Taxonomic discordance of immersive realities in dentistry: A systematic scoping review

OBJECTIVES

This review aimed to map taxonomy frameworks, descriptions, and applications of immersive technologies in the dental literature.

DATA

The Preferred reporting items for systematic reviews and meta-analyses extension for scoping reviews (PRISMA-ScR) guidelines was followed, and the protocol was registered at open science framework platform (https://doi.org/10.17605/OSF.IO/H6N8M).

SOURCES

Systematic search was conducted in MEDLINE (via PubMed), Scopus, and Cochrane Library databases, and complemented by manual search.

STUDY SELECTION

A total of 84 articles were included, with 81 % between 2019 and 2023. Most studies were experimental (62 %), including education (25 %), protocol feasibility (20 %), in vitro (11 %), and cadaver (6 %). Other study types included clinical report/technique article (24 %), clinical study (9 %), technical note/tip to reader (4 %), and randomized controlled trial (1 %). Three-quarters of the included studies were published in oral and maxillofacial surgery (38 %), dental education (26 %), and implant (12 %) disciplines. Methods of display included head mounted display device (HMD) (55 %), see through screen (32 %), 2D screen display (11 %), and projector display (2 %). Descriptions of immersive realities were fragmented and inconsistent with lack of clear taxonomy framework for the umbrella and the subset terms including virtual reality (VR), augmented reality (AR), mixed reality (MR), augmented virtuality (AV), extended reality, and X reality.

CONCLUSIONS

Immersive reality applications in dentistry are gaining popularity with a notable surge in the number of publications in the last 5 years. Ambiguities are apparent in the descriptions of immersive realities. A taxonomy framework based on method of display (full or partial) and reality class (VR, AR, or MR) is proposed.

CLINICAL SIGNIFICANCE

Understanding different reality classes can be perplexing due to their blurred boundaries and conceptual overlapping. Immersive technologies offer novel educational and clinical applications. This domain is fast developing. With the current fragmented and inconsistent terminologies, a comprehensive taxonomy framework is necessary.

A comparison of virtual reality and three-dimensional multiplanar educational methods for student learning of cone beam computed tomography interpretations

OBJECTIVES

The purpose of this study was to compare student learning of cone beam computed tomography (CBCT) interpretation using immersive virtual reality (VR) and three-dimensional multiplanar (MP) reconstructions.

METHODS

Sixty first-year dental students were randomly allocated to two groups, VR and MP, and underwent a one-on-one educational intervention to identify anatomic structures using CBCT data. All participants completed three multiple-choice questionnaires (MCQs) before (T1), immediately after (T2), and 2 weeks following (T3) the intervention. Additionally, pre-survey, post-survey, NASA Task Load Index (NASA-TLX), and presence questionnaires were completed. Analysis of objective measures of performance on MCQs and subjective data from the questionnaires was completed (α = 0.05).

RESULTS

There was a significant increase in test performance and informational recall between T1-T2 and T1-T3 for VR and MP groups (p < 0.001). However, there were no significant differences in performance on MCQs between T2 and T3. Analysis of the Presence questionnaire indicated that the VR group felt decreased distraction (p = 0.013), increased realism (p = 0.035), and increased involvement (p = 0.047) during the educational intervention when compared with the MP group. Analysis of the NASA-TLX indicated that the VR group experienced more physical demand (p < 0.01) but similar cognitive demand when compared with the MP group. Qualitative responses indicated that the VR group had a more dynamic sense of visualization and manipulation compared to the MP group.

CONCLUSION

Results from this study show that VR is as effective as traditional MP methods of CBCT interpretation learning. Further benefits of VR educational intervention include increased involvement, realism and less distraction.

Assessment of the students' performance and support needs in a novel digital carving exercise

OBJECTIVES

In recent years, digital technology has been rapidly expanding in dental practice, which entails an early integration of digital dentistry into the preclinical dental curriculum. This study introduces first-year dental students to a digital carving exercise and investigates its role in enhancing their understanding and performance in traditional wax carving activities. Another objective was to explore the students' challenges and needs for support in the digital carving activity.

METHODS

Digital carving exercise was introduced into the first-year dental morphology curriculum in 2020. Students' performance in anterior wax carving was quantitively compared prior to and following the implementation of the exercise. The students' grades in the digital carving exercise were also compared across three academic years: 2020, 2021, and 2022. Qualitatively, an interpretive description approach using focus group with 31 first-year dental students was utilized to explore their perspectives regarding the digital exercise.

