Technical skill training and assessment in dental education

Impact of the modified curricula on periodontal instrumentation skills development during the COVID-19 pandemic from 2020 to 2023

OBJECTIVES

This study aimed to evaluate the impact of curriculum modifications on periodontal instrumentation skills development among classes of 2021, 2022, and 2023 during the COVID-19 pandemic.

METHODS

The pandemic began and affected the three classes at different stages of their studies. Onsite simulation-based learning (SBL) was employed for the classes of 2021 and 2022; remote SBL was adopted for the class of 2023. Modified clinical education, due to social distancing guidelines, impacted the class of 2021 significantly and the class of 2022 to a lesser extent. A multiple linear regression model was built to examine the association between the fourth-year patient-based scaling competency examination scores and selected predictors.

RESULTS

The classes of 2021 and 2023 showed consistent performances over time, while the class of 2022 exhibited significant variation exhibiting the lowest performance at the second-year practical examination. While the clinical experience of the class of 2021 was significantly less than that of the classes of 2022 and 2023, the fourth-year competency examination scores did not differ across the three classes. The clinic points (p = 0.014) significantly affected the fourth-year competency examination score while student gender (p = 0.18), the first-year (p = 0.736), and second-year (p = 0.198) practical examination scores showed no correlations.

CONCLUSION

Based on student performance in the fourth-year scaling competency examination, the curriculum modifications due to the COVID pandemic did not affect student learning outcomes. Clinical experience was the most influential determinant of skill development in periodontal instrumentation.

Implementation of Patient-Individualized 3D-Printed Models in Undergraduate Students' Education for Various Prosthetic Treatments: A Cross-Sectional Survey Study

BACKGROUND

Due to rapid changes in dental practice, digital technologies have become prominent in undergraduate dental education at German universities in recent years. This shift has prompted a re-evaluation of content as well as teaching methods, particularly in courses where students are prepared for patient treatment. Traditional training on standardized models with resin teeth cannot cover the complexity of individual dental arch configuration encountered in patient situations. This study explores the use of 3D printing technology to create individualized models for prosthetic treatment simulations, aiming to evaluate students' feedback towards their experience with this training setting.

METHODS

First, the study describes the design and fabrication of individualized models with exchangeable teeth based on intraoral scans, mounted on connected plates with distance holders that can be fixed to standard phantom heads. Second, students provided feedback through a questionnaire, assessing various aspects such as the effectiveness of the 3D-printed models compared to traditional frasaco models for preparation exercises.

RESULTS

The results indicated that the design of the realized models was feasible for preparation training (question no. 4: 93% positive rating) and showed positive perceptions of the 3D-printed models, with students finding them effective for preparation exercises and beneficial in bridging the gap between simulation and real patient situations (question no. 6: 69% positive rating).

CONCLUSIONS

The study suggests that 3D printing technology offers a valuable tool in dental education, providing realistic and patient-specific scenarios for students to enhance their skills and readiness for clinical practice. Further improvements in material properties in hand with cost-effective approaches are essential for widespread implementation.

The impact of virtual reality simulation on dental education: A systematic review of learning outcomes and student engagement

PURPOSE

Virtual reality (VR) simulations have been increasingly employed to train dental students prior to clinical practice. According to the literature, blended learning designs in the form of VR simulations can be utilized by both dental students and instructors to provide quality education. They can also save time and improve motor skills before students enter clinical stages. Therefore, this study was designed to review the importance of available VR simulators and their impact on student learning and outcomes.

METHOD

The Preferred Reporting Items for Systematic Reviews and Meta-Analysis guidelines were followed to review the literature systematically, and different databases such as PubMed, ScienceDirect, Cochrane Library, Scopus, and Google Scholar were searched (up to December 2023) for relevant articles using keywords: "virtual reality," "virtual reality simulators," "virtual reality simulation," and "dental education." The Mixed Methods Appraisal Tool was used to assess the study quality.

RESULTS

After a comprehensive literature search, 1477 research articles were identified, of which 16 were included in the present study. In terms of students' learning outcomes, engagement, and optimal approach, a significant improvement was observed compared to conventional training methods, specifically in their knowledge, performance, confidence, and psychomotor skills.

CONCLUSION

The findings suggest that VR simulators enhance the overall learning abilities of dental students and should be regarded as an integral component of the current curriculum. However, it is important to recognize that VR simulators cannot fully substitute traditional training methods; rather, they can effectively complement them.

Questionnaire survey on hands-on simulation training using a dental humanoid robot (SIMROID®)

INTRODUCTION

A dental humanoid robot, SIMROID®, is able to replicate the actions characteristic of human beings and enable training for communicating with patients and coping with unexpected situations. This study assessed user experiences via a survey questionnaire following hands-on training on the SIMROID®.

