Learning by doing virtually

Technology-enhanced learning: a role for video animation

The last 20 years has seen a shift in medical education from printed analogue formats of knowledge transfer to digital knowledge transfer via media platforms and virtual learning environments. Traditional university medical teaching was characterised by lectures and printed textbooks, which to a degree still have an important role to play in knowledge acquisition, but which in isolation do not engage the modern learner, who has become reliant on digital platforms and 'soundbite' learning. Recently, however, traditional methods of teaching and learning have been augmented by, and indeed sometimes replaced by, the alternative learning methods such as: problem-based learning; a greater integration of basic science and clinical considerations; smaller teaching groups; the 'flipped classroom' concept; and various technological tools which promote an interactive learning style. The aim of these new teaching methods is to overcome the well-documented limitations of traditional lectures and printed material in the transfer of knowledge from expert to student, by better engaging the minds of more visual learners and encouraging the use of diverse resources for lifelong learning. In this commentary paper, we share the concept of video animation as an additional educational tool, and one that can help to integrate molecular, cellular and clinical processes that underpin our understanding of biology and pathology in modern education. Importantly, while they can provide focused and attractive formats for 'soundbite' learning, their aim as a tool within the broader educational toolbox is to direct the interested reader towards more traditional formats of learning, which permit a deeper dive into a particular field or concept. In this manner, carefully constructed video animations can serve to provide a broad overview of a particular field or concept and to facilitate deeper learning when desired by the student.

Teaching the knowledge explosion is a challenge.

Video animation plays a future role in teaching complex biological concepts and processes.

Video animation helps in educating professionals and the public.

Surgical Training 2.0: A systematic approach reviewing the literature focusing on oral maxillofacial surgery - Part II

PURPOSE

Many technologies are emerging in the medical field. Having an overview of the technological arsenal available to train new surgeons seems very interesting to guide subsequent surgical training protocols.

METHODS

This article is a systematic approach reviewing new technologies in surgical training, in particular in oral and maxillofacial surgery. This review explores what new technologies can do compared to traditional methods in the field of surgical education. A structured literature search of PubMed was performed in adherence to PRISMA guidelines. The articles were selected when they fell within predefined inclusion criteria while respecting the key objectives of this systematic review. We looked at medical students and more specifically in surgery and analysed whether exposure to new technologies improved their surgical skills compared to traditional methods. Each technology is reviewed by highlighting its advantages and disadvantages and studying the feasibility of integration into current practice.

RESULTS

The results are encouraging. Indeed, all of these technologies make it possible to reduce the learning time, the operating times, the operating complications and increase the enthusiasm of the students compared to more conventional methods. The start-up cost, the complexity to develop new models, and the openness of mind necessary for the integration of these technologies are all obstacles to immediate development. The main limitations of this review are that many of the studies have been carried out on small numbers, they are not interested in acquiring knowledge or skills over the long term and obviously there is a publication bias.

CONCLUSION

Surgical education methods will probably change in the years to come, integrating these new technologies into the curriculum seems essential so as not to remain on the side. This second part therefore reviews, social networks, serious games and virtual reality. This Systematic review is registered on PROSPERO (CRD42020181376).

DIVA, a 3D virtual reality platform, improves undergraduate craniofacial trauma education

Craniofacial fractures management is challenging to teach due to the complex anatomy of the head, even when using three-dimensional CT-scan images. DIVA is a software allowing the straightforward visualization of CT-scans in a user-friendly three-dimensional virtual reality environment. Here, we assess DIVA as an educational tool for craniofacial trauma for undergraduate medical students. Three craniofacial trauma cases (jaw fracture, naso-orbital-ethmoid complex fracture and Le Fort 3 fracture) were submitted to 50 undergraduate medical students, who had to provide diagnoses and treatment plans. Each student then filled an 8-item questionnaire assessing satisfaction, potential benefit, ease of use and tolerance. Additionally, 4 postgraduate students were requested to explore these cases and to place 6 anatomical landmarks on both virtual reality renderings and usual slice-based three-dimensional CT-scan visualizations. High degrees of satisfaction (98%) without specific tolerance issues (86%) were reported. The potential benefit in a better understanding of craniofacial trauma using virtual reality was reported by almost all students (98%). Virtual reality allowed a reliable localization of key anatomical landmarks when compared with standard three-dimensional CT-scan visualization. Virtual reality interfaces such DIVA are beneficial to medical students for a better understanding of craniofacial trauma and allow a reliable rendering of craniofacial anatomy.

