Haptic-Enhanced Learning in Preclinical Operative Dentistry

Background: Virtual reality haptic simulators represent a new paradigm in dental education that may potentially impact the rate and efficiency of basic skill acquisition, as well as pedagogically influence the various aspects of students’ preclinical experience. However, the evidence to support their efficiency and inform their implementation is still limited. Objectives: This thesis set out to empirically examine how haptic VR simulator (Simodont®) can enhance the preclinical dental education experience particularly in the context of operative dentistry. We specify 4 distinct research themes to explore, namely: simulator validity (face, content and predictive), human factors in 3D stereoscopic display, motor skill acquisition, and curriculum integration. Methods: Chapter 3 explores the face and content validity of Simodont® haptic dental simulator among a group of postgraduate dental students. Chapter 4 examines the predictive utility of Simodont® in predicting subsequent preclinical and clinical performance. The results indicate the potential utility of the simulator in predicting future clinical dental performance among undergraduate students. Chapter 5 investigates the role of stereopsis in dentistry from two different perspectives via two studies. Chapter 6 explores the effect of qualitatively different types of pedagogical feedback on the training, transfer and retention of basic manual dexterity dental skills. The results indicate that the acquisition and retention of basic dental motor skills in novice trainees is best optimised through a combination of instructor and visualdisplay VR-driven feedback. A pedagogical model for integration of haptic dental simulator into the dental curriculum has been proposed in Chapter 7. Conclusion: The findings from this thesis provide new insights into the utility of the haptic virtual reality simulator in undergraduate preclinical dental education. Haptic simulators have promising potential as a pedagogical tool in undergraduate dentistry that complements the existing simulation methods. Integration of haptic VR simulators into the dental curriculum has to be informed by sound pedagogical principles and mapped into specific learning objectives

Methods and Tools for Objective Assessment of Psychomotor Skills in Laparoscopic Surgery

Training and assessment paradigms for laparoscopic surgical skills are evolving from traditional mentor–trainee tutorship towards structured, more objective and safer programs. Accreditation of surgeons requires reaching a consensus on metrics and tasks used to assess surgeons’ psychomotor skills. Ongoing development of tracking systems and software solutions has allowed for the expansion of novel training and assessment means in laparoscopy. The current challenge is to adapt and include these systems within training programs, and to exploit their possibilities for evaluation purposes. This paper describes the state of the art in research on measuring and assessing psychomotor laparoscopic skills. It gives an overview on tracking systems as well as on metrics and advanced statistical and machine learning techniques employed for evaluation purposes. The later ones have a potential to be used as an aid in deciding on the surgical competence level, which is an important aspect when accreditation of the surgeons in particular, and patient safety in general, are considered. The prospective of these methods and tools make them complementary means for surgical assessment of motor skills, especially in the early stages of training. Successful examples such as the Fundamentals of Laparoscopic Surgery should help drive a paradigm change to structured curricula based on objective parameters. These may improve the accreditation of new surgeons, as well as optimize their already overloaded training schedules

Influence of Haptic Communication on a Shared Manual Task in a Collaborative Virtual Environment

International audienceWith the advent of new haptic feedback devices, researchers are giving serious consideration to the incorporation of haptic communication in collaborative virtual environments. For instance, haptic interactions based tools can be used for medical and related education whereby students can train in minimal invasive surgery using virtual reality before approaching human subjects. To design virtual environments that support haptic communication, a deeper understanding of humans' haptic interactions is required. In this paper, human's haptic collaboration is investigated. A collaborative virtual environment was designed to support performing a shared manual task. To evaluate this system, 60 medical students participated to an experimental study. Participants were asked to perform in dyads a needle insertion task after a training period. Results show that compared to conventional training methods, a visual-haptic training improves user's collaborative performance. In addition, we found that haptic interaction influences the partners' verbal communication when sharing haptic information. This indicates that the haptic communication training changes the nature of the users' mental representations. Finally, we found that haptic interactions increased the sense of copresence in the virtual environment: haptic communication facilitates users' collaboration in a shared manual task within a shared virtual environment. Design implications for including haptic communication in virtual environments are outlined

A Novel Haptic Simulator for Evaluating and Training Salient Force-Based Skills for Laparoscopic Surgery

