Introduction of a robot patient into dental education

Humanoid patient robot for diagnostic training in medical and psychiatric education

Simulation-based learning is an integral part of hands-on learning and is often done through role-playing games or patients simulated by professional actors. In this article, we present the use of a humanoid robot as a simulation patient for the presentation of disease symptoms in the setting of medical education. In a study, 12 participants watched both the patient simulation by the robotic patient and the video with the actor patient. We asked participants about their subjective impressions of the robotic patient simulation compared to the video with the human actor patient using a self-developed questionnaire. In addition, we used the Affinity for Technology Interaction Scale. The evaluation of the questionnaire provided insights into whether the robot was able to realistically represent the patient which features still need to be improved, and whether the robot patient simulation was accepted by the participants as a learning method. Sixty-seven percent of the participants indicated that they would use the robot as a training opportunity in addition to the videos with acting patients. The majority of participants indicated that they found it very beneficial to have the robot repeat the case studies at their own pace.

Effect of simulated hearing loss on automatic speech recognition for an android robot-patient

The importance of simulating patient behavior for medical assessment training has grown in recent decades due to the increasing variety of simulation tools, including standardized/simulated patients, humanoid and android robot-patients. Yet, there is still a need for improvement of current android robot-patients to accurately simulate patient behavior, among which taking into account their hearing loss is of particular importance. This paper is the first to consider hearing loss simulation in an android robot-patient and its results provide valuable insights for future developments. For this purpose, an open-source dataset of audio data and audiograms from human listeners was used to simulate the effect of hearing loss on an automatic speech recognition (ASR) system. The performance of the system was evaluated in terms of both word error rate (WER) and word information preserved (WIP). Comparing different ASR models commonly used in robotics, it appears that the model size alone is insufficient to predict ASR performance in presence of simulated hearing loss. However, though absolute values of WER and WIP do not predict the intelligibility for human listeners, they do highly correlate with it and thus could be used, for example, to compare the performance of hearing aid algorithms.

Artificial Intelligence in Endodontic Education

AIMS

The future dental and endodontic education must adapt to the current digitalized healthcare system in a hyper-connected world. The purpose of this scoping review was to investigate the ways an endodontic education curriculum could benefit from the implementation of artificial intelligence (AI) and overcome the limitations of this technology in the delivery of healthcare to patients.

METHODS

An electronic search was carried out up to December 2023 using MEDLINE, Web of Science, Cochrane Library, and a manual search of reference literature. Grey literature, ongoing clinical trials were also searched using ClinicalTrials.gov.

RESULTS

The search identified 251 records, of which 35 were deemed relevant to artificial intelligence (AI) and Endodontic education. Areas in which AI might aid students with their didactic and clinical endodontic education were identified as follows: 1) radiographic interpretation; 2) differential diagnosis; 3) treatment planning and decision-making; 4) case difficulty assessment; 5) preclinical training; 6) advanced clinical simulation and case-based training, 7) real-time clinical guidance; 8) autonomous systems and robotics; 9) progress evaluation and personalized education; 10) calibration and standardization.

CONCLUSIONS

AI in endodontic education will support clinical and didactic teaching through individualized feedback; enhanced, augmented, and virtually generated training aids; automated detection and diagnosis; treatment planning and decision support; and AI-based student progress evaluation, and personalized education. Its implementation will inarguably change the current concept of teaching Endodontics. Dental educators would benefit from introducing AI in clinical and didactic pedagogy; however, they must be aware of AI's limitations and challenges to overcome.

Questionnaire survey on hands-on simulation training using a dental humanoid robot (SIMROID®)

INTRODUCTION

A dental humanoid robot, SIMROID®, is able to replicate the actions characteristic of human beings and enable training for communicating with patients and coping with unexpected situations. This study assessed user experiences via a survey questionnaire following hands-on training on the SIMROID®.

MATERIALS AND METHODS

A total of 112 participants, consisting of 50 high school students who visited AUSD (Asahi University School of Dentistry) to participate in open campus events, 42 fourth-year students at AUSD and 20 dental students from Mexico State Autonomy University, University of Siena and Peking University took the survey. The participants observed the movements and reactions of a SIMROID® robot placed on a dental unit for approximately 20 min after which they completed a questionnaire survey. Both Japanese and English versions of the questionnaire were prepared for local and visiting foreign dental students. The questionnaire comprised 8 items, with a further two items for those undertaking dental training and an open comment field.

