Enhancing learning experiences in pre-clinical restorative dentistry: the impact of virtual reality haptic simulators

BACKGROUND

Utilization of Virtual Reality haptic simulation (VRHS) to aid in the training of various pre-clinical skills is of recent interest. The aim of this study was to evaluate the impact of VRHS in restorative dentistry on the learning experiences and perceptions of dental students.

METHODS

An interventional study design was utilized to recruit third year students. All participants provided informed consents and were randomly divided into two groups. Group 1: Initially performed a Class I cavity preparation with the VRHS, followed by the same exercise using the phantom head/ acrylic typodont teeth in a conventional simulation environment (CSE). Group 2: Initially performed Class I preparations in a CSE, followed by the same exercise using VRHS. Both groups performed the exercises on a lower right first molar. To understand students' perception, an online questionnaire was circulated. Data analysis involved Chi-square tests, independent t-tests and Mann-Whitney U-tests using the R statistical environment package.

RESULTS

A total of 23 dental students participated in this study. Although student's perceptions were similar in both groups, a strong agreement that VRHS training might be used to supplement standard pre-clinical training was noted. Advancements to the VRHS hardware and software are required to bridge the gap and provide a smooth transition to clinics.

CONCLUSION

Novice dental students generally perceived VRHS as a useful tool for enhancing their manual dexterity. Dental institutions should endorse virtual reality technology with caution, ensuring a planned integration into the curriculum to optimize benefit. Feedback is pivotal to effective learning in simulation-based education, and the triangulation of feedback could serve as a powerful aid to maximize the learning experience.

Towards best practice in developing motor skills: a systematic review on spacing in VR simulator-based psychomotor training for surgical novices

OBJECTIVE

Repeated practice, or spacing, can improve various types of skill acquisition. Similarly, virtual reality (VR) simulators have demonstrated their effectiveness in fostering surgical skill acquisition and provide a promising, realistic environment for spaced training. To explore how spacing impacts VR simulator-based acquisition of surgical psychomotor skills, we performed a systematic literature review.

METHODS

We systematically searched the databases PubMed, PsycINFO, Psychology and Behavioral Sciences Collection, ERIC and CINAHL for studies investigating the influence of spacing on the effectiveness of VR simulator training focused on psychomotor skill acquisition in healthcare professionals. We assessed the quality of all included studies using the Medical Education Research Study Quality Instrument (MERSQI) and the risk of bias using the Cochrane Collaboration's risk of bias assessment tool. We extracted and aggregated qualitative data regarding spacing interval, psychomotor task performance and several other performance metrics.

RESULTS

The searches yielded 1662 unique publications. After screening the titles and abstracts, 53 publications were retained for full text screening and 7 met the inclusion criteria. Spaced training resulted in better performance scores and faster skill acquisition when compared to control groups with a single day (massed) training session. Spacing across consecutive days seemed more effective than shorter or longer spacing intervals. However, the included studies were too heterogeneous in terms of spacing interval, obtained performance metrics and psychomotor skills analysed to allow for a meta-analysis to substantiate our outcomes.

CONCLUSION

Spacing in VR simulator-based surgical training improved skill acquisition when compared to massed training. The overall number and quality of available studies were only moderate, limiting the validity and generalizability of our findings.

Effects of a one-year physical activity intervention on fundamental movement skills of boys with severe intellectual disabilities

BACKGROUND

Little is known about the effectiveness of using physical activity-based interventions to improve fundamental movement skills (FMS) of children with severe intellectual disabilities (ID).

AIMS

The purpose of this study was to examine the effect of a one-year physical activity intervention on FMS among boys with severe ID.

METHODS AND PROCEDURES

Forty-two boys with severe ID (M_age= 9.6 years₎ were randomized into experimental and control groups. The experimental group participated in a semi-structured physical activity intervention, while the control group engaged in a supervised free play program, for 60 min per meeting, five times per week, over 12 months. Participants' FMS were assessed for pretest, 6-month midterm, and posttest; their age, body mass index (BMI) were also collected.

OUTCOMES AND RESULTS

Controlling for participants' BMI and pretest scores, the intervention significantly improved posttest FMS in the experimental group compared to the comparison group. No significant improvement was found from midterm to posttest for the comparison group. No significant improvement was found from pretest to midterm FMS performance for both groups.

