Performance of two different digital evaluation systems used for assessing pre-clinical dental students' prosthodontic technical skills

Utilization of 3D evaluation for assessing selective caries removal practice in pre-clinical dental students: a pilot study

BACKGROUND

Practicing and assessment of selective caries removal techniques in dental students remain challenges in many dental schools. The aim of this study was to utilize a 3D assessment technique, within a designated acceptable range of deviation, to evaluate the tendency of dental students in performing selective caries removal (SCR). The correlation between 3D assessment results and the conventional rubric rated by an instructor was also determined.

METHODS

Fifth-year dental students (n = 61) performed the SCR task on 3D-printed teeth containing simulated deep caries lesions in occlusal and proximal surfaces. One instructor assessed the results using a conventional analytic rubric. The excavated teeth were additionally evaluated using 3D analysis software with the designated acceptable range of deviations (± 0.5 mm) from the standard cavities. The average root mean square (RMS) value, representing the deviation between student-prepared cavities and the predefined standard cavities, was recorded. A tendency towards over-excavation was defined for RMS values > 0.5 mm, and towards under-excavation for RMS values < 0.5 mm.

RESULTS

The mean (min-max) of RMS was 0.27 (0.18-0.40) for occlusal and 0.29 (0.20-0.57)for proximal cavities. A tendency of dental students toward over-excavation was observed in both occlusal (74%) and proximal cavities (87%). There was a moderate negative correlation between the RMS values and the traditional rubric scores for both occlusal (R2 = 0.148, P = 0.002) and proximal cavities (R2 = 0.107, P = 0.010).

CONCLUSIONS

The 3D evaluation technique effectively revealed specific tendencies in dental students' caries removal skills. The integration of computerized assessments with traditional methods could potentially assist the instructors in delivering more objective and specific feedback to students. Further research is encouraged to investigate the impact of this assessment technique on improving student performance in selective caries removal skills.

Use of digital tools for preclinical training in complete denture: A pilot study

INTRODUCTION

Advances in CAD-CAM complete dentures open up opportunities in preclinical laboratory education. A cross-over study was conducted to assess the benefit of digital training in custom tray fabrication. Hypotheses were that digital training improved conceptual skill acquisition and that assessment of digital work helps in the discrimination of students' difficulty.

MATERIALS AND METHODS

Third-year students were allocated either into group A and took the manual practical classes before the digital ones, or into group B (N = 154). Prior to the sessions, a motor skill test was conducted. The influence on the learning process was evaluated by comparing the groups' results to the manual lab work with a Student's t-test. The effectiveness of the assessment in discriminating manual aptitude and conceptual skill was studied through Spearman's rank coefficient between digital and manual scores in conceptual skill and with a subgroup analysis according to the results of the motor skill test. The level of significance was set up at .05. Students' satisfaction was also assessed with a questionnaire.

RESULTS

Students in group B achieved better scores. Spearman's rank coefficient test showed a weak correlation, R = .16. For manual lab work, the most manually skilled students did significantly better. In contrast, for the digital session, the medium manually skilled students did better. More than half of the students (55%) found the manual and digital sessions complementary, without identifying any difference depending on the learning sequence.

CONCLUSION

Digital training improved the students' results in the conventional practical exercise. Assessments of the digital and conventional custom trays were complementary in order to distinguish conceptual and motor skills.

Effect of magnifying loupes on tooth preparation of complete coverage crown: A quantitative assessment using a digital approach

OBJECTIVE

The purpose of this study was to evaluate the use of magnifying loupes (×2.5) on the quality of tooth preparation for complete coverage crowns; performed by predoctoral students using an objective and quantitative digital method.