MATERIALS AND METHODS

A total of 112 participants, consisting of 50 high school students who visited AUSD (Asahi University School of Dentistry) to participate in open campus events, 42 fourth-year students at AUSD and 20 dental students from Mexico State Autonomy University, University of Siena and Peking University took the survey. The participants observed the movements and reactions of a SIMROID® robot placed on a dental unit for approximately 20 min after which they completed a questionnaire survey. Both Japanese and English versions of the questionnaire were prepared for local and visiting foreign dental students. The questionnaire comprised 8 items, with a further two items for those undertaking dental training and an open comment field.

RESULTS

All participants who observed the SIMROID® completed the questionnaire giving a 100% response rate. Generally, simulation training with SIMROID® was highly appreciated by all participants. The comprehensive evaluation score for SIMROID® was 4.56 ± 0.50 points for high school students, 4.05 ± 0.82 points for students at AUSD and 4.70 ± 0.47 points for foreign dental students, showing all participants had a very positive experience and impression of the SIMROID®.

CONCLUSIONS

Therefore, simulation training using SIMROID® seems beneficial learning tool.

Effectiveness of virtual reality interactive simulation practice in prosthodontic education: A systematic review and meta-analysis

INTRODUCTION

Virtual reality-based interactive simulation (VRIS) provides a safe and controlled environment for dental students and professionals to develop skills and knowledge. This study aimed to investigate the effectiveness of using the VRIS for prosthodontic practice and to explore the trends, application areas, and users' attitudes towards VRIS.

MATERIALS AND METHODS

This review followed the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) guidelines for searching studies published until 21 March 2023 that reported quantitative or qualitative learning outcomes related to the use of VRIS for dental prosthodontic practice and clinical training. The quality of the included studies was assessed using the Medical Education Research Study Quality Instrument (MERSQI) and Newcastle-Ottawa Scale-Education (NOS-E) tools. A random-effects meta-analysis was conducted to compare the intervention group (utilizing VRIS) and the control group (employing conventional prosthodontic training methods) based on performance skill scores and task completion time, with a significance level set at <.05.

RESULTS

The meta-analysis revealed that the utilization of VRIS generally improves students' performance scores (SMD = 1.04; 95% CI, -0.35 to 2.44; I2  > 50%; p = .13) and reduces task completion time (SMD = -0.03; 95% CI, 1.39-7.72; I2  > 50%; p = .93). Notably, using VRIS significantly enhanced the performance scores in implant surgery practice (SMD = 0.26; 95% CI, 0.09-0.42; p < .05). Additionally, the VRIS method significantly reduced task completion time in the cavity restorative preparation task (SMD = -1.19; 95% CI, -1.85 to -0.53; p < .05).

CONCLUSION

Engaging in practice with VRIS has the potential to enhance learning proficiency in prosthodontic education. The advantages associated with VRIS encompass the provision of immediate feedback, decreased task completion time, heightened confidence and motivation, accelerated skill acquisition, improved performance scores, and increased learning engagement.

Measuring satisfaction with dental education among dentists and dental students in Croatia: A cross-sectional study

INTRODUCTION

The study aimed to determine satisfaction level with the quality of education among dental students and dentists in Croatia based on the acquired knowledge and clinical and soft skills.

MATERIALS AND METHODS

An online cross-sectional survey was conducted among 533 dentists and dental students. The questionnaire consisted of four sections with closed-ended questions. The first section included personal and professional data, whereas the second to fourth sections assessed satisfaction with learned basic dental, professional technical or clinal and interpersonal social or soft skills on a 5-point Likert scale. The data were analysed using the Mann-Whitney U-test and linear regression analysis. The significance level was set at .05.

RESULTS

When comparing satisfaction scores between dentists and dental students in terms of basic dental knowledge and skills learned, students showed higher satisfaction scores for the categories of "Emergency Medical Situations" (p = .005) and "Ergonomic Principles of Work" (p = .004). Dentists, on the other hand, showed higher satisfaction for the categories "Selection and use of local anaesthetics and local antibiotics" (p = .005, p = .026; respectively). For the type of technical skills from the different areas of dentistry, dentists were most satisfied with "Oral Surgery" (4.26 ± 0.85), while students were most satisfied with "Oral Medicine" (4.29 ± 0.89). Finally, when comparing satisfaction scores with social skills, dentists had lower satisfaction scores in all categories studied (p ≤ .05).

CONCLUSION

Dental students showed higher overall satisfaction than dentists. The most significant satisfaction was expressed in technical skills learned, and the most considerable dissatisfaction was recorded in the unmeasurable skills category focused on "Career management".

