Second Life for Dental Education

Using a Virtual Patient via an Artificial Intelligence Chatbot to Develop Dental Students’ Diagnostic Skills

Knowing how to diagnose effectively and efficiently is a fundamental skill that a good dental professional should acquire. If students perform a greater number of clinical cases, they will improve their performance with patients. In this sense, virtual patients with artificial intelligence offer a controlled, stimulating, and safe environment for students. To assess student satisfaction after interaction with an artificially intelligent chatbot that recreates a virtual patient, a descriptive cross-sectional study was carried out in which a virtual patient was created with artificial intelligence in the form of a chatbot and presented to fourth and fifth year dental students. After several weeks interacting with the AI, they were given a survey to find out their assessment. A total of 193 students participated. A large majority of the students were satisfied with the interaction (mean 4.36), the fifth year students rated the interaction better and showed higher satisfaction values. The students who reached a correct diagnosis rated this technology more positively. Our research suggests that the incorporation of this technology in dental curricula would be positively valued by students and would also ensure their training and adaptation to new technological developments.

Comparison of COVID-19 relevant knowledge and attitudes of clinical and preclinical dental students in Turkey

Background/Aim: Dental care settings invariably carry the risk of Coronavirus Disease 2019 (COVID-19) infection because dental practice involves face-to-face communication with patients and the generation of large amounts of aerosol and droplets mixed with patients' saliva. Since droplet and aerosol transmission are the most important concerns in dental clinics, informing future dentists about pandemic diseases at the undergraduate stage is important. In this context, the aim of this study was to compare the knowledge and attitudes of clinical and preclinical dental students regarding the COVID-19 pandemic. Material and Methods: 159 preclinical and 130 clinical dental students were included in this cross sectional study. The researchers developed a closed-ended questionnaire with the help of the existing literature. The questionnaire contained 17 questions about the knowledge and attitudes of dental students regarding the COVID-19 pandemic. Results: Clinical students feel significantly more threatened with exposure to COVID-19 infection than preclinical students (p<0.05, chi-square test). The proportion of students who do not want to treat an individual who has had a COVID-19 infection and recovered is statistically higher in clinical students (p<0.05, chi-square test). The proportion of students who think that using protective equipment during dental practice will not protect them against COVID-19 infection is statistically higher in clinical students (p<0.05, chi-square test). Conclusions: More education and training courses are need in order to improve students' knowledge and attitudes regarding newly emerging pandemic diseases.

Conflicting demands that dentists and dental care professionals experience when using social media: a scoping review

Introduction There are many conflicting demands for dentists and dental care professionals (DCPs) when using social media, for example between using social media for marketing and as professional provider of information. To gain a fuller understanding of how dentists/DCPs should optimally use social media, these conflicting demands need to be explored. The aim of this scoping review was to map out the current state of the literature describing the conflicting demands encountered by dentists and DCPs when using social media and the approaches used to manage these conflicting demands.Methods A scoping review was carried out. PubMed and Web of Science Core Collection were searched using inclusion and exclusion criteria. Data was extracted from the identified articles and analysed.Results The review identified 39 articles for inclusion. Conflicting demands were related to marketing and education with little information about how these conflicting demands can be managed.Conclusions The published literature on dentists'/DCPs' use of social media highlights that there are conflicting demands and little advice on management strategies. To gain an understanding of these conflicting demands, further research is required, including looking at the patient perspective, to inform future practice.

Top-Cited Articles from Dental Education Journals, 2009 to 2018: A Bibliometric Analysis

The number of citations an article receives is an important indicator to quantify its influence in its field. The aim of this study was to identify and analyze the characteristics of the 50 top-cited articles addressing dental education published in two journals dedicated to dental education (European Journal of Dental Education and Journal of Dental Education). The Web of Science database was searched to retrieve the 50 most-cited articles from the two journals in December 2018. The top-cited articles were analyzed for journal of publication, number of citations, institution and country of origin, year of publication, study type, keywords, theme and subtheme, and international collaborations. The results showed the 50 top-cited articles were cited between 24 and 146 times each. The majority of these top-cited articles (n=34) were published in the Journal of Dental Education Half (n=25) of the articles were by authors in the U.S. The most common study types were surveys (n=26) and reviews (n=10). The main themes of these top-cited articles were curriculum and learner characteristics. This bibliometric analysis can serve as a reference for recognizing studies with the most impact in the scholarship of dental education.