MATERIALS AND METHODS

Forty-two predoctoral students were randomly assigned into 2 groups to perform tooth preparation for a complete coverage crown on a mandibular first molar in a manikin, with and without the use of magnifying loupes. All preparations were digitally evaluated by PrepCheck 3.0 (Dentsply Sirona). Parameters including tooth reduction, total occlusal convergence (TOC), undercut, margin quality and surface quality were assessed. Continuous data were analysed using Paired t-tests or Wilcoxon Signed Ranks tests. Ordinal data were analysed by McNemer's tests. To further detect the majority pattern ( > 50%) in each group (with and without loupes), one-sample t-test or one-sample Wilcoxon Signed Rank test was performed. The level of significance was set at p = .001 after Bonferroni adjustments for multiple testing.

RESULTS

No significant differences in the measured outcomes were found between the groups with or without the use of magnifying loupes (p > .002). The majority (>50%) of both groups had no undercuts (99.3% and 99.4% both p < .001) and the preparation type was within tolerance (81.6% and 85.3%, both p < .001) with acceptable margin (86.4% and 86.3%, both p < .001) and acceptable surface quality (99.0% and 99.1%, both p < .001). However, the majority of both groups underprepared occlusally (96.0% and 95.4%, both p < .001) and axially (65.3% and 67%, both p < .001). Only 30.0%-42.1% of the participants achieved the TOC within 0-20°.

CONCLUSIONS

Within the limitations of this study, the use of magnification loupes does not appear to significantly improve the quality of tooth preparation for complete coverage crown. The TOC was also found to be overprepared and occlusally underprepared.

Comparison of digital and conventional assessment methods for a single tooth preparation and educational satisfaction

INTRODUCTION

Digital feedback for tooth preparation can provide dental practitioners with more objective and accurate evaluations compared to conventional methods. This study aimed to evaluate the educational effect and satisfaction of digital feedback compared with those of the conventional putty index method for tooth preparation.

MATERIAL AND METHODS

Forty-eight third-grade dental students were selected. All students performed a full-coverage preparation on a right mandibular first molar resin tooth. They were randomly divided into four groups (n = 12)-no guide (control), putty index, digital feedback, and digital and putty index assessment. Three-dimensional analysis was performed using an analysis software (GomInspect 2018, Gom) to evaluate the amount of tooth structure removed. At the end of the practice, the students completed a questionnaire to evaluate the educational satisfaction of the respective methods.

RESULTS

There was no statistical significance of the amount of preparation amongst groups in most of the measured areas only except for several specific points. Overall occlusal surface showed 0.99 ± 0.27 mm in the N group (no guide) and 1.15 ± 0.31 mm in the D group (digital feedback), and overall axial surface showed no statistical differences (p > .05). The groups that used digital assessment showed a high level of satisfaction compared with conventional assessment.

CONCLUSIONS

It was difficult to confirm that the digital-based feedback promotes accurate tooth preparation compared to conventional feedback within the limitation of this study. However, it improved educational satisfaction and permitted objective evaluation.

Dental students' self-reported confidence level in restorative crown and bridge procedures: A UK quantitative study

INTRODUCTION

Graduating confident students who can flourish and develop in their future career is an important outcome of dental education. The aim of the study was to gain an insight into students' self-reported level of confidence in restorative crown and bridge procedures, highlighting in which stage of the process students have the highest and lowest confidence, depending on the level of supervision required.

MATERIALS AND METHODS

Fourth and final year students (n = 85) were invited to complete a 71-item closed questionnaire specific to self-reported confidence based on the level of supervision required in stages of crown and bridge procedures. Clinical activity for each student from their portfolio system was collected. Non-parametric tests, specifically the Mann-Whitney U-test was used to analyse the continuous non-normal data.

RESULTS

A response rate of 65% was obtained. Final year students were more confident in crown and bridge procedures than fourth year students. Fourth year students were more confident in bridges, whilst final year students were more confident with crowns. Majority of students expressed "average confidence requiring minimal supervision" in crown and bridge procedures. An association between clinical activity, confidence and year of study was noted. Gender was not strongly associated with confidence. Stages in crown and bridge procedures were noted where students lacked confidence.