RESULTS

A statistically significant improvement was found in the students wax carving performance following the incorporation of the digital carving activity (p-value = 0.0001). Students' performance in the digital carving exercise also statistically improved over the years. Students' challenges included the technology's unfamiliarity, and a perceived irrelevance of the exercise. Additional guidance, resources, and timely feedback were reported among the students' support needs during the exercise.

CONCLUSION

Digital carving is a promising tool in anatomical education that can improve the students' spatial understanding and manual dexterity. However, educators need to carefully integrate it into the curriculum to address the students' challenges and optimize their learning experience.

Exploring user experience (UX) research methods in health professions education

OUR ISSUE

Researchers often design interventions or experiences to meet the needs of a specific user. However, the user's perspective is often excluded in the process, which can minimize effectiveness due to a lack of understanding about the user, their perspective, and/or their needs. User experience (UX) research methods offer an opportunity to capture additional information about the user that can inform the design of these solutions.

METHODOLOGICAL LITERATURE REVIEW

UX research became prominent during the 1990s to describe the complexity of human interactions with technological solutions. UX research methods emerged in other disciplines as strategies for describing user perspectives, needs, challenges, and potential impact of proposed solutions-these may be useful in health professions education research.

OUR RECOMMENDATIONS AND THEIR APPLICATIONS

Those interested in UX research methods should define the user, establish focused research questions, and select applicable strategies cognizant of time and resource constraints. UX research often requires a clear outline of research activities, how they address the questions, and techniques to engage representative users for data collection. Researchers can optimize data collection by creating inclusive spaces that emphasize active listening. Researchers should compile insights regularly and remember UX research emphasizes an iterative approach to design.

POTENTIAL IMPACT

UX research can support deeper insights into users, their perspectives, their needs, and offers opportunities to co-construct solutions with their experiences in mind. These methods may help educators design impactful experiences that better achieve targeted outcomes in collaboration with their users (e.g., learners, faculty, teams).

Can self-assessment ability predict student performance in a dental anatomy course?

INTRODUCTION

The development of early self-assessment skills and determining its correlation with academic performance could provide evidence to alter dental curricula. The aim of this retrospective study was to examine the relationships between students' early self-assessment ability in waxing and three different evaluation methods (waxing assessment, written examinations, and tooth identification examination) in a dental anatomy course.

MATERIALS AND METHODS

The dental anatomy scores during the academic years of 2018-2019 and 2019-2020 from two cohorts of second-year pre-doctoral dental students at the Harvard School of Dental Medicine were analyzed. Regression analyses were completed to assess the relationship between all evaluation methods.

RESULTS

There was a statistically significant correlation between self-assessment ability and the waxing assessment but no significant correlation between self-assessment ability and the other evaluation methods.

CONCLUSION

Our results showed that the introduction of self-assessments in dental anatomy waxing was correlated with successful waxing skills. Furthermore, a relevant finding is that students who received higher classifications were also capable of doing better self-assessments. These findings provide evidence that impacts dental curricula.

Augmented reality in orthodontics for bracket placement using conventional mobile devices: Technical note

BACKGROUND

Improving bracket placement accuracy through computer-aided design and a bracket navigation set supported by augmented reality (AR).

METHODS

A technical workflow was developed for implementing AR-assisted orthodontic bracket positioning through a smartphone application. This innovative approach eliminates the need for three-dimensional radiation imaging or physical guides, making it a safe and convenient option for clinical use by overlapping the digitally planned bracket position over the patient clinical crown for a precise recommendation of bracket positioning.

RESULTS

It was found that it is achievable and can be easily recognized from all view angles, and this proves that new techniques with new opportunities could be considered.

CONCLUSIONS

AR smartphone applications can potentially be used for the accurate placement of dental brackets; thus, such applications show promise for use in the field of orthodontics.

Evaluating augmented reality e-typodont to improve a patient's dental implant health literacy

STATEMENT OF PROBLEM

Information regarding dental implants can be difficult to understand for participants. Improving patients' dental implant health literacy remains a challenging process.

