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

Introduction Virtual reality (VR) dental simulators are gaining momentum as a useful tool to educate dental students. To date, no VR dental simulator exercise has been designed which is capable of reliably providing validated, meaningful clinical feedback to dental students. This study aims to measure the concurrent validity of the assessment and the provision of qualitative feedback, pertaining to cavity preparations by VR dental simulators. Methods A cavity preparation exercise was created on a VR dental simulator, and assessment criteria for cavity preparations were developed. The exercise was performed 10 times in order to demonstrate a range of performances, and for each, the simulator feedback was recorded. The exercises were subsequently three-dimensionally printed, and 12 clinical teachers were asked to assess the preparations according to the same criteria. Inter-rater reliability (IRR) between clinical teachers was measured using a free-marginal multirater kappa value. Clinical teacher assessment responses were compared with the VR simulator responses and percentage agreements calculated. Results IRR values for each exercise ranged from 0.39 to 0.77 (69.39%-88.48%). The assessment of smoothness (kappa free 0.58, 78.79%) and ability to follow the outline (kappa free 0.56, 77.88%) demonstrated highest agreement between clinical teachers, whilst the assessment of undercut (kappa free 0.15, 57.58%) and depth (kappa free 0.28, 64.09%) had the lowest agreement. The modal percentage agreement between clinical teachers and the VR simulator was, on average, 78% across all exercises. Conclusion The results of this study demonstrate that it is possible to provide reliable and clinically relevant qualitative feedback via a VR dental simulator. Further research should look to employ this technique across a broader range of exercises that help to develop other complex operative dental skills.

Automated summary

This study demonstrates the potential for providing reliable and clinically relevant qualitative feedback via a VR dental simulator. The agreement between clinical teachers and the simulator was high for smoothness and ability to follow the outline, but lower for undercut and depth assessments. Further research should explore the application of this technique to develop a broader range of complex operative dental skills.