Laparoscopic surgery has evolved from an \u27alternative\u27 surgical technique to currently being considered as a mainstream surgical technique. However, learning this complex technique holds unique challenges to novice surgeons due to their \u27distance\u27 from the surgical site. One of the main challenges in acquiring laparoscopic skills is the acquisition of force-based or haptic skills. The neglect of popular training methods (e.g., the Fundamentals of Laparoscopic Surgery, i.e. FLS, curriculum) in addressing this aspect of skills training has led many medical skills professionals to research new, efficient methods for haptic skills training. The overarching goal of this research was to demonstrate that a set of simple, simulator-based haptic exercises can be developed and used to train users for skilled application of forces with surgical tools. A set of salient or core haptic skills that underlie proficient laparoscopic surgery were identified, based on published time-motion studies. Low-cost, computer-based haptic training simulators were prototyped to simulate each of the identified salient haptic skills. All simulators were tested for construct validity by comparing surgeons\u27 performance on the simulators with the performance of novices with no previous laparoscopic experience. An integrated, \u27core haptic skills\u27 simulator capable of rendering the three validated haptic skills was built. To examine the efficacy of this novel salient haptic skills training simulator, novice participants were tested for training improvements in a detailed study. Results from the study demonstrated that simulator training enabled users to significantly improve force application for all three haptic tasks. Research outcomes from this project could greatly influence surgical skills simulator design, resulting in more efficient training

WYFIWIF: A Haptic Communication Paradigm For Collaborative Motor Skills Learning

International audienceMotor skills transfer is a challenging issue for many applications such as surgery, design and industry. In order to design virtual environments that support motor skills learning, a deep understanding of humans' haptic interactions is required. To ensure skills transfer, experts and novices need to collaborate. This requires the construction of the common frame of reference between the teacher and the learner in order to understand each other. In this paper, human-human haptic collaboration is investigated in order to understand how haptic information is exchanged. Furthermore, WYFIWIF (What You Feel Is What I Feel), a haptic communication paradigm is introduced. This paradigm is based on a hand guidance metaphor. The paradigm helps operators to construct an efficient common frame of reference by allowing a direct haptic communication. A learning virtual environment is used to evaluate this haptic communication paradigm. Hence, 60 volunteer students performed a needle insertion learning task. The results of this experiment show that, compared to conventional methods, the learning method based on haptic communication improves the novices' performance in such a task. We conclude that the WYFIWIF paradigm facilitate expert-novice haptic collaboration to teach motor skills

WYFIWIF: A Haptic Communication Paradigm For Collaborative Motor Skills Learning

International audienceMotor skills transfer is a challenging issue for many applications such as surgery, design and industry. In order to design virtual environments that support motor skills learning, a deep understanding of humans' haptic interactions is required. To ensure skills transfer, experts and novices need to collaborate. This requires the construction of the common frame of reference between the teacher and the learner in order to understand each other. In this paper, human-human haptic collaboration is investigated in order to understand how haptic information is exchanged. Furthermore, WYFIWIF (What You Feel Is What I Feel), a haptic communication paradigm is introduced. This paradigm is based on a hand guidance metaphor. The paradigm helps operators to construct an efficient common frame of reference by allowing a direct haptic communication. A learning virtual environment is used to evaluate this haptic communication paradigm. Hence, 60 volunteer students performed a needle insertion learning task. The results of this experiment show that, compared to conventional methods, the learning method based on haptic communication improves the novices' performance in such a task. We conclude that the WYFIWIF paradigm facilitate expert-novice haptic collaboration to teach motor skills