PURPOSE

The purpose of this clinical study was to develop and evaluate patients' understanding of the implant treatment procedure, components, and sequences using traditional typodont and augmented reality (AR) applications (e-typodont), with the goal of improving their oral health literacy.

MATERIAL AND METHODS

Participants who had sought dental implant treatment at the group practice and implant clinic at the University of Illinois Chicago (UIC) College of Dentistry were invited to enroll in this study. Participants were asked to fill out the first questionnaire (Q1) assessing their understanding of implant treatment procedures, components, and sequences. The participants were randomly exposed to 1 of the 2 modes of delivering education, typodont or AR e-typodont. The participants were asked to complete the additional 2 questionnaires (Q2 and Q3), and the posttest questionnaire (Q1) to re-evaluate their understanding of the implant treatment procedure, components, and sequences. All data were entered and coded into a spreadsheet. Descriptive (mean) and statistical (Wilcoxon Signed Ranks and Mann-Whitney U test) analyses were used (α=.05).

RESULTS

Both interventions significantly increased participants' understanding of implant treatments (typodont: P=.004; e-typodont: P<.001), implant components (typodont: P=.003; e-typodont: P<.001), and implant treatment sequences (typodont: P=.001; e-typodont: P<.001). The e-typodont group significantly improved participants' understanding of implant treatments (P=.006), implant components (P=.023), and implant treatment sequences (P=.008) compared with the typodont group. Participants perceived the e-typodont mode of delivery to be significantly more interesting (P=.002), interactive (P=.008), educational (P=.002), user-friendly (P=.016), and "Wow" (P=.002) compared with the traditional typodont mode of delivery.

CONCLUSIONS

Both interventions improved participants' understanding of implant treatment procedures, components, and sequences. The e-typodont showed better improvement in participants' understanding of dental implants compared with the traditional typodont.

A scoping review on the trends of digital anatomy education

Digital technologies are changing the landscape of anatomy education. To reveal the trend of digital anatomy education across medical science disciplines, searches were performed using PubMed, EMBASE, and MEDLINE bibliographic databases for research articles published from January 2010 to June 2021 (inclusive). The search was restricted to publications written in English language and to articles describing teaching tools in undergraduate and postgraduate anatomy and pre-vocational clinical anatomy training courses. Among 156 included studies across six health disciplines, 35% used three-dimensional (3D) digital printing tools, 24.2% augmented reality (AR), 22.3% virtual reality (VR), 11.5% web-based programs, and 4.5% tablet-based apps. There was a clear discipline-dependent preference in the choice and employment of digital anatomy education. AR and VR were the more commonly adopted digital tools for medical and surgical anatomy education, while 3D printing is more broadly used for nursing, allied health and dental health education compared to other digital resources. Digital modalities were predominantly adopted for applied interactive anatomy education and primarily in advanced anatomy curricula such as regional anatomy and neuroanatomy. Moreover, there was a steep increase in VR anatomy combining digital simulation for surgical anatomy training. There is a consistent increase in the adoption of digital modalities in anatomy education across all included health disciplines. AR and VR anatomy incorporating digital simulation will play a more prominent role in medical education of the future. Combining multimodal digital resources that supports blended and interactive learning will further modernize anatomy education, moving medical education further away from its didactic history.

Obtaining human teeth for dental education: A cross-sectional study to create ethical and transparent processes

OBJECTIVES

This study explores the practices of obtaining human teeth for teaching and research in Paraguay. The goal of this research is to understand whether the data supports the need to improve ethical training within dental education, including the creation of a human tooth bank (HTB) METHODS: An observational cross-sectional study was conducted. Three semi-structured questionnaires were developed, one for each target population: dental students, dentists in practice, and the general population. The questionnaires were distributed between February and April 2021, using Google Forms RESULTS: The main places where human teeth were obtained by a student are dental clinics, followed by cemeteries. 94% of students and 91% of dentists paid for teeth on at least one occasion. There is a willingness on the part of students and dentists to donate collections of teeth, and among the general population to donate their teeth if they are extracted, for both teaching and research use. Note that, 31% of students and 6% of the population are aware of what an HTB is, at the same time only 16% of dentists know how it functions CONCLUSION: The number of respondents who obtain teeth from cemeteries and who pay for their acquisition is high. Both of these practices raise ethical concerns. The implementation of informed consent for the donation of extracted teeth is practically nil; although there is a positive attitude towards its implementation. Also, there is a lack of knowledge about the role of an HTB; although the population expressed a willingness to donate extracted teeth.