RESULTS

All participants who observed the SIMROID® completed the questionnaire giving a 100% response rate. Generally, simulation training with SIMROID® was highly appreciated by all participants. The comprehensive evaluation score for SIMROID® was 4.56 ± 0.50 points for high school students, 4.05 ± 0.82 points for students at AUSD and 4.70 ± 0.47 points for foreign dental students, showing all participants had a very positive experience and impression of the SIMROID®.

CONCLUSIONS

Therefore, simulation training using SIMROID® seems beneficial learning tool.

Virtual and Interprofessional Objective Structured Clinical Examination in Dentistry and Dental Technology: Development and User Evaluations

BACKGROUND

Interprofessional education (IPE) facilitates interprofessional collaborative practice (IPCP) to encourage teamwork among dental care professionals and is increasingly becoming a part of training programs for dental and dental technology students. However, the focus of previous IPE and IPCP studies has largely been on subjective student and instructor perceptions without including objective assessments of collaborative practice as an outcome measure.

OBJECTIVE

The purposes of this study were to develop the framework for a novel virtual and interprofessional objective structured clinical examination (viOSCE) applicable to dental and dental technology students, to assess the effectiveness of the framework as a tool for measuring the outcomes of IPE, and to promote IPCP among dental and dental technology students.

METHODS

The framework of the proposed novel viOSCE was developed using the modified Delphi method and then piloted. The lead researcher and a group of experts determined the content and scoring system. Subjective data were collected using the Readiness for Interprofessional Learning Scale and a self-made scale, and objective data were collected using examiner ratings. Data were analyzed using nonparametric tests.

RESULTS

We successfully developed a viOSCE framework applicable to dental and dental technology students. Of 50 students, 32 (64%) participated in the pilot study and completed the questionnaires. On the basis of the Readiness for Interprofessional Learning Scale, the subjective evaluation indicated that teamwork skills were improved, and the only statistically significant difference in participant motivation between the 2 professional groups was in the mutual evaluation scale (P=.004). For the viOSCE evaluation scale, the difference between the professional groups in removable prosthodontics was statistically significant, and a trend for negative correlation between subjective and objective scores was noted, but it was not statistically significant.

CONCLUSIONS

The results confirm that viOSCE can be used as an objective evaluation tool to assess the outcomes of IPE and IPCP. This study also revealed an interesting relationship between mutual evaluation and IPCP results, further demonstrating that the IPE and IPCP results urgently need to be supplemented with objective evaluation tools. Therefore, the implementation of viOSCE as part of a large and more complete objective structured clinical examination to test the ability of students to meet undergraduate graduation requirements will be the focus of our future studies.

Simulator education in Japanese dental education

Advances in information and communication technology (ICT) and digital technology have contributed greatly to the development of educational methods, and new educational styles have been introduced over the past several years. In recent years, it has become possible to provide more realistic simulator training to prepare for patient care through the development of phantom heads with jaws and artificial teeth that reflect actual anatomical structures and composition. While these phantom head simulator resources are becoming more realistic, the development of digital devices utilizing virtual reality has enabled training that is even more realistic than the jaw models, such as scanning the teeth and transfer this scan into a VR model in the simulator which can be used to practice on prior to treating the patient. There was a basic research report on the development of VR haptics simulators in Japan about 20 years ago, but there have been no reports for some time since then, and there are several reports on VR haptics simulators published after 2018. Even now, in terms of utilization in dental education, it is difficult to say that VR haptics simulator has been widely introduced in Japan. The reasons for this may be related to the evaluation system for clinical dental skills in the Japanese dental education system, as well as issues with budgets and in current condition of dental clinical practice in dental schools. It must be that the VR haptics simulator will be utilized in terms of preparatory training for patient care as clinical dental practice participation is enhanced in the future.

Role of robotics and artificial intelligence in oral health education. Knowledge, perception and attitude of dentists in India

BACKGROUND

Artificial intelligence or AI may be identified as the use of Personal Computers and/or machines in performing certain specific types of tasks that usually have the requirement of humanized knowledge. These specific tasks include acknowledgment of the problem, understanding disease dynamics, and determining the clinical diagnosis.