CONCLUSION

The study highlighted areas in which students were most and least confident in crown and bridge procedures. A positive relationship between clinical activity in crown and bridge procedures and student self-confidence has been noted for both years, though slightly higher in the bridge procedure for fourth year students. We attribute this to the fact that fourth year students had recently completed their bridge competency assessment. Upon graduating, final year students still require supervision and reported average confidence in certain aspects of crown and bridge procedures, namely occlusal, bevel and axial reduction.

Implementation of a Full Digital Workflow by 3D Printing Intraoral Splints Used in Dental Education: An Exploratory Observational Study with Respect to Students' Experiences

Fully digital workflows gained acceptance in dental practice and thereby are of interest for undergraduate education. An exploratory clinical observation was designed to track the implementation of such a workflow with novice digital users in order to describe its feasibility, time investment, and pitfalls.

METHODS

Students were invited to provide feedback for their experiences with a training module that consisted of the following: intraoral scanning, computer-aided design (CAD), manual finishing, and insertion of a 3D-printed bite splint for the lower jaw.

RESULTS

A total of 82 fourth-year students participated in the module. The average time required to perform an intraoral scan was 17 m 5 s, and all students were able to design a splint with an average time of 2 h 38 m. Students who indicated prior experience with CAD seem to outperform inexperienced students in both CAD task completion and intraoral scanning. The initial fit was reported as clinically acceptable by 68.5% of the participants, while 79% rated the workflow as very good to satisfactory and indicated that the training was helpful for dental practice.

CONCLUSIONS

The implementation of a digital workflow in undergraduate dental education is feasible and has acceptable clinical results. However, CAD is time-intensive, and the experience can be challenging.

3D Digital technology as an alternative educational tool in preclinical dentistry

INTRODUCTION

The advancement of 3D digital scanners has allowed educators to uphold the quality of education whilst implementing novel methods of assessment.

OBJECTIVE

The purpose of this study was to compare two evaluation methods, conventional and digital scanned assessments, on student cavity preparations and students and faculty's perceptions of these assessment methods.

METHODS

Predoctoral students performed Class II amalgam and Class III resin composite preparations on simulated teeth for their preclinical competency examinations. Two calibrated faculty evaluated the students' preparations using dental instruments for conventional assessments and 3D scanned images for digital assessments. Faculty scores from both assessment methods were compared and statistically analysed (p < .05). Students also self-assessed their performance using the digital scanned images and filled out a perception survey.

RESULTS

There was no statistically significant difference between the conventional (Class II; 73.3 ± 12.2 and Class III; 82.5 ± 8.9) and the digital assessment with scanned images (Class II; 71.3 ± 11.0 and Class III; 82.2 ± 8.2). Faculty scores from both methods have shown a trend of comparability. Most students agreed that digital ideal preparation models were useful (84.2%) and almost all students agreed that digital technology helped them learn operative dentistry (91.1%). In contrast, most students agreed that conventional assessment should be the main self-evaluation system (82.2%) and disagreed that digital assessment is more effective than conventional self-assessment (68.3%).

CONCLUSION

Our study demonstrated that 3D digital technology could be an alternative and/or supplementary educational tool to aid in upholding the quality of dental education.

Rating criteria to evaluate student performance in digital wax-up training using multi-purpose software

PURPOSE

The aim of this study was to introduce rating criteria to evaluate student performance in a newly developed, digital wax-up preclinical program for computer-aided design (CAD) of full-coverage crowns and preliminarily investigate the reliability and internal consistency of the rating system.

MATERIALS AND METHODS

This study, conducted in 2017, enrolled 47 fifth-year dental students of Okayama University Dental School. Digital wax-up training included a fundamental practice using computer graphics (CG), multipurpose CAD software programs, and an advanced practice to execute a digital wax-up of the right mandibular second molar (#47). Each student’s digital wax-up work (stereolithography data) was evaluated by two instructors using seven qualitative criteria. The total qualitative score (0-90) of the criteria was calculated. The total volumetric discrepancy between each student’s digital wax-up work and a reference prepared by an instructor was automatically measured by the CAD software. The inter-rater reliability of each criterion was analyzed using a weighted kappa index. The relationship between the total volume discrepancy and the total qualitative score was analyzed using Spearman’s correlation.

