Denise Higgins is a lecturer in oral health and Simulation Coordinator at the School of Health Sciences at the University of Newcastle in Australia. After a number of years of working in the field of dentistry, she has developed a virtual reality (VR) program aimed at helping oral health students practise the application of different types of anaesthetic procedures. In an interview with DTI Higgins discusses her forward-thinking innovation and its impact thus far.
How does your VR anaesthesia simulation work?
Practically speaking, the student puts the VR headgear on, holds the hand controllers and interacts with the particular program he or she is working with. It requires the student to select and move the syringe, identify the injection site, position the syringe at the correct angulation, penetrate the mucosa at the correct depth, position the needle tip adjacent to the apex of the tooth and deposit the correct amount of anaesthetic solution at the ideal speed.
It’s a computer-assisted learning program that was developed to complement existing student learning and provide typical dental local anaesthetic administration scenarios that are relevant to dental and oral health treatments. As the students participate in different scenarios, progress feedback is provided to facilitate student learning and guide procedural skills. I developed it so that the students can follow the scenario from choosing the armamentarium through to delivering the dental local anaesthetic and so that it is fully immersive and provides scenarios for students to demonstrate clinical reasoning and decision-making based on dental local anaesthetic administration.
“I was inspired by giving students the best opportunity to learn, using educational theories like student-centred learning and deliberate practice to improve procedural skills.”
What inspired you to create this forward-thinking program?
The literature indicates that dental and oral health students acquire and practise dental local anaesthetic administration using an apprenticeship and student-to-student model. It is unsafe and unethical to allow students to acquire the skills of dental local anaesthetic administration by injecting each other. My research involved the development of a VR simulation modality that would enable a safe and nurturing environment for student learners to deliberately practise (repetitive practice) the procedural skills of dental local anaesthetic administration. I was inspired by giving students the best opportunity to learn, using educational theories like student-centred learning and deliberate practice to improve procedural skills. That method of education is best delivered in a simulation-based learning environment and contributes to increased patient safety.
What kind of dental procedures can students practise with the VR simulation?
The VR simulation-based program contains nine typical scenarios in which a dental and oral health practitioner would administer dental local anaesthetic. These include infiltrations, inferior alveolar nerve (IAN) block injections, palatal injections, interdental injections, and lingual and buccal injections. The VR program was developed to inject solution and to aspirate prior to IAN block injections.
“…the VR simulator has positively influenced their confidence and skill level in dental local anaesthetic administration.”
How have students responded to the new technology and has the training strengthened their confidence?
The students have embraced the VR program as part of their dental local anaesthetic education. They have taken up multiple opportunities to engage in the technology-enhanced simulation in order to acquire and improve their skills of dental local anaesthetic administration. They have returned multiple times to access the technology, and anecdotally the VR simulator has positively influenced their confidence and skill level in dental local anaesthetic administration.
What phase of development are you now in?
The program has progressed from the proof-of-concept phase to the reflection and redesign phase. That means it has been evaluated and reflected upon, with formulation of feedback given, and now is undergoing redevelopment to adjust the design based on required improvements, with the entire project abiding by design-based research principles. The next stage of the program will be available in the near future.