MATERIALS AND METHODS

This cross-sectional and prospective study was conducted on Dental professionals who were practicing all across India after obtaining approval from the Institutional Ethical Board. A previously validated as well as pre-analyzed questionnaire form was distributed using electronic mail and through the use of social media with a briefly explained description of the study purpose and an informed consent form. The study questionnaire comprised "close-ended" queries that were then divided into foursections. All the study participants were then instructed to select any one option among all the provided answers. The entire study was completed within one month. Collected observations were entered within a Microsoft Excel 2007® master chart. Statistical analytical software tool SPSS version 20.0, IBM Corporation was employed. "Chi-square" test was performed for evaluating statistical association. A P value lesser than 0.05 was fixed with statistical significance.

RESULTS

On analyzing the level of knowledge, 82.5% of subjects had knowledge of artificial intelligence while 11.4% had no knowledge and 6.1% had some knowledge of this tool. 69.1% were knowledgeable regarding the use of AI in lesional diagnosis, 12.8% had no knowledge regarding artificial intelligence for the diagnosis and 18.1% had no knowledge regarding AI in the diagnosis. 71% had knowledge concerning the use of AI for Imaging. Knowledge of AI in Oral Hygiene was seen in 54.3%. 91.2% of participants had knowledge of robotics use in Oral Surgery. 77% of dentists had knowledge regarding the use of AI for the enhancement of clinical practice. 95.5% had a higher 'positive' attitude toward the use of AI in academics. 69.1% of dentists had a positive attitude regarding AI incorporation in practice. 5% of dentists considered artificial intelligence better than human intelligence for diagnosis. 10% believed that disparities can exist between AI-based and human diagnosis.

CONCLUSION

Positive correlations were noted between knowledge, attitude, and practice of AI among studied dentists.

Evaluating the effectiveness of a virtual reality simulation for preclinical local anaesthesia dental education

INTRODUCTION

Traditional manikin training has limitations that virtual reality can address. This study investigated the effectiveness of two part-task training simulation methods, a virtual reality (VR Sim) vs a plastic manikin (PM Sim), on learning outcomes for local anaesthesia skills for second-year pre-clinical dental students.

METHODS

In an experimental study, 58 second-year students were randomly assigned to one of two groups, VR Sim or PM Sim. Both groups completed the same pre-post survey. The VR Sim group practiced with a VR simulation, completed a built-in treatment test and a transfer test with a live person, and was evaluated by an expert teaching assistant (TA) with a rubric. The PM Sim group practiced with a plastic manikin and completed a treatment test on the same manikin evaluated by a TA, followed by the same transfer test with a live person and evaluated by a TA with a rubric.

RESULTS

Covering knowledge and skills in the delivery of local anaesthesia, mean final transfer test scores were statistically significantly higher for the PM Sim compared to VR Sim, F(1, 57) = 9.719, p = .003 with effect size, η2 p  = 0.148. Scores on respective treatment tests were similar to final transfer test scores for each group suggesting differences were localised to the practice methods. Pre-survey results indicated participants had low prior experience with VR technology.

CONCLUSION

Whilst outcomes showed higher results for plastic manikin tutor training over the VR training method, they are complementary. As students practice more with the technology and the VR simulation they may improve further. Likewise, as the technology for haptics with VR improves beyond hand controllers so may the experience and learning of this skill for students.

Preliminary User Evaluation of a New Dental Technology Virtual Simulation System: Development and Validation Study

BACKGROUND

With the advancements in the dental health care industry, the demand for dental technicians has increased. Dental technicians should be thoroughly assessed and trained in practical skills and pass professional certification examinations to ensure that they are competent to work closely with dentists. Unfortunately, such training courses and tests are in short supply worldwide. The use of virtual simulation technology can help solve these problems.

OBJECTIVE

This study presents a new strategic framework design for a certified dental technician practical examination called as the certified Objective Manipulative Skill Examination of Dental Technicians (OMEDT), which is based on the Objective Structured Clinical Examination (OSCE). We present the development and validation of the OMEDT system, a new virtual simulated training system, to meet the demands of the OMEDT framework. The combination of OMEDT and the OMEDT system can solve the complex problems encountered in the certified dental technician practical examination with excellent efficiency, high quality, and low cost.

METHODS

The OMEDT framework design was constructed according to the OSCE guide and the Chinese vocational skill standards for dental technicians. To develop the OMEDT system, we organized a new framework based on the virtual learning network platform, the haptic feedback system, and the real-time dental training and evaluation system. The effectiveness evaluation of the OMEDT system was divided into 2 phases: in the first phase, 36 students were recruited to use the test module to finish the task and their performance data were collected and analyzed; and in the second phase, a questionnaire was administered to 30 students who used the system for their studies and graduation exams.