RESULTS

The weighted kappa values for the seven qualitative criteria ranged from 0.62 - 0.93. The total qualitative score and the total volumetric discrepancy were negatively correlated (ρ = -0.27, P = .09, respectively); however, this was not statistically significant.

CONCLUSION

The established qualitative criteria to evaluate students’ work showed sufficiently high inter-rater reliability; however, the digitally measured volumetric discrepancy could not sufficiently predict the total qualitative score.

Comparison of Digital Self-Assessment Systems and Faculty Feedback for Tooth Preparation in a Preclinical Simulation

Background: Regarding the new dental licensing regulations in Germany (AOZ), this study evaluated the effectiveness of two different digital tooth preparation validation systems in comparison to traditional faculty feedback. Methods: Participants were randomly divided into groups: Faculty Feedback (FF: n = 33), PrepCheck^® (PC: n = 32) and Dental Teacher™ (n = 32). Students had the task to prepare tooth 16 for a retentive full-cast crown. Preparations could be repeated as often as desired. Feedback was provided either by faculty staff or by digital validation systems only. Exams were conducted and graded by two independent and experienced examiners. A survey was performed to evaluate the assessment concepts. Results: No statistical difference in examination performance between groups could be observed. Nevertheless, the survey showed participants preferred consulting the faculty staff rather than the digital validation systems. Students preferred practising with DT rather than with PC. Conclusions: Although both classical and digital methods showed comparable results regarding the preparation examination performance, direct feedback by the faculty staff is still appreciated by the students. A combination of both methods is mandatory since demonstration and advice by the teacher is needed. However, digital tooth preparation validation systems are predestined for free practice sessions, providing self-assessment.

Improvement preclinical and clinical skills for dental preparations using assisted training software

INTRODUCTION

Digital workflow is currently available for different fields of dentistry. Additionally, to clinical use, digital technology is focused on the education and training of students. The objective of this study was to show the potential benefit of the use of digital CAD / CAM technology and assisted training software in the evaluation and improvement of student skills in preclinical and clinical environments.

MATERIALS AND METHODS

30 models of dental preparations were digitalised and analysed by PrepCheck software, after that was used the PrepCheck Report tool, gathering the results of the analysis in an automatically created report and containing the following parameters: analysis of the conicity, distance between a preparation and the opposing jaw, analysis of the type of preparation, quality of the margin and total occlusal convergence.

RESULTS

The use of the PrepCheck Pro 2.1 software makes evident the errors made by the students during the biomechanical preparation, since they generally change the inclination, in order to have less difficulties to comply with the parameters established in the preparations. Regarding the evaluated parameters for anterior and posterior fixed prosthesis) such as: 'Conicity', 'Type of preparation' and 'Distance to the antagonist', the preparations, in their majority, were classified within the tolerance range with of 50-60%, 80-93% and 53-67%, respectively.

CONCLUSION

This pilot study demonstrated the benefits of using software and CAD/CAM technology in both preclinical and clinical environments for teaching and learning. Its use on preclinical environments allows the student observe qualitatively and quantitatively a preparation flaws when compared to a master's preparation. Lastly, the ease of visualising errors associated with magnification would allow students to improve their skills.

Technical skill training and assessment in dental education

Highly competent clinical practice requires cognitive, psychomotor and affective skills. Therefore, the ultimate goal of dental education is for practitioners to be competent in all of these domains. While many methods have been introduced to assess knowledge and non-technical skills, it is still very difficult for educators to assess technical skill. Assessment methods for technical skills are still not well established because it is very difficult to assure objectivity, validity and fairness. Nonetheless, technical skill is especially important in dental treatments, along with knowledge and attitude. The aim of this review was to summarize the methods of technical skill training in dental education and how they are assessed. This is a literature review. We searched PubMed MEDLINE using terms related to technical skill training and those assessment as of June 2020 and reviewed them. There have been many reports introducing methods of technical skill training and assessment, including the use of digital technology. However, no single assessment method had demonstrated validity of it. Technical skill training is very important in dental education and there are various ways of learning. The validity of current assessment methods is limited; therefore, a combination of several methods may achieve the best results.

