Construct Validity and Expert Benchmarking of the Haptic Virtual Reality Dental Simulator

Abstract

The aim of this study was to demonstrate construct validation of the haptic virtual reality (VR) dental simulator and to deine expert benchmarking criteria for skills assessment. Thirty-four self-selected participants (fourteen novices, fourteen intermediates, and six experts in endodontics) at one dental school performed ten repetitions of three mode tasks of endodontic cavity preparation: easy (mandibular premolar with one canal), medium (maxillary premolar with two canals), and hard (mandibular molar with three canals). The virtual instrument's path length was registered by the simulator. The outcomes were assessed by an expert. The error scores in easy and medium modes accurately distinguished the experts from novices and intermediates at the onset of training, when there was a signiicant difference between groups (ANOVA, p<0.05). The trend was consistent until trial 5. From trial 6 on, the three groups achieved similar scores. No signiicant difference was found between groups at the end of training. Error score analysis was not able to distinguish any group at the hard level of training. Instrument path length showed a difference in performance according to groups at the onset of training (ANOVA, p<0.05). This study established construct validity for the haptic VR dental simulator by demonstrating its discriminant capabilities between that of experts and non-experts. The experts' error scores and path length were used to deine benchmarking criteria for optimal performance.

Simulation training for ceramic crown preparation in the dental setting using a virtual educational system

“…The human‐computer interface facilitates interactive visualisation and control of computer‐generated three‐dimensional images and their related environment. This is done with sufficient detail and speed so as to evoke a sensorial experience close to that of a real experience …”

Re‐defining the virtual reality dental simulator: Demonstrating concurrent validity of clinically relevant assessment and feedback

“…These systems are gaining momentum as a useful tool to educate dental students 7,8 . The reported advantages of VR simulation in dental education include 9‐11 : The potential to provide iterative and unlimited practical learning Greatly reduced overheads for resource consumables and teaching staff Immediate, objective feedback The ability to create tailored and standardised exercises …”

“…Different aspects of validity can be demonstrated through objective (construct, concurrent and predictive validity) or subjective (face and content validity) means 15 . Most of the literature that attempts to establish the validity of VR dental simulator feedback claims to establish construct validity, by comparing the assessment of the performance of experts and novices 11,16‐18 . Most often, this involves comparison of single criterion data, although it is argued that a number of different sources of evidence are required in order to demonstrate and establish construct validity 19‐21 .…”

“…A likely reason for this lack of research is that all of the published assessment methods in VR dental simulators are quantitative in nature 4,9,11,16‐18,23,24 . The exercises that have been developed for dental education typically involve either the preparation of various geometric shapes 16,18,23,24 or operative procedures on teeth 4,9,11,17,22,25,26 . This quantitative feedback typically provides the user with a score that is based on the amount of the target material removed, the amount of surrounding (non‐target) material removed and the time taken to complete the exercise.…”

“…Despite multiple calls for feedback to conform with that given by dental educators in clinical settings, 11,18 to date no VR dental simulator exercise has been designed which is capable of reliably providing this meaningful clinical feedback. This sentiment is echoed by Bakr 29 and Rhienmora 4 .…”