Survey on multisensory feedback virtual reality dental training systems

Compared with traditional dental training methods, virtual reality training systems integrated with multisensory feedback possess potentials advantages. However, there exist many technical challenges in developing a satisfactory simulator. In this manuscript, we systematically survey several current dental training systems to identify the gaps between the capabilities of these systems and the clinical training requirements. After briefly summarising the components, functions and unique features of each system, we discuss the technical challenges behind these systems including the software, hardware and user evaluation methods. Finally, the clinical requirements of an ideal dental training system are proposed. Future research/development areas are identified based on an analysis of the gaps between current systems and clinical training requirements.

Development of a virtual reality training system for endoscope-assisted submandibular gland removal

PURPOSE

Endoscope-assisted surgery has widely been adopted as a basic surgical procedure, with various training systems using virtual reality developed for this procedure. In the present study, a basic training system comprising virtual reality for the removal of submandibular glands under endoscope assistance was developed. The efficacy of the training system was verified in novice oral surgeons.

MATERIAL AND METHODS

A virtual reality training system was developed using existing haptic devices. Virtual reality models were constructed from computed tomography data to ensure anatomical accuracy. Novice oral surgeons were trained using the developed virtual reality training system.

RESULTS

The developed virtual reality training system included models of the submandibular gland and surrounding connective tissues and blood vessels entering the submandibular gland. Cutting or abrasion of the connective tissue and manipulations, such as elevation of blood vessels, were reproduced by the virtual reality system. A training program using the developed system was devised. Novice oral surgeons were trained in accordance with the devised training program.

CONCLUSIONS

Our virtual reality training system for endoscope-assisted removal of the submandibular gland is effective in the training of novice oral surgeons in endoscope-assisted surgery.

A new preoperative radiological assessment in LeFort I surgery: anterior nasal spine-sphenoidal rostrum

OBJECTIVE

The aim of this study is to assess the distance between the anterior nasal spine and the sphenoidal rostrum related to the LeFort I surgery in a Turkish population sample.

MATERIAL AND METHODS

We retrospectively reviewed multidetector computerized tomography (MDCT) scans of 209 patients (134 males and 75 females). The images were obtained on a 64-MDCT scanner. The imaging parameters were 0.5 × 64 mm slice thickness, 0.5/0.3 mm increment, 120 kV, 250 mAs, 0.5 sn rotation time, 0.641 pitch, and 512 matrix. The distance between the anterior nasal spine and the sphenoidal rostrum was assessed with the Vitrea 2 software program.

RESULTS

The study group consisted of 134 male (mean age 57.90 ± 5.86) and 75 female (mean age 54.84 ± 4.31) patients. The distance between the anterior nasal spine and the sphenoidal rostrum was ranging between 40.4 and 70.9 mm (average 58.3 ± 5.9) in males and 45.0 and 63.2 mm in (average 55.2 ± 4.3) females. In addition, no statistically significant differences were found between genders.

CONCLUSION

The results of the current study showed that after 40 mm proceeding of the ball end nasal osteotome, the surgeons must be aware of penetrating the sphenoidal rostrum.