The "Painting by Numbers Method" for education of students in crown preparation

INTRODUCTION

No commercially available solution to improve the teaching of a crown preparation directly on typodont teeth exists at the moment. To fill this gap and support the supervisors of dental courses, a printable and inexpensive tooth was created for structured self-assessment. The aim of this study was to test this printable tooth under realistic pre-clinical situations.

MATERIALS AND METHODS

A two-coloured, double-layer practice tooth was developed. This tooth was consisting of a layer for a correct preparation and the crown. All printed teeth were produced with a stereolithographic printer. 35 voluntary second-year dental students in the second pre-clinical course in prosthodontics were randomly divided into two groups. All students had experience with typodont teeth and models. The first group was trained on four standard model teeth. The second group used model teeth for the first and fourth attempt and printed teeth for second and third attempt. The preparations of the students were scanned by an in-lab scanner and the surface deviations in contrast to a perfect preparation were measured. The differences between the first and fourth attempt were calculated. Benefits of the printed tooth were also evaluated by a questionnaire using German school grades completed by the students (1 = Excellent, 2 = Good, 3 = Satisfactory, 4 = Adequate, 5 = Poor, 6 = Unsatisfactory).

RESULTS

The workflow was feasible and cost-effective regarding the production of the printed teeth. The overall rating of the printed tooth in the questionnaire was good (Ø 2.1 ± 0.22). Students reported different advantages of this method in the free text. The comparison of the preparation between the first and fourth attempt showed that there was a significant better preparation with the printed teeth. The complete preparation had median values of 0.05 mm (Group1: standard model tooth) and -0.03 mm (Group2: printed tooth) (P = .005). Divided into single surfaces, the vestibular and occlusal regions were significantly better. The vestibular surface was 0.11 mm (Group1) and -0.04 mm (Group2) (P = .018). The occlusal surface was 0.13 mm (Group1) and -0.05 mm (Group2) (P = .009).

CONCLUSIONS

The aim of this study was fulfilled. The printed tooth was tested successfully in a pre-clinical course. The feasibility of this teaching concept was confirmed by the questionnaire and the analysis of the preparation form. A significant difference to a standard model tooth was measurable. The students had the possibility to learn a correct crown preparation on a standardised two-layered tooth with included preparation. This printed tooth enabled the students to control the crown preparation directly on their own.

Rethinking Assessment Concepts in Dental Education

Introduction

Dental education involves teaching and assessing the acquisition of verifiable domains that require superior psychomotor, communication, and cognitive skills. Evolving technologies and methods of assessment could enhance student's learning environment and improve tutor assessment experience. The aim of this study was to review the current body of research and evaluate the effectiveness of various methods of assessments in improving learning and performance in preclinical and clinical dental practice.

Materials and Methods

A search strategy was implemented using electronic search in major databases. The following key terms, clinical skills, preclinical, dental students, and assessment, were included in the search. Two reviewers independently screened all the articles retrieved following very specific inclusion criteria.

Results

The initial search generated 5371 articles and 24 articles were selected for review and data extraction. Cohen's kappa coefficient was used to measure interrater agreement and a score of 94.7% was obtained.

Conclusion

Preclinical assessment is an effective tool for promoting skills transfer to clinical phase. Early psychomotor skills assessment is valuable. It allows early intervention in the learning process and assists in effective utilization of learning resources. Technology-enhanced assessment systems allow better patient simulation, enhance learning and self-assessment experiences, and improve performance evaluation. However, these systems serve as an adjunct to conventional assessment methods. Further research should aim at calibrating and integrating these systems to optimize students learning and performance.

