Preliminary Assessment of Faculty and Student Perception of a Haptic Virtual Reality Simulator for Training Dental Manual Dexterity

Benefits of using immersive virtual reality in haptic dental simulation for endodontic access cavity training: A comparative crossover study

INTRODUCTION

The use of haptic virtual reality simulators in preclinical dental education is evolving rapidly. However, the application of immersive haptic simulations for specific dental procedures, such as access cavity preparation, has not been extensively explored.

AIMS

This study aimed to (i) evaluate the impact of using the VirTeaSy Dental® simulator in conjunction with a virtual reality (VR) headset on student performance during access cavity preparation, with a focus on haptic parameters; (ii) assess students' perceptions of the experience; and (iii) examine the side effects associated with VR headset use.

METHODOLOGY

The study included 90 third-year dental students from the Dental Faculty of Nantes University, enrolled in January 2023. Participants were divided into two parallel groups. In Phase 1, Group 1 (n = 45) completed two endodontic access cavity exercises on the VirTeaSy Dental® without the VR headset, whilst Group 2 performed the same exercises using the VR headset. In Phase 2, the groups switched conditions and followed the same protocol. Performance was assessed using haptic parameters, and comparisons between groups for each phase were made using parametric and non-parametric tests (p < .05). Students also completed questionnaires to assess their experience and report any side effects from using the VR headset.

RESULTS

Across both groups and phases, participants performed better in access cavity preparation without the VR headset. They showed greater accuracy, made fewer errors, and completed the exercises more quickly. Notably, more students failed to complete the exercises within the 10-minute time limit when using the VR headset (27 vs. 12 in Group 1, 23 vs. 13 in Group 2). Most participants expressed a preference for using VirTeaSy Dental® without the VR headset. Approximately, 20% of students reported side effects, including dizziness, nausea, migraines, and neck muscle fatigue.

CONCLUSION

The results suggest that full immersion in haptic simulation, when paired with a VR headset, negatively impacts student performance in complex tasks such as access cavity preparation. These findings underscore the current limitations of immersive virtual reality in dental education and highlight the need for technical refinements before its widespread adoption in preclinical training.

Tactile Weight Rendering: A Review for Researchers and Developers

Haptic rendering of weight plays an essential role in naturalistic object interaction in virtual environments. While kinesthetic devices have traditionally been used for this aim by applying forces on the limbs, tactile interfaces acting on the skin have recently offered potential solutions to enhance or substitute kinesthetic ones. Here, we aim to provide an in-depth overview and comparison of existing tactile weight rendering approaches. We categorized these approaches based on their type of stimulation into asymmetric vibration and skin stretch, further divided according to the working mechanism of the devices. Then, we compared these approaches using various criteria, including physical, mechanical, and perceptual characteristics of the reported devices. We found that asymmetric vibration devices have the smallest form factor, while skin stretch devices relying on the motion of flat surfaces, belts, or tactors present numerous mechanical and perceptual advantages for scenarios requiring more accurate weight rendering. Finally, we discussed the selection of the proposed categorization of devices together with the limitations and opportunities for future research. We hope this study guides the development and use of tactile interfaces to achieve a more naturalistic object interaction and manipulation in virtual environments.

From Virtual Reality to Reality: Fine-Tuning the Taxonomy for Extended Reality Simulation in Dental Education

INTRODUCTION

Digital simulation in dental education has substantially evolved, addressing several educational challenges in dentistry. Following global lockdowns and sustainability concerns, dental educators are increasingly adopting digital simulation to enhance or replace traditional training methods. This review aimed to contribute to a uniform taxonomy for extended reality (XR) simulation within dental education.

METHODS

This scoping review followed the PRISMA and PRISMA-ScR guidelines. PubMed/MEDLINE, EMBASE, Web of Science and Google Scholar were searched. Eligible studies included English-written publications in indexed journals related to digital simulation in dental/maxillofacial education, providing theoretical descriptions of extended reality (XR) and/or immersive training tools (ITT). The outcomes of the scoping review were used as building blocks for a uniform of XR-simulation taxonomy.

RESULTS

A total of 141 articles from 2004 to 2024 were selected and categorised into Virtual Reality (VR), Mixed Reality (MR), Augmented Reality (AR), Augmented Virtuality (AV) and Computer Simulation (CS). Stereoscopic vision, immersion, interaction, modification and haptic feedback were identified as recurring features across XR-simulation in dentistry. These features formed the basis for a general XR-simulation taxonomy.

DISCUSSION

While XR-simulation features were consistent in the literature, the variety of definitions and classifications complicated the development of a taxonomy framework. VR was frequently used as an umbrella term. To address this, operational definitions were proposed for each category within the virtuality continuum, clarifying distinctions and commonalities.

CONCLUSION

This scoping review highlights the need for a uniform taxonomy in XR simulation within dental education. Establishing a consensus on XR-related terminology and definitions facilitates future research, allowing clear evidence reporting and analysis. The proposed taxonomy may also be of use for medical education, promoting alignment and the creation of a comprehensive body of evidence in XR technologies.

Effectiveness of manual dexterity assessment methods for preclinical training in Dentistry

OBJECTIVE

This study aimed to verify the predictive capacity of manual dexterity assessment methods for pre-clinical training in Dentistry.

METHOD

Students from the fifth year of the undergraduate course in Dentistry (N = 95) participated in this study. Manual dexterity was investigated as a variable of interest, measured by the O'Connor Finger Dexterity Test methods-Model 32021, Purdue Pegboard Test-Model 32020A, Dental Manual Dexterity Assessment-DMDA, Class One Cavity Preparation Assessent-COCA and Class One Composite Resin Restoration Assessment-COCRA. The average score obtained in the evaluation of the quality of the cavity preparations and restorations was considered as gold standard, and from these data the sensitivity and specificity of the tests were estimated. Receiver Operating Characteristic (ROC) curves were constructed to assess the diagnostic performance of each dexterity test. The analysis included calculating the Area Under the Curve (AUROC) to evaluate their discriminative power, and cutoff points were determined that optimize the balance between sensitivity and specificity.

RESULTS

The DMDA test showed better performance, with statistical significance (p <0.001) and acceptable predictive ability (AUROC = 0.775), while the O'Connor test (AUROC = 0.644, p = 0.050) and Purdue Pegboard test (Purdue 1: AUROC = 0.542, p = 0.560; Purdue 2: AUROC = 0.564, p = 0.423; Purdue 3: AUROC = 0.517, p = 0.828; Purdue 4: AUROC = 0.608, p = 0.083) were not statistically significant.

CONCLUSION

The DMDA test presented the best performance, with statistical significance and acceptable discrimination, showing greater effectiveness for assessing students' manual dexterity. Therefore, the implementation of the DMDA test can significantly contribute to the early identification of motor dexterity difficulties in dental students, enabling more effective and targeted interventions.