RESULTS

The OMEDT and the corresponding skill training virtual simulation OMEDT system were developed, and preliminary user evaluation was performed to assess their effectiveness and usefulness. The OMEDT system was found to improve students' practical skills by training with the evaluation results. In addition, several key research topics were explored, including the effects of positive feedback of the knowledge of results on the improvement of the students' skill level and the common sense transformation of educators in the virtual simulation technology environment.

CONCLUSIONS

The development of OMEDT and the OMEDT system has been completed and their effectiveness has been verified.

Pilot study to evaluate a novel measure of self-perceived competencies among dental students

BACKGROUND

PRISM is a novel approach to support self-reflection and learning appraisal in dental students, based on a visual metaphor. The aim of this study was to evaluate whether PRISM measurments would be reproducible and sensitive to detect learning progress in undergraduate dental students in their clinical years.

METHODS

Voluntarily participating dental students were included. To evaluate reproducibility, a mixed cohort of 10 students each in 3^rd, 4^th and 5^th year (total n = 30) was recruited and received three identically structured PRISM interviews within one week without any other teaching events. To assess perceived learning progress, 29 volunteer 3^rd year students participated in three interviews during their clinical simulation course (beginning, middle, end). Distances between Subject and Objects was measured in millimeter; objects were classified into close or branched clusters depending on their distance from each other on the PRISM board.

RESULTS

Values for perceived competencies within PRISM interviews during one week were comparable between the three time points in the mixed cohort (n = 30; p > 0.05). Comparing the three subgroups (3^rd, 4^th and 5^th year, each n = 10), PRISM indicated that 3^rd year students perceived their competencies are significantly lower than the 4^th and 5^th year students (p < 0.01). 3^rd year students had less often a branched cluster of objects than the other two groups (p < 0.05). PRISM showed that over time, 3^rd year students perceived a gain in their competencies in conservative dentistry and its sub-disciplines (p ≤ 0.01). The PRISM data indicated that by the end of the simulation course, the students appeared to show higher discrimination of their self-perceptions between sub-topics in conservative dentistry than at the start of the course (p = 0.01).

CONCLUSION

PRISM yields a reproducible measure of individual students' learning progress. It is a promising novel approach for appraisal in dental education. Further work is needed to confirm the generalisability of the findings.

Impact of the Haptic Virtual Reality Simulator on Dental Students' Psychomotor Skills in Preclinical Operative Dentistry

One of the current trends in dental education is to empower dental students on a global platform using advanced technology. Haptic virtual reality simulation (HVRS) is a relatively new technology in the field of teaching and learning operative dentistry. This study aims to assess the impact of haptic virtual reality simulation (HVRS) on dental students’ psychomotor skills acquisition in preclinical operative dentistry. Class I cavity preparations (CP) were performed at baseline by 21 novice dental students on plastic teeth. Duration of CP was recorded and cavity features were evaluated and scored. Then, students were exposed to HVRS training on CP. Another Class I CP was performed by each student on plastic teeth after HVRS training, then evaluated, and the duration was recorded. There was a statistically significant decrease in CP performance time after HVRS training (p < 0.001) and an increase in the mean total marks of CP after HVRS training (p < 0.001). The change in the students’ performance in the CP displayed a statistically significant improvement after HVRS training in smoothness of the pulpal floor (p = 0.047), pulpal floor direction (p = 0.029), buccal, lingual, and mesial wall direction (p = 0.004, p = 0.025, p = 0.002), mesial and distal wall smoothness (p = 0.01, p = 0.001), internal line angle (p = 0.024), and internal point angle (p = 0.029). Overall improved performance in psychomotor skills was found after HVRS training. It could be beneficial to incorporate HVRS training early in pre-clinical operative dentistry courses as an adjunct to conventional phantom head training.

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.

Robot technology in dentistry, part one of a systematic review: literature characteristics

OBJECTIVES

To provide dental practitioners and researchers with a comprehensive and transparent evidence-based overview of the characteristics of literature regarding initiatives of robot technology in dentistry.

DATA

All articles in which robot technology in dentistry is described, except for non-scientific articles and articles containing secondary data (reviews). Amongst others, the following data were extracted: type of study, level of technological readiness, authors' professional background and the subject of interaction with the robot.

SOURCES

Bibliographic databases PubMed, Embase, and Scopus were surveyed. A reference search was conducted. The search timeline was between January 1985 and October 2020.

