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Objectives: The advent of artificial intelligence (AI) and large language model (LLM)-based AI applications (LLMAs) has tremendous implications for our society. This study analyzed the performance of LLMAs on solving restorative dentistry and endodontics (RDE) student assessment questions., Materials and Methods: 151 questions from a RDE question pool were prepared for prompting using LLMAs from OpenAI (ChatGPT-3.5,-4.0 and -4.0o) and Google (Gemini 1.0). Multiple-choice questions were sorted into four question subcategories, entered into LLMAs and answers recorded for analysis. P-value and chi-square statistical analyses were performed using Python 3.9.16., Results: The total answer accuracy of ChatGPT-4.0o was the highest, followed by ChatGPT-4.0, Gemini 1.0 and ChatGPT-3.5 (72%, 62%, 44% and 25%, respectively) with significant differences between all LLMAs except GPT-4.0 models. The performance on subcategories direct restorations and caries was the highest, followed by indirect restorations and endodontics., Conclusions: Overall, there are large performance differences among LLMAs. Only the ChatGPT-4 models achieved a success ratio that could be used with caution to support the dental academic curriculum., Clinical Relevance: While LLMAs could support clinicians to answer dental field-related questions, this capacity depends strongly on the employed model. The most performant model ChatGPT-4.0o achieved acceptable accuracy rates in some subject sub-categories analyzed., (© 2024. The Author(s).)

Purpose: In the realm of restorative dentistry, the integration of virtual reality haptic simulation (VRHS) for learning operative skills has garnered varied perceptions among dental students. Therefore, the aim of this study was to delve deep into undergraduates dental students' perceptions related to the impact of VRHS in pre-clinical restorative dentistry., Methods: A homogeneous purposive sampling method was utilized to gather data from third-year undergraduate dental students (n = 23) at the College of Dental Medicine, Qatar University, to thoroughly investigate their views on the impact of VRHS on their learning experience in preparing a standard class I cavity. An explorative qualitative method using face-to-face focus group sessions were conducted in English during 2023. Focus group sessions were recorded and transcribed using Microsoft Teams. Two authors independently read the transcripts, coded the text, and manually analyzed text using an inductive thematic approach., Results: A total of 21 (91.3%) students participated in this study. Analysis of 3 focus group interviews revealed five primary themes summarized with the term "MASTR" (M = manual dexterity, A = assessment, S = sequence, T = training, and R = realism). Based on frequency of reported themes, students perceived realism/ lifelike nature of VRHS requiring further enhancement to achieve the desired learning objective., Conclusion: Although, VRHS play a crucial role in modern dental education, offering innovative solutions for training, evaluation, and feedback, the need to enhance their ability to simulate real-life dental procedures and learning environment (realism), coupled with interactive and immersive learning experiences were the most frequently raised theme by students. In terms of curriculum design and learning pedagogies, dental educators should consider the appropriate sequence when integrating VRHS within the undergraduate curricula., (© 2024. The Author(s).)

Purpose/objective: A career in healthcare is built on the foundations of continuous self-reflection and self-assessment. Previous studies have solely compared student self-assessment to faculty grades in a single discipline. The objective of this study was to investigate whether associations of a student's self-assessment skills exist across multiple disciplines in the predoctoral setting., Methods: Sixty-five students from two class years at the Harvard School of Dental Medicine completed preclinical competency exams in dental anatomy waxing and operative dentistry. The difference between the student's self-assessment score and average faculty grade for each exercise was calculated as the student‒faculty (S-F) gap, which served as a proxy to determine how students evaluate their work. Regression analysis was performed to assess associations between wax-up and preclinical operative S-F gaps., Results: Mean S-F gaps for waxing and preclinical operative procedures were positive (5.7 ± 6.1 and 7.6 ± 6.7, respectively). Additionally, students in the lower quartile tended to overestimate performance to a greater degree than their peers in the upper quartile. Furthermore, the waxing S-F gaps were positively associated with S-F gaps of each operative procedure, particularly with the combined operative exercise S-F gaps, where a statistically significant association was seen (coefficient = 0.28; p = 0.04)., Conclusion(s): Previously, we identified a negative correlation between students' self-assessment skills (S-F gaps) and their preclinical performance. In this study, we further demonstrated an association of S-F gaps in two fundamental exercises: wax-up and operative dentistry. This underscores the roles of S-F gaps as possible indicators of students' preclinical and clinical performance, and it holds potential to become a widely standardized and applicable calculation that may help evaluate the effectiveness of the dental curricula and optimize student learning., (© 2024 American Dental Education Association.)

Objectives: To explore the experience of and satisfaction with workplace-based assessment tools among dental postgraduate trainees., Methods: The cross-sectional study was conducted from March to October 2022 at the Aga Khan University Hospital, Karachi, and comprised all Operative Dentistry, Prosthodontics and Orthodontics postgraduate trainees. A questionnaire with both open-ended and closed-ended questions was used to record the experiences and satisfaction level of the dental residents who had earlier been subjected to workplace-based assessment. Data was analysed using SPSS 20, while thematic analysis was used for open-ended questions., Results: Of the 20 Subjects, 15(75%) were females. Also, 11(55%) participants had received prior training for workplacebased assessment. There were 16(80%) residents who were satisfied with workplace-based assessment tools in the dental residency programme, 15(75%) agreed that the tools improved their clinical skills and helped them identify their weak areas, all the 20(100%) participants said the feedback given to them was constructive, 18(90%) reported that they were allowed to put in their views. However, 7(35%) participants reported that being observed adversely affected their performance., Conclusions: Dental residents generally gave positive feedback related to workplace-based assessment tools in a clinical setting.

Dental academia in Pakistan has recently achieved an important milestone. The name of Operative Dentistry speciality has been changed to Operative Dentistry & Endodontics (ODE). It was a much-needed change that was first felt about two decades ago. However, with the correction of name, there are certain challenges that this speciality has to manage now. These include improving the curriculum, setting up standards, and lastly, setting up its boundaries and scope of practice as some of its scope overlaps with a sister speciality called Prosthodontics. This overlapping of the boundaries of dental disciplines is a problem that is unique to Pakistan, India, and some East Asian countries where Operative Dentistry or Conservative Dentistry is combined with Endodontics. This paper aims to discuss the objective delineation of dental procedures and suggest a model of peaceful co-existence of sister dental specialities.

Objectives: Approaches for combining scores have been based on weighted mean (WM) without consideration for psychometric characteristics of each individual assessments. This study evaluates consequences of WM and composite score (CS) approach., Methods: Data from two longitudinal cohorts (n = 219) were utilized for performance in three Operative Dentistry courses as basis to compare the two score-combining methods. Four assessments (two written and two practical exams) from each course were combined using WM and CS approaches. WM scores were calculated by multiplying the score by its weight and summing across assessments. The CS approach follow a modification of the Kane and Case method, by standardizing scores, taking into account the reliability and associations between each assessment score. t-Tests and Pearson's correlation were used to evaluate the consequences of the WM and CS approaches. In addition, changes in each student's rank across WM and CS were determined., Results: Combining scores using CS method produced lower scores and higher percentage failure in all courses compared to WM. Students ranks were changed significantly when CS was used with only 15% of the cohorts retained their ranks., Conclusions: CS produced a composite that is correlated with WM but still being substantively different providing meaningful and psychometrically rigorous information., (© 2023 American Dental Education Association.)