Development and Assessment of a Three-Dimensional Tooth Morphology Quiz for Dental Students

Tooth morphology has a pivotal role in the dental curriculum and provides one of the important foundations of clinical practice. To supplement tooth morphology teaching a three-dimensional (3D) quiz application (app) was developed. The 3D resource enables students to study tooth morphology actively by selecting teeth from an interactive quiz, modify their viewpoint and level of zoom. Additionally, students are able to rotate the tooth to obtain a 3D spatial understanding of the different surfaces of the tooth. A cross-over study was designed to allow comparison of students' results after studying with the new application or traditionally with extracted/model teeth. Data show that the app provides an efficient learning tool and that students' scores improve with usage (18% increase over three weeks, P < 0.001). Data also show that student assessment scores were correlated with scores obtained while using the app but were not influenced by the teaching modality initially accessed (r²  = 0.175, P < 0.01). Comparison of the 2016 and 2017 class performance shows that the class that had access to the app performed significantly better on their final tooth morphology assessment (68.0% ±15.0 vs. 75.3% ±13.4, P < 0.01). Furthermore, students reported that the 3D application was intuitive, provided useful feedback, presented the key features of the teeth, and assisted in learning tooth morphology. The 3D tooth morphology app thus provides students with a useful adjunct teaching tool for learning dental anatomy. Anat Sci Educ 00: 000-000. © 2018 American Association of Anatomists.

Faculty Perception of Virtual 3-D Learning Environment to Assess Student Learning

This chapter presents some of the methods and approaches that are used in the assessment of student outcomes in 3-D virtual learning environments. Distance learning or eLearning that includes the 3-D virtual learning environments have been increasing dramatically because of the rise in demand by students. Because of this advent in eLearning, assessment of the outcomes is crucial when measuring student learning. In addition to the measurement of student learning, the instructional designers will need assessment of student learning as a means to upgrade the 3-D virtual learning environments and maintain the relevancy of the content for students. Much of the research on measurement of outcomes is based on anecdotal evidence provided by students. A comprehensive examination of assessment of the 3-D virtual learning environment becomes paramount, so educators will have a better idea how to carefully assess outcomes of student learning.

Evaluation of the appreciation of virtual teeth with and without pathology

AIM

Virtual teeth with and without tooth pathology have been developed for use in a virtual learning environment in dental education. The objective of this study was to evaluate the appearance of these virtual teeth for use in dental education and to compare them with contemporary educational models, such as plastic teeth (Frasaco GmbH) and extracted human teeth.

MATERIAL AND METHODS

Six sets of photographs representing six different teeth were shown to dentists, teachers (dentists) and dental students (bachelor's and master's degree students). Each set consisted of 15 pictures showing five views of the extracted human tooth, the similar virtual tooth and the plastic tooth. The five views represented the mesial, distal, occlusal, buccal and lingual surfaces. The virtual tooth was the same as the extracted tooth (scanned with a cone beam CT, coloured and edited in ColorMapEditor(®) ), and the plastic tooth presented the best possible match to the extracted tooth. The participants were asked to rate the appearance of the virtual teeth (overall and in terms of caries, restoration and colours), whether the virtual or plastic teeth resembled the extracted teeth better and from which teeth they expected to learn the most (extracted, virtual or plastic).

RESULTS

Each group of participants found that the virtual teeth resembled the extracted teeth more than they resembled the plastic teeth; 71% of the participants expected to learn more from the virtual teeth than from the plastic teeth.

CONCLUSION

The results show that the appearance of the virtual teeth was considered more realistic than the appearance of the plastic teeth. The expectation was that the learning opportunities of the virtual teeth are better than of the plastic teeth.

