Introduction There is currently no gold standard for teaching spatial anatomy related to radiographic appraisal. Yet, interpreting radiographs is a core skill for healthcare professionals, particularly chiropractors, whomust consistently translate two-dimensional (2D) images into three-dimensional (3D) anatomical understanding. Traditional learning methods, which rely heavily on textbook images and online resources, often fail to cultivate the spatial ability required to mentally manipulate anatomical structures in three dimensions. Without this capacity, radiographic interpretation and the clinical reasoning that flows from it are compromised. In response to this challenge, a project at the University of Johannesburg has pioneered the integration of three-dimensional printing (3D printing) and art-based instructional design. This initiative aimed to enhance spatial learning, diagnostic accuracy, and palpation skills among undergraduate chiropractic students. Grounded in structured pedagogical frameworks such as ORDER (Observe–Reflect–Draw–Edit–Repeat), HVOD (HapticoVisual Observation and Drawing), and PLHET (Preparation, Linking, Hook, Engagement, Transfer), the project bridges the gap between static 2D representations and the complex reality of 3D anatomy. This innovation forms part of the University of Johannesburg’s celebration of Two Decades of Teaching and Learning, underscoring the institution’s commitment to advancing pedagogy through creativity, inclusivity, and research-informed practice. The Innovation: Haptic Paint and Colour Session using a novel framework The teaching activity research, coined ‘Haptic Paint and Colour’ (HP&C), combines 3D-printed cervical vertebrae with colour application to physical models and radiographs using water-based paints. Sessions were carefully structured, beginning with short lectures to establish context, relevance to chiropractic practice, and link to prior anatomy teaching. Students are then “hooked” through clinical cases that highlight the diagnostic importance of radiographic appraisal. Engagement occurred during the core of the session, when students painted 3D-printed vertebrae and applied the corresponding colours to their radiographs. This tactile and visual integration allowed students to map anatomical regions across modalities, reinforcing their understanding of structure and spatial relationships. Transfer is achieved as students repeatedly apply consistent colour schemes, embedding recognition and interpretation skills vital for clinical practice. Figure 1 illustrates how the sessions adapted an ORDER protocol proposed by Backhouse et al. (2017) by replacing the traditional drawing step with painting. This modification preserved the core cycle of observation, reflection, editing, and repetition, while adding the Traditional learning methods, which rely heavily on textbook images and online resources, often fail to cultivate the spatial ability required to mentally manipulate anatomical structures in three dimensions. 27 A Journey of Innovation
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