Haptic devices as an educational approach for oral and maxillofacial surgical procedures

OBJECTIVE

Developing the skills of a proficient surgeon with a deep understanding of force requires extensive training and repetitive practice. Traditionally, dental students and surgical trainees observed and participated in procedures using models, animals, or cadavers under expert supervision before performing the procedures independently. To address these challenges, interactive simulators with visuo-haptic features have been introduced in surgical training, providing visual and tactile feedback that replicates the sense of touch through applied forces, vibrations, or motions.

STUDY DESIGN

Two independent reviewers employed a specific search strategy to explore online databases such as PubMed, Scopus, and Web of Science (WoS). This strategy included keywords such as "haptic device," "education," "oral surgery," "surgery," and "maxillofacial surgery." All types of studies related to maxillofacial surgery, except for case reports, reviews, and eBooks, were considered for inclusion.

RESULTS

A total of 22 articles meeting the screening criteria were identified. The use of haptic devices for training dental students in oral surgery, anesthesia, as well as oral and maxillofacial trainees and surgeons in various surgical procedures, was evaluated.

CONCLUSION

Incorporating tactile devices into the training of residents and maxillofacial surgeons offers numerous advantages, including improved technical skills and enhanced patient safety.

Impact of haptic simulators in preclinical dental education: A systematic review

BACKGROUND

Haptic technologies have opened a new avenue in preclinical dental education, with evidence that they can be used to improve student performance. The aim of this systematic review was to (1) determine the effect of haptic simulators on motor skill acquisition during preclinical dental training, (2) explore students' perception, and (3) explore the ability of haptic systems to distinguish users based on their initial level of manual dexterity.

METHODS

A comprehensive search of articles published up to February 2023 was performed using five databases (i.e., PubMed/Medline, ScienceDirect, Web of Sciences, Scopus, and Cochrane Library) and specialized journals. The Preferred Reporting Items for Systematic Review and Meta-Analysis 2020 guidelines were followed, and the risk of bias was assessed. Only studies on the application of haptic simulators in dentistry preclinical training were included. Qualitative synthesis of data was performed, and the protocol was registered in PROSPERO (ID = CRD42022337177).

RESULTS

Twenty-three clinical studies, including 1303 participants, were included. The authors observed a statistically significant improvement in dental students' motor skills in various dental specialties, such as restorative dentistry, pediatric, prosthodontics, periodontics, implantology, and dental surgery, after haptic training. Haptic technologies were perceived well by all participants, with encouraging data regarding their ability to differentiate users according to their initial level of manual dexterity.

CONCLUSIONS

Our work suggests that haptic simulators can significantly improve motor skill acquisition in preclinical dental training. This new digital technology, which was well perceived by the participants, also showed encouraging results in discriminating users according to their level of experience.

Virtual reality and haptics in dental education: Implementation progress and lessons learned after a decade

INTRODUCTION

The search for alternative training environments in dentistry responded mainly to scarcity and lack of standardisation of training material and non-availability of specific clinical procedures. The development of haptic virtual reality (VR) dental trainers provides a platform where irreversible procedures can be safely and unlimitedly practised. The aim of this study was to assess the educational implementation of these devices and evaluate schools' satisfaction.

METHODS

Dental schools that were using haptic VR dental trainers, were approached. The Dental Trainer User Inventory (DTUI), addressing the educational implementation and users' satisfaction, was developed and distributed.

RESULTS

Twenty-seven schools completed the DTUI. The total number of VR dental trainers available varied from one to 42 devices with a mean of 7 devices. The dental trainer was mostly made available from the first year (63.0%) of the undergraduate program, but it was mostly integrated into the curriculum by the third year (70.4%). Curricular integration was reported by 18 schools (66.7%), while nine schools (33.3%) indicated that they had not yet achieved integration. Twenty-one schools (69.4%) were 'satisfied' or 'very satisfied' with the devices, while two schools (7.4%) were dissatisfied and six schools (22.2%) were neither satisfied nor dissatisfied.

CONCLUSION

VR haptic dental trainers are implemented in multiple dental programs and are also being used for educational research and clinical training. Even though curricular changes and teachers' acceptance remain a challenge, most schools are satisfied with VR haptic dental trainers and would recommend the device to other schools.

Turbine effect on dental students' lateral pinch modulation and performances

BACKGROUND

Dental turbines can generate significant vibrations that may be transmitted to dentists' hands. The vibrations contribute to neural impairment and decrease dexterity over the long duration. It is unclear whether such vibration effects would be detected in the short time during the pre-clinical year of dentistry study.

AIMS

To investigate the effect of vibrations on lateral pinch modulation and manual performance of dentistry students.

METHODS

Four lateral pinch modulation tests by a square-shaped force sensing resistor (FSR) were administered to 30 dental students during their phantom course. Tests were performed with dominant and non-dominant hands at two time points: T0 (2 months after commencing phantom training) and T1 (end of phantom training). At each time point, students accomplished two manual performance tests on plastic teeth. Comparisons were made between lateral pinch modulation test scores at different times, considering the differences between hands and gender. The relationships between the FSR tests and manual performance were also determined.

RESULTS

The participating 19 female and 11 male students had a combined 50% response rate. At T1, the lateral pinch modulation for all tests significantly decreased for the dominant hand (P < 0.05) and non-dominant hand (P < 0.05). For the non-dominant hand at T1, the lateral pinch modulation of females significantly decreased as compared to males (P < 0.05). No significant correlations were found between lateral pinch modulation and manual tasks at T0 and T1.

CONCLUSIONS

The lateral pinch modulation of the fingers of dental students deteriorated after only 8 months of training at phantom (short-time exposure), with females at higher risk and possibly earlier symptoms manifestation.

Manual dexterity in dentistry: Development and evaluation of a preclinical training program

OBJECTIVES

The aim of this study was to develop and evaluate the effect of a manual dexterity training program on manual dexterity, perception of self-confidence, quality of cavity preparations, and ergonomic work posture of dental students prior to preclinical training.

METHODS

Students in the first year of the undergraduate dentistry program (N = 63) participated in this study. The program consisted of eight phases in which students performed different types of activities. The dependent variables were: manual dexterity assessed by the modified Dental Manual Dexterity Assessment; self-confidence to perform a preclinical procedure using the VAS scale; quality of Class I cavity preparation; angular deviation from the neutral position of the neck, trunk, wrist and distance between the student's eyes and the mannequin's tooth. These variables were evaluated at two different times: before and after the application of the program. The independent variable was the preclinical manual dexterity training program. After meeting the assumption of normality, the paired t-Student test was performed, the significance level was 5%.

RESULTS

The results showed a statistically significant difference in relation to manual dexterity (p < 0.001), self-confidence (p < 0.001), quality of cavity preparations (p < 0.001), distance from the eyes of the student/mannequin (p < 0.001), deviation angle of the neutral position of the trunk (p = 0.007) and wrists (p < 0.001), with better results in posttraining.

CONCLUSION

It was possible to conclude that, in general, the proposed training positively influenced the self-confidence, dexterity, quality of work, and ergonomics of the evaluated students.

