site and on their schedule.

Importantly, 3D printing can lower costs over time. Once a printer is available, the material cost for each item (filament) is relatively low, so many copies can be made for learners to practice. Open-source communities have shared files for a variety of medical training models from simple anatomical parts to complex simulators that educators in Africa can download and adapt. Overall, 3D printing offers realism, adaptability, and cost savings that directly address many challenges in African emergency medicine training programs.

Examples of 3D-printed models in training

To illustrate the practical impact of 3D printing in emergency medicine education, we present two example projects from our program, thereafter we present other examples which could be applicable to African contexts.

3D-printed airway manikin: airway manikin project

We printed a realistic airway management manikin using 3D-printed moulds, available through Decent Simulators, and silicone casting [9]. The moulds were printed and then filled with medical-grade silicone to form an airway model for intubation practice. The initial development cost (excluding acquiring the 3D files) was about $110, but each additional unit costs only around $36 to produce. This project provided a high-fidelity airway trainer at a fraction of the cost of a commercial manikin.

Basic suturing pad: custom arm for final year medical student practice and exams

We developed a custom suture practice arm to enhance training for final-year Objective Structured Clinical Examinations (OSCE). The project involved designing a 3D-printed arm attachment to hold a replaceable silicone suturing pad, integrated with an existing IV hand model. After multiple iterations and testing with faculty and students, the final suture arm was implemented. It offers a realistic, hands-on suturing experience and is now used regularly in 6th year OSCE training. Notably, excluding the IV hand base, each complete suture arm (printed arm plus pad) costs only about $11.80 to manufacture. This low-cost tool improved the quality of suturing practice, received positive feedback, and showed that 3D printing can produce effective training aids in-house.

Beyond these two cases, other 3D-printed training models have been developed. For example, 3D-printed tracheas embedded in mannequins have been used for cricothyrotomy (surgical airway) practice [2]. In South Africa, the University of Pretoria’s simulation centre has created 3D-printed models for emergency medicine exams, providing affordable, reusable alternatives to imported devices. These examples demonstrate that many procedural task trainers can be produced using basic 3D printing techniques, though more complex simulators may require hybrid methods or additional materials such as silicone.

Trauma & emergency medicine: low-cost chest and bone models

Trauma care training in Africa is often limited by the lack of cadavers and expensive manikins. 3D printing enables affordable, anatomically accurate models for essential procedures like chest tube insertion and fracture fixation. A Tunisian team developed a 3D-printed ribcage model from CT scans to simulate chest tube insertion for trauma and TB-related pleural effusions. Costing only approximately $133, it proved as effective as animal cadavers for teaching intercostal space identification and safe insertion [10].

For orthopaedic trauma, the SELF project by the Intuitive Foundation provides open-source STL files for adult bones that can be 3D-printed locally. These models accurately replicate human bone geometry, cortical thickness, and drilling resistance. A commonly used example is the adult tibia, designed to train external fixation of open fractures; frequent injuries in road accidents and rural trauma settings [11].

Infectious disease simulations: tuberculosis complications

3D printing also supports training for acute infectious disease complications. For TB pericarditis, which can lead to cardiac tamponade, researchers developed a 3D-printed pericardiocentesis mannequin. This life-sized chest model with a simulated pericardial sac allowed students to train under ultrasound guidance, improving fine motor skills and anatomical confidence more than VR-only training [12].

Pulmonary TB often requires bronchoscopy, a skill difficult to master without practice. Pedersen et al. developed a low-cost, 3D-printed bronchoscopy simulator from CT scans. In a randomized trial, 30 clinicians rated it more anatomically realistic than two commercial simulators, especially for identifying the right upper lobe bronchus, with comparable performance for other tasks. Costing only £85 compared to £2000+, the model is an accessible, open-source training tool ideal for African contexts [13].

