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Investigating the construct validity of a haptic virtual caries simulation for dental education
  1. Cecilie Osnes1,2,
  2. Alice Duke1,
  3. Jianhua Wu1,
  4. Paul Franklin1,
  5. Faisal Mushtaq3,
  6. Andrew Keeling1
  1. 1 School of Dentistry, Faculty of Medicine and Health, University of Leeds, Leeds, UK
  2. 2 Department of Medical Biotechnologies, University of Siena, Siena, Italy
  3. 3 School of Psychology, Faculty of Medicine and Health, University of Leeds, Leeds, UK
  1. Correspondence to Cecilie Osnes, School of Dentistry, Faculty of Medicine and Health, University of Leeds, Leeds, LS2 9JT, UK; C.A.Osnes{at}


Introduction Teaching dental caries removal is limited by the material and methods available in the preclinical teaching space. Plastic teeth do not simulate the tactile feel of a lesion and natural teeth do not allow for standardised training and assessment. A novel method for simulating caries has been reported. Here, to investigate the construct validity of a caries simulation, whether haptic simulation could contribute to the understanding of caries removal, the performance of first-year dental students on the haptic simulation exercise is compared with that of experienced dentists.

Method A virtual block comprising healthy dentine, pulp, enamel and a carious lesion with significant spread along the amelodentinal junction (ADJ) was developed for the Simodont dental trainer. The case was presented to 112 first-year students and 17 clinicians following a 15 min training period on a block which contained green caries and displayed live progress throughout the exercise. All participants were given the same verbal instructions: to remove all unsupported enamel and caries along the ADJ while retaining as much healthy tissue as possible.

Results Clinicians performed better than the dental novices in precision and overall performance. Clinicians removed more material on average, except for healthy dentine, of which similar amounts were removed by both groups.

Discussion We presented a novel haptic caries exercise and investigated the construct validity of the task. The simulation may bridge the gap between preclinical and clinical dental education in caries removal.

Conclusion Clinically experienced dentists outperformed novices on a haptic caries simulation exercise. The exercise may be a useful tool for assessing conceptual understanding of caries removal.

  • simulation
  • simulation-based learning
  • simulation-based education
  • virtual reality
  • validation

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  • Contributors CO and AK contributed to conception and design of study, acquisition, analysis and write-up. AD and PF contributed to conception and design of study, acquisition and write-up. JW contributed to analysis and write-up. FM contributed to concept and design of study, analysis and write-up.

  • Funding FM is supported by a Research Grant from the EPSRC (EP/R031193/1) and a fellowship from the Alan Turing Institute.

  • Competing interests None declared.

  • Ethics approval The study was approved by the University of Leeds Dental Research Ethics Committee.

  • Provenance and peer review Not commissioned; externally peer reviewed.

  • Data availability statement Data are available on request from the corresponding author CO.

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