Preclinical dental training: Association between fine motor skills and compliance with ergonomic posture techniques

OBJECTIVE

The aim of this study was to evaluate the dental students' fine motor skills and their compliance with ergonomic posture techniques over the course of a preclinical training year. The correlation between fine motor skills and compliance was also assessed.

METHODS

The ergonomic posture of students enrolled in the second year of a five-year undergraduate dental degree programme (n = 62) was assessed using the Compliance Assessment of Dental Ergonomic Posture Requirements (CADEP). This assessment relied on photographs of the students performing preclinical laboratory procedures during the school year. The photographs of each procedure received a score, and the final score obtained (0 to 10) corresponded to the extent of the student's compliance with ergonomic posture techniques. Initial compliance was calculated during the first two months of the training programme, whilst final compliance was calculated during the last two months. Fine motor skills were evaluated using the modified Dental Manual Dexterity Assessment (DMDA), which was also applied at the beginning and the end of the school year. Data were assessed statistically by Student's paired t test, and the correlation between fine motor skills and compliance with ergonomic posture techniques was estimated by Pearson's correlation coefficient (r) and Student's t test (α = 0.05).

RESULTS

The compliance scores were higher at the end of the academic year than at the beginning of year (p < 0.001; t = -5.300). Fine motor skills improved significantly with time (p < 0.001; t = -10.975). Non-significant correlations were found between students' fine motor skills and their economic posture compliance both at the beginning (r = -0.197; p = 0.126) and at the end of the training year (r = 0.226; p = 0.078).

CONCLUSION

The students' manual dexterity and compliance with ergonomic posture techniques increased over the course of the preclinical training year, and the correlation between students' fine motor skills and their ergonomic posture compliance was not significant.

Perceptions and Expectations of Academic Staff in Bucharest towards the COVID-19 Pandemic Impact on Dental Education

Dental education was severely challenged by the COVID-19 pandemic worldwide. The evaluation of the viewpoint of the dental teachers of the Faculty of Dentistry at "Carol Davila" University of Medicine and Pharmacy in Bucharest, Romania, on these exceptional circumstances' consequences was the objective of this paper. A cross-sectional study was conducted in April 2022, on the academic staff who reported their perceptions of the emotional and educational impact of the pandemic by completing a Google Forms questionnaire. Although a significant emotional impact of the pandemic was reported by over a third of the participants (31.2%), most of them being teachers of fifth-year dental students (p = 0.019), the perceived stress had an impact on the teaching performance in few of them (14%), the quality of sleep remaining unaffected in most of them (53.7%), whereas the level of anxiety was low (57%). An educational impact regarding the techno difficulties during the online transition was mentioned by few respondents (16.1%), with male teaching staff facing the fewest problems (p = 0.024), as well as low levels of difficulties in transmitting academic information (11.9), with men also being the most unaffected (p = 0.006). More than half of the participants (59.1%) rather see digital and/or virtual education during the pandemic as having adverse effects on the educational system, the most sceptical being teachers of the fifth (p = 0.001) and sixth years (p = 0.001). The COVID-19 pandemic affected the academic staff of the Faculty of Dentistry at "Carol Davila" University of Medicine and Pharmacy in Bucharest, Romania, not only at a personal level but also at a professional, pedagogical one, due to the introduction of the online teaching system followed by the hybrid one. Age group, gender, and teaching year differentiated the degree of emotional and educational impairment.

Haptic and Force Feedback Technology in Dental Education: A Bibliometric Analysis

The haptic and force feedback technology has received an increasing attention in dental schools due to its effectiveness in psychomotor skill training. However, the bibliometric analysis on haptic and force feedback technology in dental education is still scarce. Therefore, the aim of this study was to perform a bibliometric analysis of the development of haptic and force feedback technology and its changing trends in dental education. From 1 January 2001 to 30 November 2022, all papers published on haptic and force feedback technology were searched from the Web of Science Core Collection database. These data were then entered into Apple Numbers for descriptive bibliometric analysis and visualized using VOSviewer software. A total of 85 articles were retrieved following the inclusive and exclusive criteria. The results demonstrated that USA and China exhibited the most publications. The combination of correspondence author and author co-citation analysis identified the more prominent authors in this research field. The top-cited and the average citation count per year ranking led to different views of popularity. A significant increase in the number of haptic and force feedback technology publications were found in the last two years. Virtual reality is the main keyword that indicates more new integrative applications currently underway. Taken together, this study provides a detailed bibliographic analysis of haptic and force feedback technology in dental education to indicate representative authors, literatures, keywords, and trends. These detailed data will help researchers, teachers, and dental students as a very useful information when trying to make haptic and force feedback technology more prevalent in dental education in the near further.

A complex haptic exercise to predict pre-clinic operative dentistry performance: A prospective study

PURPOSE/OBJECTIVES

The purpose of this study was to determine whether performance on a complex manual dexterity haptic test was associated with preclinical operative dentistry practical examination scores in handpiece naïve students.

METHODS

Thirty-nine first-year pre-clinical operative dentistry students completed a 15-min complex manual dexterity exercise "D-circle" repeated eight times in succession before the beginning of the preclinical operative dentistry course. A composite haptic score was compared with students' subsequent preclinical operative examination performance and perceptual ability test scores.

RESULTS

Mean accuracy scores on the haptic test increased, and failures decreased across the eight repetitions. Thirty students were successful at least twice in eight attempts, while nine failed all or all but one attempt. The group that failed all or all but one had lower mean scores on the first practical examination (Exam 1) (78.4 vs. 82.2, p = 0.23 Student's t-test), and 7.0 odds of failing the examination (confidence interval 0.95-51.4, p = 0.06). As a diagnostic predictor of pre-clinical operative dentistry performance, failing all, or all but one attempt at the haptic test had 60% sensitivity and 82% specificity as a predictor of failure on Exam 1. This resulted in correct classification of 79%.

CONCLUSIONS

These data provide evidence for the first time that a complex manual dexterity test on a haptic simulator given to dental students was predictive of early pre-clinical success. These prospective results confirm previous retrospective studies and if replicated in larger cohorts may lead to improvements in the dental school admissions process.

A Literature Review of Barriers and Opportunities Presented by Digitally Enhanced Practical Skill Teaching and Learning in Health Science Education

INTRODUCTION

An evidence gap exists identifying the challenges and opportunities presented by digitally enhanced practical skill teaching and learning in health science education. A literature review was carried out to address this gap and to provide recommendations for overcoming identified challenges.

METHOD

A systematic search strategy was carried out using PRISMA guidelines. The research databases PubMed, ERIC, Medline and CINHL, were searched using MeSH terms. Barriers and opportunities were identified through deductive thematic analysis of the included articles.