Objectives: The aim was to investigate aspects of the teaching of restoration repair as a minimally invasive alternative to replacing defective direct composite restorations in undergraduate curricula teaching programs in Brazilian dental schools., Methods: A 14-item validated survey questionnaire was mailed to directors/coordinators of operative/restorative dentistry teachers of Brazilian Dental Schools. Data were collected on demographic characteristics of the teachers and institutions, together with questions on the teaching of the repair of defective resin-based composite restorations as part of the school curriculum; the rationale behind the teaching; the nature of the teaching (preclinical and/or clinical); how techniques were taught, indications for repair, operative techniques, materials used, patient acceptability and expected longevity of completed repairs., Results: Two hundred and twenty-two (94%) directors/ coordinators of dental curricula in Brazil were contacted. One hundred and thirty-one directors/coordinators (59%) replied, providing the e-mail address from the teacher responsible for the operative/restorative dentistry program in their school. Of these, 104 responded to the questionnaire (79% response rate). Ninety-three (89%) of the participating schools reported teaching composite repairs as an alternative to replacing restorations. Of the theoretical content, 43% was taught at preclinical and clinical levels, whereas most practical experience (53%) was acquired at clinical levels. Eighty-eight schools (95%) reported tooth substance preservation being the main reason for teaching repair techniques. All schools that taught repairs reported high patient acceptability., Conclusions: The teaching of composite restoration repair as an alternative to restoration replacement is established in undergraduate programs in most of the Brazilian dental schools surveyed., Clinical Significance: The reasons for teaching restoration repair in Brazil were found to be quite unanimous among teachers, especially regarding the preservation of tooth structure. Variations were found in the clinical indications for repair, suggesting the need for further investigations. Monitoring repaired restorations should be encouraged and could contribute to future studies., Competing Interests: Declaration of Competing Interest The authors declare that they have no known competing financial interests or personal relationships that could have appeared to influence the work reported in this paper., (Copyright © 2023. Published by Elsevier Ltd.)

To test and evaluate the second installment of DENTIFY, a virtual reality haptic simulator for Operative Dentistry (OD), on preclinical dental students, by focusing on user performance and self-assessment. Twenty voluntary unpaid preclinical dental students, with different background experience, were enrolled for this study. After the completion of an informed consent, a demographic questionnaire, and being introduced to the prototype (on the first testing session), three testing sessions followed (S1, S2, S3). Each session involved the following steps: (I) free experimentation; (II) task execution; S3 also included (III) completion of questionnaires associated with the experiment (total of 8 Self-Assessment Questions (SAQ)); and (IV) guided interview. As expected, drill time decreased steadily for all tasks when increasing prototype use, verified by RM ANOVA. Regarding performance metrics (Comparisons by Student's t-test and ANOVA) recorded at S3, in overall, a higher performance was verified for participants with the following characteristics: female, non-gamer, no previous VR experience and with over 2 semesters of previous experience of working on phantom models. The correlation between the participants' performance (drill time), for the four tasks, and user self-assessment evaluation, verified by Spearman's rho analysis, allowed to conclude that a higher performance was observed in students who responded that DENTIFY improved their self perception of manual force applied. Regarding the questionnaires, Spearman's rho analysis showed a positive correlation between the improvement DENTIFY inputs on conventional teaching sensed by students, also enhancing their interest in learning OD, their desire to have more simulator hours and the improvement sensed on manual dexterity. All participating students adhered well to the DENTIFY experimentation. DENTIFY allows for student self-assessment and contributes to improving student performance. Simulators with VR and haptic pens for teaching in OD should be designed as a consistent and gradual teaching strategy, allowing multiplicity of simulated scenarios, bimanual manipulation, and the possibility of real-time feedback to allow for the student's immediate self-assessment. Additionally, they should create performance reports per student to ensure self-perception/criticism of their evolution over longer periods of learning time., (© 2023. The Author(s).)

Objectives: To investigate the latest teaching policies for posterior resin composite placement versus amalgam and to determine the actual numbers of posterior resin composites versus amalgam restorations placed in American dental schools from 2008 to 2018., Methods: Emails were sent to the deans of all 66 dental schools in the United States to collect data in the forms of: 1) Questionnaire on current teaching policies of posterior composite and amalgam restorations; and 2) Data entry form to collect the actual numbers of posterior composite and amalgam restorations placed in their clinics. Descriptive statistics were used to summarize ratios of posterior restorations. Inferential analysis (chi-square test and z-test) was employed to compare posterior restoration proportions over time and within each year. Level of significance was set at 0.05., Results: For the teaching questionnaire, the response rate was 52% (n=34). Seventy-six per cent of the responding schools reported that they assign 50% or more of their preclinical restorative teaching time towards posterior resin composite placement, while 50% of the responding schools devoted 25% or less towards amalgam teaching. Data entry response rate was 26% (n=17). In 2008, amalgam and resin composite restorations were placed almost equally. However, resin composite restorations were placed significantly more frequently from 2009 onwards in all responding schools. The results revealed a significant ongoing increasing trend in placing posterior resin composites in all responding schools over time (p<0.05)., Conclusions: Data analysis revealed a clear trend towards an increase in posterior resin composite restoration placement and a decrease in the number of amalgam restorations. However, the time assigned for posterior resin composite teaching is not aligned with quantity of restorations placed. Review and adjustment of the time allocated for teaching and training of each material are suggested., (© Operative Dentistry, 2023.)

Purpose/objectives: The purpose of this study was to determine whether performance on a complex manual dexterity haptic test was associated with preclinical operative dentistry practical examination scores in handpiece naïve students., Methods: Thirty-nine first-year pre-clinical operative dentistry students completed a 15-min complex manual dexterity exercise "D-circle" repeated eight times in succession before the beginning of the preclinical operative dentistry course. A composite haptic score was compared with students' subsequent preclinical operative examination performance and perceptual ability test scores., Results: Mean accuracy scores on the haptic test increased, and failures decreased across the eight repetitions. Thirty students were successful at least twice in eight attempts, while nine failed all or all but one attempt. The group that failed all or all but one had lower mean scores on the first practical examination (Exam 1) (78.4 vs. 82.2, p = 0.23 Student's t-test), and 7.0 odds of failing the examination (confidence interval 0.95-51.4, p = 0.06). As a diagnostic predictor of pre-clinical operative dentistry performance, failing all, or all but one attempt at the haptic test had 60% sensitivity and 82% specificity as a predictor of failure on Exam 1. This resulted in correct classification of 79%., Conclusions: These data provide evidence for the first time that a complex manual dexterity test on a haptic simulator given to dental students was predictive of early pre-clinical success. These prospective results confirm previous retrospective studies and if replicated in larger cohorts may lead to improvements in the dental school admissions process., (© 2022 American Dental Education Association.)

Introduction: The advancement of 3D digital scanners has allowed educators to uphold the quality of education whilst implementing novel methods of assessment., Objective: The purpose of this study was to compare two evaluation methods, conventional and digital scanned assessments, on student cavity preparations and students and faculty's perceptions of these assessment methods., Methods: Predoctoral students performed Class II amalgam and Class III resin composite preparations on simulated teeth for their preclinical competency examinations. Two calibrated faculty evaluated the students' preparations using dental instruments for conventional assessments and 3D scanned images for digital assessments. Faculty scores from both assessment methods were compared and statistically analysed (p < .05). Students also self-assessed their performance using the digital scanned images and filled out a perception survey., Results: There was no statistically significant difference between the conventional (Class II; 73.3 ± 12.2 and Class III; 82.5 ± 8.9) and the digital assessment with scanned images (Class II; 71.3 ± 11.0 and Class III; 82.2 ± 8.2). Faculty scores from both methods have shown a trend of comparability. Most students agreed that digital ideal preparation models were useful (84.2%) and almost all students agreed that digital technology helped them learn operative dentistry (91.1%). In contrast, most students agreed that conventional assessment should be the main self-evaluation system (82.2%) and disagreed that digital assessment is more effective than conventional self-assessment (68.3%)., Conclusion: Our study demonstrated that 3D digital technology could be an alternative and/or supplementary educational tool to aid in upholding the quality of dental education., (© 2021 John Wiley & Sons A/S. Published by John Wiley & Sons Ltd.)