Usability Methods and Attributes Reported in Usability Studies of Mobile Apps for Health Care Education: Scoping Review

BACKGROUND

Mobile devices can provide extendable learning environments in higher education and motivate students to engage in adaptive and collaborative learning. Developers must design mobile apps that are practical, effective, and easy to use, and usability testing is essential for understanding how mobile apps meet users' needs. No previous reviews have investigated the usability of mobile apps developed for health care education.

OBJECTIVE

The aim of this scoping review is to identify usability methods and attributes in usability studies of mobile apps for health care education.

METHODS

A comprehensive search was carried out in 10 databases, reference lists, and gray literature. Studies were included if they dealt with health care students and usability of mobile apps for learning. Frequencies and percentages were used to present the nominal data, together with tables and graphical illustrations. Examples include a figure of the study selection process, an illustration of the frequency of inquiry usability evaluation and data collection methods, and an overview of the distribution of the identified usability attributes. We followed the Arksey and O'Malley framework for scoping reviews.

RESULTS

Our scoping review collated 88 articles involving 98 studies, mainly related to medical and nursing students. The studies were conducted from 22 countries and were published between 2008 and 2021. Field testing was the main usability experiment used, and the usability evaluation methods were either inquiry-based or based on user testing. Inquiry methods were predominantly used: 1-group design (46/98, 47%), control group design (12/98, 12%), randomized controlled trials (12/98, 12%), mixed methods (12/98, 12%), and qualitative methods (11/98, 11%). User testing methods applied were all think aloud (5/98, 5%). A total of 17 usability attributes were identified; of these, satisfaction, usefulness, ease of use, learning performance, and learnability were reported most frequently. The most frequently used data collection method was questionnaires (83/98, 85%), but only 19% (19/98) of studies used a psychometrically tested usability questionnaire. Other data collection methods included focus group interviews, knowledge and task performance testing, and user data collected from apps, interviews, written qualitative reflections, and observations. Most of the included studies used more than one data collection method.

CONCLUSIONS

Experimental designs were the most commonly used methods for evaluating usability, and most studies used field testing. Questionnaires were frequently used for data collection, although few studies used psychometrically tested questionnaires. The usability attributes identified most often were satisfaction, usefulness, and ease of use. The results indicate that combining different usability evaluation methods, incorporating both subjective and objective usability measures, and specifying which usability attributes to test seem advantageous. The results can support the planning and conduct of future usability studies for the advancement of mobile learning apps in health care education.

INTERNATIONAL REGISTERED REPORT IDENTIFIER (IRRID)

RR2-10.2196/19072.

Practice makes perfect? Association between students' performance measures in an advanced dental simulation course

PURPOSE

This study examines the relationship between student performance measures during practice and exams using advanced dental simulation.

METHODS

Data from 11 classes of first-year dental students were extracted from Advanced Simulation software (DentSim™) related to Class I and Class II preparations including: total number of practice sessions, average practice score, exam scores, average time preparing teeth during practice/exam, and average time self-evaluating preparations during practice/exam. Comparisons of average practice and exam scores were examined using paired t-test. Relationships between practice/exam measures and exam scores were determined with multiple linear regression.

RESULTS

Practice mean and exam scores were significantly associated; exam scores were significantly higher in both procedures. Class I: a significant positive relationship exists between both practice and exam measures: The average practice score was significantly associated with exam score (p < 0.001); time spent preparing the exam tooth was negatively associated with the exam score (p < 0.001); conversely, time spent self-evaluating the exam tooth was significantly associated with an increase in exam score (p = 0.0135). Class II: exam score was significantly associated with two practice measures but neither of the exam measures: exam score for Class II mesioocclusal preparation was significantly associated with average practice score (p < 0.001) and the number of practice attempts (p = 0.025).

CONCLUSION

This study emphasizes the predictive value of novice learners' deliberate, repetitive practice using advanced dental simulation, which enhances self-assessment in early stages of psychomotor skill development. Future studies are needed to demonstrate the translation of these skills into a patient care setting.