RESULTS

Of the 602 articles identified through the database screening, 29 were included in the current review. Potential challenges posed by technologically supported practical skill teaching identified were i) Inaccessibility and Inequity of Online Learning (ii) Digital illiteracy Among Staff (iii) Technological Challenges (iv) Lack of Engagement with Preparatory Material Hinders Practical Learning (v) Lack of Staff-Student Interaction (vi) Negative Attitudes Towards Online Learning and (vii) Skill Suitability. The opportunities presented by digital technologies identified were (i) Facilitates Higher Order Learning (ii) Ability to Practice in a Safe Environment (iii) Efficacious Use of Class Time (iv) Access to Education (v) Learning Brought to Life (vi) Diverse Range of Learning Materials (vii) Promotes Autonomous Learning.

DISCUSSION

This literature review demonstrates the acceptability and usability of digitally enhanced practical teaching in health science education among students and educators.

CONCLUSION

To consolidate the positive disturbances in higher education from the Covid-19 pandemic, potential barriers to online delivery and student engagement must be acknowledged and addressed by relevant stakeholders. Recommendations detailed as part of this paper suggest means of overcoming barriers and leveraging opportunities.

Virtual and augmented reality in dental education: The good, the bad and the better

INTRODUCTION

Virtual reality and augmented reality (VR/AR) are becoming established technologies with a wide range of possibilities in various academic fields, including dentistry. The practice of dentistry encompasses a spectrum of skills and knowledge of anatomy, complex technical and clinical skills and sound academic understanding. This review aims to scope the current use of these technologies in dental education, explore their impact on teaching and learning and envisage their potential in this field.

MATERIALS AND METHODS

The Cochrane Library, PubMed and EMBASE were searched. Cochrane Handbook was used to conduct this systematic review. Inclusion and exclusion criteria were applied; randomised control trials published in English in the last 10 years (2010-2020) were considered and screened independently by two authors.

RESULTS

Fourteen of 524 studies were included and assessed. The majority of articles describing the use of VR/AR focused on an Undergraduate/General Dental Practitioner audience. Its use in Oral and Maxillofacial Surgery, Endodontics and Restorative dentistry was also described. There is evidence of motor skill acquisition using these systems which is comparative to that of traditional methods.

CONCLUSION

The use of VR/AR is well established in dental education; most applications relate to undergraduate education as a useful adjunct to dental training. In this article, the breadth of learning in dental education using VR/AR was exploited providing an overview to aid dental education. VR/AR is a useful adjunct to conventional learning in dentistry. However, there are limitations preventing VR/AR widespread use and applications, such as lack of trials, standardisation and accreditation of systems/content.

Influence of practical and clinical experience on dexterity performance measured using haptic virtual reality simulator

INTRODUCTION

Development of dexterity, hand-eye coordination and self-assessment are essential during the preclinical training of dental students. To meet this requirement, dental simulators have been developed combining virtual reality with a force feedback haptic interface. The aim of this study was to assess the capability of the VirTeaSy^© haptic simulator to discriminate between users with different levels of practical and clinical experience.

MATERIALS AND METHODS

Fifty-six volunteers divided into five groups (non-dentists, 1st/3rd/final-year dental students, recent graduates) had three attempts to prepare an occlusal amalgam cavity using the simulator. Percentages of volumes prepared inside (%IV) and outside (%OV) the required cavity, skill index and progression rate, referring to the evolution of skill index between trials 1 and 3, were assessed. The dental students and recent graduates completed a questionnaire to gather their opinions about their first hands-on experience with a haptic simulator.

RESULTS

The results showed no significant difference between the groups at the first attempt. Following the third attempt, the skill index was improved significantly. Analysis of progression rates, characterised by large standard deviations, did not reveal significant differences between groups. The third attempt showed significant differences in skill index and %IV between 1st-year undergraduate dental students and both non-dentists and recent dental graduates. The questionnaire indicated a tendency for dental operators to consider the simulator as a complement to their learning and not a substitute for traditional methods.

CONCLUSION

This study did not show the ability of a basic aptitude test on VirTeaSy^© haptic simulator to discriminate between users of different levels of expertise. Optimisations must be considered in order to make simulation-based assessment clinically relevant.

Preliminary User Evaluation of a New Dental Technology Virtual Simulation System: Development and Validation Study

BACKGROUND

With the advancements in the dental health care industry, the demand for dental technicians has increased. Dental technicians should be thoroughly assessed and trained in practical skills and pass professional certification examinations to ensure that they are competent to work closely with dentists. Unfortunately, such training courses and tests are in short supply worldwide. The use of virtual simulation technology can help solve these problems.

OBJECTIVE

This study presents a new strategic framework design for a certified dental technician practical examination called as the certified Objective Manipulative Skill Examination of Dental Technicians (OMEDT), which is based on the Objective Structured Clinical Examination (OSCE). We present the development and validation of the OMEDT system, a new virtual simulated training system, to meet the demands of the OMEDT framework. The combination of OMEDT and the OMEDT system can solve the complex problems encountered in the certified dental technician practical examination with excellent efficiency, high quality, and low cost.

METHODS

The OMEDT framework design was constructed according to the OSCE guide and the Chinese vocational skill standards for dental technicians. To develop the OMEDT system, we organized a new framework based on the virtual learning network platform, the haptic feedback system, and the real-time dental training and evaluation system. The effectiveness evaluation of the OMEDT system was divided into 2 phases: in the first phase, 36 students were recruited to use the test module to finish the task and their performance data were collected and analyzed; and in the second phase, a questionnaire was administered to 30 students who used the system for their studies and graduation exams.

RESULTS

The OMEDT and the corresponding skill training virtual simulation OMEDT system were developed, and preliminary user evaluation was performed to assess their effectiveness and usefulness. The OMEDT system was found to improve students' practical skills by training with the evaluation results. In addition, several key research topics were explored, including the effects of positive feedback of the knowledge of results on the improvement of the students' skill level and the common sense transformation of educators in the virtual simulation technology environment.

CONCLUSIONS

The development of OMEDT and the OMEDT system has been completed and their effectiveness has been verified.

Assessment of Virtual Reality among University Professors: Influence of the Digital Generation

This paper conducts quantitative research on the assessment made by a group of 623 Spanish and Latin American university professors about the use of virtual reality technologies in the classroom and their own digital skills in this respect. The main objective is to analyze the differences that exist in this regard due to the digital generation of the professors (immigrants or digital natives). As an instrument, a survey designed for this purpose was used, the validity of which has been tested in the study. It was found that digital natives say they are more competent in the use of virtual reality and value its technical and didactic aspects more highly, although they also identify more disadvantages in its use than digital immigrants. Differences in responses were found by gender and areas of knowledge of the professors with respect to the opinions expressed. It is suggested that universities design training plans on teaching digital competence and include in them the didactic use of virtual reality technologies in higher education.