Global collaboration and team-building through 3D virtual environments

Certain aspects of healthcare education are difficult to teach in real world environments or in isolated classroom settings. These include, but are not limited to, collaboration and interdisciplinary teamwork skills that are necessary for improved team performance and patient care outcomes. Virtual simulation is a growing field for training and continuous professional development activities and is conducive to local and international clinical training and collaborative projects.

The authors examine theories of collaboration applied to virtual worlds, along with case studies, to demonstrate virtual simulation's applicability to a variety of teaching environments.

In addition, virtual environments have applications to interprofessional healthcare training and team formation. International partnerships for education can benefit from using virtual environments to foster team-building activities without geographic boundaries.

Virtual environments have been instrumental in the growth and sustainability of international networks of educators and, when feasible, should be utilized as a tool for the development of international partnerships.

Exploring design requirements for repurposing dental virtual patients from the web to second life: a focus group study

Background

Since their inception, virtual patients have provided health care educators with a way to engage learners in an experience simulating the clinician’s environment without danger to learners and patients. This has led this learning modality to be accepted as an essential component of medical education. With the advent of the visually and audio-rich 3-dimensional multi-user virtual environment (MUVE), a new deployment platform has emerged for educational content. Immersive, highly interactive, multimedia-rich, MUVEs that seamlessly foster collaboration provide a new hotbed for the deployment of medical education content.

Objective

This work aims to assess the suitability of the Second Life MUVE as a virtual patient deployment platform for undergraduate dental education, and to explore the requirements and specifications needed to meaningfully repurpose Web-based virtual patients in MUVEs.

Methods

Through the scripting capabilities and available art assets in Second Life, we repurposed an existing Web-based periodontology virtual patient into Second Life. Through a series of point-and-click interactions and multiple-choice queries, the user experienced a specific periodontology case and was asked to provide the optimal responses for each of the challenges of the case. A focus group of 9 undergraduate dentistry students experienced both the Web-based and the Second Life version of this virtual patient. The group convened 3 times and discussed relevant issues such as the group’s computer literacy, the assessment of Second Life as a virtual patient deployment platform, and compared the Web-based and MUVE-deployed virtual patients.

Results

A comparison between the Web-based and the Second Life virtual patient revealed the inherent advantages of the more experiential and immersive Second Life virtual environment. However, several challenges for the successful repurposing of virtual patients from the Web to the MUVE were identified. The identified challenges for repurposing of Web virtual patients to the MUVE platform from the focus group study were (1) increased case complexity to facilitate the user’s gaming preconception in a MUVE, (2) necessity to decrease textual narration and provide the pertinent information in a more immersive sensory way, and (3) requirement to allow the user to actuate the solutions of problems instead of describing them through narration.

Conclusions

For a successful systematic repurposing effort of virtual patients to MUVEs such as Second Life, the best practices of experiential and immersive game design should be organically incorporated in the repurposing workflow (automated or not). These findings are pivotal in an era in which open educational content is transferred to and shared among users, learners, and educators of various open repositories/environments.

Scientific Knowledge Transfer Training Through a Virtual World

The aim of this study was to use the virtual world Second Life (SL) to perform a knowledge transfer training to Pharmacy students. The presentation of assignments of different subjects was organized as scientific congress communications. The activities were carried out at the facilities created at the USALPHARMA Island in SL. The content and format of these works, together with their oral presentation and interventions in debates were evaluated. These experiences provided adequate learning results and a high level of student satisfaction. This teaching strategy can foster development of creativity, critical thinking, communication, co-teamwork and digital competence. Likewise, it can facilitate teacher-student relations and relations among the students themselves. It also implies significant savings in time and money, since real facilities and equipment and physical movement of people are not involved. All of this encourages us to recommend this platform to host all kinds of conferences or scientific conferences.

Usalpharma: a cloud-based architecture to support quality assurance training processes in health area using virtual worlds

This paper discusses how cloud-based architectures can extend and enhance the functionality of the training environments based on virtual worlds and how, from this cloud perspective, we can provide support to analysis of training processes in the area of health, specifically in the field of training processes in quality assurance for pharmaceutical laboratories, presenting a tool for data retrieval and analysis that allows facing the knowledge discovery in the happenings inside the virtual worlds.

