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Impact of the virtual patient introduction on the clinical reasoning process in dental education

Zary N, Johnson G., Fors U. G. H.

Bio-Algorithms and Med-Systems

2012

Vol. 8, no. 2

173--184

In the Virtual patient (VP) system Web-SP, the case authoring is entirely delegated to faculty. An analysis of the virtual patients (VPs)VPs authored by faculty showed that the most common practice chosen by the case authors was to provide an introductory clinical vignette including rich anamnestic data. To evaluate the influence of the vignette, a controlled trial was conducted to determine if the absence of vignette would influence the students’ therapeutic decisions and their clinical reasoning. This double blind controlled trial randomized 57 fourth year dentistry students into two groups. Two virtual patient cases were created with the same content in both groups, but the VPs encountered by the intervention group lacked the introductory vignette. The therapy decisions and the history taking activity were scored and analysed by the course director. A stratified analysis was undertaken, stratifying by day. There were no statistically significant differences between the two groups with respect to their therapeutic decision scores (p=.16). Participants in both groups were equivalent with respect to the number of relevant medical history questions asked (p=.33) and the number of irrelevant questions asked (p=.20). This study indicates that vignettes did not have an impact on students' problem solvingclinical reasoning process. The use of detailed vignettes or case introductions might not be needed. A possible reason includes students’ prior exposure for a full semester to other VPs for course work and problem solvingclinical reasoning. Perhaps the intervention was too subtle to impact on learners at this stage of development. Clinical vignettes might have more impact at earlier stages of student learning such as early in the semester but not as preparation for final exam. The limited number of participants may have concealed differences between the groups. We also need to investigate if the one-hour limit given the students might influence the therapeutic decisions.

Transfer of manual dexterity skills acquired on the Simodont, a dental haptic trainer with a virtual environment, to reality. A pilot study

Bakker D., Lagerweij M., Wesselink P., Vervoorn M.

Bio-Algorithms and Med-Systems

2010

Vol. 6, no. 11

21--24

Introduction: Dental students invest many hours in manual dexterity training to prepare themselves for the clinics. Exercising on plastic has the advantage of learning within a standardized environment; continuing exercises on prefab teeth are unrealistic as plastic does not generate a training facility for clinical problem solving. Introducing a virtual learning environment with haptics and 3D models with realistic pathology (the Simodont) enables students to become competent before they enter clinics, assuming that the competences are easily transferred from virtual reality to reality. Therefore a study has been carried out to investigate if skills developed in virtual reality are transferred to reality. Methodology: Twenty-eight students participated in the study; 10 trained in the traditional phantom lab, 10 trained in the Simodont lab and 8 acted as a control group. Performance was tested before, during and after training. Result: It turned out that all students performed better after little or more training, independent of the training environment. Conclusion: Skills developed in virtual reality on the Simodont were transferred to reality.