Purpose/objective: Admission to dental school is based on various factors including academic achievements in undergraduate coursework and the Dental Admission Test (DAT) scores. Students' success in an operative course requires fundamental knowledge, hand skills, spatial awareness, and self-assessment ability. The goal of this study is to evaluate how admissions factors, such as Grade Point Average (GPA) and DAT, including the Perceptual Ability Test (PAT), relate to students' academic and preclinical performance and self-assessment skills in preclinical operative dentistry., Methods: A total of 239 students were included from seven class years (2016-2022). Third-year dental students participated in a preclinical operative dentistry course. At the end of the course, they took the final multiple-choice exam and performed four competency examination procedures: Class II amalgam preparation and restoration and Class III resin-composite preparation and restoration. Calibrated faculty graded students' work independently and students also self-assessed their performance using the same rubrics as faculty. Linear regressions were performed to estimate the association between the admission factors with the mean faculty scores (measuring preclinical performance), student-faculty (S-F) gap scores (evaluating self-assessment skills), and their final didactic exam scores., Results: Overall, students' self-assessment was higher compared to faculty score. Linear regression analysis demonstrated positive correlations between the PAT and students' preclinical performance as well as between the DAT and their didactic exam scores. In general, S-F gap score decreased as PAT score increased, and it was statistically significant lower for the Class III preparation, indicating a better self-assessment skill. No correlations were observed between student performance and GPA scores., Conclusion: The findings from the association between student performance and admission factors may play an important role in the dental school admissions process and assist students who may benefit from early faculty intervention and support., (© 2022 American Dental Education Association.)

Background: Dental preclinical training has been traditionally centered onverbal instructions and subsequent execution on phantom heads and plastic training models. However, these present present limitations. Virtual Reality (VR) and haptic simulators have been proposed with promising results and advantages and have showed usefullness in the preclinical training environment. We designed DENTIFY, a multimodal immersive simulator to assist Operative Dentistry learning, which exposes the user to different virtual clinical scenarios while operating a haptic pen to simulate dental drilling., Objective: The main objective is to assess DENTIFY's usability, acceptance, and educational usefulness to dentists, in order to make the proper changes and, subsequently, to test DENTIFY with undergraduate preclinical dental students., Methods: DENTIFY combines an immersive head mounted VR display, a haptic pen in which the pen itself has been replaced by a 3D printed model of a dental turbine and a controller with buttons to adjust and select the scenario of the simulation, along with 3D sounds of real dental drilling. The user's dominant hand operated the virtual turbine on the VR-created scenario, while the non-dominant hand is used to activate the simulator and case selection. The simulation sessions occurred in a controlled virtual environment. We evaluated DENTIFY's usability and acceptance over the course of 13 training sessions with dental professionals, after the users performed a drilling task in virtual dental tissues., Results: The conducted user acceptance indicates that DENTIFY shows potencial enhancing learning in operative dentistry as it promotes self-evaluation and multimodal immersion on the dental drilling experience., Conclusions: DENTIFY presented significant usability and acceptance from trained dentists. This tool showed to have teaching and learning (hence, pedagogical) potential in operative dentistry., Competing Interests: Declaration of Competing Interest The authors declare that they have no known competing financial interests or personal relationships that could have appeared to influence the work reported in this paper., (Copyright © 2022 Elsevier B.V. All rights reserved.)

Introduction: During the COVID-19 pandemic, dental schools were required to reformat their curricula to accommodate regulations mandated to protect the health of students and faculty. For students enrolled in the Operative Dentistry preclinical courses at the Harvard School of Dental Medicine (HSDM), this modified curriculum included frontloading the course with lectures delivered remotely, followed by in-person laboratory exercises of learned concepts. The aim of this article was to determine the impact that the modifications had on student performance and student self-evaluation capabilities., Materials and Methods: Thirty-eight students were introduced to this restructured course. Their performance in a final multiple-choice (MC) examination, four preclinical laboratory competency assessments (class II amalgam preparation and restoration, class III composite preparation and restoration) and their self-assessment of these preclinical competency assessments were then compared with the pre-COVID pandemic (P-CP) classes from years 2014 to 2019 (n = 216 students). Linear regressions were performed to determine differences in mean faculty scores, self-assessment scores, student-faculty score gaps (S-F gaps) and absolute S-F gaps seen between the class impacted by the pandemic and the P-CP classes., Results: The results demonstrated that students during the COVID-19 pandemic (D-CP) had a higher average faculty score in all four preclinical laboratory competency assessments and in the final MC examination. In addition, the S-F gap was smaller in this cohort as compared with the P-CP classes., Conclusion: Despite the challenges of restructuring the preclinical curricula, D-CP students performed better than their P-CP predecessors in multiple facets of this Operative Dentistry course including self-assessment accuracy., (© 2021 John Wiley & Sons A/S. Published by John Wiley & Sons Ltd.)

Objectives: To investigate the latest teaching policies of posterior composite placement versus amalgam and to determine the actual numbers of posterior composites versus amalgam restorations placed in Canadian dental schools, over the years from 2008 to 2018., Methods: Emails were sent to Chairs/Heads of Restorative Departments and Clinic Directors of all 10 Canadian dental schools to collect data in the forms of: 1) Questionnaire on current teaching policies of posterior composite and amalgam restorations; 2) data entry form to collect the actual numbers of posterior composite and amalgam restorations placed in their clinics., Results: For the teaching questionnaire, the response rate was 90% (n=9). Seven (78%) of the responding schools reported that they assign 25%-50% of their preclinical restorative teaching time towards posterior composite placement. While, three (33%) of the responding schools allocated 50%-75% of their restorative teaching towards amalgam placement. Data entry response rate was 80% (n=8). Amalgam material was dominant in the restoration distribution from 2008 to 2012. While from 2013 to 2018, resin composite material was dominant in all eight responding schools. Linear regression analysis revealed a significant increasing trend in placing posterior composites in all the responding schools over time (p<0.05)., Conclusions: Data analysis revealed a clear trend towards an increase of posterior composite restoration placement and a decrease in the number of amalgam restorations placed. However, the teaching time assigned for posterior composite is not aligned with quantity placed. Review and adjustment of time allocated for teaching and training of each material are recommended., (©Operative Dentistry, 2021.)

Abstract: Evaluating students' professional training satisfaction with operative dentistry teaching and curriculum can help identify their educational needs and improve the quality of the education imparted. This study aimed to assess the professional training satisfaction of senior undergraduate dental students in Saudi Arabia from the operative dentistry course teaching and its curriculum at different levels and among genders.A total of 193 (109 male, 56.48%; and 84 female, 43.52%) students participated in the survey. The respondents were at the 10th, 11th, and 12th levels of the Operative Dentistry course in a ratio of 34.2%, 32.1%, and 33.7%, respectively. Data were collected from survey items (18 questions) covering 6 areas: learning objectives, course materials, content relevance, instructor knowledge, instructor delivery and style, and facility and environment. Descriptive and analytical tests were performed using SPSS Software 19, with the significance level set at 0.05.A high level of satisfaction was seen among level 10 (68.18%), 11 (79.03%), and 12 (86.15%) students. A significant statistical difference was observed among level 10 students with a low level of satisfaction and a high level of satisfaction (P = .045). The percentage of satisfaction increased with the level. A high level of satisfaction was seen among male (78.90%) and female (76.19%) students, with a total satisfaction level of 77.72%.Continuous evaluation and assessment of teaching and curriculum can be a tool to improve the quality of education imparted, especially in clinical courses such as operative dentistry. This helps to prepare students for their professional life as healthcare providers. The role of teaching skills related to amalgam must be re-evaluated. It is recommended to include student representation and participation in course development committees, as they are the final recipients of the educational process., Competing Interests: The authors have no conflicts of interests to disclose., (Copyright © 2021 the Author(s). Published by Wolters Kluwer Health, Inc.)