STUDY SELECTION

A total of 911 articles were screened on title and abstract of which 161 deemed eligible for inclusion. Another 71 articles were excluded mainly because of unavailability of full texts or the sole use of secondary data (reviews). Four articles were included after hand searching the reference lists. In total, 94 articles were included for analysis.

CONCLUSIONS

Since 2013 an average of six articles per year concern robot initiatives in dentistry, mostly originating from East Asia (57%). The vast majority of research was categorized as either basic theoretical or basic applied research (80%). Technology readiness levels did not reach higher than three (proof of concept) in 55% of all articles. In 84%, the first author of the included articles had a technical background and in 36%, none of the authors had a dental or medical background. The overall quality of literature, especially in terms of clinical validation, should be considered as low.

Robot technology in dentistry, part two of a systematic review: an overview of initiatives

OBJECTIVES

To provide dental practitioners and researchers with a comprehensive and transparent evidence-based overview of physical robot initiatives in all fields of dentistry.

DATA

Articles published since 1985 concerning primary data on physical robot technology in dentistry were selected. Characteristics of the papers were extracted such as the respective field of dentistry, year of publication as well as a description of its usage.

SOURCES

Bibliographic databases PubMed, Embase, and Scopus were searched. A hand search through reference lists of all included articles was performed.

STUDY SELECTION

The search timeline was between January 1985 and October 2020. All types of scientific literature in all languages were included concerning fields of dentistry ranging from student training to implantology. Robot technology solely for the purpose of research and maxillofacial surgery were excluded. In total, 94 articles were included in this systematic review.

CONCLUSIONS

This study provides a systematic overview of initiatives using robot technology in dentistry since its very beginning. While there were many interesting robot initiatives reported, the overall quality of the literature, in terms of clinical validation, is low. Scientific evidence regarding the benefits, results and cost-efficiency of commercially available robotic solutions in dentistry is lacking. The rise in availability of open source control systems, compliant robot systems and the design of dentistry-specific robot technology might facilitate the process of technological development in the near future. The authors are confident that robotics will provide useful solutions in the future but, strongly, encourage an evidence-based approach when adapting to new (robot) technology.

Robotic Applications in Orthodontics: Changing the Face of Contemporary Clinical Care

The last decade (2010-2021) has witnessed the evolution of robotic applications in orthodontics. This review scopes and analyzes published orthodontic literature in eight different domains: (1) robotic dental assistants; (2) robotics in diagnosis and simulation of orthodontic problems; (3) robotics in orthodontic patient education, teaching, and training; (4) wire bending and customized appliance robotics; (5) nanorobots/microrobots for acceleration of tooth movement and for remote monitoring; (6) robotics in maxillofacial surgeries and implant placement; (7) automated aligner production robotics; and (8) TMD rehabilitative robotics. A total of 1,150 records were searched, of which 124 potentially relevant articles were retrieved in full. 87 studies met the selection criteria following screening and were included in the scoping review. The review found that studies pertaining to arch wire bending and customized appliance robots, simulative robots for diagnosis, and surgical robots have been important areas of research in the last decade (32%, 22%, and 16%). Rehabilitative robots and nanorobots are quite promising and have been considerably reported in the orthodontic literature (13%, 9%). On the other hand, assistive robots, automated aligner production robots, and patient robots need more scientific data to be gathered in the future (1%, 1%, and 6%). Technological readiness of different robotic applications in orthodontics was further assessed. The presented eight domains of robotic technologies were assigned to an estimated technological readiness level according to the information given in the publications. Wire bending robots, TMD robots, nanorobots, and aligner production robots have reached the highest levels of technological readiness: 9; diagnostic robots and patient robots reached level 7, whereas surgical robots and assistive robots reached lower levels of readiness: 4 and 3, respectively.

Development of Simulation Methods in Biomedical Sciences - From Phantoms to Virtual Patients

Simulation is an imitation of the operation of a real process or system over time that is applied for a variety of purposes, including entertainment, education, training, system evaluation, and research. Medical simulation is an artificial presentation of real clinical situations, which is applied in education. Medical simulation allows the acquisition of clinical skills without the risk of harming the patient. Medical simulations have been developed and refined over the years-simulation models, cadavers, actors and robots have found wide application in medical training. Of more sophisticated simulation technologies, Virtual and Augmented Realities are used. The presence of science in the digital world is necessary in order to market the proven knowledge acquired in an adequate manner. The traditional teaching process, despite serious and thorough research, seems non-inspirational, and it is important that educators and teachers keep up with the times and provide students with the latest teaching and work methods.

