Effectiveness of Virtual Reality-Based Training on Oral Healthcare for Disabled Elderly Persons: A Randomized Controlled Trial

Ai-Hua Chang, Pei-Chen Lin, Pei-Chao Lin, Yi-Ching Lin, Yuji Kabasawa, Cheng-Yu Lin, Hsiao-Ling Huang, Ai-Hua Chang, Pei-Chen Lin, Pei-Chao Lin, Yi-Ching Lin, Yuji Kabasawa, Cheng-Yu Lin, Hsiao-Ling Huang

Abstract

(1) Background: Virtual reality (VR) technology is a widely used training tool in medical education. The present study aimed to evaluate the effectiveness of VR training of oral hygiene students on providing oral healthcare to disabled elderly persons. (2) Methods: A randomized controlled trial was conducted. In 2021, oral hygiene students were randomly assigned to a VR experimental group (EG; n = 11) and a control group (CG; n = 12). The EG received two-hour, thrice-repeated VR-based training interventions at 2-week, 4-week, and 6-week follow-ups. The CG received no VR-based interventions. Data were collected using a self-administered questionnaire before and immediately after each intervention. We performed generalized estimating equations to compare the responses. (3) Results: The EG exhibited a more significant improvement in oral care-related knowledge, attitude, self-efficacy, and intention at the 6-week follow-up than the CG. The students' intention to assist the elderly in using interdental brushes (β = 0.91), with soft tissue cleaning (β = 0.53), and with oral desensitization (β = 0.53), and to have regular dental visits (β = 0.61) improved significantly at the 6-week follow-up. (4) Conclusions: VR training positively affected students' knowledge, attitude, self-efficacy, and intentions on providing oral healthcare to disabled elderly persons.

Keywords: disabled; elderly; medical education; oral hygiene; virtual reality.

Conflict of interest statement

The authors declare no conflict of interest. The funders had no role in the design of the study; in the collection, analyses, or interpretation of data; in the writing of the manuscript; or in the decision to publish the results.

Figures

Figure 1
Figure 1
Depiction of three-dimensional (3D) virtual reality (VR) controller, glasses, and motion detectors used in the Cave Automatic Virtual Environment (CAVE) VR system during interventions.
Figure 2
Figure 2
Screen captures of oral healthcare training scenarios in the interactive and immersive virtual reality (VR) system.
Figure 3
Figure 3
Procedure of the virtual reality (VR)-based training. (a) A short introduction by the researcher. (b) A student using the VR-based curriculum. (c) Evaluation.
Figure 4
Figure 4
CONSORT flowchart.