3D Printed Teeth with Included Veneer Preparation Guide

PURPOSE

The purpose of this study was the design, feasibility, and evaluation of a 3D printed tooth model with internal preparation for dental education in veneer preparation.

MATERIAL AND METHODS

A tooth with two different colored layers for the crown and the preparation form was designed and printed by a stereolithographic printer. In a voluntary course, 40 third- to fifth-year dental students were trained with these printed teeth in the clinical course. They had the opportunity to prepare four 3D printed teeth with an integrated veneer preparation. During their studies, they used standardized model teeth. The students rated the advantage in a questionnaire according to German school grades (1 best to 6 worst). For reliability analysis, Cronbach's alpha was calculated. Significant differences between groups were calculated using the Mann-Whitney U-test.

RESULTS

The production of the teeth was feasible and cost-effective. The overall mean rating of the printed teeth in the questionnaire was 1.8 ± 0.18. The students rated the learning results with the printed tooth as significantly better than the standard model tooth (mean 3.0 ± 0.86 vs. mean 2.1 ± 0.95; p < 0.001). The item "is a more suitable exercise option" in contrast to standard model teeth was evaluated with 1.9 ± 0.61. The item "the included preparation was clearly visible in color" was rated with 1.7 ± 0.71. "The tooth model illustrated visually an ideal preparation" was rated with 1.8 ± 0.65. Additionally, the students were interested in including more printed teeth into their studies (1.7 ± 0.86). In the open questions the students reported great benefits of this method.

CONCLUSIONS

The feasibility of this teaching concept was confirmed. The students favored working on the innovative 3D-teeth with internal veneer preparation, emphasizing the usefulness of this technique in dental education. The tooth enabled the students to control their preparation permanently on their own.

Digital assessment of a retentive full crown preparation-An evaluation of prepCheck in an undergraduate pre-clinical teaching environment

INTRODUCTION

Acquiring practical skills is essential for dental students. These practical skills are assessed throughout their training, both formatively and summatively. However, by means of visual inspection alone, assessment cannot always be performed objectively. A computerised evaluation system may serve as an objective tool to assist the assessor.

AIM

The aim of the study was to evaluate prepCheck as a tool to assess students' practical skills and as a means to provide feedback in dental education.

METHODS

As part of a previously scheduled practical examination, students made a preparation for a retentive crown on the maxillary right central incisor-tooth 11. Assessments were made four times by two independent assessors in two different ways: (a) conventionally and (b) assisted by prepCheck. By means of Cohen's kappa coefficient, agreements between conventional and digitally assisted assessments were compared. Questionnaires were used to assess how students experienced working with prepCheck.

RESULTS

Without the use of prepCheck, ratings given by teachers differed considerably (mean κ = 0.19), whereas the differences with prepCheck assistance were very small (mean κ = 0.96). Students found prepCheck a helpful tool for teachers to assess practical skills. Extra feedback given by prepCheck was considered useful and effective. However, some students complained about too few scanners and too little time for practice, and some believed that prepCheck is too strict.

CONCLUSION

prepCheck can be used to assist assessors in order to obtain a more objective outcome. Results showed that practicing with feedback from both prepCheck and the teacher contributes to an effective learning process. Most students appreciated prepCheck for learning practical skills, but introducing prepCheck requires enough equipment and preparation time.