Design and evaluation of a simulation for pediatric dentistry in virtual worlds

BACKGROUND

Three-dimensional virtual worlds are becoming very popular among educators in the medical field. Virtual clinics and patients are already used for case study and role play in both undergraduate and continuing education levels. Dental education can also take advantage of the virtual world's pedagogical features in order to give students the opportunity to interact with virtual patients (VPs) and practice in treatment planning.

OBJECTIVE

The objective of this study was to design and evaluate a virtual patient as a supplemental teaching tool for pediatric dentistry.

METHODS

A child VP, called Erietta, was created by utilizing the programming and building tools that online virtual worlds offer. The case is about an eight-year old girl visiting the dentist with her mother for the first time. Communication techniques such as Tell-Show-Do and parents' interference management were the basic elements of the educational scenario on which the VP was based. An evaluation of the simulation was made by 103 dental students in their fourth year of study. Two groups were formed: an experimental group which was exposed to the simulation (n=52) and a control group which did not receive the simulation (n=51). At the end, both groups were asked to complete a knowledge questionnaire and the results were compared.

RESULTS

A statistically significant difference between the two groups was found by applying a t test for independent samples (P<.001), showing a positive learning effect from the VP. The majority of the participants evaluated the aspects of the simulation very positively while 69% (36/52) of the simulation group expressed their preference for using this module as an additional teaching tool.

CONCLUSIONS

This study demonstrated that a pediatric dentistry VP built in a virtual world offers significant learning potential when used as a supplement to the traditional teaching techniques.

Simulation in healthcare: a taxonomy and a conceptual framework for instructional design and media selection

BACKGROUND

Simulation in healthcare lacks a dedicated framework and supporting taxonomy for instructional design (ID) to assist educators in creating appropriate simulation learning experiences.

AIMS

This article aims to fill the identified gap. It provides a conceptual framework for ID of healthcare simulation.

METHODS

The work is based on published literature and authors' experience with simulation-based education.

RESULTS

The framework for ID itself presents four progressive levels describing the educational intervention. Medium is the mode of delivery of instruction. Simulation modality is the broad description of the simulation experience and includes four modalities (computer-based simulation, simulated patient (SP), simulated clinical immersion, and procedural simulation) in addition to mixed, hybrid simulations. Instructional method describes the techniques used for learning. Presentation describes the detailed characteristics of the intervention. The choice of simulation as a learning medium is based on a matrix of simulation relating acuity (severity) to opportunity (frequency) of events, with a corresponding zone of simulation. An accompanying chart assists in the selection of appropriate media and simulation modalities based on learning outcomes.

CONCLUSION

This framework should help educators incorporate simulation in their ID efforts. It also provides a taxonomy to streamline future research and ID efforts in simulation.

Medical mentoring via the evolving world wide web

OBJECTIVES

Mentoring, for physicians and surgeons in training, is advocated as an essential adjunct in work-based learning, providing support in career and non-career related issues. The World Wide Web (WWW) has evolved, as a technology, to become more interactive and person centric, tailoring itself to the individual needs of the user. This changing technology may open new avenues to foster mentoring in medicine. DESIGN, SYSTEMATIC REVIEW, MAIN OUTCOME MEASURES: A search of the MEDLINE database from 1950 to 2012 using the PubMed interface, combined with manual cross-referencing was performed using the following strategy: ("mentors"[MeSH Terms] OR "mentors"[All Fields] OR "mentor"[All Fields]) AND ("internet"[MeSH Terms] OR "internet"[All Fields]) AND ("medicine"[MeSH Terms] OR "medicine"[All Fields]) AND ("humans"[MeSH Terms] AND English[lang]). Abstracts were screened for relevance (UJ) to the topic; eligibility for inclusion was simply on screening for relevance to online mentoring and web-based technologies.