CONCLUSIONS AND IMPLICATIONS

The results suggest that the fundamental movement skill performance of children with severe ID can be improved, although the significant effects may only be evident after long (1 year), rather than short-term (6 months), time periods.

Evaluation of students' clinical performance post-simulation training

INTRODUCTION

Traditionally in Australia, sonographer skills are learnt on patients in clinical practice. A four-year undergraduate-postgraduate course introduced ultrasound simulation to prepare novice sonographer students for interaction with patients. Second-year students learnt psychomotor and patient-sonographer communication skills during simulation using commercial ultrasound machines and volunteer year-group peers as standardised patients. This paper reports on the transfer of the ultrasound skills learnt in simulation to clinical practice.

METHODS

Clinical performance evaluations were completed by 94 supervisors involved in the initial clinical practice of 174 post-simulation second-year students over a two-year period (2015-2016). Student performance of each component skill, and skill category, was analysed by modelling binomial proportions with logistic regression.

RESULTS

Students demonstrated substantial transfer of learnt ultrasound skills to achieve a mean of advanced beginner competence (mean score of equal to or >3/5) in complex psychomotor and patient-sonographer communication skills, as measured one month into clinical practice. Knowledge and skill components, or sub-tasks, varied significantly (P < 0.001) in transferability. Scanning tasks in general, particularly the skill of 'extending the examination', transferred with significantly (P < 0.001) less efficacy than pre-exam, instrumentation, post-exam, and additional tasks. Skill transfer improved significantly (P < 0.001) following increased deliberate practice with tutor feedback.

CONCLUSION

Preclinical simulation, using standardised patients, clearly stated objectives to manage cognitive load and immediate tutor feedback, facilitated substantial transfer of ultrasound skills to clinical practice. The efficacy of skill transfer varied but improved with increased deliberate practice and feedback quality.

IMPLICATIONS FOR PRACTICE

The incorporation of preclinical simulation into the core curriculum of sonographer courses is recommended to improve student performance, reduce the burden on clinical staff and increase patient safety during the early stages of ultrasound education.

Performance assessment - The knowledge, skills and attitudes of surgical performance

Pediatric surgical education has traditionally focused on the hard cognitive and psychomotor (technical) skills. While more and more attention is being paid to softer skills such as communication, collaboration, leadership, health advocacy, professionalism and scholarship, the bulk of curricula remain focused on the hard skills. An intricate part of education is the assessment of performance. This article reviews the current literature on the assessment of cognitive and psychomotor skills, focusing particularly on the assessment of technical skills in the realm of simulation.

A model to teach concomitant patient communication during psychomotor skill development

Many health professionals use psychomotor or task-based skills in clinical practice that require concomitant communication with a conscious patient. Verbally engaging with the patient requires highly developed verbal communication skills, enabling the delivery of patient-centred care. Historically, priority has been given to learning the psychomotor skills essential to clinical practice. However, there has been a shift towards also ensuring competent communication with the patient during skill performance. While there is literature outlining the steps to teach and learn verbal communication skills, little is known about the most appropriate instructional approach to teach how to verbally engage with the patient when also learning to perform a task. A literature review was performed and it identified that there was no model or proven approach which could be used to integrate the learning of both psychomotor and communication skills. This paper reviews the steps to teach a communication skill and provides a suggested model to guide the acquisition and development of the concomitant -communication skills required with a patient at the time a psychomotor skill is performed.

Improvement of Skills in Cardiopulmonary Resuscitation of Pediatric Residents by Recorded Video Feedbacks

OBJECTIVE

To evaluate the pediatric residents' cardiopulmonary resuscitation (CPR) skills, and their improvements after recorded video feedbacks.

METHODS

Pediatric residents from a university hospital were enrolled. The authors surveyed the level of pediatric resuscitation skill confidence by a questionnaire. Eight psychomotor skills were evaluated individually, including airway, bag-mask ventilation, pulse check, prompt starting and technique of chest compression, high quality CPR, tracheal intubation, intraosseous, and defibrillation. The mock code skills were also evaluated as a team using a high-fidelity mannequin simulator. All the participants attended a concise Pediatric Advanced Life Support (PALS) lecture, and received video-recorded feedback for one hour. They were re-evaluated 6 wk later in the same manner.