References

    1. Pottle J. Virtual reality and the transformation of medical education. Future Health J. 2019;6:181–185. doi: 10.7861/fhj.2019-0036.
    1. Graafland M., Schraagen J.M., Schijven M.P. Systematic review of serious games for medical education and surgical skills training. Br. J. Surg. 2012;99:1322–1330. doi: 10.1002/bjs.8819.
    1. Abe S., Noguchi N., Matsuka Y., Shinohara C., Kimura T., Oka K., Okura K., Rodis O.M.M., Kawano F. Educational effects using a robot patient simulation system for development of clinical attitude. Eur. J. Dent. Educ. 2018;22:e327–e336. doi: 10.1111/eje.12298.
    1. Ekstrand C., Jamal A., Nguyen R., Kudryk A., Mann J., Mendez I. Immersive and interactive virtual reality to improve learning and retention of neuroanatomy in medical students: A randomized controlled study. CMAJ Open. 2018;6:E103–E109. doi: 10.9778/cmajo.20170110.
    1. Towers A., Field J., Stokes C., Maddock S., Martin N. A scoping review of the use and application of virtual reality in pre-clinical dental education. Br. Dent. J. 2019;226:358–366. doi: 10.1038/s41415-019-0041-0.
    1. Li Y., Ye H., Ye F., Liu Y., Lv L., Zhang P., Zhang X., Zhou Y. The Current Situation and Future Prospects of Simulators in Dental Education. J. Med Internet Res. 2021;23:e23635. doi: 10.2196/23635.
    1. Huang T.-K., Yang C.-H., Hsieh Y.-H., Wang J.-C., Hung C.-C. Augmented reality (AR) and virtual reality (VR) applied in dentistry. Kaohsiung J. Med Sci. 2018;34:243–248. doi: 10.1016/j.kjms.2018.01.009.
    1. Luciano C., Banerjee P., DeFanti T. Haptics-based virtual reality periodontal training simulator. Virtual Real. 2009;13:69–85. doi: 10.1007/s10055-009-0112-7.
    1. Welk A., Splieth C., Rosin M., Kordas B., Meyer G. DentSim-a future teaching option for dentists. Int. J. Comput. Dent. 2004;7:123–130.
    1. Kishimoto N., Mukai N., Honda Y., Hirata Y., Tanaka M., Momota Y. Simulation training for medical emergencies in the dental setting using an inexpensive software application. Eur. J. Dent. Educ. 2018;22:e350–e357. doi: 10.1111/eje.12301.
    1. Roy E., Quinsat V.E., Bazin O., Lesclous P., Lejus-Bourdeau C. High-fidelity simulation in training dental students for medical life-threatening emergency. Eur. J. Dent. Educ. 2018;22:e261–e268. doi: 10.1111/eje.12284.
    1. Soltanimehr E., Bahrampour E., Imani M.M., Rahimi F., Almasi B., Moattari M. Effect of virtual versus traditional education on theoretical knowledge and reporting skills of dental students in radiographic interpretation of bony lesions of the jaw. BMC Med. Educ. 2019;19:233. doi: 10.1186/s12909-019-1649-0.
    1. Urbankova A. Impact of Computerized Dental Simulation Training on Preclinical Operative Dentistry Examination Scores. J. Dent. Educ. 2010;74:402–409. doi: 10.1002/j.0022-0337.2010.74.4.tb04885.x.
    1. Quinn F., Keogh P., McDonald A., Hussey D. A study comparing the effectiveness of conventional training and virtual reality simulation in the skills acquisition of junior dental students. Eur. J. Dent. Educ. 2003;7:164–169. doi: 10.1034/j.1600-0579.2003.00309.x.
    1. Leblanc V.R., Urbankova A., Hadavi F., Lichtenthal R.M. A Preliminary Study in Using Virtual Reality to Train Dental Students. J. Dent. Educ. 2004;68:378–383. doi: 10.1002/j.0022-0337.2004.68.3.tb03754.x.
    1. United Nations Department of Economic and Social Affairs Population Dynamics. Revis. World Popul. Prospect. 2019. [(accessed on 13 December 2021)]. Available online:
    1. National Development Council Taiwan Executive Yuan, Population Estimation. [(accessed on 13 December 2021)];2020 Available online:
    1. Batchelor P. The changing epidemiology of oral diseases in the elderly, their growing importance for care and how they can be managed. Age Ageing. 2015;44:1064–1070. doi: 10.1093/ageing/afv148.
    1. Red A., O’Neal P.V. Implementation of an Evidence-Based Oral Care Protocol to Improve the Delivery of Mouth Care in Nursing Home Residents. J. Gerontol. Nurs. 2020;46:33–39. doi: 10.3928/00989134-20200316-01.
    1. Warren C., Medei M.K., Wood B., Schutte D. A Nurse-Driven Oral Care Protocol to Reduce Hospital-Acquired Pneumonia. AJN Am. J. Nurs. 2019;119:44–51. doi: 10.1097/01.NAJ.0000553204.21342.01.
    1. Lewis A., Edwards S., Whiting G., Donnelly F. Evaluating student learning outcomes in oral health knowledge and skills. J. Clin. Nurs. 2018;27:2438–2449. doi: 10.1111/jocn.14082.