Digital Undergraduate Education in Dentistry: A Systematic Review

The aim of this systematic review was to investigate current penetration and educational quality enhancements from digitalization in the dental curriculum. Using a modified PICO strategy, the literature was searched using PubMed supplemented with a manual search to identify English-language articles published between 1994 and 2020 that reported the use of digital techniques in dental education. A total of 211 articles were identified by electronic search, of which 55 articles were selected for inclusion and supplemented with 27 additional publications retrieved by manual search, resulting in 82 studies that were included in the review. Publications were categorized into five areas of digital dental education: Web-based knowledge transfer and e-learning, digital surface mapping, dental simulator motor skills (including intraoral optical scanning), digital radiography, and surveys related to the penetration and acceptance of digital education. This review demonstrates that digitalization offers great potential to revolutionize dental education to help prepare future dentists for their daily practice. More interactive and intuitive e-learning possibilities will arise to stimulate an enjoyable and meaningful educational experience with 24/7 facilities. Augmented and virtual reality technology will likely play a dominant role in the future of dental education.

Undergraduate dental students' perspective on the implementation of digital dentistry in the preclinical curriculum: a questionnaire survey

Background

Digitalisation is an expanding field in dentistry and implementation of digital teaching methods in dental education is an essential part of modern education. Therefore, two digital training modules were implemented in the preclinical curriculum at the Justus Liebig University Giessen. The aim of this study was to assess the students’ perspective on the implementation with a questionnaire survey.

Methods

Since the fall term 2017/18, students of the course of dental prosthodontics I attended the training module I, where they learned to use computer-aided learning (CAL) approaches for the digital analysis of tooth preparations. In training module II, students of the course of dental prosthodontics II learned how to manufacture a computer-aided design/computer-aided manufacturing restoration. After the completion of the training modules, all students starting with the fall term 2017/18 to the spring term 2019 were asked to fill in a questionnaire regarding the aspects of handling, didactic benefit, motivation, and overall assessment.

Results

Students rated the implementation of digital aspects in teaching as positive in terms of handling, didactic benefit, and motivation, but gave preference to the assessment of the tooth preparations by dental instructors. In addition, students assessed the feedback from the faculty regarding tips and tricks better than the digital feedback. More than 90% of the students indicated that they could imagine using an intraoral scanner for treatment of patients in the dental office in future.

Conclusions

The results of the present study revealed a positive perspective of students on the implementation of digital dentistry in the preclinical curriculum. However, difficulties with CAL systems were reported and most students preferred evaluation of preparation by dental instructors. Thus, CAL approaches offer an additional teaching method besides the traditional teaching of manual skills.

Use of Digital Technology to Improve Objective and Reliable Assessment in Dental Student Simulation Laboratories

The aim of this study was to assess inter-and intra-grader agreement with the use of digital scanning and a tooth preparation assessment software program in comparison to the current traditional visual grading method in a dental student simulation laboratory. Students' typodont teeth preparations from previous practical examinations were used (cast crown n=50; cast fixed partial denture abutments n=50). Five preclinical instructors received calibration training and evaluated each of the preparations by the traditional visual grading method using a rubric. The same preparations were assessed by the same instructors using a tooth preparation assessment software program (PrepCheck, Sirona). The results showed that intra-grader agreement was significantly higher when grades were determined by PrepCheck compared to the traditional visual grading method. The traditional method was associated with significantly greater inter-grader disagreement in comparison to grading using PrepCheck (p<0.05). When the average final grade for students' crown preparations by each grader was compared for the traditional method and PrepCheck, significant differences were found for all graders (p<0.001). In this study, the use of the PrepCheck software program greatly improved intra-and inter-grader agreement during grading in a student simulation laboratory. Digital technology may improve the objectivity and reliability of assessments by preclinical evaluators.

Comparison of a prepCheck-supported self-assessment concept with conventional faculty supervision in a pre-clinical simulation environment

OBJECTIVES

This study aimed to evaluate the educational outcome of a digitally based self-assessment concept (prepCheck; DentsplySirona, Wals, Austria) for pre-clinical undergraduates in the context of a regular phantom-laboratory course.