The effectiveness of a 3D virtual tooth identification test as an assessment tool for a dental anatomy course

INTRODUCTION

There has been a recent demand in dental education for distance learning and the use of virtual assessment tools that can leverage technology to potentially replace physical testing facilities. However, virtual tools that evaluate student learning should be validated prior to adoption. The aim of this study was to investigate the effectiveness, efficiency and user satisfaction of a 3D tooth identification test for a dental anatomy course that can be given remotely.

MATERIALS AND METHODS

First-year dental students (n = 41) enrolled in a dental anatomy course took both traditional in-person practical and virtual 3D tooth identification tests consisting of 25 test items. The test scores, average test durations, faculty time commitment and user perception were collected and analysed. Pearson product-moment correlation coefficients (p < .05) were determined for the criterion measures including real tooth identification test scores, comprehensive written examination and overall grade for the course.

RESULTS

The average number of correct answers for the real and 3D virtual tooth identification examination was 21.3 ± 2.65 and 20.7 ± 2.56, respectively. The average test duration for the real and 3D virtual tooth identification test was 25:00 and 21:16 min, respectively. There was a positive correlation (p < .05) of the 3D virtual tooth identification test with the real tooth identification test (0.368), comprehensive written examination (0.334) and the overall course grade (0.646). The total faculty time commitment for the real and 3D virtual tooth identification test was 96 and 65 min, respectively. The students cited difficulty in manipulating the 3D models.

CONCLUSION

This study presents evidence that the 3D virtual tooth identification test can be used to assess dental students' understanding of dental anatomy effectively and efficiently.

Application of holography and augmented reality based technology to visualize the internal structure of the dental root - a proof of concept

BACKGROUND

The Augmented Reality (AR) blends digital information with the real world. Thanks to cameras, sensors, and displays it can supplement the physical world with holographic images. Nowadays, the applications of AR range from navigated surgery to vehicle navigation.

DEVELOPMENT

The purpose of this feasibility study was to develop an AR holographic system implementing Vertucci's classification of dental root morphology to facilitate the study of tooth anatomy. It was tailored to run on the AR HoloLens 2 (Microsoft) glasses. The 3D tooth models were created in Autodesk Maya and exported to Unity software. The holograms of dental roots can be projected in a natural setting of the dental office. The application allowed to display 3D objects in such a way that they could be rotated, zoomed in/out, and penetrated. The advantage of the proposed approach was that students could learn a 3D internal anatomy of the teeth without environmental visual restrictions.

CONCLUSIONS

It is feasible to visualize internal dental root anatomy with AR holographic system. AR holograms seem to be attractive adjunct for learning of root anatomy.

Scoping review of artificial intelligence and immersive digital tools in dental education

PURPOSE

The aim of this scoping review is to examine artificial intelligence (AI) and virtual teaching models within the context of dental education, establish methods to address the resources being investigated, and ultimately augment this approach for future scientific research.

METHODS

To evaluate the applications of AI and immersive technology, a scoping literature review was conducted using the Embase, PubMed, Web of Science, and Cochrane Library database from the years 2018 to May 19, 2021. Additionally, a manual search was completed. The search strategy was formulated according to the Preferred Reporting Items for Systematic Reviews and Meta-Analyses Extension for Scoping Reviews (PRISMA-ScR) guidelines. Studies that addressed the current uses of virtual devices and their revolutionary potential in dental education were categorized separately for further evaluation.

RESULTS

 Of the 2500 articles found in our initial search results, 31 articles met the inclusion criteria set for this review. The selected studies were directly related to AI and immersive tools in dental education.

CONCLUSION

To our knowledge, there are very few comprehensive literature reviews identifying the applications and efficacy of virtual and AI-driven tools in dental education. With limited verifiable evidence, an improved understanding of virtual and AI domains is needed to enable dental students to adapt to changes within and beyond their dental training education. To increase the scientific value of digital-related research, the scientific community must quickly define guidelines to enhance methodological approaches in order to effectively digitalize dentistry.

Malaysian dental students' knowledge of managing dental trauma in children

OBJECTIVE

This study sought to assess dental students' training and experiences in addressing traumatic dental injury (TDI), and, more specifically, their knowledge of TDI management in children.

METHODS

All Year 1 to Year 5 dental students (n = 413; response rate = 72.9%) were invited to participate in an online, self-administered survey, which was based on a validated questionnaire. Quantitative data were analysed via chi-squared test (p < .05) using the Statistical Package for the Social Sciences software program.