Benefits of 3D printing in the African context

• •Accessibility and Cost-Effectiveness: 3D printing can greatly reduce the cost of simulation models compared to imported simulators. Commercial task trainers may cost thousands of dollars, whereas a basic 3D printer can be a few hundred dollars and filament only a few dollars per model. Once the printer is set up, unlimited copies of models can be produced at low cost, allowing many trainees to practice simultaneously. This is especially impactful where budgets have limited simulation equipment. By making models locally, programs also save on shipping and import fees, and printed models are easily replaced or repaired by reprinting parts.
• •Adaptability and Local Relevance: Educators can tailor 3D-printed tools to local needs. Instead of one-size-fits-all models designed elsewhere, they can create or adjust models to reflect the patient populations and conditions they encounter. For example, a neonatal intubation trainer could be printed from infant scan data if neonatal airway management is a priority. Community-specific health issues (like certain snakebites or uncommon surgical complications) can be simulated with custom-printed models. This also allows educational materials (labels, instructions) to be produced in local languages and culturally appropriate forms, making simulation more effective and relatable.
• •Self-Sufficiency and Distributed Manufacturing: 3D printing enables training programs to become more self-reliant. Rather than waiting for donations or expensive imports, an institution with a printer can create the models it needs on demand. In education, if a new need arises (say an outbreak requiring a novel procedure), a simulator can be quickly designed and printed. Sharing design files also means a model developed at one institution can be sent electronically and reproduced at another, fostering collaboration. This distributed approach reduces dependence on external suppliers and builds local capacity [3].
• •Enhanced Learning Outcomes: Early experience suggests 3D-printed models can improve learning outcomes. Students appreciate the realistic look and feel of printed models, which can augment or replace scarce resources like cadavers or costly manikins [3]. Realistic models allow repeated, hands-on practice in a safe setting, building confidence and competence. Moreover, when trainees see a model was developed in-house (or help build it), it nurtures a culture of innovation and problem-solving. In the long run, more frequent practice on 3D-printed simulators could translate into better preparedness for real emergencies [14].

Limitations and challenges of 3D printing adoption

• •Initial Costs and Infrastructure: While basic 3D printers are more affordable than before, a reliable printer and supplies still require upfront investment and institutional support. There are ongoing costs for materials and maintenance. Many African training centres have tight budgets, so spending on a 3D printer must be balanced against other needs. Additionally, the printer needs a stable power supply (to avoid failed prints), a computer with the necessary software, and a safe space to operate (with ventilation for some printers). These infrastructure needs can be difficult to meet in resource-limited settings.
• •Technical Skills and Training: Using a 3D printer and designing models requires technical skills that educators may initially lack. The learning curve can be steep, some printers demand a tinkerer’s dedication to achieve good results [2]. It helps to have a faculty or staff member become a 3D printing champion, or to partner with local engineers/makers. Training in 3D modelling software is needed to create custom models. Without in-house expertise, printers might be underutilized or produce poor-quality models. Regular maintenance and troubleshooting (like unclogging nozzles and calibration) are also necessary to keep the printer running well.
• •Material Constraints: 3D printing materials (filaments, resins) must be available and affordable. In some regions, obtaining these supplies is challenging, and importing them can add cost and delay. Furthermore, basic materials may not perfectly mimic all properties needed in a simulator, for instance, hard plastic alone may not simulate soft tissue without additional techniques (such as casting silicone into printed moulds). Also, low-cost printers can have limitations in precision or durability, meaning models might wear out faster and need more frequent replacement.
• •Perception and Engagement: Some faculty may be sceptical of 3D-printed models, perceiving them as lower fidelity than commercial ones. There can be an initial bias that only high-end simulators are “good enough.” Overcoming this requires demonstrating that printed models are effective for training. Busy programs might also be slow to adopt new tools without a champion advocating their use. Learners and instructors might initially be unsure about the accuracy of homemade models (Ismail et al., 2024), but confidence grows as they gain experience with the tools and see positive results.
• •Sustainability: Starting a 3D printing initiative is easier than sustaining it long-term. Programs need plans for continuous material supply, equipment upkeep, and training new personnel so expertise is maintained. Technology will also evolve, today’s printer might be outdated in a few years if training needs expand. It’s important to keep 3D printing projects aligned with educational goals (rather than printing for its own sake) and to periodically verify that skills learned on printed simulators transfer well to real patient care. Maintaining standards and quality control for in-house models will help ensure training remains effective and safe.

Practical considerations for implementation

Implementing 3D printing in an emergency medicine training program involves planning, training, and iteration. Key steps include:

