An Investigation into the Performance Progression of BDS-Year 1 Undergraduate Students' Clinical Skills Using the HapTEL Virtual Dental Simulation

Aim
The aim was to determine the performance progression of novice dental students’ cavity preparation skills using a haptic dental simulator through its personalised immediate feedback and the log files of each student’s cavity preparation attempts.
Materials and Methods
Teaching Resource: The hapTEL virtual dental work-stations, which simulate cavity preparation were used to teach Year-1 BDS students’ basic clinical skills.
Student cohort: 101 BDS-Year-1 dental students (January and February 2015). All students, working in pairs, were taught during two 1-hour sessions to remove caries from simulated teeth.
Tasks: Task 2 – Small caries lesion of single tooth; Tasks 3 –5 increasingly complex caries lesions of lower left 6 in a jaw.
Assessment: All student performances for both sessions were anonymously recorded of: (i) percentage of caries removed; (ii) healthy tissue remaining; (iii) whether or not the pulp had been exposed; and (iv) the time taken to start the drilling exercise and time spent drilling a tooth.
Data collection: During the sessions the students photographed their onscreen log files and emailed them to the tutor/researchers. After the final sessions, the log files stored on the hapTEL server were downloaded and entered into an Excel spread-sheet. 98 students attended session 1 and 53 attempts on tasks 2-5 were recorded. 94 students attended session 2 and 74 attempts on tasks 2-5 were recorded.
Not all student individual activities were recorded because they worked in pairs and sometimes recorded both students’ attempts instead of individual attempts
Results
Results analysed to date show that the percentage of caries tissue removed, healthy tissue remaining and pulp exposure
improved for over 90% of the students from Session 1 to Session 2.
In Session 1 most students exposed the pulp working on a simple caries lesion compared with the second session in which the pulp was minimally exposed by a minority of students when working on the more complex simulated cavities.
For the most difficult Task 5, there was more caries remaining even with a longer time spent on the task
Conclusions
The results show that a haptic system simulating simple dental procedures can enhance novice dental-undergraduate
students’ cavity preparation skills with only two hours’ practice.

These latest results also support the previous hapTEL results involving 5 years of student evaluations with 600+ students confirming 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.

Compared with the traditional Phantom Head Lab excercises at King’s College Dental Institute in which there are 3 tutors for 101 students, where a tutor provides feedback during the session to a small proportion of the students at any one time while circulating round the laboratory, the virtual dental system can record every action and procedure of every student which enables accurate assessments to be made of their skills and learning progression.