MATERIALS AND METHODS

A sample of 47 third-year dental students participated in the course. Students were randomly divided into a prepCheck-supervised (self-assessment) intervention group (IG; n = 24); conventionally supervised students constituted the control group (CG; n = 23). During the preparation of three-surface (MOD) class II amalgam cavities, each IG participant could analyse a superimposed 3D image of his/her preparation against the "master preparation" using the prepCheck software. In the CG, several course instructors performed the evaluations according to pre-defined assessment criteria. After completing the course, a mandatory (blinded) practical examination was taken by all course participants (both IG and CG students), and this assessment involved the preparation of a MOD amalgam cavity. Then, optical impressions by means of a CEREC-Omnicam were taken to digitalize all examination preparations, followed by surveying and assessing the latter using prepCheck.

RESULTS

The statistical analysis of the digitalized samples (Mann-Whitney U test) revealed no significant differences between the cavity dimensions achieved in the IG and CG (P = .406). Additionally, the sum score of the degree of conformity with the "master preparation" (maximum permissible 10% of plus or minus deviation) was comparable in both groups (P = .259).

CONCLUSION

The implemented interactive digitally based, self-assessment learning tool for undergraduates appears to be equivalent to the conventional form of supervision. Therefore, such digital learning tools could significantly address the ever-increasing student to faculty ratio.

Increasing clinical relevance in oral radiology: Benefits and challenges when implementing digital assessment

AIMS

The aims of the study were to investigate benefits and challenges in implementing a digital examination and study the clinical relevance of the digital examination in relation to clinical training and practice.

MATERIAL AND METHOD

The study was based on semi-structured focus-group interviews from two distinct student populations (2016 and 2017) in a bachelor programme in dental hygiene. In addition, conversational data from a plenary discussion from the whole second student population (2017) were collected and analysed. The data were approached on basis of content analysis.

RESULTS

A benefit experienced in the digital examination was the ease in typing and editing answers on the computer. This suggests an increased effectiveness in computer-based compared to analogue examinations. An additional advantage was the experienced relevance of the examination related to the clinic. This finding refers not only to the digital presentations of images, but also to the entire setting in the clinic and dental practice. The limitations reported by the students were non-optimal viewing conditions for presenting radiographic images and difficulties in obtaining an overview of the assignments compared to paper-based examinations due to the linear digital examination format. The last finding on lacking overview revealed an influence on student performances which should be taken seriously in designing digital examinations.

CONCLUSION

In conclusion, the digital layout increases efficiency and clinical relevance of examinations to a certain extent. Obstacles were found in limitations related to image presentation and lack of overview of the examination. The latter challenge raises questions related to developing suitable assessment software.

Evaluating the efficiency of the Dental Teacher system as a digital preclinical teaching tool

AIM

To investigate the use of a preparation evaluation system for enhancing the learning and performance of undergraduate dental students when cutting preparations.

MATERIALS AND METHODS

Two groups of eighteen students each were randomly chosen from the fourth year of the dental programme. The task chosen for this study was to make a cavity in preparation for a mesio-occlusal ceramic onlay in a plastic tooth. The dimensions of the cavity were defined, and 2 burs of known size were used for preparation. For assessment, each tooth preparation was scanned with a digital scanner and analysed using the Dental Teacher software. In the control group, a second corrective preparation was made following the supervisor's instructions. In the test group, the second preparation was made based on Dental Teacher analysis. The final cavities were all scanned and assessed by Dental Teacher comparing the similarity of students' onlay cavity preparations to the ideal preparation. All data were recorded and analysed by the software, including cavity depth and width in the occlusal and proximal box, the extent of mesiobuccal cusp reduction and shoulder width around the mesiobuccal cusp. Finally, the data were statistically evaluated using a Wilcoxon matched pairs test and a Mann-Whitney U test.

RESULTS

Three of the 6 cavity dimension parameters improved significantly in the test group whilst no improvement was found in the control group. A positive correlation was found between the improvement and the deviation measured for the first preparations, and it was stronger in the test group than in the control group.

CONCLUSIONS

The use of Dental Teacher helped students to learn the preparation technique for onlay restorations more efficiently and seems to be a promising and useful method to facilitate their individual performance. Student feedback showed a great demand for digital aids in education.