1. Simodont Training in virtual reality to prepare for the reality Training in virtual reality to prepare for the reality

3. Current educational circumstances Golden standard from the best preparation.Golden standard from the best preparation. Criteria – inter and intra observer reliability low.Criteria – inter and intra observer reliability low. Mental model developed on preparation model on plastic teeth.Mental model developed on preparation model on plastic teeth. Internal model not based on pathology.Internal model not based on pathology. Problem solving is taught as a separate skill.Problem solving is taught as a separate skill. Only in the clinic problem solving, pathology and preparation design are integrated.Only in the clinic problem solving, pathology and preparation design are integrated.

4. Why change? Educational reasonsEducational reasons - improve integration theory and practice - improve integration theory and practice - process and outcome evaluation - process and outcome evaluation - incorporation of problem solving in preclinical training - incorporation of problem solving in preclinical training - practice in realistic context closing the gap to the clinic - practice in realistic context closing the gap to the clinic

5. Why change? Practical reasonsPractical reasons - reduction of maintenance costs - reduction of maintenance costs - no waste of materials - no waste of materials - no water problems ( legionella) - no water problems ( legionella) - unlimited availability of practice material - unlimited availability of practice material

6. Need for educational and practical adaptationsNeed for educational and practical adaptations Opportunities of virtual realityOpportunities of virtual reality The Simodont and its system bordersThe Simodont and its system borders User case in SimodontUser case in Simodont Teacher and the SimodontTeacher and the Simodont DiscussionDiscussion

7. Virtual learning environment A simulated domain specific image of the reality

8. Practical skill development and caries treatment Accurate realistic 3D simulation of both manual dexterity and pathologic concepts.Accurate realistic 3D simulation of both manual dexterity and pathologic concepts. Proper haptics and realistic images. Realistic mental modeling, muscle memory, proprioceptive training. Integration of existing and present knowledge.Integration of existing and present knowledge. This is the case, why are you going to do what and how are you going to do it? Realistic interaction with the virtual patientRealistic interaction with the virtual patient Simulation of space limitations (tongue, cheek) and patients perceptions. Simulation of space limitations (tongue, cheek) and patients perceptions.

9. Advantage of complete virtual imitation Integration of techniques and theory.Integration of techniques and theory. Unlimited practicing in a safe and almost real-life situation.Unlimited practicing in a safe and almost real-life situation. Time and partially space independent ( lap top work station).Time and partially space independent ( lap top work station). Level of skill can be easily adapted.Level of skill can be easily adapted. Development from skills to competenciesDevelopment from skills to competencies Saving of materials, equipment and staff.Saving of materials, equipment and staff.

10. Borders of the virtual dimensions Complete patient.Complete patient. Complete oral cavity.Complete oral cavity. Dental arch(es) with soft tissue.Dental arch(es) with soft tissue. Dental arch(es) only.Dental arch(es) only. Single tooth.Single tooth.

11. Need for educational and practical adaptationsNeed for educational and practical adaptations Opportunities of virtual realityOpportunities of virtual reality The Simodont and its system bordersThe Simodont and its system borders User case in SimodontUser case in Simodont Teacher and the SimodontTeacher and the Simodont DiscussionDiscussion

12. Haptic feedback Stereo Projection Course ware 3D models of real teeth

13. System borders selected for Simodont version I Realistic force feedback.Realistic force feedback. Realistic imaging.Realistic imaging. -resolution of 3D models. -hardness and color of tissue structures. -stereo imaging -collocation of image and haptics. Dental arch(es) only.Dental arch(es) only.

14. Additional value of complete virtual imitation Integration of knowledge and skills.Integration of knowledge and skills. Incorporation of clinics in simulation lab.Incorporation of clinics in simulation lab. Unlimited practicing in an almost real-life situation.Unlimited practicing in an almost real-life situation. Level of skill and complexity can be easily adapted.Level of skill and complexity can be easily adapted. Standardization procedures.Standardization procedures. Saving of materials, equipment and time.Saving of materials, equipment and time.

15. Clinic Patients Preclinic lab Simodont Preclinic/lab Clinic Patients

16. Purpose of the study To investigate if students without any dental experience practicing at the Simodont will develop skills transferable to reality at a similar level as students practicing in the traditional preclinical settingTo investigate if students without any dental experience practicing at the Simodont will develop skills transferable to reality at a similar level as students practicing in the traditional preclinical setting

17. Experiment S (n=10) P (n=10) C (n=8) Day 1 test + practice (2x30) test Day 2 practice (3x30) Day 3 test + practice (2x30) test Day 4 practice (2x30) + test test

19. Design Students practice after an initial test their manual dexterity for handling a dental bur either on the Simodont or with a real bur on resin plates.Students practice after an initial test their manual dexterity for handling a dental bur either on the Simodont or with a real bur on resin plates. Thereafter they perform a similar test on plastic blocksThereafter they perform a similar test on plastic blocks

20. 206/12/2014 Courseware

27. Criteria Preparation border within 1 st and 2 nd circle Wall perpendicular to the bottom and outer surface. Bottom within certain level and flat

32. Kruskall Wallis Control vs Ph and Simodont p<.05 Time point 1 vs 3 Ph, Simod p<.05

35. Kruskall Wallis Control vs Ph and Simodont p<.05 Time point 1 vs 3 Ph –Simo p<.05

36. Conclusions Practicing resulted in a better performance than without practicing.Practicing resulted in a better performance than without practicing. Skills transfer from the Simodont to reality was equal as from reality to reality.Skills transfer from the Simodont to reality was equal as from reality to reality. Practicing after the second test did not show any improvement probably due to reduced concentration and fatiguePracticing after the second test did not show any improvement probably due to reduced concentration and fatigue

37. Additional value of complete virtual imitation Integration of knowledge and skills.Integration of knowledge and skills. Incorporation of clinics in simulation lab.Incorporation of clinics in simulation lab. Unlimited practicing in an almost real-life situation.Unlimited practicing in an almost real-life situation. Level of skill and complexity can be easily adapted.Level of skill and complexity can be easily adapted. Standardization procedures.Standardization procedures. Saving of materials, equipment and time.Saving of materials, equipment and time.

38. Clinic Patients Preclinic lab Simodont Preclinic/lab Clinic Patients

39. Decision strategy in new development Innovation or evidence, what first?

40. Thanks p.wesselink@acta.nl