German dental faculty attitudes towards computer-assisted simulation systems correlated with personal and professional profiles

Design of an interactive system for access cavity assessment: A novel feedback tool for preclinical endodontics

INTRODUCTION

A software program was developed to provide visual, guided feedback to students for access cavity preparations in preclinical learning. The specific aim of the study was to investigate students' overall experiences with the new learning method and compare their experiences with traditional teaching.

MATERIALS AND METHODS

A workflow based on freely available software was designed to interactively register three-dimensional models of molars with access cavities, and to metrically compare these to instructor-prepared standard cavities. Third-year students practicing molar endodontics access cavity preparation in the preclinical course were then surveyed. A total of 44/79 students completed self-administered questionnaires prior and after the use of the feedback software to gauge their learning experience.

RESULTS

The results of the post-training questionnaire illustrated that all surveyed students agreed/strongly agreed that the software assisted their learning in access cavity preparation. In addition, 86 and 89%, respectively, of students agreed that the use of the software improved their skills of access cavity preparation and felt more confident about their access cavity preparation skills after using the software package, 3D Dental Align.

DISCUSSION

The presented software solution permitted setting and comparing access cavity preparations by students against a standard access prepared by an instructor. The process of data acquisition and registration was fast and straightforward. Student feedback was very positive and suggested the integration of this type of experiential learning into the preclinical curriculum.

CONCLUSION

This feasibility study demonstrated the utility of the new technology to assist dental students' access cavity preparation learning.

Accuracy assessment of implant placement with versus without a CAD/CAM surgical guide by novices versus specialists via the digital registration method: an in vitro randomized crossover study

BACKGROUND

Many studies demonstrated that surgical guides might reduce discrepancies compared with freehand implant placement. This randomized crossover study aimed to assess the effects of approaches, practitioners' experience and learning sequences on the accuracy of single tooth implantation via digital registration method. No similar study was found.

METHODS

This in vitro randomized crossover study enrolled 60 novice students (Group S) and 10 experienced instructors (Group I). Sixty students were randomly and evenly assigned to two groups (Group SA and SB). In Group SA, 30 students first performed single molar implant on a simulation model freehand (Group SAFH), and then with a CAD/CAM surgical guide (Group SASG). In Group SB, another 30 students first performed guided (Group SBSG) and then freehand (Group SBFH). Ten instructors were also divided into Group IAFH/IASG (n = 5) and IBSG/IBFH (n = 5) following the same rules. The accuracy of implant placement was assessed by the coronal and apical distance (mm) and angular (°) deviations using the digital registration method. T tests and nonparametric tests were used to compare the results among different groups of approaches, experience and sequences.

RESULTS

For students, the coronal and apical distance and the angular deviations were significantly lower in surgical guide group than freehand group in total and in learning freehand first subgroup, but for learning surgical guide first subgroup the apical distance deviation showed no significant difference between two approaches. For students, the angular deviation of freehand group was significantly lower in learning surgical guide first group than learning freehand first group. For instructors, the coronal and apical distance and angular deviations showed no significant difference between two approaches and two sequences. For freehand approach, the coronal and apical distance and the angular deviations were significantly higher in student group than instructor group, while not significantly different between two groups for surgical guide approach.

CONCLUSIONS

For novices, using a surgical guide for the first implant placement may reduce the potential deviations compared with freehand surgery, and may reach a comparable accuracy with that of specialists. For simple single molar implantation, the surgical guide may not be significantly helpful for experienced specialists.

Effect of Impression Technique and Operator Experience on Impression Time and Operator-Reported Outcomes

PURPOSE

To investigate the effect of impression technique (conventional preliminary alginate and digital scan) and operator experience in impression making (experienced in digital and conventional, experienced in conventional and inexperienced in digital, and inexperienced in conventional and digital) on impression time, satisfaction and stress levels, and the preference of the operators.

MATERIAL AND METHODS

One patient was assigned for each of the 60 operators, who were experienced in impression techniques at different levels (Group 1: experienced in conventional and digital, Group 2: experienced in conventional and inexperienced in digital, Group 3: inexperienced in conventional and digital). They made conventional impressions (irreversible hydrocolloid) and digital scans (Trios 3) from the same patient. The impression times were recorded at each step (patient registration, maxillary arch, mandibular arch, and bite registration) and in total. A visual analog scale (VAS) was used for the operator satisfaction for applicability, comfort, and hygiene; the State-Trait Anxiety Inventory form (STAI-TX1) was used for stress, and a questionnaire was completed to measure the operator's impression preference. The data were analyzed with a 2-way ANOVA and Chi-square test (α = 0.05).

RESULTS

A significant interaction was found between the operator experience in impression making and the impression technique on time for maxillary and mandibular arch impressions and total time (p ≤ 0.002). Operator experience and impression technique interaction had a significant effect on comfort and average VAS scores (p ≤ 0.016). Whereas, no significant effect of this interaction was found on stress (p ≥ 0.195). Operator experience in impression making had a significant effect on applicability (p < 0.001), and the impression technique had a significant effect on hygiene VAS scores (p < 0.001). Operators in Group 1 and Group 3 preferred the digital scans, however, operators in Group 2 had no preference (p = 0.022).