A 3D Model of the Jaw Applied to Paediatric Dentistry

As education and knowledge are adapted to new education systems, as per the Bologna Plan, new technologies are required for educational support. In dentistry, the creation of virtual simulators can advance understanding in areas like anatomy. With this aim, a three-dimensional virtual model of the maxilo-mandibular system was created, based on a real infantile specimen. Once this model was developed, we applied this virtual structure to a teaching tool in a dentistry subject.The main objective of this project is the creation of a virtual model of the jaw, based on a real and infantile subject that serves as an educative tool in the scope of Paediatric Dentistry Anatomy. The secondary aims were to evaluate this model as an educational tool in a paediatric dentistry subject. For the main objective we obtained tomographic cuts of the craniofacial skeleton of a three-year-old girl that were transcribed to the program Amira 5.3.0. On the cuts, we segmented and named all the mandibular structures: jaw, temporary teeth, and permanent teeth. For the secondary aims we developed virtual clinical cases based on this mandibular model and gave a questionnaire to 29 dentistry students in order to evaluate the tool. A total of 512 cuts were obtained in sagittal and coronal planes and 309 in the cross-sectional plane of a thickness of 0.625 mm. In different colours, we segmented the total 25 structures to generate a three-dimensional mandibular model. For the questionnaire, the results of the students’ satisfaction of the tool were high, with an overall score of 8.5 out of 10. The educative system based on the Bologna Plan is a reality. The self-training based on test and error, is a strategy of extreme utility for the student. With an interactive model, the student is able to value his knowledge instantaneously, and the presence of a professor is not essential at all times. Through this real model, we have described the anatomical study of temporary teething, as well as its interactions with the developing permanent dentition, in a three-dimensional form. The students’ satisfaction of the teaching tool was high.

Virtual aids and students' performance with haptic simulation in implantology

OBJETIVES

This study aims to validate that haptic simulator assistance could improve drilling ability in implantology and that the repetition of training session could highlight a learning curve.

METHODS

This work was carried out with 88 first-year dental students. After randomization, students were divided into two groups. Group 1 was assigned to prepare an implant site for a left first mandibular molar (36) on haptic simulator with assistance provided by simulator. Group 2 had to perform the same exercise without assistance. Whatever the group, the maximum time for each reparation was restricted to 5 min. An interval of 1 week was done between each session. For each test, different objective parameters provided by the simulator were recorded and analyzed.

RESULTS

This study showed that the presence of virtual aids led to quickly obtain better results, and the training led to gradually acquire sufficient competence to do without virtual aids.

CONCLUSION

By associating virtual assistance and repetition, the student will acquire more quickly the skills allowing to carry out his clinical gestures in real conditions.

Impact of the Haptic Virtual Reality Simulator on Dental Students' Psychomotor Skills in Preclinical Operative Dentistry

One of the current trends in dental education is to empower dental students on a global platform using advanced technology. Haptic virtual reality simulation (HVRS) is a relatively new technology in the field of teaching and learning operative dentistry. This study aims to assess the impact of haptic virtual reality simulation (HVRS) on dental students’ psychomotor skills acquisition in preclinical operative dentistry. Class I cavity preparations (CP) were performed at baseline by 21 novice dental students on plastic teeth. Duration of CP was recorded and cavity features were evaluated and scored. Then, students were exposed to HVRS training on CP. Another Class I CP was performed by each student on plastic teeth after HVRS training, then evaluated, and the duration was recorded. There was a statistically significant decrease in CP performance time after HVRS training (p < 0.001) and an increase in the mean total marks of CP after HVRS training (p < 0.001). The change in the students’ performance in the CP displayed a statistically significant improvement after HVRS training in smoothness of the pulpal floor (p = 0.047), pulpal floor direction (p = 0.029), buccal, lingual, and mesial wall direction (p = 0.004, p = 0.025, p = 0.002), mesial and distal wall smoothness (p = 0.01, p = 0.001), internal line angle (p = 0.024), and internal point angle (p = 0.029). Overall improved performance in psychomotor skills was found after HVRS training. It could be beneficial to incorporate HVRS training early in pre-clinical operative dentistry courses as an adjunct to conventional phantom head training.

Technical skill training and assessment in dental education

Highly competent clinical practice requires cognitive, psychomotor and affective skills. Therefore, the ultimate goal of dental education is for practitioners to be competent in all of these domains. While many methods have been introduced to assess knowledge and non-technical skills, it is still very difficult for educators to assess technical skill. Assessment methods for technical skills are still not well established because it is very difficult to assure objectivity, validity and fairness. Nonetheless, technical skill is especially important in dental treatments, along with knowledge and attitude. The aim of this review was to summarize the methods of technical skill training in dental education and how they are assessed. This is a literature review. We searched PubMed MEDLINE using terms related to technical skill training and those assessment as of June 2020 and reviewed them. There have been many reports introducing methods of technical skill training and assessment, including the use of digital technology. However, no single assessment method had demonstrated validity of it. Technical skill training is very important in dental education and there are various ways of learning. The validity of current assessment methods is limited; therefore, a combination of several methods may achieve the best results.

RoboEthics in COVID-19: A Case Study in Dentistry

The COVID-19 pandemic has caused dramatic effects on the healthcare system, businesses, and education. In many countries, businesses were shut down, universities and schools had to cancel in-person classes, and many workers had to work remotely and socially distance in order to prevent the spread of the virus. These measures opened the door for technologies such as robotics and artificial intelligence to play an important role in minimizing the negative effects of such closures. There have been many efforts in the design and development of robotic systems for applications such as disinfection and eldercare. Healthcare education has seen a lot of potential in simulation robots, which offer valuable opportunities for remote learning during the pandemic. However, there are ethical considerations that need to be deliberated in the design and development of such systems. In this paper, we discuss the principles of roboethics and how these can be applied in the new era of COVID-19. We focus on identifying the most relevant ethical principles and apply them to a case study in dentistry education. DenTeach was developed as a portable device that uses sensors and computer simulation to make dental education more efficient. DenTeach makes remote instruction possible by allowing students to learn and practice dental procedures from home. We evaluate DenTeach on the principles of data, common good, and safety, and highlight the importance of roboethics in Canada. The principles identified in this paper can inform researchers and educational institutions considering implementing robots in their curriculum.

The utility of haptic simulation in early restorative dental training: A scoping review

BACKGROUND

Haptic dental simulators are becoming increasingly available in dental schools around the world; however, there is a paucity of evidence on their pedagogical effectiveness particularly in early dental training for the acquisition of the highly specific fine motor dental skills.

METHODS

A scoping review was performed to broadly map the available evidence and to detect knowledge gaps on the utility of haptic dental simulation in early dental training. The review is reported using the PRISMA-ScR guidelines. Eight bibliographic databases were searched: Web of Science, Scopus, MEDLINE via PubMed, Cochrane library, CENTRAL, ERIC, IEEE Xplore, and TRIP. Charted data were reported by clustering results according to study characteristics, research themes, research purpose, and type of validity evidence identified.