Dental education and training in Pakistan and India are largely influenced by the British system of education. However, there are some differences in the mode of postgraduate training in these countries. In Pakistan, hospital-based residency training is the mainstay, culminating in a fellowship diploma awarded by the College of Physicians and Surgeons of Pakistan. Whereas, in Indian students of dentistry pursue university-based MDS programme as the primary pathway to specialist training. From the beginning the Indian dental academia has remained vigilant in adopting a correct nomenclature for the specialty concerned with the dental conservation. They named it Conservative Dentistry & Endodontics while in Pakistan the same specialty termed Operative Dentistry has become an obsolete term and does not represent the scope of work practiced by specialists in this discipline. A simple addition of the term "Endodontics" to the present nomenclature of "Operative Dentistry" will resolve the matter of a missing identity in a clinical specialty in Pakistan. The present paper suggests the need for advocacy to change the term used for this particular dental specialty.

Objective: The acquisition of motor skills is a key competency for the practice of dentistry, and innate abilities have been shown to influence motor performance. Thus, finding the most efficient manual dexterity tests may predict performance of dental students. The current study used the Bruininks-Oseretsky Test of Motor Proficiency, to assess motor skills of first year (D1) and second year (D2) dental students., Materials and Methods: Three fine motor subsets of the BOT-2-fine motor precision, fine motor integration, and manual dexterity-were administered to D1 and D2 dental students in 2017 and 2018. The BOT-2 subset scores of D1 students were compared with those of D2 students, who had preclinical dental experiences. For D2 students, we tested for correlations between BOT-2 subset scores and performance scores in a preclinical operative dentistry course., Results: No differences were found between D1 and D2 students for any BOT-2 subtest scores (all P s > .09). No correlations were found between total scores of each BOT-2 subtest and the operative dentistry course for D2 students (all P s > .20)., Conclusions: Our results suggested the BOT-2 was not predictive of manual skills of dental applicants or preclinical dental students. Although we assumed students would perform well with instruction, practice, and feedback, we were unable to determine whether innate abilities influenced acquisition of manual dexterity skills. More research about the acquisition of technical clinical skills in dentistry is required., Competing Interests: The authors have no conflicts of interest or financial interests to disclose., (©2019 The Authors. Clinical and Experimental Dental Research published by John Wiley & Sons Ltd.)

Increased concerns about the safety of amalgam restorations in children have resulted in many dental schools emphasizing the teaching of alternative dental materials. This study investigated the current teaching of different dental materials for use in posterior teeth in the United States predoctoral pediatric dentistry programs. In 2011, the authors invited the chairs of the predoctoral pediatric dentistry departments in all accredited dental schools at that time ( N  = 57) to participate in an internet-based survey. Descriptive statistics were calculated to describe the frequency of using different restorative materials. Regression models were developed to explore the factors related to the use of dental restorations in predoctoral pediatric clinics. Among the 44 dental schools that responded (77% response rate), 74% used amalgam, and 93% used composite in primary posterior teeth. Glass ionomer was used by 61% of the schools in primary posterior teeth. Placing amalgam in primary posterior teeth was associated with programs that treated more 3-5-year-old patients (β = .302, p  < .043), whereas the use of glass ionomer was associated with having students serving at off-site satellite dental clinics (β = .015, p  < .012). In general, having departments with chairs who had positive attitudes towards Minimal Invasive Dentistry (MID) used composite (β = .091, p  < .0001) and glass ionomer (β = 103, p  < .0001) more frequently and were less likely to use amalgam (β = -.077, p  < .005) in primary posterior teeth. Although teaching MID concepts in predoctoral pediatric clinics in dental schools is increasing, the use of amalgam in posterior primary and permanent teeth is still widely practiced., Competing Interests: The authors declare no conflict of interest.

Introduction: The aim was to assess the competencies of undergraduate students in their roles of dental expert, scholar, communicator, collaborator, health advocate, manager and professional., Materials and Methods: For this retrospective, pseudonymised observational study (pre-/post-testing), students in two cohorts in their first clinical semester in operative dentistry were asked to judge their competencies (1 = very good to 6 = insufficient) with a learning objective catalogue designed at the Goethe University Frankfurt (modelled after the National Competency-Based Learning Objective Catalogue Dentistry), at the beginning and end of their phantom course. In order to relate the students' subjective competency judgements to objective evidence of their skills, at the end of the semester their marks from the summative Objective Structured Practical Examination (OSPE) were compared with the subjective judgement of their exam performance before the final results were known., Results: The reliability of the evaluation sheet was evaluated with Cronbach's alpha 0.98. The students judged their competencies as "sufficient" (4.23 ± 0.51) at the beginning and "satisfactory" (2.82 ± 0.43) at the end. A significant improvement in competencies was observed within all roles. The students' subjective judgement of the exam results (3.66 ± 0.62) was significantly correlated with the actual marks (3.69 ± 0.83) in the OSPE at 0.3547 (P = 0.0015)., Conclusion: The evaluation instrument showed excellent reliability. The students judged that their competencies significantly increased during the semester. The triangulation with the actual marks in the context of an OSPE demonstrated a significant correlation with the students' exam judgements., (© 2019 John Wiley & Sons A/S. Published by John Wiley & Sons Ltd.)

Preclinical operative dentistry courses have traditionally involved a lockstep series of live lectures and laboratory exercises. The aims of this study were to assess the effects of an experimental self-paced operative dentistry course on students' perceptions and performance and to compare performance outcomes for this class with the classes two years prior and two years after, which were instructed with the traditional curriculum. In 2013, all lectures in one of three operative dentistry courses at the University of Minnesota School of Dentistry were placed online as narrated slide sequences. For the study, conducted in 2017, students' performance in the course in all five years was assessed, based on exams taken after the laboratory and lecture segments of the course and the practical exam. The experimental class was also invited to complete an end-of-course survey on perceptions of the learning experience. The number of students in classes using the traditional format (in 2011, 2012, 2014, and 2015) ranged from 103 to 108. In the experimental year (2013), 106 students were in the class; course assessments were done for all 106, and 104 responded to the survey (response rate 98%). The results showed no significant differences in assessments between the experimental class and the traditional classes. However, bench instructors reported feeling students in the experimental class were not as well prepared in laboratory sessions as were the traditionally trained students. On the survey, only 22% of students in the experimental class said they always viewed assigned material before the lab periods, with 78% viewing it often, sometimes, seldom, or never. In this class, 48% preferred the online lectures, 37% preferred live lectures, and 16% had no preference. These mixed results suggest caution when developing self-paced courses.

Objective:: The study aimed to evaluate teaching trends and use of materials in direct posterior restorations during a 13-year period in an Israeli dental school., Methods:: Data registered in computerized files, relating to posterior restorations performed in the student clinic during the past 13 years (2004-2016), were collected. The restorative materials used (ie, amalgam vs composite), the type of tooth, and the number of surfaces restored were analyzed., Results:: Data analysis included 26,925 restorations performed during 13 years. The number of one-surface composite restorations increased from 54.7% (n=330) to 81.9% (n=873). Two-surface restorations increased from 33.3% (n=254) to 64.3% (n=721). The percentage of amalgam restorations in three-surface restorations decreased from 72.08% to 51.34% (n=173). Analysis of tooth type showed that in 2016, the number of composite restorations performed in premolars reached 80.87% (n=723) and in molars 63.50% (n=1035). The percentage of composite restorations in the mandible and the maxilla was virtually equal., Conclusions:: A clear trend in favor of composite resin restorations is evident in the 13-year survey and suggests a move toward an amalgam-free era.

