Augmented, Virtual and Mixed Reality in Dentistry: A Narrative Review on the Existing Platforms and Future Challenges

The recent advancements in digital technologies have led to exponential progress in dentistry. This narrative review aims to summarize the applications of Augmented Reality, Virtual Reality and Mixed Reality in dentistry and describes future challenges in digitalization, such as Artificial Intelligence and Robotics. Augmented Reality, Virtual Reality and Mixed Reality represent effective tools in the educational technology, as they can enhance students’ learning and clinical training. Augmented Reality and Virtual Reality and can also be useful aids during clinical practice. Augmented Reality can be used to add digital data to real life clinical data. Clinicians can apply Virtual Reality for a digital wax-up that provides a pre-visualization of the final post treatment result. In addition, both these technologies may also be employed to eradicate dental phobia in patients and further enhance patient’s education. Similarly, they can be used to enhance communication between the dentist, patient, and technician. Artificial Intelligence and Robotics can also improve clinical practice. Artificial Intelligence is currently developed to improve dental diagnosis and provide more precise prognoses of dental diseases, whereas Robotics may be used to assist in daily practice.

Face to face education to virtual classroom in the health sector during covid pandemic

The lockdown posed a great impact on teaching and learning process which aided in the shift of face to face education to virtual classroom. As the e- learning was newly introduced, it was difficult to execute initially due to prior unpreparedness. We put forth this study to analyse student's perspective and challenges faced in online education during pandemic times.The study was done in medical and allied health science colleges of Chennai and Puducherry. This is cross-sectional study conducted between June and August 2020. This is an online survey conducted through google forms circulated to undergraduates and post graduates of medical and allied health science courses. Frequencies and percentages were used to express the data. Statistical Analyses were done by SPSS software and graphs were made by Microsoft excel. We received response from 419 participants. Mobile phone was the widely used gadget to access online class. Most of the institutes conducted online class daily and assessment twice weekly. In student’s point of view, though e- learning had several disadvantages like poor net connectivity, clinical training inadequacy, difficulty in attending class for longer duration and unfavourable learning environment, it proved constructive at pandemic time. On improvement in the design of the learning environment and teaching system, the online learning platform would better to serve its purpose in future pandemic.

Implementing coronavirus disease 2019 scale-up registry protocol in national multiple sclerosis registry system of Iran

Background: The national multiple sclerosis (MS) registry is aimed at monitoring and improving quality of care and providing feedback to improve health outcomes by systematic recording of data. In 2018, the nationwide MS registry of Iran (NMSRI) was initiated for collecting epidemiological data and information on health care provision for patients with MS. The aim of the current study was to introduce the role of implementing coronavirus disease 2019 (COVID-19) scale-up registry protocol in NMSRI and arrange the national MS generality with information obtained during the COVID-19 pandemic. Methods: The NMSRI group set up a program with crucial elements to collect the data of patients with MS who developed COVID-19. All MS cases with confirmed diagnosis of COVID-19 were enrolled in this study. New elements were considered to be added into the dataset, including demographic characteristics, definite diagnosis of COVID-19 and its symptoms, history of comorbidities, history of medications and hospitalization, changes in magnetic resonance imaging (MRI), and infection outcomes. Results: The COVID-19 data collection program was designed in NMSRI to collect data of MS cases with COVID-19 infection. The data collection protocol was explained to neurologists through an online training workshop. To the date of the study, 21 centers from 17 provinces of Iran were involved in the COVID-19 databases promoting NMSRI and 612 participants were registered successfully. Conclusion: We extended an agreement on data collection and developed it in NMSRI with various contributors to discover a critical need for COVID-19 awareness and monitor clinical training in MS.

An educational approach for early student self-assessment in clinical periodontology

Background Self-assessment is a mandated educational requirement for use in dental undergraduate programmes. It is weakly supported for use in early clinical training and studies are criticized for the conceptual and methodology shortfalls. The aim of the study was to compare the alignment of student self-assessment to both staff assessment and written exams in early clinical training using an educational approach. Methods In 2014-2015, 55 third-year dental students completed three educational sessions comprising of (a) classroom teaching (lecture, video) with post-lesson written exam and (b) clinical activity with student self-assessment, staff assessment and student reflection. An intra-individual analysis approach, staff validation, and student scoring standardization were implemented. Cognitive (clinical competency) and non-cognitive (professionalism) items were separated in the analyses. Results There were medium correlations (Spearman’s rho, r) between student self-assessment and staff assessment scores for cognitive items (r, 0.32) and for non-cognitive items (r, 0.44) for all three combined sessions. There were large correlations for individual sessions. Compared to the post-lesson written exam, students showed small correlation (r, 0.22, 0.29) and staff showed medium correlation (r, 0.31, 0.34) for cognitive and non-cognitive items. Students showed improvements in their mean scores for both cognitive (t-test; p > 0.05) and non-cognitive items (t-test; p = 0.000). Mean scores of students were not different statistically from that of staff (p > 0.05). Conclusions Students may adequately act as self-assessors at the beginning of their clinical work in periodontology. Self-assessment may potentially improve the clinical performance. Self-assessment may be nurtured through clear guidelines, educational training strategies, feedback and reflection leading to better evaluative judgement and lifelong learning.