Development and Validation of Robot Patient Equipped with an Inertial Measurement Unit and Angular Position Sensors to Evaluate Transfer Skills of Nurses

To more efficiently enhance the patient transfer skills of nursing students, this study aims to integrate a transfer skills evaluation system and a robot patient. The evaluation parameters, namely, the translational acceleration of the waist, rotational speed of the chest, and joint angles of the shoulder, hip, and knee, were selected on the basis of the pre-experimental results obtained with a simulated patient acted by the human individuals. To measure these parameters, inertial measurement unit (IMU) and angular position sensors were installed on the robot patient. An experiment was conducted with four nursing teachers to verify whether the robot patient could distinguish the incorrect methods of the transfer skills, determined to be a common mistake made by the nurses. According to the results, most transfer steps had the same effect on the simulated patient and the robot patient, which demonstrates that the robot patient is a suitable substitute for an actual patient. However, in certain steps, the robot patient was not able to distinguish between the correct and incorrect methods using the chosen parameters owing to the differences being insignificant. These insignificant differences were mostly attributed to the passive joint design of the robot patient.

Computer simulation and virtual reality in undergraduate operative and restorative dental education: A critical review

The primary aim of this review was to synthesize the literature for studies investigating the use of computer simulation (CS) and virtual reality (VR) in undergraduate dental education in operative and restorative dentistry. The secondary aim was to list best practices that maximize the simulation experience in dental education. A literature review of the PubMed and ERIC databases was conducted using the search terms "Dental AND Simulator," "Dental AND Virtual reality," and "Simulation AND Dental education." Studies in English language were categorized into 1 of 5 themes: Manual dexterity and cavity preparation, light curing skills, simulation perception and experience, predictability, and simulation model development. Main practices of simulation education indicated in the McGaghie et al. critical review published in 2010 were used as a reference to identify common practices for dental simulation. Thirty nine of 579 identified abstracts met the inclusion criteria. Skill acquisition and feedback were the two most frequently investigated parameters found in the review. CS was efficient in teaching cavity preparation and light curing skills. Feedback and deliberate practice were among the best practices that should be emphasized in order to enhance the efficiency of the CS and VR simulation exercises. The use of CS is effective in teaching operative skills (such as light curing and cavity preparation) reliably; whereas, the use of VR in undergraduate curricula is debatable. To achieve the maximum benefits of the simulation exercises, emphasis must be given to the timely feedback and deliberate practice approaches.

A Tale of Two Teaching Methods: Students' Clinical Perspectives on Administering Dental Local Anesthetics

Various preclinical methodologies have been adopted by dental and oral health programs to develop student competence in administering dental local anesthetics (LA). Student-to-student practice is the most common preclinical training method. However, manikin simulation models have been introduced to avoid possible complications and ethical concerns with student-to-student injections. In 2017, the methodology was changed in the Bachelor of Oral Health program at The University of Sydney School of Dentistry in Australia from student-to-student practice to manikin simulation models. The aim of this study was to compare the students' learning experience, perceived confidence, and anxiety in giving their first injections to patients in these two preclinical training methods. A mixed-methods cohort design was used to compare the 2016 (n = 42) and 2017 (n = 32) oral health students' experiences and perceptions and evaluate students' clinical experience after commencing LA practice on patients. Students completed a questionnaire about their perceived level of confidence and anxiety before and after their first LA to a child and an adult for both infiltration and inferior alveolar nerve b lock (IANB) injections. Focus groups were conducted to further investigate the students' experience. The results showed that the perceived confidence and anxiety of the two cohorts did not differ significantly from each other. Although students found it difficult to transition into clinical practice without having experienced LA themselves, the manikin simulation practice provided a safe learning platform that avoided ethical and legal concerns. These findings support the use of manikin simulation models as an alte rnative method for dental local anesthetic preclinical training.

Digital dentistry: The new state of the art - Is it disruptive or destructive?

OBJECTIVE

Summarizing the new state of the art of digital dentistry, opens exploration of the type and extent of innovations and technological advances that have impacted - and improved - dentistry. The objective is to describe advances and innovations, the breadth of their impact, disruptions and advantages they produce, and opportunities created for material scientists.

METHODS

On-line data bases, web searches, and discussions with industry experts, clinicians, and dental researchers informed the content. Emphasis for inclusion was on most recent publications along with innovations presented at trade shows, in press releases, and discovered through discussions leading to web searches for new products.