The aim of this study was to evaluate dental students' retention of factual and procedural knowledge gained in a preclinical course in operative dentistry during a clinical dental curriculum. In 2017, all 157 seventh- to tenth-semester dental students at a dental school in Germany were asked to repeat the same written examination performed at the end of the preclinical course in the sixth semester. The examinations consisted of 30 multiple-choice questions covering factual and procedural knowledge. The percentage of correctly answered questions per exam and differences in correct answers between the original examination and the re-examination (per question) were analyzed. Students were also asked to self-rate their percentage of correctly answered questions and their knowledge in various disciplines of operative dentistry at the times of the original examination and the re-examination. After exclusions, data were analyzed for 129 students, for a participation rate of 82%. For the seventh- and tenth-semester students, the results on the original examination and the re-examination were not significantly different, while the eighth- and ninth-semester students performed significantly better on the original examination than the re-examination. In all semesters, procedural knowledge remained stable between the original examination and the re-examination, while factual knowledge decreased slightly. Their performance on the original examination was underestimated by the eighth- and ninth-semester students. All the students underestimated their performance on the re-examination. Students mostly rated their knowledge level significantly higher on the original examination than on the re-examination. Overall, this study found that factual and procedural knowledge gained in a preclinical course in operative dentistry was not increased during the clinical dental curriculum.

Predoctoral dental psychomotor examinations are known to generate high levels of stress among dental students, which may compromise their academic performance. At one U.S. dental school, all 93 first-year dental students were invited to attend a series of three workshop sessions prior to enrollment in their initial operative dentistry course. The workshops were developed to facilitate academic transition from the dental anatomy course to the operative dentistry course; provide early exposure to materials, instruments, and laboratory techniques; support the early development of psychomotor and self-assessment skills; and lessen students' stress and anxiety levels regarding psychomotor examinations. The aim of this study was to assess the impact of the workshops on the students' academic performance and self-reported stress and preparedness. All students who attended the workshop sessions and all who did not were asked to complete a pre-exam survey (immediately preceding the exam) and a post-exam survey (immediately after the exam) on the day of their first operative dentistry psychomotor exam. Of the 93 students, 21 attended one, 34 attended two, and 25 attended three workshop sessions, while 13 students did not attend any. Response rates for the pre- and post-exam surveys were 100% and 98.9%, respectively. Students who attended all three workshop sessions reported being significantly less stressed about taking the exam than the other groups. The mean exam grade of students who attended the workshop sessions was significantly higher than that of students who did not attend the sessions. These findings support the development and implementation of preparatory workshops to improve academic performance and decrease the stress levels of dental students prior to the first operative dentistry psychomotor exam.

Preclinical training in phantom heads has until now been considered the 'gold standard' for restorative dental education, but the transition from preclinic to the treatment of real patients has remained a challenge. With the introduction of the latest generation of virtual reality simulators, students and dental practitioners can make digital impressions of their patients in virtual reality models and practice procedures in virtual reality before clinically performing them. In this way, clinical decisions can be investigated and practiced prior to actual treatment, enhancing the safety of the treatment and the self-confidence to perform it. With the 3M™ True Definition Scanner and the Moog Simodont Dental Trainer, 3 masters students and a general dental practitioner practiced their procedures in virtual reality prior to performing them on real patients. They were very satisfied with this preparation and the result of the treatment.

Aim: Preclinical dental training is essential for the development of psychomotor skills necessary for clinical practice. The study aimed to investigate the impact of teaching with a layered base plate blocks on cavity preparations and students' self-perceived confidence, readiness, and ability., Materials and Methods: A cross-sectional study recruited 52 dental students into two groups; one trained (test) with layered base plate and the other without (control). Students answered an eight-question survey to assess self-perceived confidence, readiness, and ability for performing cavity preparation at the start of their first preclinical operative dentistry course. Students prepared one molar tooth for a class I cavity and two for class II cavities. Preparations were assessed for different elements of depth and outline extension by two blinded examiners., Results: Statistically significant differences were found between the median scores with respect to the preparation of class II cavities among students exposed to layered base plate (Mann-Whitney U-test, p < 0.05). There were no significant differences between the median scores awarded with respect to the preparation of class I cavity. A statistically significant difference was reported in self-perceived confidence among students who trained with the layered base plate (x 2 , p < 0.05)., Conclusion: Training on the layered base plate blocks increased students' initial confidence level in performing cavity preparations, and improved the preparation skills in class II cavity., Clinical Significance: This study explores the methods of enhancing motor skills taught in preclinical operative dentistry courses, especially in short academic programs.

Background: The Australian and New Zealand chapter of the Alliance for a Cavity Free Future was launched in 2013 and one of its primary aims was to conduct a survey of the local learning and teaching of cariology in dentistry and oral health therapy programs., Methods: A questionnaire was developed using the framework of the European Organisation for Caries Research (ORCA)/Association of Dental Education in Europe (ADEE) cariology survey conducted in Europe in 2009. The questionnaire was comprised of multiple choice and open-ended questions exploring many aspects of the cariology teaching. The survey was distributed to the cariology curriculum coordinator of each of the 21 programs across Australia and New Zealand via Survey Monkey in January 2015. Simple analysis of results was carried out with frequencies and average numbers of hours collated and open-ended responses collected and compiled into tables., Results: Seventeen responses from a total of 21 programs had been received including 7 Dentistry and 10 Oral Health programs. Key findings from the survey were - one quarter of respondents indicated that cariology was identified as a specific discipline with their course and 41% had a cariology curriculum in written format. With regard to lesion detection and caries diagnosis, all of the program coordinators who responded indicated that visual/tactile methods and radiographic interpretation were recommended with ICDAS also being used by over half them. Despite all respondents teaching early caries lesion management centred on prevention and remineralisation, many taught operative intervention at an earlier stage of lesion depth than current evidence supports. Findings showed over 40% of respondents still teach operative intervention for lesions confined to enamel., Conclusion: Despite modern theoretical concepts of cariology being taught in Australia and New Zealand, they do not appear to be fully translated into clinical teaching at the present time.

The aim of this study was to compare the daily clinical grades of third-year dental students during routine clinical activities involving direct and indirect operative procedures to clinical and laboratory assessments. The authors compared students' daily clinical grades to graded clinical assessments and compared daily clinical grades to laboratory assessments at one U.S. dental school. A total of 50 third-year students (participation rate: 98%) participated in this study during the school year of 2014-15. The study analyzed the students' daily clinical grades and graded assessments during regular clinical activities and two laboratory examinations. The results found no statistically significant differences between daily grades and the clinical assessments (p=0.2845). There were statistically significant differences between daily clinical grades and laboratory assessments (p=0.0024). This study found higher grades were given for procedures completed and graded in the clinical setting. Further studies are needed to explore the possibility of clinical grades being positively skewed.

