Preclinical dental students self-assessment of an improved operative dentistry virtual reality simulator with haptic feedback

Abstract

To test and evaluate the second installment of DENTIFY, a virtual reality haptic simulator for Operative Dentistry (OD), on preclinical dental students, by focusing on user performance and self-assessment. Twenty voluntary unpaid preclinical dental students, with different background experience, were enrolled for this study. After the completion of an informed consent, a demographic questionnaire, and being introduced to the prototype (on the first testing session), three testing sessions followed (S1, S2, S3). Each session involved the following steps: (I) free experimentation; (II) task execution; S3 also included (III) completion of questionnaires associated with the experiment (total of 8 Self-Assessment Questions (SAQ)); and (IV) guided interview. As expected, drill time decreased steadily for all tasks when increasing prototype use, verified by RM ANOVA. Regarding performance metrics (Comparisons by Student's t-test and ANOVA) recorded at S3, in overall, a higher performance was verified for participants with the following characteristics: female, non-gamer, no previous VR experience and with over 2 semesters of previous experience of working on phantom models. The correlation between the participants' performance (drill time), for the four tasks, and user self-assessment evaluation, verified by Spearman's rho analysis, allowed to conclude that a higher performance was observed in students who responded that DENTIFY improved their self perception of manual force applied. Regarding the questionnaires, Spearman's rho analysis showed a positive correlation between the improvement DENTIFY inputs on conventional teaching sensed by students, also enhancing their interest in learning OD, their desire to have more simulator hours and the improvement sensed on manual dexterity. All participating students adhered well to the DENTIFY experimentation. DENTIFY allows for student self-assessment and contributes to improving student performance. Simulators with VR and haptic pens for teaching in OD should be designed as a consistent and gradual teaching strategy, allowing multiplicity of simulated scenarios, bimanual manipulation, and the possibility of real-time feedback to allow for the student's immediate self-assessment. Additionally, they should create performance reports per student to ensure self-perception/criticism of their evolution over longer periods of learning time.

Figure 1

Tool selection process: using the controller, the user points their hand towards the instrument tray and at their desired tool. The selected tool is highlighted in blue and upon pressing the trigger is equiped in the user’s hand. The user may press the cancel button to release the tool.

Figure 2

Haptic Pen and VR Controller combined workflow: using the haptic pen with their dominant hand, the user moves the drill, feeling force feedback and vibration. With their other hand, the user holds a regular VR controller that can be used to manipulate the environment, interact with the UI or operate auxiliary tools.

Figure 3

Different cavity types supported: on the left, a class 1 cavity, and on the right, a class 2 cavity. The denture model is scaled to double its original size and the drilling is executed with the help of a mirror for extra visibility. Additionally, the opacity of the Gums was turned down so the user could clearly see the root of the tooth.

Figure 4

Optional settings: in training mode, the user is given a wide range of settings and information to complement the exercise. A text, visual and spoken description of the clinical case, metrics along with visibility options. The user may start the exercise whenever they are ready to begin. Scaled Replica model: optionally, the user can manipulate a large copy of the tooth in their non-dominant hand for referencing during the exercise.

Figure 5

Over the duration of the exercise an array of metrics is collected and saved for analysis. These metrics can be monitored in real time by an examiner on the computer screen. The gums along with every layer of the tooth tissue can be set to translucent or invisible allowing users to easily view inner structures like the dentine and pulp that would otherwise always be obscured.