RESULTS

Thirty-eight residents were enrolled. All the participants had a moderate to high level of confidence in their CPR skills. Over 50 % of participants had passed psychomotor skills, except the bag-mask ventilation and intraosseous skills. There was poor correlation between their confidence and passing the psychomotor skills test. After course feedback, the percentage of high quality CPR skill in the second course test was significantly improved (46 % to 92 %, p = 0.008).

CONCLUSIONS

The pediatric resuscitation course should still remain in the pediatric resident curriculum and should be re-evaluated frequently. Video-recorded feedback on the pitfalls during individual CPR skills and mock code case scenarios could improve short-term psychomotor CPR skills and lead to higher quality CPR performance.

A new strategy in nursing education: From hybrid simulation to clinical practice

BACKGROUND

Various instructional environments are used in nurse education to develop students' psychomotor and communication skills, reduce their anxiety levels, and enhance their satisfaction.

OBJECTIVES

To examine the effect of three different instructional environments on the development of the students' psychomotor and communication skills and their levels of anxiety and satisfaction.

DESIGN

A prospective study design was used.

METHODS

The study sample consisted of 60 nursing students. Before the implementation of the study, the students' cognitive skills and trait anxiety levels were evaluated. The students were divided into five groups and five nursing activities (Leopold's maneuvers, teaching breastfeeding, family planning education, teaching vulvar self-examination and teaching breast self-examination) were specified for each group. They implemented these nursing activities under the supervision of a faculty member in the nursing skills laboratory (NSL), standardized patient laboratory (SPL) and clinical practice environment (CPE) respectively. In each instructional environment, the students' psychomotor and communication skills, state anxiety levels and satisfactions were evaluated.

RESULTS

The median scores for psychomotor skills [NSL=73.1;SPL=81.5;CPE=88.6] and communication skills [NSL=64.9;SPL=71.6;CPE=79.0] were found to increase as the students went on practicing in a more complicated environment (p<0.05). Similarly, it was determined that the students' anxiety levels decreased as they were practicing incrementally [NSL=33.0;SPL=32.0;CPE=31.0]. As the instructional environments were getting more similar to the reality, the students' satisfaction levels were found to become higher.

CONCLUSIONS

Students who deliberately practice in the instructional environments until they are competent develop their psychomotor skills while reducing their anxiety levels, and enhancing their communication skills and satisfaction. For that reason, the development of students' competency areas is thought to be effective for enhancement of patients and health care workers' safety.

Determining the effect of periodic training on the basic psychomotor skills of nursing students

BACKGROUND

Basic psychomotor skill training starts in the first year in nursing education. The psychomotor skills taught in the first year of nursing training constitute a foundation for all professional practices. Conducting periodic training for skills with which students are deficient can support mastery learning.

OBJECTIVES

The study was conducted as an interventional study for determining the effect of periodic training on the basic psychomotor skills learned in the Fundamentals of Nursing course.

DESIGN

The sample consisted of 70 students attending the Fundamentals of Nursing course at nursing students in a university in Ankara, over 4 years between 2010 and 2013.

METHODS

The study was conducted as an interventional study for a period of 4 years. The data were collected through a questionnaire that was applied 4 times at the end of each academic year. According to the results of the forms evaluated at the end of each year, 4 additional laboratory activities were conducted addressing the deficient psychomotor skills of students at the beginning of the new academic semester in the 2nd and 3rd years. In the 4th-year clinic practice, courses were arranged to practice still deficient psychomotor skills.

RESULTS

It was determined that students practiced nearly all of the basic psychomotor skills during clinical practice and that the practices with which they felt themselves to be inadequate gradually decreased following periodic training; this decrease was significant (p<0.05). While the number of students who could practice was low at the first measurement, following 3 years of periodic training, these skills increased significantly (p<0.05).

CONCLUSION

This study determined that periodic training addressing the deficient psychomotor skills of nursing students was effective. We recommend that students' psychomotor skills be evaluated periodically and repetitive training based on the results of this evaluation be provided throughout the undergraduate nursing education process.