The aim of this study was to determine how dental student self-assessment and faculty assessment of operative preparations compared for conventional visual assessment versus assessment of scanned digital 3D models. In 2016, all third-year students in the Class of 2018 (N=35) at Harvard School of Dental Medicine performed preclinical exams of Class II amalgam preparations (C2AP) and Class III composite preparations (C3CP) and completed self-assessment forms; in 2017, all third-year students in the Class of 2019 (N=34) performed the same exams. Afterwards, the prepared typodont teeth were digitally scanned. Students self-assessed their preparations digitally, and four faculty members graded the preparations conventionally and digitally. The results showed that, overall, the students assessed their preparations higher than the faculty assessments. The mean student-faculty gaps for C2AP and C3CP in the conventional assessments were 11% and 5%, respectively. The mean digital student-faculty gap for C2AP and C3CP were 8% and 2%, respectively. In the conventional assessments, preclinical performance was negatively correlated with the student-faculty gap (r=-0.47, p<0.001). The correlations were not statistically significant with the digital assessments (p=0.39, p=0.26). Students in the bottom quartile significantly improved their self-assessment accuracy using digital self-assessments over conventional assessments (C2AP 10% vs. 17% and C3CP 3% vs. 10%, respectively). These results suggest that digital assessments offered a significant learning opportunity for students to critically self-assess themselves in operative preclinical dentistry. The lower performing students benefitted the most, improving their assessment ability to the level of the rest of the class.

Objective: To evaluate the efficacy of augmented reality (AR) in the gaining of knowledge and skills amongst dental students in the design of cavity preparations and analyse their degree of satisfaction., Material and Methods: AR cavity models were prepared for use with computers and mobile devices. Forty-one students were divided into two groups (traditional teaching methods vs AR). Questionnaires were designed to evaluate knowledge and skills, with the administration of a satisfaction questionnaire for those using AR. The degree of compliance with the standards in cavity design was assessed. The Mann-Whitney U-test was used to compare knowledge and skills between the two groups, and the Wilcoxon test was applied to compare intragroup differences. The chi-square test in turn was used to compare the qualitative parameters of the cavity designs between the groups. Statistical significance was considered for P<.05 in all cases., Results: No significant differences were observed in level of knowledge before, immediately after or 6 months after teaching between the two groups (P>.05). Although the results corresponding to most of the studied skills parameters were better in the experimental group, significant differences (P<.05) were only founded for cavity depth and extent for Class I and divergence of the buccal and lingual walls for the Class II. The experience was rated as favourable or very favourable by 100% of the participants. The students showed preference for computers (60%) vs mobile devices (10%)., Conclusions: The AR techniques favoured the gaining of knowledge and skills and were regarded as a useful tool by the students., (© 2017 John Wiley & Sons A/S. Published by John Wiley & Sons Ltd.)

Objectives: Repair instead of complete replacement is recommended to manage partially defective restorations. It is unclear if and why such treatment is taught at dental schools or practiced by dentists. We aimed to identify barriers and facilitators for repairs using a systematic review and meta- and qualitative analysis., Sources: Electronic databases (PubMed, CENTRAL, Embase, PsycINFO) were searched., Study Selection: Quantitative studies reporting on the proportion of (1) dentists stating to perform repairs, (2) dental schools teaching repairs, (3) failed restorations having been repaired were included. We also included qualitative studies on barriers/facilitators for repairs. Random-effects meta-analyses, meta-regression and a thematic analysis using the theoretical domains framework were conducted., Data: 401 articles were assessed and 29, mainly quantitative, studies included. 7228 dentists and 276 dental schools had been surveyed, and treatment data of 30,172 restorations evaluated. The mean (95% CI) proportion of dentists stating to perform repairs was 71.5% (49.7-86.4%). 83.3% (73.6-90.0%) of dental schools taught repairs. 31.3% (26.3-36.7%) of failed restorations had been repaired. More recent studies reported significantly more dentists to repair restorations (p=0.004). Employment in public health practices and being the dentist who placed the original restoration were facilitators for repairs. Amalgam restorations were repaired less often, and financial aspects and regulations came as barriers., Conclusions: While most dentists state to perform repairs and the vast majority of dental schools teach repairs, the proportion of truly repaired restorations was low. A number of interventions to implement repair in dental practice can be deduced from our findings., Clinical Significance: Partially defective restorations are common in dental practice. While repairs are taught and dentists are aware of the recommendation towards repairs, the actually performed proportion of repairs seems low., (Copyright © 2017 Elsevier Ltd. All rights reserved.)

Purpose: Computer-assisted learning (CAL) programs are becoming more widely used in medical and dental training. However, the combination of CAL programs and evidence-based education in dentistry has not been described previously. The aim was to determine the acceptance and user-friendliness of a CAL program combined with evidence-based training., Methods: The didactic concept of the module includes the case-oriented, problem-based embedding of a total of 32 EbM learning assignments, which can be completed interactively and self-determinedly in an interdisciplinary context using focus patients with different diseases. The present study was conducted at the Dental School of the Goethe University in Frankfurt/Main. Data on acceptance and user-friendliness were collected from three consecutive cohorts of 114 dental students attending their first clinical semester. They used the "Toothache Walk-in Clinic: FOCUS" CAL, which can be downloaded via the Internet. The instrument consisted of 64 statements. The first part addressed general information about the user. The second part contained 43 specific statements on the CAL program. These included factors A (handling and technical aspects), B (content and functional range), and C (didactics and suitability for education). Possible responses ranged from 0 to 3 (0 = strongly disagree, 3 = strongly agree)., Results: All of the 114 questionnaires distributed were returned (response rate 100%). Most users (90.1%) considered the topics of evidence-based dentistry important for their training. They rated the program by using German school grades, and the overall rating was 2.26 (SD = 0.64). Most students (88.6%) considered the program useful for their clinical training in the treatment of patients. The mean scores for the 43 specific items amounted to 1.90 (factor A, SD = 0.63), 1.55 (factor B, SD = 1.93), and 2.23 (factor C, SD = 0.79)., Conclusions: The CAL program with dental medicine vignettes and learning elements for evidence-based medicine received a primarily positive assessment. Students welcome that EbM contents are offered as part of their dental studies curriculum., (Copyright © 2017. Published by Elsevier GmbH.)

The aim of this study was to evaluate the process of student self-assessment on operative dentistry skills across four years at the University of Louisville School of Dentistry. First, a retrospective analysis of the Class of 2016 students' self-assessment and faculty assessment grade sheets was conducted to determine mean differences and correlations across time. Both preclinical (D2: n=120) and clinical (D3: n=120; D4: n=120) grade sheets were evaluated. Second, 25 students from each of the D1, D2, D3, and D4 classes in 2016 were asked to evaluate dentoform work, and 25 operative calibrated faculty members graded the same two dentoforms. The results of the retrospective analysis were that the D2 students' self-assessment scores were significantly higher than the faculty scores (t-test; p<0.05), and there was a negative correlation of scores (r=-0.503). The D3 students' self-assessment scores were also significantly higher than the faculty scores (t-test; p<0.05), and there was a negative correlation (r=-0.235). The D4 students' self-assessment scores were not significantly different from the faculty scores (t-test; p>0.05), and there was a positive correlation (r=0.408). In the prospective analysis, the D1, D2, and D3 students graded the dentoforms significantly higher (ANOVA; p<0.05) than did the D4 students and faculty members. There was an increasing correlation of scores directly related to experience (D1: r=-0.120; D2: r=0.255; D3: r=0.352; D4: r=0.689). These results support the concept that students' self-assessment is a learned process through experiential and continual encounters across time. The summative goal for all dental schools is to provide students with the skills and knowledge to critically evaluate their work for self-directed learning.

Introduction: This paper conducted standard setting (SS) (Angoff and Hofstee methods) to determine cutoff scores for summative examinations and to compare the derived passing levels to the existing fixed passing score of 60% in the Faculty of Dentistry at King Abdulaziz University., Methods: Historic performance data for final examinations in preclinical Operative Dentistry course were used by four raters to conduct both Angoff and Hofstee methods to determine the cut off scores for three academic years (2012, 2013, and 2014)., Results: Both methods yielded higher than 60% cut off scores for each year. For the first examination of academic year 2012, the cutoff score was 64.75, while it was 63.5 for year 2013, and 66.75 for the last academic year of 2014. Hofstee scores were 64.5, 65.25, and 62.25 consecutively for years 2012 through 2014., Conclusions: Using Angoff or Hofstee methods, yielded higher than the fixed 60% passing score currently used by the dental school. The use of Angoff method alone is encouraged as there were limitations to using the Hofstee method to determine the cut off score. This finding provides preliminary support to use evidence-based SS methods to determine the cutoff score for the whole Dentistry program.