RESULTS

Only a few students were found to have undergone first-aid training in TDI (19.3%) and to have encountered TDI incidents (10.6%) before. Almost all preclinical and clinical students agreed that TDI constitutes an emergency (97.8% vs. 99.4%, respectively) and that tooth avulsion requires immediate care (97.1% vs. 99.0%, respectively). However, almost half of the students (48.8%) did not know the management protocols for a fractured tooth. Compared with clinical students, a significantly lower percentage of those in preclinical study knew the following: (1) the main cause of TDI, (2) the teeth that most commonly experience avulsion, (3) the management protocols for an avulsed tooth (e.g., handling, transportation and urgency of professional intervention) and (4) the management protocols for a fractured tooth (e.g., appropriate storage medium and need for immediate treatment). Amongst the clinical students, a significantly lower percentage of those in Year 3 knew how to transport and store avulsed and fractured teeth, and which teeth are most likely to experience avulsion.

CONCLUSION

This study identified areas of TDI education in need of further refinement. Revision of the dental curriculum in terms of design, content, teaching method and delivery time may thus be warranted.

A comparison of pre-clinical instructional technologies: Natural teeth, 3D models, 3D printing, and augmented reality

PURPOSE/OBJECTIVES

To assess student perceptions on learning dental anatomy using natural extracted teeth, 3D printed models, 3D virtual models, and augmented reality (AR) technology.  METHODS: Eighty first-year dental students enrolled in the dental anatomy course were instructed to examine four stations. The stations included four versions of a mandibular first molar: an extracted natural tooth, a 3D printed model, a 3D virtual model, and a model displayed on a novel AR device. After examining all stations, the students were asked to complete an electronic survey. Bivariate analysis was performed to determine whether students' perceptions are related to their demographic characteristics and technological experience with computer use, 3D modeling, and video games.  RESULTS: Seventy students completed the survey (87.5% response rate). Students rated natural teeth to have the highest educational value, the 3D printed tooth to be the most accessible, and the AR application to be the most interesting modality. Students who played little to no video games were more likely to rate AR as high educational value (48.8% vs. 10.3%; p < 0.001), while students with little 3D modeling experience were more likely to rate high accessibility of the 3D Model (78.1% vs. 48.3%; p < 0.001). No statistically significant associations between the perceptions and students' demographic characteristics or use of computer were noted.

CONCLUSION

The natural extracted tooth was rated highest in educational value, while the 3D printed model was rated easiest to use, and the AR model was the most interesting to the students.

Development and Student Perception of Virtual Reality for Implant Surgery

(1) Introduction: New and innovative approaches to dental education have continued to improve with time. The coronavirus disease 2019 (COVID-19) pandemic forced dental education to change as social distancing implementations were enforced. Virtual reality was used as a resource before the COVID-19 pandemic, and it has become more essential due to social restrictions. Virtual reality can allow students to be fully immersed in a clinical environment without leaving their homes. (2) Methods: The development of virtual reality (VR) for implant surgery was described. Selected students filled out a survey before and after using the program. Then, a focus group discussion for the students was held to analyze the program further. (3) Results: Seven dental students enrolled in the Advanced Predoctoral Implant Program (APIP) participated in the study. Qualitative analysis of this study suggests that virtual reality can be used as a supplemental resource to enhance student learning of specific topics. Additionally, the students had positive outlooks for using virtual reality as a resource in dental education and were hopeful to use it in the future for particular topics and subjects. (4) Discussion: The advantages and disadvantages of VR application in education were described. This application allows the students to be immersed fully with virtual dental operatory. The application provides the student with an enhanced learning experience in implant dentistry. Students displayed supportive attitudes towards the applicability of VR in dental education but considered this application as an adjunctive tool for learning. (5) Conclusion: The application of this technology in dental education is promising. The use of virtual reality in teaching and learning implant dentistry offers positive enhancement, especially during these challenging times.

Comparisons of orthodontic residents' performance and attitudes using 2D, 3D, and virtual reality surgical simulation methods

PURPOSE

Advances in virtual reality technology for surgical simulation methods may improve diagnosis and treatment planning of complex orthognathic surgery cases. The objectives were to assess orthodontic residents' performance and attitudes when treatment planning orthognathic surgery cases using two-dimensional (2D) digital, three-dimensional (3D) digital, and virtual reality (VR) surgical simulations.