RESULTS

The review process resulted in the inclusion of 36 studies published between 2009 and 2020. The majority of the studies were cross-sectional in design with short-term evaluation data. Of the studies included, 64% investigated commercially available haptic simulators, while 36% investigated experimental haptic simulators. The research themes identified were skill acquisition and transfer, task-specific haptic training, trainee level discrimination, feedback, subjective user evaluation, performance prediction, and human factors in haptic training.

CONCLUSION

Short-term evaluation evidence from reviewed studies indicates the usefulness of the haptic simulators in early dental training. They complement the existing phantom head simulators by offering qualitatively different features. Further empirical research is needed to investigate the long-term impact of training with haptic dental simulators, to improve the availability of validation evidence and to enhance the results generalizability.

The Current Situation and Future Prospects of Simulators in Dental Education

The application of virtual reality has become increasingly extensive as this technology has developed. In dental education, virtual reality is mainly used to assist or replace traditional methods of teaching clinical skills in preclinical training for several subjects, such as endodontics, prosthodontics, periodontics, implantology, and dental surgery. The application of dental simulators in teaching can make up for the deficiency of traditional teaching methods and reduce the teaching burden, improving convenience for both teachers and students. However, because of the technology limitations of virtual reality and force feedback, dental simulators still have many hardware and software disadvantages that have prevented them from being an alternative to traditional dental simulators as a primary skill training method. In the future, when combined with big data, cloud computing, 5G, and deep learning technology, dental simulators will be able to give students individualized learning assistance, and their functions will be more diverse and suitable for preclinical training. The purpose of this review is to provide an overview of current dental simulators on related technologies, advantages and disadvantages, methods of evaluating effectiveness, and future directions for development.

Application of DenTeach in Remote Dentistry Teaching and Learning During the COVID-19 Pandemic: A Case Study

In December 2019, an outbreak of novel coronavirus pneumonia occurred, and subsequently attracted worldwide attention when it bloomed into the COVID-19 pandemic. To limit the spread and transmission of the novel coronavirus, governments, regulatory bodies, and health authorities across the globe strongly enforced shut down of educational institutions including medical and dental schools. The adverse effects of COVID-19 on dental education have been tremendous, including difficulties in the delivery of practical courses such as restorative dentistry. As a solution to help dental schools adapt to the pandemic, we have developed a compact and portable teaching-learning platform called DenTeach. This platform is intended for remote teaching and learning pertaining to dental schools at these unprecedented times. This device can facilitate fully remote and physical-distancing-aware teaching and learning in dentistry. DenTeach platform consists of an instructor workstation (DT-Performer), a student workstation (DT-Student), advanced wireless networking technology, and cloud-based data storage and retrieval. The platform procedurally synchronizes the instructor and the student with real-time video, audio, feel, and posture (VAFP). To provide quantitative feedback to instructors and students, the DT-Student workstation quantifies key performance indices (KPIs) related to a given task to assess and improve various aspects of the dental skills of the students. DenTeach has been developed for use in teaching, shadowing, and practice modes. In the teaching mode, the device provides each student with tactile feedback by processing the data measured and/or obtained from the instructor's workstation, which helps the student enhance their dental skills while inherently learning from the instructor. In the shadowing mode, the student can download the augmented videos and start watching, feeling, and repeating the tasks before entering the practice mode. In the practice mode, students use the system to perform dental tasks and have their dental performance skills automatically evaluated in terms of KPIs such that both the student and the instructor are able to monitor student’s work. Most importantly, as DenTeach is packaged in a small portable suitcase, it can be used anywhere by connecting to the cloud-based data storage network to retrieve procedures and performance metrics. This paper also discusses the feasibility of the DenTeach device in the form of a case study. It is demonstrated that a combination of the KPIs, video views, and graphical reports in both teaching and shadowing modes effectively help the student understand which aspects of their work needs further improvement. Moreover, the results of the practice mode over 10 trials have shown significant improvement in terms of tool handling, smoothness of motion, and steadiness of the operation.

Psychometric analysis of a measure of acceptance of new technologies (UTAUT), applied to the use of haptic virtual simulators in dental students

BACKGROUND

The aims of this study are (a) to assess the psychometric quality of an instrument of acceptance of new technologies adapted from the UTAUT model, (b) to validate the UTAUT model as a valid measure to be applied in dental education, and (c) to determine which factors of the UTAUT model predict the behavioural intention of using a haptic virtual simulator (HVS).

METHODS

A cross-sectional design study with a sample of 265 dentistry students was carried out.

RESULTS

Using structural equation modelling, confirmatory factor analysis verified the adequacy of four-factor model, although the only factor that directly predicts behavioural intention is performance expectancy. Internal consistency coefficients of each factor ranged from 0.800 to 0.969.

DISCUSSION

These findings, as well as the predictive power of performance expectancy on behaviour intention, are in line with previous evidence found in the literature.

CONCLUSION

These findings suggest that the UTAUT scale has adequate reliability and construct factorial validity; therefore, UTAUT model could be a valuable approach to assess haptic virtual simulator acceptance in dental education.

3D Technology Development and Dental Education: What Topics Are Best Suited for 3D Learning Resources?

The aim of this study is to identify topics (knowledge and skills) from the dental curricula that would benefit from having a 3D learning resource using an exploratory sequential design method. The first phase targeted stakeholders from a Scottish dental school. Seven focus groups and three interviews disclosed 97 suitable topics for 3D technology development. These results were used to construct a survey that was sent to final year dental students, newly dental graduates and academics from three Scottish universities. The survey asked participants to rank each item based on the perceived benefit that a 3D learning resource would have for dental education. Results revealed that detailed anatomy of the temporomandibular joint, dental anaesthesiology, dental clinical skills techniques, dental occlusion and mandibular functioning were top priorities. Gender differences only appeared in relation to ‘Extraction techniques: movements and force’ (p < 0.05), this topic was considered to be more beneficial by females than by males. No statistical difference was found when comparing results of graduates with undergraduates. These results serve as a starting point when developing a new 3D technology tool for dental education, considering users demands and perceived needs has the potential to benefit dental students and dental education directly.

Digital Undergraduate Education in Dentistry: A Systematic Review

The aim of this systematic review was to investigate current penetration and educational quality enhancements from digitalization in the dental curriculum. Using a modified PICO strategy, the literature was searched using PubMed supplemented with a manual search to identify English-language articles published between 1994 and 2020 that reported the use of digital techniques in dental education. A total of 211 articles were identified by electronic search, of which 55 articles were selected for inclusion and supplemented with 27 additional publications retrieved by manual search, resulting in 82 studies that were included in the review. Publications were categorized into five areas of digital dental education: Web-based knowledge transfer and e-learning, digital surface mapping, dental simulator motor skills (including intraoral optical scanning), digital radiography, and surveys related to the penetration and acceptance of digital education. This review demonstrates that digitalization offers great potential to revolutionize dental education to help prepare future dentists for their daily practice. More interactive and intuitive e-learning possibilities will arise to stimulate an enjoyable and meaningful educational experience with 24/7 facilities. Augmented and virtual reality technology will likely play a dominant role in the future of dental education.

