1. ADEE 2016 – Barcelona – August 24th – 26th
COMPARISON BETWEEN TWO SUCCESSIVE UNDERGRADUATE BDS-YEAR 1 STUDENTS’ IMPROVEMENT IN CLINICAL SKILLS THROUGH THE USE OF THE HAPTEL VIRTUAL DENTAL SIMULATOR
Margaret J. Cox, Barry F. A. Quinn, Sama Ria, Arash Shahriari-Rad. Jonathan P. San Diego, Mark Woolford
Dental Institute, King’s College London, University of London, UK.
Aim
The aim of this research was to measure and compare the learning enhancement of two successive BDS year-1 novice dental students’ cavity preparation skills using a haptic dental simulator to verify the consistency of the results across two consecutive years of hapTEL sessions .
Materials and Methods
The hapTEL work-stations which enable students to perform increasingly complex cavity preparations were used to teach 221 BDS-Year-1 dental students:
101 students during January & February 2015
120 students during February & March 2016.
All students, working in pairs, were taught during two sessions:
2015 – two 1-hour sessions
2016 – one 1.5 hour and one 1-hour session
Learning objectives: to remove caries from simulated virtual teeth while preserving healthy tissue and avoiding the pulp,
Task 1 (Cavity 1) – was a healthy floating tooth.
Task 2 (Cavity 2) –small carious lesion in a floating tooth
Tasks (Cavities 3 - 5) progressively large complex carious lesion in a lower 6th tooth located in a jaw
Performance assessment: percentage of caries removed, healthy tissue remaining, exposure of the pulp; and the time taken were anonymously recorded by the systems for both sessions for 2 consecutive years (2015 & 2016)
Research Objectives:
To determine if:
(i) students achieve better results if they spend more time on the task;
(ii) if they improve from the first to the second session; (iii) if the hapTEL virtual workstations help them to improve their clinical cavity preparation skills; and
(iv) if the results could be consolidated and verified for a second year of similar learning experiences.
Acknowledgements
Our thanks are due to:
King’s College London Dental Institute,
UK Economic and Social Research Council (ESRC)
Engineering and Physical Sciences Research Council (EPSRC) for funding the the original hapTEL project which developed and evaluated the hapTEL virtual dental system
Figure 2: Photo of a student’s
Cavity 3 on-screen log-files,
recording the cavity
preparation performance
Figure 1: The hapTEL System developed by the hapTEL project
Cavity 3
% of healthy enamel remaining
% of healthy dentine remaining
% of caries removed
Pulpal exposure
% of pulp removed
Time at first contact - secs.
Time spent drilling - Secs.
Total duration - Secs.
93.00%
99.00%
98.00%
yes
0.50%
17.50
277.96
313.02
91.88%
97.77%
94.30%
0.02%
14.11
99.03
117.71
97.03%
96.99%
91.58%
0.30%
17.81
131.81
159.76
98.34%
96.79%
82.44%
0.72%
218.11
430.44
671.30
96.56%
99.57%
96.77% no
0.00%
91.48
485.24
581.60
97.91%
98.92%
83.69%
0.61%
146.53
52.19
270.52
96.53%
97.30%
89.61%
0.87%
9.03
203.28
218.39
97.87%
99.75%
94.09%
11.48
170.26
198.90
96.24%
96.71%
94.44%
0.39%
26.88
102.86
137.29
96.29%
99.81%
96.42%
31.73
163.89
202.88
Award Number: RES
Web Address
Tel. No. +44(0)
Table 1 - Sample results for 10 students (2015) Log-files showing % of tissue remaining and removed for Cavity 3 task and the time taken
Conclusions
Results
The results collected over a two year period (2015 and 2016) for a total of 221 BDS-Year 1 students support the earlier results that this hapTEL system improves hand-eye coordination, fine and gross motor skills and through formative assessment provided by the dynamic feedback, students’ performance of cavity preparation.
The longer introductory session (1.5 hours) for the 2016 cohort confirms that the students’ hand-eye co-ordination is improved by more sustained practice with the virtual haptic simulator leading to more accurate clinical skills’ performance. This cohort obtained higher accuracy by Session 2 than the 2015 cohort.
Computerised volumetric measurements provide a new reliable parameter for measuring novice undergraduate students’ clinical skills.
References
San Diego, J.P., Newton, T., Quinn, B., Cox, M.J, Woolford, M. (2014) Levels of Agreement of Student and Staff Assessments of Skills in Performing Artificial Cavity Preparation. European Journal of Dental Education. Vol. 18(1) pp 58-64
Cox, M.J., Shahriari-Rad, A., Quinn, B., Woolford, M. & San Diego, J.P. (2015) Haptic Simulator Enhances Students’ Clinical Skills over Four Years. Journal of Dental Research. Vol. 94 (3). P 1990
2015 and 2016 results showed that for Tasks 2 and 3, students who spent more time on the task were less likely, on average, to expose the pulp and removed a higher percentage of carious tissue.
For Task 5 (lesion very near the pulp) more students exposed the pulp than for Task 4.
For the 2015 cohort of students (n=101) 90% improved their accuracy from Session 1 to Session 2.
Results for 2016 (n=120) showed similar gains (95%) in overall achievement scores with fewer students exposing the pulp for the more difficult caries removal tasks than for the 2015 cohort.
The total 2016 results consolidate the results for the previous year in proving that students’ learning was consistently enhanced through the use of the hapTEL virtual dental work station.