METHODS

The study had a mixed methods study design involving 20 graduate orthodontic residents. Their previous experiences, confidence, and competence with orthodontic diagnosis and surgical treatment planning were assessed with a baseline survey. Each resident completed 2D, 3D, and VR treatment planning and simulation tasks in a randomized order and recorded their diagnosis, objectives, treatment plan, and special surgical concerns for each case using a treatment planning worksheet. The worksheets were scored and quantitative data were analyzed. Attitudinal responses to the simulation experience were captured with a post-survey and interview.

RESULTS

The number of total prescribed surgical movements was greater for 3D and VR simulation methods (p = 0.001). There were no differences in the overall total written treatment plan analysis score among the three surgical simulation tasks. Participants took longer to complete the VR and 3D tasks (p < 0.001) and asked more questions regarding manipulation (p < 0.001) and software features (p < 0.002) for higher fidelity tools. Analysis of qualitative feedback showed positive attitudes toward higher fidelity tools with regard to visualization, manipulation, and enjoyment of the task.

CONCLUSIONS

The results demonstrate that simulation methods of increased fidelity (3D and VR) are appropriate alternatives to 2D conventional orthognathic surgical simulation methods when combined with traditional records. Qualitative feedback confirms residents' readiness to adopt VR simulation. However, comprehensive training is needed to increase familiarity and comfort with using the new technology.

Virtual exams: has COVID-19 provided the impetus to change assessment methods in medicine?

AIMS

The ongoing COVID-19 pandemic has disrupted and delayed medical and surgical examinations where attendance is required in person. Our article aims to outline the validity of online assessment, the range of benefits to both candidate and assessor, and the challenges to its implementation. In addition, we propose pragmatic suggestions for its introduction into medical assessment.

METHODS

We reviewed the literature concerning the present status of online medical and surgical assessment to establish the perceived benefits, limitations, and potential problems with this method of assessment.

RESULTS

Global experience with online, remote virtual examination has been largely successful with many benefits conferred to the trainee, and both an economic and logistical advantage conferred to the assessor or organization. Advances in online examination software and remote proctoring are overcoming practical caveats including candidate authentication, cheating prevention, cybersecurity, and IT failure.

CONCLUSION

Virtual assessment provides benefits to both trainee and assessor in medical and surgical examinations and may also result in cost savings. Virtual assessment is likely to be increasingly used in the post-COVID world and we present recommendations for the continued adoption of virtual examination. It is, however, currently unable to completely replace clinical assessment of trainees. Cite this article: Bone Jt Open 2021;2(2):111-118.

From Traditional to VR-Based Online Education Platforms: A Model of the Mechanism Influencing User Migration

VR technology can help create optimal virtual learning spaces. Such spaces offer new visual experiences that break through the limitations of time and space and greatly stimulate people’s imagination and creativity in learning. Currently, the bandwidth required for such spaces limits the large-scale application of virtual reality (VR) technology for this purpose. With the large-scale deployment and application of high-speed networks, however, online education platforms based on VR technology will be better able to meet the diversified and personalized learning needs of learners. To promote the development and popularization of new online education platforms based on VR, the factors influencing the migration of learners from traditional online education platforms to new platforms need to be understood more clearly. A model based on the theory of negative, positive, and anchoring effects can explain learners’ migration behavior in this connection. To this end, a structural equation model based on the PLS variance algorithm was used to analyze data obtained through offline and online questionnaires. It was found that in terms of “negative effects”, the afunction and loyalty associated with traditional online education platforms reduced learners’ willingness to migrate to new platforms based on VR technology. In terms of “positive effects”, the novel interactivity and personalization brought by the new platform increased the willingness of users of traditional platforms to migrate to new platforms. In terms of “anchoring effects”, the system quality and relationship quality of learners’ use of traditional online education platforms, as well as the transfer costs associated with the new platform, generated learners’ risk perception about platform migration. In addition, risk perception not only negatively affects learners’ migration to the new platforms, but also strengthens their cognition of the system quality and relationship quality of the traditional platforms, while reducing their interactive awareness of those platforms. Therefore, by adjusting the psychological component of virtual learning, the online education platforms based on VR technology can create high-quality platforms migrating from traditional platforms.