Objectives: To evaluate the teaching and operative techniques for the repair and/or replacement of direct resin-based composite restorations (DCRs) in dental schools in Oceania., Methods: A 14-item questionnaire was mailed to the heads of operative dentistry in 16 dental schools in Oceania (Australia, New Zealand, Fiji and Papua New Guinea). The survey asked whether the repair of DCRs was taught within the curriculum; the rationale behind the teaching; how techniques were taught, indications for repair, operative techniques, materials used, patient acceptability, expected longevity and recall systems., Results: All 16 schools participated in the study. Thirteen (81%) reported the teaching of composite repairs as an alternative to replacement. Most schools taught the theoretical and practical aspects of repair at a clinical level only. All 13 schools (100%) agreed on tooth substance preservation being the main reason for teaching repair. The main indications for repair were marginal defects (100%), followed by secondary caries (69%). All 13 schools that performed repairs reported high patient acceptability, and considered it a definitive measure. Only three schools (23%) claimed to have a recall system in place following repair of DCRs. Most respondents either did not know or did not answer when asked about the longevity of DCRs., Conclusions: Repair of DCRs seems to be a viable alternative to replacement, which is actively taught within Oceania. Advantages include it being minimally invasive, preserving tooth structure, and time and money saving. However, standardised guidelines need to be developed and further clinical long-term studies need to be carried out., Clinical Significance: The decision between replacing or repairing a defective composite restoration tends to be based on what clinicians have been taught, tempered by experience and judgement. This study investigated the current status of teaching and operative techniques of repair of direct composite restorations in dental schools in Oceania., (Copyright © 2017 Elsevier Ltd. All rights reserved.)

Self-assessment is a critical skill for health care professionals. Because these professionals must be lifelong, self-directed learners and self-regulating practitioners, the ability to self-assess is essential for them. The aims of this study were to measure how dental students self-assessed and peer-assessed their performance in preclinical operative procedures and to evaluate any relationship between their assessment ability and preclinical skills or academic performance. The study was conducted from 2015 to 2016. Third-year students at Harvard School of Dental Medicine self-assessed their work on four preclinical practical exams: Class II amalgam preparation, Class II amalgam restoration, Class III composite preparation, and Class III composite restoration. Three faculty members graded the same preparations and restorations. The difference between the students' self-assessment and the mean faculty assessment was calculated as the student-faculty (S-F) gap. An absolute S-F gap was also calculated with absolute values of differences. A total of 71 students completed these practical exams: 36 in the Class of 2016 and 35 in the Class of 2017. All 71 self-assessments for each of the four practical exams were collected for a response rate of 100%. The results showed that the mean S-F gap ranged from 2% to 8%, and the absolute S-F gap ranged from 7% to 12%. Preclinical performance was correlated with self-assessment accuracy. Low-performing students significantly overestimated their self-assessments compared to the rest of the class. High-performing students had more accurate self-assessments and tended to underestimate themselves. Overall, these results showed that the students had room for improving the accuracy of their self-assessments.

Statement of Problem: The definition of centric relation (CR) has been both controversial and divisive, with little consensus., Purpose: The purpose of this study was to determine whether agreement can be reached on a definition for CR among the Fellows of the Academy of Prosthodontics, the organization that writes the Glossary of Prosthodontic Terms., Material and Methods: A survey of the Fellows of the Academy of Prosthodontics was conducted at the organization's annual business meeting., Results: Of the 83 eligible Fellows in attendance, 72 responded to the survey, a response rate of 86%. Of those, the 5 responders who did not indicate a preferred definition and the 2 that chose 2 definitions were censored, yielding an analyzable sample of 65 for the definitions. The most common definition received 19 votes, the next 16, and the third 13, with the other 6 definitions receiving from 2 to 5 votes. Some of the variability in definition depended on the era of training., Conclusions: Disagreement and confusion continues regarding the definition of centric relation. Some of this disagreement can be explained by training era., (Copyright © 2016 Editorial Council for the Journal of Prosthetic Dentistry. Published by Elsevier Inc. All rights reserved.)

Introduction: The aim of the study presented here was to evaluate the reliability of an OSPE end-of-semester exam in the phantom course for operative dentistry in Frankfurt am Main taking into consideration different modes of evaluation (examiner's checklist versus instructor's manual) and number of examiners (three versus four)., Methods: In an historic, monocentric, comparative study, two different methods of evaluation were examined in a real end-of-semester setting held in OSPE form (Group I: exclusive use of an examiner's checklist versus Group II: use of an examiner's checklist including an instructor's manual). For the analysis of interrater reliability, the generalisability theory was applied that contains a generalisation of the concept of internal consistency (Cronbach's alpha)., Results: The results show that the exclusive use of the examiner's checklist led to higher interrater reliability values than the in-depth instructor's manual used in addition to the list., Conclusion: In summary it can be said that the examiner's checklists used in the present study, without the instructor's manual, resulted in the highest interrater reliability in combination with three evaluators within the context of the completed OSPE.

The aims of this study were to identify the level of interexaminer agreement among preclinical operative dentistry faculty members when grading Class II preparations performed by first-year dental students; to develop discrimination exercises for specific preparation components where interexaminer agreement was poor; and to evaluate if the discrimination exercises were able to improve inter- and intraexaminer agreement. In the preliminary phase of this study, 13 components of 32 Class II cavity preparations were assessed by eight course faculty members at one U.S. dental school. Analysis of average interexaminer agreement on these components revealed that six were below 60%. These were proximal contact clearance, retention groove placement, retention groove depth, preparation walls, preparation margins, and preparation toilet/debris. A 30-minute calibration session was subsequently developed to provide discrimination exercises utilizing 3-D models and digital images of various levels of student performance for five of the six components. Immediately following calibration, the course faculty assessed the same 32 preparations (Phase I) followed by a delayed assessment without calibration (Phase II) approximately six months later. The results showed that overall interexaminer reliability improved after calibration. Although there was a decline in interexaminer reliability after an interval of six months (Phase II), the degree of variation among examiners was lower than in the preliminary assessment. These findings support the use of discrimination exercises for preclinical operative dentistry course faculty to increase interexaminer agreement and thereby improve the consistency of faculty-student communication.

Medical procedures often involve the use of the tactile sense to manipulate organs or tissues by using special tools. Doctors require extensive preparation in order to perform them successfully; for example, research shows that a minimum of 750 operations are needed to acquire sufficient experience to perform medical procedures correctly. Haptic devices have become an important training alternative and they have been considered to improve medical training because they let users interact with virtual environments by adding the sense of touch to the simulation. Previous articles in the field state that haptic devices enhance the learning of surgeons compared to current training environments used in medical schools (corpses, animals, or synthetic skin and organs). Consequently, virtual environments use haptic devices to improve realism. The goal of this paper is to provide a state of the art review of recent medical simulators that use haptic devices. In particular we focus on stitching, palpation, dental procedures, endoscopy, laparoscopy, and orthopaedics. These simulators are reviewed and compared from the viewpoint of used technology, the number of degrees of freedom, degrees of force feedback, perceived realism, immersion, and feedback provided to the user. In the conclusion, several observations per area and suggestions for future work are provided.