Relative contribution of haptic technology to assessment and training in implantology

Background. The teaching of implant surgery, as in other medical disciplines, is currently undergoing a particular evolution. Aim of the Study. To assess the usefulness of haptic device, a simulator for learning and training to accomplish basic acts in implant surgery. Materials and Methods. A total of 60 people including 40 third-year dental students without knowledge in implantology (divided into 2 groups: 20 beginners and 20 experiencing a simulator training course) and 20 experienced practitioners (experience in implantology >15 implants) participated in this study. A basic exercise drill was proposed to the three groups to assess their gestural abilities. Results. The results of the group training with the simulator tended to be significantly close to those of the experienced operators. Conclusion. Haptic simulator brings a real benefit in training for implant surgery. Long-term benefit and more complex exercises should be evaluated.

Thiel embalming technique: a valuable method for teaching oral surgery and implantology

BACKGROUND

Because of its high requirements on surgical experience and the need of complete understanding of the anatomy, oral surgery and especially implantology belong to the most demanding procedures in dentistry. Therefore, hands-on courses for oral surgery and implantology are considered a prerequisite to prepare for clinical practice. To achieve teaching conditions as realistic as possible, we used a novel human cadaver embalming method enabling tissue dissection comparable with the living body.

METHODS

Thirty cadavers which were offered by the Institute of Anatomy for the purpose of running oral surgery and implantology courses were embalmed in the technique described by Thiel. On each cadaver, dissection of soft and hard tissue and implantological procedures were performed according to a structured protocol by each course participant. The conservation of fine anatomical structures and the suitability of the embalmed tissue for dissecting, drilling, and suturing were observed and photographically documented.

RESULTS

By means of the Thiel embalming technique, oral surgery and implantological procedures could be performed under realistic conditions similar to the living body. Due to the conservation procedure, preparations could be carried out without any time limit, always maintaining the same high quality of the tissue. The maxillary sinus membrane, mucosa, bone, and nerves could be exposed and allowed dissecting, drilling, and suturing even after weeks like fresh specimens.

CONCLUSION

The Thiel embalming method is a unique technique which is ideally suited to practice and teach oral surgery and implantology on human material.

A Web-based, integrated simulation system for craniofacial surgical planning

BACKGROUND

Advances in computing over the last 10 years have rapidly improved imaging and simulation in health care. Implementation of three-dimensional protocols and image fusion techniques are moving diagnosis, treatment planning, and teaching to a next-generation paradigm. In addition, decreasing cost and increasing availability make generalized use of these techniques possible.

METHODS

In this article, the authors present a Web-based, integrated simulation system for craniofacial surgical planning and treatment. Image fusion technology was utilized to create a realistic virtual image that can be manipulated in real time. The resultant data can then be shared over the Internet by distantly located practitioners.

RESULTS

Initial use of this system proved to be beneficial from a planning standpoint and to be accurate as to the reliability of landmark identification. Additional case studies are needed to further document the results of actual surgical simulation.

CONCLUSION

This technology presents significant advantages in surgical planning and education, both of which can improve patient safety and outcomes.

Assessment of knowledge and competencies related to implant dentistry in undergraduate and postgraduate university education

Learning in academic settings is strongly related to the way the students are tested or examined. Assessment therefore must be integrated in the curriculum design, coordinated and should reflect the learning outcomes of the education. Assessment within the field of implant dentistry must fulfil four major objectives: complete and direct the learning process with feedback (formative), ensure that students are adequately prepared (summative), assess attitudes and skills such as critical thinking, reflection and self-assessment ability, and supply continuous feedback to teachers on curricular content and impact. Different assessment methods should be used to assess different levels of competencies throughout the curriculum. Various forms of written or oral assessment methodologies are applicable at earlier stages in the curriculum. At intermediate levels, interactive assessment methods, such as patient simulations (paper based or virtual) and more could encourage the necessary synthesis of several disciplines and aspects of the theoretical knowledge. At higher levels of competence, documentation of clinical proficiency by means of reflective portfolios and diaries is an appropriate assessment method with both formative and summative potential. The highest level of competence requires performance assessment using structured, objective, clinical criteria. The group strongly encourages the use of reflective forms of assessment methods which engage the students in a process of self-appraisal, identification of individual learning needs and self-directed learning. The ultimate goal of this would be to allow the student to develop a lifelong learning attitude.