CONCLUSION

Operator experience in impression making and impression technique had varying effects on clinician's impression time, comfort, applicability, hygiene, and preference. Operators needed less time for the impressions they were experienced with. Operator stress level was not affected by the operator experience in impression making and the impression technique. Dental students and operators experienced in both techniques were satisfied with the digital scans and they preferred digital scans. Operators experienced with conventional impressions were satisfied with conventional impressions but didn't have a preference for the impression type.

Dental Decision Simulation (DDSim): Development of a virtual training environment

PURPOSE

Case-based simulations are powerful training tools that can enhance learning and drive behavior change. This is an overview of the design/development of Dental Decision Simulation (DDSim), a web-based simulation of an electronic dental record (EDR). The purpose was to use DDSim to train dentists to make evidence-based treatment planning decisions consistent with current evidence. This simulated EDR provides case-based information in support of a set of defined evidence-based learning objectives.

METHODS

The development of this complex simulation model required coordinated efforts to create several components: identify behavior changes, case authoring mechanism, create virtual patient visits, require users to make treatment plan decisions related to learning objectives, and a feedback mechanism to help users recognize departures from those learning objectives. This simulation was evaluated in a 2-arm, clinic-randomized, controlled pilot study examining the extent to which DDSim changed dentists' planned treatment to conform to evidence-based treatment guidelines relative to change in dentists not exposed to DDSim. Outcomes were measured by comparing preintervention and postintervention patient EDR treatment data.

RESULTS

Changes in behavior over time did not favor intervention or control clinics.

CONCLUSION

DDSim provides a standardized learning platform that cannot be achieved through the use of live patients. Both live patients and case-based simulations can be used to transfer knowledge and skill development. DDSim offers the advantage of providing a platform for developing treatment planning skills in a low-risk environment. However, further research examining behavior change is needed.

Undergraduate dental students' perspective on the implementation of digital dentistry in the preclinical curriculum: a questionnaire survey

Background

Digitalisation is an expanding field in dentistry and implementation of digital teaching methods in dental education is an essential part of modern education. Therefore, two digital training modules were implemented in the preclinical curriculum at the Justus Liebig University Giessen. The aim of this study was to assess the students’ perspective on the implementation with a questionnaire survey.

Methods

Since the fall term 2017/18, students of the course of dental prosthodontics I attended the training module I, where they learned to use computer-aided learning (CAL) approaches for the digital analysis of tooth preparations. In training module II, students of the course of dental prosthodontics II learned how to manufacture a computer-aided design/computer-aided manufacturing restoration. After the completion of the training modules, all students starting with the fall term 2017/18 to the spring term 2019 were asked to fill in a questionnaire regarding the aspects of handling, didactic benefit, motivation, and overall assessment.

Results

Students rated the implementation of digital aspects in teaching as positive in terms of handling, didactic benefit, and motivation, but gave preference to the assessment of the tooth preparations by dental instructors. In addition, students assessed the feedback from the faculty regarding tips and tricks better than the digital feedback. More than 90% of the students indicated that they could imagine using an intraoral scanner for treatment of patients in the dental office in future.

Conclusions

The results of the present study revealed a positive perspective of students on the implementation of digital dentistry in the preclinical curriculum. However, difficulties with CAL systems were reported and most students preferred evaluation of preparation by dental instructors. Thus, CAL approaches offer an additional teaching method besides the traditional teaching of manual skills.

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.

Evaluating the effectiveness of a preclinical practice of tooth preparation using digital training system: A randomised controlled trial

PURPOSE

This study aimed to evaluate the effectiveness of preclinical training on ceramic crown preparation using digital training system compared with traditional training method.

MATERIALS AND METHODS

A sample of 66 participating fourth-year undergraduate dental students were randomly assigned to one of two groups for ceramic crown preparation: experimental group as trained using digital method with Online Peer-Review System (OPRS) and Real-time Dental Training and Evaluation System (RDTES); control group as trained using traditional method with instructor demonstration and evaluation. At the completion of training periods, both groups performed the preparation of ceramic crown of upper left central incisor, which were blindly scored by the experienced instructors under the pre-defined assessment criteria. The results of both were compared using Student's t-test or Wilcoxon signed rank test. The level of significance was P < .05. The questionnaires regarding the benefits or drawbacks of digital training system were answered by the students of experimental group.

RESULTS

Five of 15 items in the assessment outcome of the digital group were significantly better than the traditional group. The questionnaire results from the students of the experimental group indicated 96.97% of the students agreed or strongly agreed that using digital training system could better improve the practical ability than traditional method. The total scores of practical results were significantly positively correlated with the points of the questionnaires.