Students’ intentions to practice primary care are associated with their motives to become doctors: a longitudinal study

Background Medical schools can contribute to the insufficient primary care physician workforce by influencing students’ career preferences. Primary care career choice evolves between matriculation and graduation and is influenced by several individual and contextual factors. This study explored the longitudinal dynamics of primary care career intentions and the association of students’ motives for becoming doctors with these intentions in a cohort of undergraduate medical students followed over a four-year period. Methods The sample consisted of medical students from two classes recruited into a cohort study during their first academic year, and who completed a yearly survey over a four-year period from their third (end of pre-clinical curriculum) to their sixth (before graduation) academic year. Main outcome measures were students’ motives for becoming doctors (ten motives rated on a 6-point scale) and career intentions (categorized into primary care, non-primary care, and undecided). Population-level flows of career intentions were investigated descriptively. Changes in the rating of motives over time were analyzed using Wilcoxon tests. Two generalized linear mixed models were used to estimate which motives were associated with primary care career intentions. Results The sample included 217 students (60% females). Career intentions mainly evolved during clinical training, with smaller changes at the end of pre-clinical training. The proportion of students intending to practice primary care increased over time from 12.8% (year 3) to 24% (year 6). Caring for patients was the most highly rated motive for becoming a doctor. The importance of the motives cure diseases, saving lives, and vocation decreased over time. Primary care career intentions were positively associated with the motives altruism and private practice, and negatively associated with the motives prestige, academic interest and cure diseases. Conclusion Our study indicates that career intentions are not fixed and change mainly during clinical training, supporting the influence of clinical experiences on career-related choices. The impact of students’ motives on primary care career choice suggests strategies to increase the attractivity of this career, such as reinforcing students’ altruistic values and increasing the academic recognition of primary care.

Impact of the COVID-19 pandemic on the clinical training of last year medical students in Mexico: a cross-sectional nationwide study

Background The COVID-19 pandemic has brought unprecedented changes to medical education. However, no data are available regarding the impact the pandemic may have on medical training in Mexico. The aim of our study was to evaluate and identify the medical school students’ perceptions of the changes in their clinical training due to the pandemic in Mexico. Methods This was a cross-sectional study where a previous validated online survey was translated and adapted by medical education experts and applied to senior medical students from March to April of 2021. The 16-item questionnaire was distributed online combining dichotomous, multiple-choice, and 5-point Likert response scale questions. Descriptive and multivariate analyses were performed to compare the student’s perceptions between public and private schools. Results A total of 671 responses were included in the study period. Most participants were from public schools (81%) and female (61%). Almost every respondent (94%) indicated it was necessary to obtain COVID-19 education, yet only half (54%) received such training. Students in private schools were less likely to have their clinical instruction canceled (53% vs. 77%, p = 0.001) and more likely to have access to virtual instruction (46% vs. 22%, p = 0.001) when compared to students from public schools. Four out of every five students considered their training inferior to that of previous generations, and most students (82%) would consider repeating their final year of clinical training. Conclusions The impact of the COVID-19 on medical education in Mexico has been significant. Most final-year medical students have been affected by the cancellation of their in-person clinical instruction, for which the majority would consider repeating their final year of training. Efforts to counterbalance this lack of clinical experience with virtual or simulation instruction are needed.

A Qualitative Exploration of Medical Student Empathy During the COVID-19 Pandemic

BackgroundThere is evidence that medical student self-reported empathy may decline as one progresses through their clinical training. Due to the unprecedented changes to both patient care and medical education caused by COVID-19, it is reasonable to assume that medical student empathy may be impacted. The goal of this July 2020 study was to qualitatively explore how the COVID-19 pandemic might affect medical students’ reported experience of empathy.MethodUsing a semi-structured interview, the authors interviewed 12 medical students, 6 second-year and 6 fourth-year. They selected these groups because of the distinct differences in their clinical experience. ResultsData analysis identified 5 major themes: 1) Expanded Perspective (e.g., a feeling of “we’re in this together”, increased awareness of patient vulnerability) 2) Moral Dilemmas (e.g., difficult decisions faced by students as a result of the pandemic such as weighing educational vs. family responsibilities, students risking their own health to provide the best possible care) 3) Confirmation of Values (e.g., Feeling reaffirmed in decision to enter medicine, feeling the pandemic was “what we signed up for” by entering medical school) 4) Shaping Priorities (e.g., changes in medical specialty or populations of interest) 5) Barriers to Empathy and Adaptive Strategies (e.g., COVID-19 created many physical, psychological, and social barriers to empathy for students, students presented many strategies for ameliorating these barriers). Five students (42%) reported increased empathy with no students reporting a decrease in empathy due to experiences during the pandemic. Conclusions Participants did not report that their personal experience of empathy for patients was negatively influenced by the COVID-19 pandemic. Many reported that their empathy increased. The observed differences in responses by pre-clinical (second-year) and clinical (fourth-year) students suggests a possible shift in how empathy is experienced and practiced as one progresses through their medical education. The overwhelmingly positive responses to the semi-structured interview, emphasizing appreciation of the opportunity to discuss topics not previously openly discussed, underscores the importance of providing explicit opportunities for students to discuss their emotional/interpersonal experiences within medical education, particularly in difficult times such as the COVID-19 pandemic.

Competence of clinical nurse educators in university hospitals: A cross-sectional study

The role of clinical nurse educators is essential in improving the quality of mentoring, supporting students’ learning and professional development during clinical training. The purpose was to explore the competence profiles of clinical nurse educators and background factors associated with these profiles. Data of this cross-sectional study were collected from clinical nurse educators ( n = 19) at Finnish university hospitals, using two instruments measuring the competence of healthcare educators. Data were analysed with K-means clustering and two profiles were identified based on sum variables. Significance between the differences of Profile 1 and Profile 2 was evaluated by comparing independent groups. The STROBE checklist was used as the reporting guideline for the manuscript. Educators’ competence varied between intermediate (2.50–3.49) and high (≥ 3.50) levels, and self-assessment of the Profile 1 was average higher than those in Profile 2. The results can be used to identify and develop the competence of clinical nurse educators and to consolidate the role and position of clinical nurse educators within healthcare education.