The effect of 3D stereopsis and hand-tool alignment on learning effectiveness and skill transfer of a VR-based simulator for dental training

Recent years have seen the proliferation of VR-based dental simulators using a wide variety of different VR configurations with varying degrees of realism. Important aspects distinguishing VR hardware configurations are 3D stereoscopic rendering and visual alignment of the user's hands with the virtual tools. New dental simulators are often evaluated without analysing the impact of these simulation aspects. In this paper, we seek to determine the impact of 3D stereoscopic rendering and of hand-tool alignment on the teaching effectiveness and skill assessment accuracy of a VR dental simulator. We developed a bimanual simulator using an HMD and two haptic devices that provides an immersive environment with both 3D stereoscopic rendering and hand-tool alignment. We then independently controlled for each of the two aspects of the simulation. We trained four groups of students in root canal access opening using the simulator and measured the virtual and real learning gains. We quantified the real learning gains by pre- and post-testing using realistic plastic teeth and the virtual learning gains by scoring the training outcomes inside the simulator. We developed a scoring metric to automatically score the training outcomes that strongly correlates with experts' scoring of those outcomes. We found that hand-tool alignment has a positive impact on virtual and real learning gains, and improves the accuracy of skill assessment. We found that stereoscopic 3D had a negative impact on virtual and real learning gains, however it improves the accuracy of skill assessment. This finding is counter-intuitive, and we found eye-tooth distance to be a confounding variable of stereoscopic 3D, as it was significantly lower for the monoscopic 3D condition and negatively correlates with real learning gain. The results of our study provide valuable information for the future design of dental simulators, as well as simulators for other high-precision psycho-motor tasks.

Multisensory Preclinical Training Strategy of Periodontal Scaling for Undergraduates

BACKGROUND

Invisibility of subgingival scaling is the most important negative factor affecting the performance of periodontal treatment. A multisensory teaching strategy is used in the preclinical training of undergraduates in order to increase the haptic-auditory-visual feedback, aiming to overcome the invisibility and achieve minimal postoperative complications, improving patients' treatment experience.

METHODS

One hundred undergraduate dental students in grade 5 were divided into a multisensory teaching strategy group (MTS: n = 50) and a conventional training pattern group (CTP: n = 50). All participants attended a lecture on using an ultrasonic subgingival scaler (USS) and Gracey curettes (GRA), followed by a 3-week training programme. Students in the MTS group were trained in a haptic/auditory-visual feedback manner, whereas students in the CTP group were trained conventionally. After the training phase, paired students in the 2 different groups performed subgingival scaling in paired patients with equivalent teeth of periodontitis using USS and GRA. Objective and subjective postoperative evaluations were recorded. Probing depth (PD) and gingival index (GI) were evaluated before and 4 weeks after scaling by the same periodontal specialist.

RESULTS

MTS significantly reduced treatment time and ameliorated postoperative complications (gingival injury, haemorrhage and root surface roughness; P < .05). Postoperative sensitivity was reduced in the MTS group from day 1 to day 7 (D1-D5: P < .001; D6: P = .002; D7: P = .003), whereas postoperative pain was reduced on day 1 (P = .006), compared with that in the CTP group. The PD reduction was not significant between the groups (MTS: 3.17 ± 0.95 mm vs CTP: 3.07 ± 0.97 mm, P > .05), whereas the GI change showed a significant difference between the groups (MTS: 1.71 ± 0.41 vs CTP: 1.67 ± 0.41, P < .05).

CONCLUSIONS

Multisensory teaching strategies in the preclinical periodontal training of undergraduates can reduce postoperative complications (gingival injury, postoperative haemorrhage, and root surface roughness) and provide a better treatment experience (decreased treatment time and postoperative pain and sensitivity) for patients.

Knowledge assessment on cleft lip and palate among recently graduated dentists: a cross-sectional study

BACKGROUND

The complex presentation, associated co-morbidities and multi-disciplinary requirements dictate the requirement for in-depth knowledge in order to effectively manage patients with cleft lip and palate (CLP). We aimed to develop a validated questionnaire for cleft lip and palate knowledge assessment and to evaluate the knowledge of cleft lip and palate among a group of recently-graduated dentists.

MATERIALS AND METHODS

A multiple-site, cross-sectional questionnaire-based study was conducted. The study population included recently graduated dentists involved in a dental internship program. A bespoke questionnaire was developed and validated, with internal consistency assessed using Cronbach's alpha and factor analysis performed. A 47-item prototype was distilled into a 15-item questionnaire. This was distributed to the participants with a response rate of 67% obtained.

RESULTS

The overall proportion of correct responses among dental interns was moderate (73%). The best results were found in relation to CLP treatment including the effect of unfavorable surgical outcomes on speech (89.5%) and the impact of CLP on the occlusion (87.6%). The lowest rate of correct responses (26.7%) was identified in relation to the association between CLP and smoking.

CONCLUSION

A validated CLP questionnaire was developed, permitting evaluation of the knowledge of cleft lip and palate and its management among recently graduated dentists. There is limited appreciation among dental interns of the risk factors for CLP as well as post-surgical complications. Given that general dentists are often the gatekeepers for the management of patients with cleft lip and palate, it is important that the findings of this survey are used to inform the curriculum and teaching of cleft lip and palate.