Implications of haptic virtual reality training for dental skills acquisition

Abstract

Historically, dental degree curricula have relied on traditional physical simulation methods such as ‘phantom head’ manikins as a medium for psychomotor skill practice. In recent years, using technology from the aviation and surgical fields, haptic virtual reality (VR) simulators have provided an alternative method of training. As yet, however, there appears to be limited evidence concerning the most effective curricula and training pathways for VR simulation technologies. Additionally, little is known regarding the process of psychomotor skill acquisition in the VR environment.

This thesis addresses these issues through the use of an international curriculum survey and empirical studies. The survey was able to provide details of current patterns of the clinical skills component in dental curricula with a particular emphasis on VR haptic simulation. Of the empirical studies reviewed here, two analysed cohorts of undergraduate dental students during VR simulation skill training, to consider features that improve training effectiveness and to provide a picture of the development of psychomotor skills in VR over time. The final two studies involved the neural analysis of dentists and dental students using electroencephalography (EEG) and functional near-infrared spectroscopy (fNIRS) when carrying out haptic dental VR tasks, in order to examine neural patterns when carrying out different task types and in light of one particular personality feature, the propensity to reinvest.

Results from the curriculum survey indicated substantial variation in the uptake of haptic VR simulation within dental curricula globally. The studies of dental students and their learning with haptic VR simulators indicated the importance of task complexity and verified the ability of haptic VR simulators to track individual psychomotor skill improvements over time. In addition to demonstrating the ability of the Simodont to differentiate between experts and novices in terms of performance, the EEG study identified the potential for reinvestment to affect performance. The final study used functional Near Infrared Spectroscopy (fNIRS) which indicated differences in patterns of oxygenated blood flow between individuals with high and low propensities to reinvest.

Based on these findings and evidence from the literature, a psychomotor taxonomy of clinical skill acquisition in a haptic VR environment is proposed. It is hoped that such a tool could be used as a framework for course design in the healthcare setting, or as a basis of reference for future studies.