• 1.Assess Needs and Define Objectives: Identify critical skills that lack adequate training models and could be improved with 3D-printed simulators. Engage faculty and trainees to pinpoint these gaps (e.g., paediatric airway management, chest decompression) and set clear objectives (such as improving success rates for a specific procedure).
• 2.Secure Buy-In and Resources: Present the benefits (cost savings, self-sufficiency) to institutional leaders to gain support. Obtain a modest budget for an entry-level 3D printer and materials, and set up the necessary infrastructure (a computer with slicing software, reliable power, and an appropriate workspace with ventilation if needed).
• 3.Build Skills and Team: Designate a tech-savvy champion or small team to learn and manage the 3D printing process. Train them in printer operation and maintenance (using online resources or local experts), and introduce the printed models to other faculty through demonstrations to build broader acceptance.
• 4.Start Small with Proven Designs: Begin with simple, well-tested 3D model files rather than attempting complex custom projects first. Printing “off-the-shelf” designs (like a suturing pad) provides quick wins, builds confidence, and produces immediate tools for training sessions.
• 5.Iterate and Customize: After initial models are in use, gather feedback and make improvements. As the team gains experience, modify designs or create new models to better suit local needs. Each iteration will enhance the models’ effectiveness and improve the team’s design skills.
• 6.Integrate into Curriculum: Incorporate the 3D-printed models into regular training scenarios and skills assessments. Train instructors on their use and utilize checklists or evaluations to ensure the models meet learning objectives. Track performance (e.g., simulation success rates) to demonstrate the impact of these tools.
• 7.Maintain and Sustain: Keep the printer running smoothly with routine maintenance and timely restocking of materials. Print spare parts for models in case of breakage, and document the process so knowledge is retained. Plan ahead by staying updated on new printing technologies or materials and preparing to expand or upgrade the program as needed.

By following these steps, even a small emergency medicine program can develop a growing library of 3D-printed training tools. The key is to treat 3D printing as a sustainable capability that evolves with the program, fostering innovation and self-reliance in medical training.

Future perspectives and opportunities

• •Higher-Fidelity Simulators: As 3D printing advances (e.g., multi-material printers and bioprinting), it will be possible to create even more realistic simulators. Future printers might produce models that include both bone-like and soft-tissue components in one build, greatly enhancing realism. We may see skin and organ models that bleed or mimic human tissue response, allowing complex procedures to be practiced on models that behave almost like real patients.
• •Broader Curriculum Integration: 3D printing is likely to become common across medical education in Africa, not just in emergency medicine. Anatomy classes might use printed organs, and surgical trainees could rehearse operations on patient-specific models. Rare but critical emergency scenarios (like a difficult congenital airway or an unusual fracture) would become easier to simulate with custom-printed models. Academic collaborations and organizations can help spread successful designs and integration strategies across institutions.
• •Collaboration and Open-Source Innovation: A collaborative network is emerging around 3D printing in medical education. We foresee online repositories where African educators share low-cost, open-source designs for simulation models that address local training needs. By pooling creativity, the community can refine models and avoid duplicating effort. An open-source approach will ensure even low-resource programs can access and print quality training tools developed elsewhere.
• •Research and Validation: As 3D-printed models become more common, research will be needed to validate their impact. Future studies could measure whether practicing procedures on 3D-printed simulators leads to better performance in real clinical situations. Studies could measure whether training on a printed surgical airway model improves success rates in real emergencies. Solid evidence will guide best practices and help convince policymakers to invest in simulation and 3D printing.
• •Integration with Other Technologies: 3D-printed models can be combined with augmented reality (AR) and virtual reality (VR) for enhanced training. For example, AR overlays could project virtual anatomy or vital signs onto a printed manikin, and VR simulations could incorporate 3D-printed props to add realistic touch and resistance. These hybrid approaches could create highly immersive learning experiences by merging physical and digital simulation.

We expect 3D printing adoption to accelerate. Early adopters in larger centres will pave the way for smaller programs. Within the next decade, access to a 3D printer may become as essential to a teaching hospital as an airway manikin. Ultimately, this technology, combined with local creativity, can bridge the gap between current training limitations and the high-quality, hands-on education that African providers and patients deserve.

Conclusion

3D printing can strengthen emergency medicine training in Africa by addressing critical gaps in simulation and skills development. By enabling local creation of realistic models, it helps overcome shortages of traditional simulators and allows training to be tailored to community needs. Early examples (like 3D-printed airway and suturing trainers) show that high-impact learning experiences can be delivered at minimal cost.

Implementing 3D printing in training does require investment in equipment and development of technical skills. However, the benefits, greater access to simulation and improved procedural skills, far outweigh the challenges. We encourage emergency medicine educators and institutions across Africa to pilot 3D printing projects, share their experiences, and collaborate regionally. Even a single 3D printer in a skills lab can spark a network of innovators who revolutionize medical training. This approach ensures that every trainee has the tools to practice critical procedures and every program can adapt training to its needs, ultimately leading to more skilled providers and better emergency care.

Dissemination of results

We will make this article accessible to all relevant stakeholders.

CRediT authorship contribution statement

Marvin Jansen: Conceptualization, Writing – original draft, Writing – review & editing. Fahmi Adams: Conceptualization, Writing – original draft, Writing – review & editing.

Declaration of competing interest

The authors declare that they have no known competing financial interests or personal relationships that could have appeared to influence the work reported in this paper.