CONCLUSION

The digital training system with OPRS and RDTES might be a good alternative to the traditional training method in the preclinical course of dental practice.

Comparison of a prepCheck-supported self-assessment concept with conventional faculty supervision in a pre-clinical simulation environment

OBJECTIVES

This study aimed to evaluate the educational outcome of a digitally based self-assessment concept (prepCheck; DentsplySirona, Wals, Austria) for pre-clinical undergraduates in the context of a regular phantom-laboratory course.

MATERIALS AND METHODS

A sample of 47 third-year dental students participated in the course. Students were randomly divided into a prepCheck-supervised (self-assessment) intervention group (IG; n = 24); conventionally supervised students constituted the control group (CG; n = 23). During the preparation of three-surface (MOD) class II amalgam cavities, each IG participant could analyse a superimposed 3D image of his/her preparation against the "master preparation" using the prepCheck software. In the CG, several course instructors performed the evaluations according to pre-defined assessment criteria. After completing the course, a mandatory (blinded) practical examination was taken by all course participants (both IG and CG students), and this assessment involved the preparation of a MOD amalgam cavity. Then, optical impressions by means of a CEREC-Omnicam were taken to digitalize all examination preparations, followed by surveying and assessing the latter using prepCheck.

RESULTS

The statistical analysis of the digitalized samples (Mann-Whitney U test) revealed no significant differences between the cavity dimensions achieved in the IG and CG (P = .406). Additionally, the sum score of the degree of conformity with the "master preparation" (maximum permissible 10% of plus or minus deviation) was comparable in both groups (P = .259).

CONCLUSION

The implemented interactive digitally based, self-assessment learning tool for undergraduates appears to be equivalent to the conventional form of supervision. Therefore, such digital learning tools could significantly address the ever-increasing student to faculty ratio.

Survey of e-learning implementation and faculty support strategies in a cluster of mid-European medical schools

BACKGROUND

The use of electronic learning formats (e-learning) in medical education is reported mainly from individual specialty perspectives. In this study, we analyzed the implementation level of e-learning formats and the institutional support structures and strategies at an institutional level in a cluster of mid-European medical schools.

METHODS

A 49-item online questionnaire was send to 48 medical schools in Austria, Germany and Switzerland using SurveyMonkey®. Data were collected between February and September of 2013 and analyzed using quantities, statistical and qualitative means.

RESULTS

The response rate was 71 %. All schools had implemented e-learning, but mainly as an optional supplement to the curriculum. E-learning involved a wide range of formats across all disciplines. Online learning platforms were used by 97 % of the schools. Full-time e-learning staff was employed by 50 %, and these had a positive and significant effect on the presence of e-learning in the corresponding medical schools. In addition, 81 % offered training programs and qualifications for their teachers and 76 % awarded performance-oriented benefits, with 17 % giving these for e-learning tasks. Realization of e-learning offers was rewarded by 33 %, with 27 % recognizing this as part of the teaching load. 97 % would use curriculum-compatible e-learning tools produced by other faculties.

CONCLUSIONS

While all participating medical schools used e-learning concepts, this survey revealed also a reasonable support by institutional infrastructure and the importance of staff for the implementation level of e-learning offerings. However, data showed some potential for increasing tangible incentives to motivate teachers to engage in further use of e-learning. Furthermore, the use of individual tools and the distribution of e-learning presentations in various disciplines were quite inhomogeneous. The willingness of the medical schools to cooperate should be capitalized for the future, especially concerning the provision of e-learning tools and concepts.

Student attitudes towards computer-aided testing

INTRODUCTION

  Computer-aided learning (CAL) is a viable alternative to traditional teaching methods. While CAL is used for teaching only, computer-aided testing (CAT) can be applied as a computer-based examination method. The aim of the present study was to evaluate students' attitude towards CAT as compared to written multiple choice tests.

MATERIALS AND METHODS

  Forty-one undergraduate dental students underwent a mock examination consisting of 15 written multiple choice questions and 15 questions delivered using the interactive MobiTed® system. A questionnaire based on an eight-item seven-point Likert scale was used to evaluate the students' attitude towards CAT. The students' performance in both tests was analysed using paired t-tests. Correlations between test performance and questionnaire were expressed by Pearson correlation coefficients.

RESULTS

  Despite study-design-related differences, students' test performance between written multiple choice and MobiTed® was comparable. No correlations between test results and questionnaire could be set up. Students rated MobiTed® to be equivalent to written multiple choice and had no difficulties with the CAT set up. The pre-defined sequence of questions with each question being shown only once was considered to be a major disadvantage of the CAT system. Complex questions should be displayed longer compared to short questions.

DISCUSSION

  Computer-aided testing appeared to be equivalent to written multiple choice tests not only in terms of student performance but also to their perception. This is consistent with previous studies.

CONCLUSIONS

  Interactive multiple choice tests may provide an alternative to written tests, but should allow examinees to have control over the sequence, as well as the length of time the questions are displayed.