Haptic Simulation Technology: Rethinking Assessment of Dental Clinical Skills

Conventional methods of assessment for dental clinical skills are subjective, based on the tutors’ opinion and there is no clear and accurate method of assessing the process of task-based learning. Students’ clinical skills performance for a cavity preparation task, in a mechanistic view, comprises of manual dexterity, visual perception, hand-eye-finger coordination, correct angle of holding the drill hand-piece, correct movement of the drill, maximum extraction of carious lesion, minimum exposure of healthy tissues (enamel and dentine) and no pulp exposure. A relationship between these abilities and conventional clinical performance can show how technology enhances the assessment methods of the students’ performance by measuring these factors more accurately and rigorously. Psychomotor parameters such as 3D/Depth perception, spatial awareness, spatial reasoning, fine and gross motor skills and hand-eye-finger coordination have been identified as important part of the students’ aptitude and ability to perform in clinical environment. To evaluate the impact of a Virtual Reality Simulator system (the hapTEL : haptics Technology Enhanced Learning) on students’ learning, four cohort studies were considered to be part this investigation. These students were undergraduate dental students at King’s College London. This investigation included collecting the results of conventional assessment methods (clinical skills examinations: Clinical Skills in the second year and OSCE in the third, fourth and fifth years of the dental programme) and correlating these results with pre and post-psychometric tests’ scores. The statistical analysis showed statistically significant correlation between the students’ psychomotor development using the conventional and VRS laboratories at different stages of their learning. Students who used the hapTEL system showed quicker and slightly better improvement in their spatial reasoning compared with the group who used the conventional system. Those who were among the best performers in their OSCE examinations used the hapTEL systems in their first year. The simulation-based laboratory such as the hapTEL not only provided a safe environment for learners with unlimited access for practice, but also the immediate feedback received from the system, the movement of the 3D vision of the worked-out tooth in space and accurate log-files saved on computer during the performance, improved their learning. The findings of this study confirms the theory of skill acquisition (Ackerman, 1988; Anderson, 1982; Fitts & Posner, 1967) can provide a framework to establish new methods of assessment with the accurate measurement of psychomotor skills which could lead to identifying when exactly students’ psychomotor skills developed from cognitive stage to associative stage and from associative stage to autonomous stage. This could result with the enhancement of their clinical skills’ assessment methods.