RESULTS

Digital dentistry has caused disruption on many fronts, bringing new techniques, systems, and interactions that have improved dentistry. Innovation has spurred opportunities for material scientists' future research.

SIGNIFICANCE

With disruptions intrinsic in digital dentistry's new state of the art, patient experience has improved. More restoration options are available delivering longer lifetimes, and better esthetics. Fresh approaches are bringing greater efficiency and accuracy, capitalizing on the interest, capabilities, and skills of those involved. New ways for effective and efficient inter-professional and clinician-patient interactions have evolved. Data can be more efficiently mined for forensic and epidemiological uses. Students have fresh ways of learning. New, often unexpected, partnerships have formed bringing further disruption - and novel advantages. Yes, digital dentistry has been disruptive, but the abundance of positive outcomes argues strongly that it has not been destructive.

Introduction of integrated dental training jaw models and rubric criteria

OBJECTIVE

The objective of the present study was to evaluate the effectiveness of introducing integrated jaw models, rubric criteria and homework tasks to a total clinical simulation training course to improve the clinical competence of preclinical dental students.

METHODS

A total simulation training course, which involved six clinical dentistry departments, was held for 110 preclinical students in 2014 and 2015. We prepared integrated jaw models having several morbidities along with corresponding medical information and homework tasks. The students formulated diagnoses and devised treatment plans before performing dental treatment on the mannequin under the direction of instructors from the respective clinical departments. Their performance was assessed by both students and instructors using the rubric criteria.

RESULTS

Based on quantitative evaluations, the introduction of integrated jaw models appeared to improve the students' ability to formulate diagnoses and devise dental treatment plans and to understand the respective clinical dentistry disciplines. The rubric criteria provided immediate feedback for the students. Based on a comparison of rubric scores, students tended to significantly underestimate their own performance compared with instructors. Moreover, the introduction of homework tasks improved student seriousness.

CONCLUSION

Introducing integrated jaw models, rubric criteria and homework tasks to a total simulation training course may be a good approach for improving student performance in terms of dental diagnoses and treatment.

Educational effects using a robot patient simulation system for development of clinical attitude

INTRODUCTION

The aim of this study was to assess the effectiveness of improving the attitude of dental students towards the use of a full-body patient simulation system (SIMROID) compared to the traditional mannequin (CLINSIM) for dental clinical education.

MATERIALS AND METHODS

The participants were 10 male undergraduate dental students who had finished clinical training in the university hospital 1 year before this study started. They performed a crown preparation on an upper pre-molar tooth using SIMROID and CLINSIM as the practical clinical trials. The elapsed time for preparation was recorded. The taper of the abutment teeth was measured using a 3-dimensional shape-measuring device after this trial. In addition, a self-reported questionnaire was collected that included physical pain, treatment safety and maintaining a clean area for each simulator. Qualitative data analysis of a free format report about SIMROID was performed using text mining analysis. This trial was performed twice at 1-month intervals.

RESULTS

The students considered physical pain, treatment safety and a clean area for SIMROID significantly better than that for CLINSIM (P < .01). The elapsed time of preparation in the second practical clinical trial was significantly lower than in the first for SIMROID and CLINSIM (P < .01). However, there were no significant differences between the abutment tapers for both systems. For the text mining analysis, most of the students wrote that SIMROID was similar to real patients.

CONCLUSION

The use of SIMROID was proven to be effective in improving the attitude of students towards patients, thereby giving importance to considerations for actual patients during dental treatment.

Simulation training for medical emergencies in the dental setting using an inexpensive software application

INTRODUCTION

Every dental provider needs to be educated about medical emergencies to provide safe dental care. Simulation training is available with simulators such as advanced life support manikins and robot patients. However, the purchase and development costs of these simulators are high. We have developed a simulation training course on medical emergencies using an inexpensive software application. The purpose of this study was to evaluate the educational effectiveness of this course.

MATERIALS AND METHODS

Fifty-one dental providers participated in this study from December 2014 to March 2015. Medical simulation software was used to simulate a patient's vital signs. We evaluated participants' ability to diagnose and treat vasovagal syncope or anaphylaxis with an evaluation sheet and conducted a questionnaire before and after the scenario-based simulation training.