Computer simulation and virtual reality in undergraduate operative and restorative dental education: A critical review

The primary aim of this review was to synthesize the literature for studies investigating the use of computer simulation (CS) and virtual reality (VR) in undergraduate dental education in operative and restorative dentistry. The secondary aim was to list best practices that maximize the simulation experience in dental education. A literature review of the PubMed and ERIC databases was conducted using the search terms "Dental AND Simulator," "Dental AND Virtual reality," and "Simulation AND Dental education." Studies in English language were categorized into 1 of 5 themes: Manual dexterity and cavity preparation, light curing skills, simulation perception and experience, predictability, and simulation model development. Main practices of simulation education indicated in the McGaghie et al. critical review published in 2010 were used as a reference to identify common practices for dental simulation. Thirty nine of 579 identified abstracts met the inclusion criteria. Skill acquisition and feedback were the two most frequently investigated parameters found in the review. CS was efficient in teaching cavity preparation and light curing skills. Feedback and deliberate practice were among the best practices that should be emphasized in order to enhance the efficiency of the CS and VR simulation exercises. The use of CS is effective in teaching operative skills (such as light curing and cavity preparation) reliably; whereas, the use of VR in undergraduate curricula is debatable. To achieve the maximum benefits of the simulation exercises, emphasis must be given to the timely feedback and deliberate practice approaches.

Preclinical assessment methodology using a dental simulator during dental students' first and third years

The aim of the present study was to analyze the parameters recorded by the Simodont dental trainer and methacrylate block grades during preclinical practicums to validate whether manual skills can be assessed by both methodologies, over a period of two years and to obtain a preclinical evaluation methodology for all the parameters that measure Simodont performance in each of the prepared figures. To this end, the methacrylate block practice's criteria and evaluation scale were used as predictors. A total of 82 students who completed the first year of dentistry were followed for 2 years. Their performance on the same task (i.e., cavity preparation of three figures in the Simodont and methacrylate blocks) was then reevaluated in the third year. Manual skill improvement was detected in all the students. The parameters measured by the Simodont were used as predictors of the methacrylate block evaluation's results, performed by a professor. Multiple linear regression models for each of the figures and years evaluated in the study were proposed. The present study demonstrates that both methodologies can detect manual skill improvement in dental students. Additionally, the Simodont practice can be reliably evaluated.

A scoping review of the use and application of virtual reality in pre-clinical dental education

Introduction Virtual reality (VR) is gaining recognition as a valuable tool for training dental students and its use by dental schools around the world is growing. It is timely to review the literature relating to the use of VR in dental education, in order to ensure that educators are well-informed of current areas of inquiry, and those requiring further investigation, to enable appropriate decisions about whether to employ VR as a teaching tool. Method A scoping review using the method outlined by Arksey and O'Malley was conducted. Both Web of Science and ERIC databases were searched. Inclusion and exclusion criteria were established to filter results. The data were collected and categorised using a custom data collection spreadsheet. Results The review identified 68 relevant articles. Following review, four educational thematic areas relating to the 'simulation hardware', the 'realism of the simulation', 'scoring systems' and 'validation' of the systems emerged. Conclusion This paper summarises and draws out themes from the current areas of inquiry in the literature, uncovering a number of weaknesses and assumptions. It recommends areas where additional investigation is required in order to form a better evidence base for the utility of VR in dental education, as well as to inform its future development.

An interventional study for improving the manual dexterity of dentistry students

Objectives

Traditionally, the acquisition of manual skills in most dental schools worldwide is based on exercises on plastic teeth placed in a "phantom head simulator". No manual trainings are done at home. Studies revealed that preliminary training of one motoric task leads to significant improvement in performance of the required motoric task that has similar components. Performing tasks indirectly via a dental mirror are complicated for the young dental students. We hypothesized that instructed training of basic skills required in dentistry at home on a tool simulating the phantom laboratory will improve the capabilities of the students and will be reflected by their clinical grades.

Methods

We developed a portable tool PhantHome which is composed of jaws, gingival tissue, rubber cover and a compatible stand. Specific teeth produced by a 3D printer with drills in different directions were placed in both jaws. Students were requested to insert pins by using tweezers and dental mirror according to instructions initiating with easy tasks and continue to ones that are more complicated. 106 first clinical year dental students participated in the study; 65 trained only in the traditional phantom lab (control). 41 trained at home by the PhantHome tool two weeks before and 2 months during the initial stage of phantom lab. The students grades routinely provided in the phantom laboratory at different stages were compared.

Results

Students who trained with the portable tool performed better than the control group in the first direct and second indirect preparations (p<0.05). These exams were taken when the PhantHome was available to the students. Then, the tool was returned and the phantom course continued regularly. We believe that this is why no differences between the grades of the groups were observed further on.

Conclusions

Training by the PhantHome improves motor skills and consequently the clinical performances.

A review of haptic simulator for oral and maxillofacial surgery based on virtual reality

INTRODUCTION

Traditional medical training in oral and maxillofacial surgery (OMFS) may be limited by its low efficiency and high price due to the shortage of cadaver resources. With the combination of visual rendering and feedback force, surgery simulators become increasingly popular in hospitals and medical schools as an alternative to the traditional training.

AREAS COVERED

The major goal of this review is to provide a comprehensive reference source of current and future developments of haptic OMFS simulators based on virtual reality (VR) for relevant researchers.

EXPERT COMMENTARY

Visual rendering, haptic rendering, tissue deformation, and evaluation are key components of haptic surgery simulator based on VR. Compared with traditional medical training, virtual and tactical fusion of virtual environment in surgery simulator enables considerably vivid sensation, and the operators have more opportunities to practice surgical skills and receive objective evaluation as reference.

Competence, competency-based education, and undergraduate dental education: a discussion paper

INTRODUCTION

The aim of undergraduate dental education is to provide competent dentists to serve societal needs and improve population oral healthcare. Competency-based education has influenced the development of dental education for decades but this term is problematic. This article explores components of competency-based undergraduate health professional education in order to help the dental profession have a better understanding of the context and purposes of undergraduate dental education.

METHODS

This is a discussion paper based on a wide reading of the literature on the education of health professionals with a specific focus on competency-based undergraduate education.

RESULTS AND DISCUSSION

Competence comprises an integration of knowledge, skills and attitudes indicating a capability to perform professional tasks safely and ethically. The process of becoming a competent practitioner is complex. Four characteristics of competency-based education are: curriculum components and content shaped by societal needs; focused on student-centred learning; learning achievement; and limited attention to time-based training and numerical targets. Alongside a competency-based approach, undergraduate dental education can be influenced by institutional features and external factors but these receive little consideration in the literature.

CONCLUSION

Understanding competence, competency-based education, and institutional and external factors will help to improve educational quality, define roles and professional development for the dental educator, and inform further research.