The primary aim of this study was to determine the characteristics that current chairpersons in restorative dentistry, general dentistry, prosthodontics, and operative dentistry departments in U.S. dental schools feel are most relevant in contributing to their success. The secondary aim was to determine these individuals' rankings of the importance of a listed set of characteristics for them to be successful in their position. All 82 current chairs of the specified departments were invited to respond to an electronic survey. The survey first asked respondents to list the five most essential characteristics to serve as chair of a department and to rank those characteristics based on importance. Participants were next given a list of ten characteristics in the categories of management and leadership and, without being aware of the category of each individual item, asked to rank them in terms of importance for their success. A total of 39 chairpersons completed the survey (47.6% response rate; 83.3% male and 16.2% female). In section one, the respondents reported that leadership, vision, work ethic, integrity, communication, and organization were the most essential characteristics for their success. In section two, the respondents ranked the leadership characteristics as statistically more important than the management characteristics (p<0.0001) for being successful in their positions.

The value of dental students' self-assessment is often debated. The aim of this study was to explore whether reflective learning with feedback enabled dental students to more accurately assess their self-perceived levels of preparedness on dental competencies. Over 16 weeks, all third- and fourth-year students at a dental school in the Republic of Korea took part in clinical rotations that incorporated reflective learning and feedback. Following this educational intervention, they were asked to assess their perceptions of their clinical competence. The results showed that the students reported feeling most confident about performing periodontal treatment (mean 7.1 on a ten-point scale) and least confident about providing orthodontic care (mean 5.6). The fourth-year students reported feeling more confident on all the competencies than the third-year students. Their self-perceived competence in periodontal treatment and oral medicine significantly predicted the instructors' clinical evaluations. This study offered insights into determining if structured reflective learning with effective feedback helps to increase dental students' self-perceived level of clinical preparedness.

The aim of this study was to investigate if a videotaped feedback method enhanced teaching and learning outcomes in a preclinical operative laboratory setting for novice learners. In 2013, 60 dental students at a dental school in India were randomly assigned to two groups: control (n=30) and experimental (n=30). The control group prepared a Class II tooth preparation for amalgam after receiving a video demonstration of the exercise. The experimental group received the same video demonstration as the control group, but they also participated in a discussion and analysis of the control groups' videotaped performance and then performed the same exercise. The self-evaluation scores (SS) and examiner evaluation scores (ES) of the two groups were compared using the unpaired t-test. The experimental group also used a five-point Likert scale to rate each item on the feedback form. The means of SS (13.65±2.43) and ES (14.75±1.97) of the experimental group were statistically higher than the means of SS (11.55±2.09) and ES (11.60±1.82) of the control group. Most students in the experimental group perceived that this technique enhanced their learning experience. Within the limits of this study, the videotaped feedback using both ideal and non-ideal examples enhanced the students' performance.

When a dental school is deciding which technology to introduce into a curriculum, it is important to identify the educational goals for the system. The authors' primary goal for the use of a computer-aided resource was to offer students another way to assess their performance, to enhance their learning, and to potentially decrease their learning curve in the preclinical environment prior to using the technique in clinical patient care. The aim of this study was to examine the validity of the "% Comparison" numbers derived from the E4D Compare software program. Three practical examinations were administered to a class of 82 students at one U.S. dental school over a six-week period. The grading of the practical examinations was performed with individual faculty members being responsible for evaluating specific aspects of each preparation. A digital image of each student's practical examination tooth was then obtained and compared to the digital image of an ideal preparation. The preparations were compared, and the "% Comparison" was recorded at five tolerance levels. Spearman's correlation coefficient (SCC) was used to measure the agreement in rankings between the faculty scores on practical exams 1-3 and the scores obtained using E4D Compare at the different tolerance levels. The SCC values for practical exams 2 and 3 were all between 0.2 and 0.4; for practical exam 1, the SCC values ranged from 0.47 to 0.56. There was no correlation between the faculty scores and the numbers given by the "% Comparison" of the software.

Dentiform teeth with simulated caries (DTSC), frequently used in preclinical courses, should show no variability in the amount of simulated caries from tooth to tooth. However, the level of caries variability among DTSC is currently unknown. The aim of this study was to assess the variation in simulated caries levels in one group of DTSC and determine whether variation among DTSC impacted the preclinical performance of dental students. In the study, 80 commercially available mandibular first molar DTSC with simulated mesio-occluso-distal caries were sectioned in coronal (n=40) and sagittal (n=40) planes where the caries depth/width was greatest. Section images were analyzed for variation in levels of simulated caries using image-processing software. Three years of practical performance data using DTSC were compared with three years of practical performance data using dentiform teeth without simulated caries, for a total of six years (students' performance on two exams, Practical 1 and Practical 2). The results showed that 70% of the coronally sectioned teeth had manufacturing defects that resulted in caries overextension at the dentino-enamel junctions (DEJs). Overextensions were found at the DEJ in 41.3% of the sagittally sectioned teeth. There was a statistically significant decrease in Practical 1 performance of the students who used DTSC as compared with students who used teeth without simulated caries (p=0.0001); there was no statistically significant difference on Practical 2 performance. Of the DTSC evaluated in this study, 56.6% contained manufacturing defects, and more than 80% were found to have excessive caries variation. Prediction of which DTSC will have caries overextension is not possible. Students preparing DTSC that contain caries overextension are therefore at increased risk of receiving undeserved negative summative assessment on practical examinations.

The aim of this study was to investigate whether there was a statistically significant positive correlation between dental students' Dental Admission Test (DAT) scores, particularly on the Perceptual Ability Test (PAT), and their performance on a dental school's competency exam. Scores from the written and clinical competency exam administered in the fall quarter of the fourth year of the curriculum at Midwestern University College of Dental Medicine-Arizona were compared to DAT scores of all 216 members of the graduating classes of 2012 and 2013. It was hypothesized that students who performed highly on one or more sections of the DAT would perform highly on the competency exam. Backward stepwise regression analyses were used to analyze the data. The results showed that the PAT scores were most strongly correlated with the competency exam scores and were a positive predictor for all three clinical sections of the exam (operative dentistry, periodontics, and endodontics). Positive predictors for the written portion of the exam were total DAT score for patient assessment and treatment planning and the DAT reading comprehension score for prosthodontics; there were no predictors for periodontics. The total variance explained by the results ranged from 4% to 15%. While statistically significant relationships were found between the students' PAT scores and clinical performance, DAT scores explained relatively little variance in the competency exam scores. According to these findings, neither the PAT nor any of the DAT components contributed to predicting these students' clinical performance.

Learning objects (LOs) associated with augmented reality have been used as attractive new technologic tools in the educational process. However, the acceptance of new LOs must be verified with the purpose of using these innovations in the learning process in general. The aim of this study was to develop a new LO and investigate the acceptance of gold onlay in teaching preparation design at a dental school in Brazil. Questionnaires were designed to assess, first, the users' computational ability and knowledge of computers (Q1) and, second, the users' acceptance of the new LO (Q2). For both questionnaires, the internal consistency index was calculated to determine whether the questions were measuring the same construct. The reliability of Q2 was measured with a retest procedure. The LO was tested by dental students (n=28), professors and postgraduate students in dentistry and prosthetics (n=30), and dentists participating in a continuing education or remedial course in dentistry and/or prosthetics (n=19). Analyses of internal consistency (Kappa coefficient and Cronbach's alpha) demonstrated a high degree of confidence in the questionnaires. Tests for simple linear regressions were conducted between the response variable (Q2) and the following explanative variables: the Q1 score, age, gender, and group. The results showed wide acceptance regardless of the subjects' computational ability (p=0.99; R2=0), gender (p=0.27; R2=1.6%), age (p=0.27; R2=0.1%), or group (p=0.53; R2=1.9%). The methodology used enabled the development of an LO with a high index of acceptance for all groups.