This is a repository copy of A scoping review of the use and application of virtual reality in pre-clinical dental education.

Kathryn Chu and colleagues describe the experiences of Médecins sans Frontières after the 2010 Haiti earthquake, and discuss how to improve delivery of surgery in humanitarian disasters.

The purpose of this study was to present and evaluate a blended-learning course developed for undergraduate (B.D.S.), postgraduate, and diploma (hygiene and therapy) students at the University of Sheffield School of Clinical Dentistry. Blended learning is the integration of classroom face-to-face learning with online learning. The overall methodology used for this study was action research. The data were collected using three processes: questionnaires to collect contextual data from the students taking the course; a student-led, nominal group technique to collect group data from the participants; and a non-participant observer technique to record the context in which certain group and individual behaviors occurred. The online component of the course was accepted as a valuable resource by 65 percent of those responding. While online information-sharing occurred (31 percent of the students posted in forums), there was no evidence of online collaboration, with only 8 percent replying to forum postings. Accessibility of the online environment was one of the main concerns of the students at the nominal group sessions. Differences regarding overall engagement with the course between the student groups (years) were observed during the sessions. The majority of the students were satisfied with the Information and Communication Technologies (ICT) course. No statistically significant differences between males and females were found, but there were differences between different student cohorts (year groups).

This article reports the results of a follow-up study conducted to investigate students' perceptions about a blended learning health informatics course that combined online and traditional classroom instruction. The course is taught to five different groups of students at the School of Clinical Dentistry of the University of Sheffield each academic year: first-, third-, and fourthyear dental students, dental hygiene and therapy students, and postgraduate dental students. The goal of the study was to determine the impact of the modifications made to the course after the first year of implementation. To accomplish this goal, students' perceptions of this blended learning course were compared after the first and second implementations. The methodology used for this study was action research. The data were collected using three processes: questionnaires were used to collect contextual data from the students taking the course; a student-led, nominal group technique was used to collect group data from the participants; and a non-participant observer technique was used to record the context in which certain group and individual behaviors occurred. Depending on group assignment, between 41.5 and 91.5 percent of students believed that the blended-learning course had added to their skills. The online learning environment was perceived as a useful resource by 75 percent of students in four of the five student groups, but only 45 percent of the fourth-year dental students indicated it was a useful resource. The perceived lack of sufficient online support material was one of the main concerns of the students at the nominal group evaluation sessions. The non-participant observer technique identified different engagement levels among the student groups. Discernible differences were identified, with improvement in some areas and a decline in others compared to a previous evaluation. The change in the delivery method influenced the students' comprehension of the material negatively and the learning environment positively, but did not influence online collaboration among students.

Abstractobjectives In a district hospital in conflict-torn Somalia, we assessed (i) the impact of introducing telemedicine on the quality of paediatric care, and (ii) the added value as perceived by local clinicians.methods A 'real-time' audio-visual exchange of information on paediatric cases (Audiosoft Technologies, Quebec, Canada) took place between clinicians in Somalia and a paediatrician in Nairobi. The study involved a retrospective analysis of programme data, and a perception study among the local clinicians.results Of 3920 paediatric admissions, 346 (9%) were referred for telemedicine. In 222 (64%) children, a significant change was made to initial case management, while in 88 (25%), a life-threatening condition was detected that had been initially missed. There was a progressive improvement in the capacity of clinicians to manage complicated cases as demonstrated by a significant linear decrease in changes to initial case management for meningitis and convulsions (92-29%, P = 0.001), lower respiratory tract infection (75-45%, P = 0.02) and complicated malnutrition (86-40%, P = 0.002). Adverse outcomes (deaths and lost to follow-up) fell from 7.6% in 2010 (without telemedicine) to 5.4% in 2011 with telemedicine (30% reduction, odds ratio 0.70, 95% CI: 0.57-0.88, P = )0.001). The number needed to be treated through telemedicine to prevent one adverse outcome was 45. All seven clinicians involved with telemedicine rated it to be of high added value.conclusion The introduction of telemedicine significantly improved quality of paediatric care in a remote conflict setting and was of high added value to distant clinicians.