Automated outcome scoring in a virtual reality simulator for endodontic surgery

BACKGROUND AND OBJECTIVE

We address the problem of automated outcome assessment in a virtual reality (VR) simulator for endodontic surgery. Outcome assessment is an essential component of any system that provides formative feedback, which requires assessing the outcome, relating it to the procedure, and communicating in a language natural to dental students. This study takes a first step toward automated generation of such comprehensive feedback.

METHODS

Virtual reference templates are computed based on tooth anatomy and the outcome is assessed with a 3D score cube volume which consists of voxel-level non-linear weighted scores based on the templates. The detailed scores are transformed into standard scoring language used by dental schools. The system was evaluated on fifteen outcome samples that contained optimal results and those with errors including perforation of the walls, floor, and both, as well as various combinations of major and minor over and under drilling errors. Five endodontists who had professional training and varying levels of experiences in root canal treatment participated as raters in the experiment.

RESULTS

Results from evaluation of our system with expert endodontists show a high degree of agreement with expert scores (information based measure of disagreement 0.04-0.21). At the same time they show some disagreement among human expert scores, reflecting the subjective nature of human outcome scoring. The discriminatory power of the AOS scores analyzed with three grade tiers (A, B, C) using the area under the receiver operating characteristic curve (AUC). The AUC values are generally highest for the {AB: C} cutoff which is cutoff at the boundary between clinically acceptable (B) and clinically unacceptable (C) grades.

CONCLUSIONS

The objective consistency of computed scores and high degree of agreement with experts make the proposed system a promising addition to existing VR simulators. The translation of detailed level scores into terminology commonly used in dental surgery supports natural communication with students and instructors. With the reference virtual templates created automatically, the approach is robust and is applicable in scoring the outcome of any dental surgery procedure involving the act of drilling.

The need for virtual reality simulators in dental education: A review

Virtual reality simulators are becoming an essential part of modern education. The benefits of Virtual reality in dentistry is constantly being assessed as a method or an adjunct to improve fine motor skills, hand-eye coordination in pre-clinical settings and overcome the monetary and intellectual challenges involved with such training. This article, while providing an overview of the virtual reality dental simulators, also looks at the link between virtual reality simulation and current pedagogical knowledge.

Survey on multisensory feedback virtual reality dental training systems

Compared with traditional dental training methods, virtual reality training systems integrated with multisensory feedback possess potentials advantages. However, there exist many technical challenges in developing a satisfactory simulator. In this manuscript, we systematically survey several current dental training systems to identify the gaps between the capabilities of these systems and the clinical training requirements. After briefly summarising the components, functions and unique features of each system, we discuss the technical challenges behind these systems including the software, hardware and user evaluation methods. Finally, the clinical requirements of an ideal dental training system are proposed. Future research/development areas are identified based on an analysis of the gaps between current systems and clinical training requirements.

A review of the use of simulation in dental education

In line with the advances in technology and communication, medical simulations are being developed to support the acquisition of requisite psychomotor skills before real-life clinical applications. This review article aimed to give a general overview of simulation in a cognate field, clinical dental education. Simulations in dentistry are not a new phenomenon; however, recent developments in virtual-reality technology using computer-generated medical simulations of 3-dimensional images or environments are providing more optimal practice conditions to smooth the transition from the traditional model-based simulation laboratory to the clinic. Evidence as to the positive aspects of virtual reality include increased effectiveness in comparison with traditional simulation teaching techniques, more efficient learning, objective and reproducible feedback, unlimited training hours, and enhanced cost-effectiveness for teaching establishments. Negative aspects have been indicated as initial setup costs, faculty training, and the lack of a variety of content and current educational simulation programs.

Testing manual dexterity using a virtual reality simulator: reliability and validity

Virtual reality dental training simulators, unlike traditional human-based assessment, have the potential to enable consistent and reliable assessment. The purpose of this study was to determine whether a haptic simulator (IDEA Dental(®) ) could provide a reliable and valid assessment of manual dexterity. A total of 106 participants were divided into three groups differing in dental manual dexterity experience: (i) 63 dental students, (ii) 28 dentists, (iii) 14 non-dentists. The groups, which were expected to display various performance levels, were required to perform virtual drilling tasks in different geometric shapes. The following task parameters were registered: (i) Time to completion (ii) accuracy (iii) number of trials to successful completion and (iv) score provided by the simulator. The reliability of the tasks was calculated for each parameter. The simulator and its scoring algorithm showed high reliability in all the parameters measured. The simulator was able to differentiate between non-professionals and dental students or non-professionals and dentists. Our study suggests that for improved construct validity, shorter working times and more difficult tasks should be introduced. The device should also be designed to provide greater sensitivity in measuring the accuracy of the task.

Simulation-based local anaesthesia teaching enhances learning outcomes

OBJECTIVE

The aim of this study was to evaluate the efficacy of simulation-based local anaesthesia teaching strategies compared to the traditional classroom lecture format on the acquisition of knowledge by students.

SUBJECTS AND METHODS

Two groups of 10 students each were included in our study. Each of the dental students was enrolled in their third year of the programme. None of the students had ever received instructions in local anaesthesia. Group I received a 45-min instructional module that was delivered in the classroom in the traditional PowerPoint lecture format. Group II received a 45-min instructional module in the simulation laboratory as a short tutorial that was followed by an integrated practical demonstration and a hands-on practice session using local anaesthesia simulation phantoms. An identical 15-question multiple-choice test was used to test student knowledge acquisition at the end of the given session.

RESULTS

There was a statistically significant difference between the two groups, as the participants in group II had higher score results than those of group I.

CONCLUSION

In contrast to the traditional classroom lecture format, simulation-based local anaesthesia teaching is an effective tool to enhance the acquisition of theoretical knowledge by students.

Handpiece and bur skills evaluation during an introductory Clinical Skills Programme in a graduate-entry dental school: a pilot study

AIM

To assess the effect of an introductory Clinical Skills Program on the development of two tasks aimed at teaching a Class II cavity preparation technique.

STUDY DESIGN

A prospective, observational study.

METHODS

Twenty three first year students (F: 19; M: 4) were asked to complete two cavities on a Frasaco(®) tooth 46 using a FG 565 pear-shaped diamond bur. Task One: A groove was cut from the central fissure area to within 1mm of the marginal ridge which was 5mm in length, 2mm in width and 2mm in depth. Task Two: As for Task One and in addition, a slot was cut vertically downward at the marginal ridge to create a box 2mm in length, 2mm in width and 3mm in depth. Both tasks were undertaken at the start of an introductory Clinical Skills course and two months later after further skills practice. Cavity dimensions were measured using a digital caliper with a depth gauge.

STATISTICS

Data were analysed using a two-sample t-test (MINITAB(®) 15.1).

RESULTS

Regarding Task One, a statistically-significant improvement in groove width was noted (p=0.001). Concerning Task Two, both the groove width and the box width improved and both were statistically significant p=0.023 and p=0.049, respectively).

CONCLUSION

A Clinical Skills Program would appear to result in an improvement in cavity preparation, particularly in relation to cavity width.