This paper describes how a relatively new style of online learning, a massive open online course, may be used to raise aspirations and widen participation in dental professions
Introduction:Students face a number of challenges in translating the skills acquired in pre-clinical simulation environments to the delivery of real patient care. These are particularly emphasised for complex operative procedures such as tooth preparations for indirect restorations. This paper reports student perceptions of a novel approach designed to improving student confidence when undertaking operative procedures on patients for the first time, by providing patient-specific simulation using virtual reality (VR) and 3D-printed models of the student's real clinical case.
Materials and Methods:Students practised on patient-specific models, in the presence of a clinical tutor, firstly using VR simulation then with 3D-printed models in a clinical skills laboratory. The students then carried out the operative procedure on their patients, on the third occasion of practice. After providing the treatment for their patients, students attended a semi-structured interview to discuss their experiences. The qualitative data were analysed using two forms of inductive analysis.
Results: Students most frequently cited: the value of the educator, increased confidence and efficiency during the clinical procedure, improved patient confidence and the complementary benefits of the two simulation modalities. Thematic analysis of participants' responses uncovered five key themes: • The value of virtual reality dental simulators • The value of clinical skills laboratory simulation with 3D-printed models • The value of educator engagement • The impact on the clinical procedure and the patient • The VR and clinical skills laboratory balance Conclusion: This paper reports the early findings of an intervention that improves dental student confidence through the use of patient-specific VR exercises and 3Dprinted models. These provided an incremental learning experience for an operative clinical procedure, prior to treatment of the live patient. Early results suggest this is a positive experience for the students, providing a valuable contribution to their confidence and preparedness. How to cite this article: Towers A, Dixon J, Field J, Martin R, Martin N. Combining virtual reality and 3D-printed models to simulate patient-specific dental operative procedures-A study exploring student perceptions.
Introduction
Virtual reality (VR) dental simulators are gaining momentum as a useful tool to educate dental students. To date, no VR dental simulator exercise has been designed which is capable of reliably providing validated, meaningful clinical feedback to dental students. This study aims to measure the concurrent validity of the assessment and the provision of qualitative feedback, pertaining to cavity preparations by VR dental simulators.
Methods
A cavity preparation exercise was created on a VR dental simulator, and assessment criteria for cavity preparations were developed. The exercise was performed 10 times in order to demonstrate a range of performances, and for each, the simulator feedback was recorded. The exercises were subsequently three‐dimensionally printed, and 12 clinical teachers were asked to assess the preparations according to the same criteria. Inter‐rater reliability (IRR) between clinical teachers was measured using a free‐marginal multirater kappa value. Clinical teacher assessment responses were compared with the VR simulator responses and percentage agreements calculated.
Results
IRR values for each exercise ranged from 0.39 to 0.77 (69.39%‐88.48%). The assessment of smoothness (κfree 0.58, 78.79%) and ability to follow the outline (κfree 0.56, 77.88%) demonstrated highest agreement between clinical teachers, whilst the assessment of undercut (κfree 0.15, 57.58%) and depth (κfree 0.28, 64.09%) had the lowest agreement. The modal percentage agreement between clinical teachers and the VR simulator was, on average, 78% across all exercises.
Conclusion
The results of this study demonstrate that it is possible to provide reliable and clinically relevant qualitative feedback via a VR dental simulator. Further research should look to employ this technique across a broader range of exercises that help to develop other complex operative dental skills.
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