RESULTS

Forty-five papers were found, of which 16 were relevant. All studies were observational in nature. To date, all medical mentoring applications utilizing the World Wide Web have enjoyed some success limited by Web 1.0 and 2.0 technologies.

CONCLUSIONS

With the evolution of the WWW through 1.0, 2.0 and 3.0 generations, the potential for meaningful tele- and distance mentoring has greatly improved. Some engagement has been made with these technological advancements, however further work is required to fully realize the potential of these technologies.

Experience with using second life for medical education in a family and community medicine education unit

BACKGROUND

The application of new technologies to the education of health professionals is both a challenge and a necessity. Virtual worlds are increasingly being explored as a support for education.

AIM

The aim of this work is to study the suitability of Second Life (SL) as an educational tool for primary healthcare professionals.

DESIGN

Qualitative study of accredited clinical sessions in SL included in a continuing professional development (CPD) programme for primary healthcare professionals.

LOCATION

Zaragoza I Zone Family and Community Medicine Education Unit (EU) and 9 health centres operated by the Aragonese Health Service, Aragon, Spain.

METHOD

The EU held two training workshops in SL for 16 healthcare professionals from 9 health centres by means of two workshops, and requested them to facilitate clinical sessions in SL. Attendance was open to all personnel from the EU and the 9 health centres. After a trail period of clinical sessions held at 5 health centres between May and November 2010, the CPD-accredited clinical sessions were held at 9 health centres between February and April 2011.

PARTICIPANTS

76 healthcare professionals attended the CPD-accredited clinical sessions in SL.

MAIN MEASUREMENTS

Questionnaire on completion of the clinical sessions.

RESULTS

Response rate: 42-100%. Questionnaire completed by each health centre on completion of the CPD-accredited clinical sessions: Access to SL: 2 centres were unable to gain access. Sound problems: 0% (0/9). Image problems: 0% (0/9). Voice/text chat: used in 100% (10/9); 0 incidents. Questionnaire completed by participants in the CPD-accredited clinical sessions: Preference for SL as a tool: 100% (76/76). Strengths of this method: 74% (56/76) considered it eliminated the need to travel; 68% (52/76) believed it made more effective use of educational resources; and 47% (36/76) considered it improved accessibility. Weaknesses: 91% (69/76) experienced technical problems, while; 9% (7/76) thought it was impersonal and with little interaction. 65.79% (50/76) believed it was better than other distance learning methods and 38.16% (29/76) believed it was better than face-to-face learning.

CONCLUSIONS

SL is a tool that allows educational activities to be designed that involve a number of health centres in different geographical locations, consequently eliminating the need to travel and making more effective use of educational resources.

The anatomy of anatomy: a review for its modernization

Anatomy has historically been a cornerstone in medical education regardless of nation or specialty. Until recently, dissection and didactic lectures were its sole pedagogy. Teaching methodology has been revolutionized with more reliance on models, imaging, simulation, and the Internet to further consolidate and enhance the learning experience. Moreover, modern medical curricula are giving less importance to anatomy education and to the acknowledged value of dissection. Universities have even abandoned dissection completely in favor of user-friendly multimedia, alternative teaching approaches, and newly defined priorities in clinical practice. Anatomy curriculum is undergoing international reformation but the current framework lacks uniformity among institutions. Optimal learning content can be categorized into the following modalities: (1) dissection/prosection, (2) interactive multimedia, (3) procedural anatomy, (4) surface and clinical anatomy, and (5) imaging. The importance of multimodal teaching, with examples suggested in this article, has been widely recognized and assessed. Nevertheless, there are still ongoing limitations in anatomy teaching. Substantial problems consist of diminished allotted dissection time and the number of qualified anatomy instructors, which will eventually deteriorate the quality of education. Alternative resources and strategies are discussed in an attempt to tackle these genuine concerns. The challenges are to reinstate more effective teaching and learning tools while maintaining the beneficial values of orthodox dissection. The UK has a reputable medical education but its quality could be improved by observing international frameworks. The heavy penalty of not concentrating on sufficient anatomy education will inevitably lead to incompetent anatomists and healthcare professionals, leaving patients to face dire repercussions.