Motor Learning and Motor Control Mechanisms in an Haptic Dyad

The word \u201cdyad\u201d defines the interaction between two human or cybernetic organisms. During such interaction, there is an organized flow of information between the two elements of the dyad, in a fully bidirectional manner. With this mutual knowledge they are able to understand the actual state of the dyad as well as the previous states and, in some cases, to predict a response for possible scenarios. In the studies presented in this thesis we aim to understand the kind of information exchanged during dyadic interaction and the way this information is communicated from one individual to another not only in a purely dyadic context but also in a more general social sense, namely dissemination of knowledge via physical and non-physical interpersonal interactions. More specifically, the focus of the experimental activities will be on motor learning and motor control mechanisms, in the general context of embodied motor cognition. Solving a task promotes the creation of an internal representation of the dynamical characteristics of the working environment. An understanding of the environmental characteristics allows the subjects to become proficient in such task. We also intended to evaluate the application of such a model when it is created and applied under different conditions and using different body parts. For example, we investigated how human subjects can generalize the acquired model of a certain task, carried out by means of the wrist, in the sense of mapping the skill from the distal degrees of freedom of the wrist to the proximal degrees of freedom of the arm (elbow & shoulder), under the same dynamical conditions. In the same line of reasoning, namely that individuals solving a certain task need to develop an internal model of the environment, we investigated in which manner different skill levels of the two partners of a dyad interfere with the overall learning/training process. It is known indeed that internal models are essential for allowing dyadic member to apply different motor control strategies for completing the task. Previous studies have shown that the internal model created in a solo performance can be shared and exploited in a dyadic collaboration to solve the same task. In our study we went a step forward by demonstrating that learning an unstable task in a dyad propitiates the creation of a shared internal model of the task, which includes the representation of the mutual forces applied by the partners. Thus when the partners in the dyad have different knowledge levels of the task, the representation created by the less proficient partner can be mistaken since it may include the proficient partner as part of the dynamical conditions of the task instead of as the assistance helping him to complete the experiments. For this reason we implemented a dyadic learning protocol that allows the na\uefve subject to explore and create an accurate internal model, while exploiting, at the same time, the advantage of working with an skilled partner

Haptic communication to support biopsy procedures learning in virtual environments

International audienceIn interventional radiology, physicians require high haptic sensitivity and fine motor skills development because of the limited real-time visual feedback of the surgical site. The transfer of this type of surgical skill to novices is a challenging issue. This paper presents a study on the design of a biopsy procedure learning system. Our methodology, based on a task-centered design approach, aims to bring out new design rules for virtual learning environments. A new collaborative haptic training paradigm is introduced to support human-haptic interaction in a virtual environment. The interaction paradigm supports haptic communication between two distant users to teach a surgical skill. In order to evaluate this paradigm, a user experiment was conducted. Sixty volunteer medical students participated in the study to assess the influence of the teaching method on their performance in a biopsy procedure task. The results show that to transfer the skills, the combination of haptic communication with verbal and visual communications improves the novices' performance compared to conventional teaching methods. Furthermore, the results show that, depending on the teaching method, participants developed different needle insertion profiles. We conclude that our interaction paradigm facilitates expert-novice haptic communication and improves skills transfer; and new skills acquisition depends on the availability of different communication channels between experts and novices. Our findings indicate that the traditional fellowship methods in surgery should evolve to an off-patient collaborative environment that will continue to support visual and verbal communication, but also haptic communication, in order to achieve a better and more complete skills training

Haptic communication to support biopsy procedures learning in virtual environments

International audienceIn interventional radiology, physicians require high haptic sensitivity and fine motor skills development because of the limited real-time visual feedback of the surgical site. The transfer of this type of surgical skill to novices is a challenging issue. This paper presents a study on the design of a biopsy procedure learning system. Our methodology, based on a task-centered design approach, aims to bring out new design rules for virtual learning environments. A new collaborative haptic training paradigm is introduced to support human-haptic interaction in a virtual environment. The interaction paradigm supports haptic communication between two distant users to teach a surgical skill. In order to evaluate this paradigm, a user experiment was conducted. Sixty volunteer medical students participated in the study to assess the influence of the teaching method on their performance in a biopsy procedure task. The results show that to transfer the skills, the combination of haptic communication with verbal and visual communications improves the novices' performance compared to conventional teaching methods. Furthermore, the results show that, depending on the teaching method, participants developed different needle insertion profiles. We conclude that our interaction paradigm facilitates expert-novice haptic communication and improves skills transfer; and new skills acquisition depends on the availability of different communication channels between experts and novices. Our findings indicate that the traditional fellowship methods in surgery should evolve to an off-patient collaborative environment that will continue to support visual and verbal communication, but also haptic communication, in order to achieve a better and more complete skills training