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 0.39‐0.77 (69.39‐88.48%). The assessment of smoothness (κfree0.58, 78.79%) and ability to follow the outline (κfree0.56, 77.88%) demonstrated highest agreement between clinical teachers, whilst the assessment of undercut (κfree0.15, 57.58%) and depth (κfree 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

Defining dental operative skills curricula: an ADEE consensus paper

This paper reports on the recent activity of the pan‐European consensus of the ADEE Special Interest Group for Pre‐Clinical Operative Skills. Following the previous recommendations from the group, and in order to support teachers and to harmonise the delivery of skills training across Europe, a more formal curriculum relating to pre‐clinical operative skills needs to be created. This paper reports European consensus surrounding the categorisation (level of importance, and difficulty) of basic operative dental clinical skills within the undergraduate curriculum and provides recommendations relating to session structure and timing of curricular elements for basic operative dental clinical skills teaching

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 0.39‐0.77 (69.39‐88.48%). The assessment of smoothness (κfree0.58, 78.79%) and ability to follow the outline (κfree0.56, 77.88%) demonstrated highest agreement between clinical teachers, whilst the assessment of undercut (κfree0.15, 57.58%) and depth (κfree 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

The management of wild large herbivores to meet economic, conservation and environmental objectives

1. Wild large herbivores provide goods and income to rural communities, have major impacts on land use and habitats of conservation importance and, in some cases, face local or global extinction. As a result, substantial effort is applied to their management across the globe. To be effective, however, management has to be science-based. We reviewed recent fundamental and applied studies of large herbivores with particular emphasis on the relationship between the spatial and temporal scales of ecosystem response, management decision and implementation.\ud \ud 2. Long-term population dynamics research has revealed fundamental differences in how sex/age classes are affected by changes in density and weather. Consequently, management must be tailored to the age and sex structure of the population, rather than to simple population counts.\ud \ud 3. Herbivory by large ungulates shapes the structure, diversity and functioning of most terrestrial ecosystems. Recent research has shown that fundamental herbivore/vegetation interactions driving landscape change are localized, often at scales of a few metres. For example, sheep and deer will selectively browse heather Calluna vulgaris at the edge of preferred grass patches in heather moorland. As heather is vulnerable to heavy defoliation, in the long term this can lead to loss of heather cover despite the average utilization rate of heather in a management area being low. Therefore, while herbivore population management requires a large-scale approach, management of herbivore impacts on vegetation may require a much more flexible and site-specific approach.\ud \ud 4. Localized impacts on vegetation have cascading effects on biodiversity, because changes in vegetation structure and composition, induced by large herbivores affect habitat suitability for many other species. As such, grazing should be considered as a tool for broader biodiversity management requiring a more sophisticated approach than just, for example, eliminating grazing from conservation areas through the use of exclosures.\ud \ud 5. Synthesis and applications. The management of wild large herbivores must consider different spatial scales, from small patches of vegetation to boundaries of an animal population. It also requires long-term planning based on a deep understanding of how population processes, such a birth rate, death rate and age structure, are affected by changes in land use and climate and how these affect localized herbivore impacts. Because wild herbivores do not observe administrative or political boundaries, adjusting their management to socio-political realities can present a challenge. Many developing countries have established co-operative management groups that allow all interested parties to be involved in the development of management plans; developed countries have a lot to learn from the developing world's example