Drawing Research in surgery and medical education: an interdisciplinary perspective Keynote paper at conference on Thinking through Drawing 2012: Drawing in STEAM Friday 14th September 2012 Margaret J Cox, Jenny Wright & Neil Shah

STEAMM Science Technology Engineering Art Mathematics Medicine

Rationale for the hapTEL project 30 years evidence of positive impact of TEL on students’ learning Simulations, generic Software, online resources Sensors, programming Little research into new multimedia impact in post-compulsory education Growth in use of TEL in dental education Haptics provides new representation systems and immersion in virtual environments Impact on students’ learning; epistemologies; manual skills; conceptual understanding;

hapTEL Interdisciplinary team Prof. Margaret Cox (Director, KCL) Prof. Nairn Wilson (User-Group Coordinator, KCL) Dr. Jonathan P. San Diego (Project Manager, KCL) Dr. Barry Quinn ((Lead Clinician, KCL) King’s College Staff and Post-graduate students Dental Clinicians; Psychologists; sociologists; educational researchers University of Reading - Cybernetics team Birmingham City University Engineering In collaboration with University of the Arts – Artists – Jen Wright (Medical school – dentist?) – Neil Shah

Research into developing virtual dental systems Physical Layout (Ergonomics, collocation, workspace) Physical interface (inclusion of rubber cheeks, synthetic tissues) Touch (Collision detection, DoF, workspace, etc.) Vision (3D or 2D, tissue models, colour changes, magnification, graphic scene changes) Audio (mono/stereo/3D, variants of feedback) Others (data logs and visualisation, motion representation, smell)

Goals and issues for Dental Education Undergraduate Dental Education hand-eye Co-ordination Developing the learner to become a practising professional Using tactile devices Manipulative skills Spatial reasoning skills Changing the way Professionals work: e.g. in teams with DCPs Increasing size of student cohorts Need to provide satisfactory and sufficient feedback to students

Clinical concepts and skills for undergraduate dental students Caries removal Depth of the cavity Angle of entry into the tooth Speed of the bur Different tactile sensations in cutting between different tissues Cavity design Time available for the task and the actual time taken

Teeth and mouth model

Graphic models

Beta Version I’m sure you will insert the screen capture of the system here Illustration and demo of the prototype

hapTEL Workstation (Curriculum Ver.) 3D Display Monitor Haptic handpiece Foot Controls Haptic Device Shutter glasses Audio speakers Camera Pod

hapTEL Traditional Removal of artificial decayed material on a plastic tooth Three sessions: Two attempts per session Removal of virtual decayed material on a virtual tooth located in a jaw Three sessions: as many attempts as they wish within a given time per session

Study Design (Large scale trials)

Strand 3 - Research design and methods to measure students‘ learning Pre and post tests Spatial reasoning; fine motor skills; 3-D perceptions Attitudes towards ICT and haptics Video observations of students’ practices in the laboratories Task performance in traditional and hapTEL laboratories Final Cavity preparation task Post-lab self assessment task

Examples of assessment techniques

Extending the research into drawing and art Year 1 cohort n=130, investigated relationship between computer drilling skills logs and drawing journal Initial drawing task was drawing a ceramic tooth which the student could not see but only touch 2 week period to visually record images of the ceramic tooth in their journal

Data from HapTEL unit(2012) Cavity=4 User Name: H031 Material Logs Enamel: Remaining 98.13% Dentine: Remaining 98.69% Carie: Removed 80.12% Pulp exposed: Yes Pulp: Removed 0.203% Timing Logs Total Duration: 149.69 seconds Time at first contact: 8.79seconds Time spent Drilling: 126.80 seconds

hapTEL virtual learning unit at Kings College Dental Institute Eyesi virtual learning unit at Moorfields Eye Hospital

Recording using non conventional drawing materials

Ceramic object for ‘blind drawing’ 5 x 3 x2 cms J E 2012 ‘blind drawing’ pencil on paper 30 x 21 cms

Examples of assessment techniques

Postgraduate Trial study: MA Drawing students exploring and recording ceramic object

Kings College Dental students exploring and recording ceramic object

Dental student journal drawings using conventional drawing materials

Close observational drawing using sight and touch together with experimental investigation

Recording using non conventional drawing materials

DO3 HO 26 (Drilled straight into the pulp in cavity 5?) User Name: H026 Material Logs Enamel: Remaining 97.16% Dentine: Remaining 95.91% Carie: Removed 80.58% Pulp exposed: Yes Pulp: Removed 15.23% Timing Logs Total Duration: 181.84 seconds Time at first contact: 6.28 seconds Time spent Drilling: 169.41 seconds

Data from HapTEL unit(2012) User Name: H115 D12 16.10.12 Cavity=4 Material Logs Enamel: Remaining 98.61% Dentine: Remaining 99.01% Carie: Removed 74.14% Pulp exposed: No Pulp: Removed 0% Timing Logs Total Duration: 143.26 seconds Time at first contact: 24.01 seconds Time spent Drilling: 80.24 seconds

Initial drawing performance comparison

Results The preliminary analysis from the journals with comparison to the computer log files indicate a correlation between certain drawing styles and the virtual clinical performance in hapTEL

Implications for Teaching The results of the study are a practical example of a pedagogical strategy that could incorporate TEL methods into under/postgraduate programmes in Dentistry, Surgery and other related fields Drawing skills can be an indication of fine motor skills equally needed for intricate processes in technical and scientific subjects

Follow us on Twitter @hapTEL and THANK YOU for your interest Contact us at: hapTEL@kcl.ac.uk http://www.haptel.kcl.ac.uk Follow us on Twitter @hapTEL and

Follow us on Twitter @hapTEL and THANK YOU for your interest Contact us at: hapTEL@kcl.ac.uk http://www.haptel.kcl.ac.uk Follow us on Twitter @hapTEL and