RESULTS

The median evaluation sheet score for vasovagal syncope increased significantly from 7/9 before to 9/9 after simulation training. The median score for anaphylaxis also increased significantly from 8/12 to 12/12 (P < .01). For the item "I can treat vasovagal syncope/anaphylaxis adequately," the percentage responding "Strongly agree" or "Agree" increased from 14% to 56% for vasovagal syncope and from 6% to 42% for anaphylaxis with simulation training.

CONCLUSIONS

This simulation course improved participants' ability to diagnose and treat medical emergencies and improved their confidence. This course can be offered inexpensively using a software application.

A review of the use of simulation in dental education

In line with the advances in technology and communication, medical simulations are being developed to support the acquisition of requisite psychomotor skills before real-life clinical applications. This review article aimed to give a general overview of simulation in a cognate field, clinical dental education. Simulations in dentistry are not a new phenomenon; however, recent developments in virtual-reality technology using computer-generated medical simulations of 3-dimensional images or environments are providing more optimal practice conditions to smooth the transition from the traditional model-based simulation laboratory to the clinic. Evidence as to the positive aspects of virtual reality include increased effectiveness in comparison with traditional simulation teaching techniques, more efficient learning, objective and reproducible feedback, unlimited training hours, and enhanced cost-effectiveness for teaching establishments. Negative aspects have been indicated as initial setup costs, faculty training, and the lack of a variety of content and current educational simulation programs.

Medical emergency education using a robot patient in a dental setting

INTRODUCTION

In an ageing society, the frequency of medical emergencies in a dental setting appears to be increasing because of a growing number of medically compromised patients. However, we currently have no dental-specific simulation environment with advanced reproducibility for medical emergencies. Therefore, we used the robot patient in objective structured clinical examinations (OSCEs) for testing student competence in emergency management. This study aimed to evaluate student responses to medical emergencies in the dental setting.

MATERIAL AND METHODS

We used 98 fifth-grade dental students at Showa University as subjects and implemented the OSCE task entitled 'Management of medical emergency using a robot patient'. Candidates were asked to manage an emergency situation immediately after local anaesthesia, with one robot patient configured to develop vasovagal syncope and the other to experience adrenaline hypersensitivity. A questionnaire on the educational value of the robot patient was completed after the examination.

RESULTS

Thirty-two per cent of students could not accurately count her pulse because of an inappropriate method. Moreover, 78% could not correctly attach either the tonometer or pulse oximetry to the patient. Accurate diagnoses were given by only 22% of students, with vasovagal syncope diagnosed by 33% and adrenaline hypersensitivity by 8%. From a questionnaire, 78% of students recognised the usefulness of the robot patient in medical emergency training.

CONCLUSION

We found that student responses to the emergency situation were poor. The robot patient is useful in dental education for medical emergency training and assessment not only for situation management but also for differential diagnosis.

Development of three-dimensional patient face model that enables real-time collision detection and cutting operation for a dental simulator

The virtual reality (VR) simulator is a useful tool to develop dental hand skill. However, VR simulations with reactions of patients have limited computational time to reproduce a face model. Our aim was to develop a patient face model that enables real-time collision detection and cutting operation by using stereolithography (STL) and deterministic finite automaton (DFA) data files. We evaluated dependence of computational cost and constructed the patient face model using the optimum condition for combining STL and DFA data files, and assessed the computational costs for operation in do-nothing, collision, cutting, and combination of collision and cutting. The face model was successfully constructed with low computational costs of 11.3, 18.3, 30.3, and 33.5 ms for do-nothing, collision, cutting, and collision and cutting, respectively. The patient face model could be useful for developing dental hand skill with VR.

Laryngeal support device enhances the learning of laryngeal anatomy and voice physiology

Multidisciplinary cooperation in health care requires a solid knowledge in the basic sciences for a common ground of communication. In speech pathology, these fundamentals improve the accuracy of descriptive diagnoses and support the development of new therapeutic techniques and strategies. The aim of this study is to briefly discuss the benefits of hands-on education on laryngeal anatomy and voice physiology in Brazilian graduate programs in speech pathology, as well as to describe a simple prototype that can be used as a useful educational tool for this purpose. The laryngeal anatomic support device was designed to provide a vertical frame to hold human or mammalian larynges with no preservation treatment, with the goal of allowing good visualization of the vocal folds during artificial phonation. The device was designed to provide the user the ability to manipulate the soft and cartilaginous structures of the larynx with near-natural biomechanical properties. The description of the project is detailed to allow the reproduction of this simple and inexpensive device. It may be used as an experimental feature in a variety of settings, from high-school programs to experimental research methods, and may suit a wide array of different educational models.