The primary objective of this research was to explore themes related to periodontal operation in a medical clinical teaching unit, based on comparation the traditional jaw simulation and virtual simulation, seeking for higher efficient manner and avert shortcomings in traditional teaching methods allows the students quickly practice new skills lasting the same amount of time [23]. Our experimental results showed that no matter promote theoretical knowledge or acquisition of periodontal supragingival scaling of clinical skills, the combination of virtual simulation and jaw model both were superior to traditional teaching methods. Our results also revealed that the order of the methods (i.e., J-V vs V-J influenced the effectiveness of clinical teaching, and this was especially noticeable for the supragingival scaling procedure.
The transition of theoretical medicine into clinical practice is difficult, however, there is an urgent need for simulation training methods that integrate theory into practice [24]. In previous studies, they offered a means of role play the communication between physician and patient simulate on different clinical specialties largely boosted their memory of theoretical knowledge [25]. Consistent with our results of improved second theoretical scores. Murbay [26] assessed undergraduate performance by introducing a randomized setting in a Moog Simodont virtual system within the per-clinical stage and found that it significantly improved student’s operation level. This type of training would be valuable for students in training programs and for undergraduate teaching. Another scholars have found that students successfully mastered tooth preparation skills using virtual simulation [27]. Further, de Boer IR [28] explained the possible causes which is force dependent feedback might practice hands agility more improve students’ clinical skills when the time reached on enough time. Our experimental and modeling results are consistent with the hypothesis that virtual simulation is beneficial for operation ability. While a single training of virtual simulation cannot achieve the best effects because of differences in the system used, proficiency of the system, and the particularity of dentistry [28, 29].
Studies have reported that virtual technology offers multiple advantages in education, including improved efficiency and quality of study through feedback signals to the brain, sufficient and free training time, and accurate and automatic training data [30]. However, some scholars believe that virtual technology should not be used as an alternative to traditional methods because of excessive critical feedback, lack of personal contact, and technical hardware difficulties that are associated with VR-based training [31]. According to Plessas [32], the guidance and evaluation of professional teachers are still indispensable and virtual systems cannot fully replace traditional training courses. Furthermore, Al-Saud et al [33]. randomly divided 63 people without oral professional training into 3 groups: the Device Feedback group, the Instructor Feedback group, and the Instructor Device Feedback group and revealed that skills and error rate in the last group were improved as compared with those in the former two groups. This difference translates into improvements in skill retention and the extension of knowledge to new tasks. The combination of professional guidance and feedback from a virtual simulation system (e.g., VR) is best for junior students to learn and master basic oral operations, which is consistent with our research design and conclusions.
However, the optimal sequence for training with jaw model and virtual simulation system has not been determined. In this study, the best supragingival scaling effect was observed in Group J-V. Jaw model training provides students with concrete experience that allows them to strengthen their operating skills separately. Indeed, studies have reported differences in the levels of performance between novice students (< 1 year) and experienced dental students after training with virtual simulation systems, and current study revealed features that are unique to VR and that may help us understand how these characteristics impact dental education [34]. In addition, there are a small number of students whose theoretical grades does not match the operating scores. According to neurophysiological research, this discrepancy may be related to differences in personal psychomotor skills [35].
There are several strengths associated with this study. Our methodology and findings address the shortcomings of VR periodontal education in the research literature, and may provide a useful reference for future medical teaching models. Furthermore, we cannot observe the therapeutic effects of subgingival scaling over a short period of time, and none of periodontitis patients do want to be treated by students. Hence, it was reasonable for us to explore the teaching method of periodontal operation by supragingival scaling. Most importantly, we used the Turesky modification of the Quigley–Hein plaque index gathering student’s training outcomes instead of practical clinical operation direct to patients. This method can be used to assess the teaching effect of supragingival scaling. At the same time, plaque can be identified by its unique color which allows for thorough and accurate supragingival scaling.
The study also had multiple limitations. First, the approach we adopted was inevitably one-sided as compared with the general strategies that are used to evaluate periodontal treatment effects, such as probing depth and attachment loss. However, few patients allow undergraduate students to perform these procedures. Additionally, the training time of the experimental subjects may have not been sufficient to fully predict the long-term application effect of the various teaching methods. Future studies will evaluate the long-term application effects of the virtual stimulation system, including the optimal application period in the teaching process. Further, there was a possibility of publication bias for different manipulation systems of VR [36]. Finally, it is necessary to develop more realistic virtual simulation equipment.