    1. Berg H., Steinsbekk A. Is individual practice in an immersive and interactive virtual reality application non-inferior to practicing with traditional equipment in learning systematic clinical observation? A randomized controlled trial. BMC Med. Educ. 2020;20:123. doi: 10.1186/s12909-020-02030-7.
    1. Lohre R., Bois A.J., Pollock J.W., Lapner P., McIlquham K., Athwal G.S., Goel D.P. Effectiveness of Immersive Virtual Reality on Orthopedic Surgical Skills and Knowledge Acquisition Among Senior Surgical Residents: A Randomized Clinical Trial. JAMA Netw Open. 2020;3:e2031217. doi: 10.1001/jamanetworkopen.2020.31217.
    1. Aksoy E. Comparing the Effects on Learning Outcomes of Tablet-Based and Virtual Reality–Based Serious Gaming Modules for Basic Life Support Training: Randomized Trial. JMIR Serious Games. 2019;7:e13442. doi: 10.2196/13442.
    1. Faul F., Erdfelder E., Lang A.G., Buchner A. G* Power 3: A flexible statistical power analysis program for the social, behavioral, and biomedical sciences. Behav. Res. Methods. 2007;39:175–191. doi: 10.3758/BF03193146.
    1. Brooke J. SUS: A ’Quick and Dirty’ Usability Scale. Usability Eval. Ind. 1996;189:4–7.
    1. Lewis J.R. The System Usability Scale: Past, Present, and Future. Int. J. HumaŽ Comput. Interact. 2018;34:577–590. doi: 10.1080/10447318.2018.1455307.
    1. Kotrlik J., Williams H.A. The Incorporation of Effect Size in The Incorporation of Effect Size in Information Technology, Learning, Information Technology, Learning, and Performance Research and Performance Research. Inf. Technol. Learn. Perform. J. 2003;21:1.
    1. Schulz K.F., Altman D.G., Moher D. CONSORT 2010 Statement: Updated guidelines for reporting parallel group randomised trials. Ann. Intern. Med. 2010;152:726–732. doi: 10.7326/0003-4819-152-11-201006010-00232.
    1. Stepan K., Zeiger J., Hanchuk S., Del Signore A., Shrivastava R., Govindaraj S., Iloreta A. Immersive virtual reality as a teaching tool for neuroanatomy. Int. Forum Allergy Rhinol. 2017;7:1006–1013. doi: 10.1002/alr.21986.
    1. Serrano C., Wesselink P., Vervoorn J. Real patients in virtual reality: The link between phantom heads and clinical dentistry. Ned. Tijdschr. Voor Tandheelkd. 2018;125:263–267. doi: 10.5177/ntvt.2018.05.17192.
    1. Zaveri P.P., Davis A.B., O’Connell K.J., Willner E., Schinasi D.A.A., Ottolini M. Virtual Reality for Pediatric Sedation: A Randomized Controlled Trial Using Simulation. Cureus. 2016;8:e486. doi: 10.7759/cureus.486.
    1. Ingrassia P.L., Ragazzoni L., Carenzo L., Colombo D., Gallardo A.R., Della Corte F. Virtual reality and live simulation: A comparison between two simulation tools for assessing mass casualty triage skills. Eur. J. Emerg. Med. 2015;22:121–127. doi: 10.1097/MEJ.0000000000000132.
    1. Khan R., Plahouras J., Johnston B.C., Scaffidi M.A., Grover S.C., Walsh C.M. Virtual reality simulation training for health professions trainees in gastrointestinal endoscopy. Cochrane Database Syst. Rev. 2018;2018:CD008237. doi: 10.1002/14651858.CD008237.pub3.
    1. Bakhos D., Galvin J., Aoustin J.-M., Robier M., Kerneis S., Bechet G., Montembault N., Laurent S., Godey B., Aussedat C. Training outcomes for audiology students using virtual reality or traditional training methods. PLoS ONE. 2020;15:e0243380. doi: 10.1371/journal.pone.0243380.
    1. Pike T., O’Donnell V. The impact of clinical simulation on learner self-efficacy in pre-registration nursing education. Nurse Educ. Today. 2010;30:405–410. doi: 10.1016/j.nedt.2009.09.013.
    1. Meechan-Rogers R., Jones H., Valler-Jones T. Students’ perspectives on their skills acquisition and confidence. Br. J. Nurs. 2011;20:445–450. doi: 10.12968/bjon.2011.20.7.445.
    1. Ajzen I. The Theory of Planned Behavior. Organ. Behav. Hum. Decis. Process. 1991;50:179–211. doi: 10.1016/0749-5978(91)90020-T.
    1. Glanz K., Rimer B.K., Viswanath K. Health Behavior and Health Education: Theory, Research, and Practice. John Wiley & Sons; Hoboken, NJ, USA: 2008.
    1. Sattar M.U., Palaniappan S., Lokman A., Hassan A., Shah N., Riaz Z. Effects of Virtual Reality training on medical students’ learning motivation and competency. Pak. J. Med Sci. 2019;35:852–857. doi: 10.12669/pjms.35.3.44.
    1. Boelen C., Heck J. Defining and Measuring the Social Accountability of Medical Schools. World Health Organization; Geneva, Switzerland: 1995.
    1. Alexander C., Millar J., Szmidt N., Hanlon K., Cleland J. Can new doctors be prepared for practice? A review. Clin. Teach. 2014;11:188–192.
    1. Ferguson G.R., Bacila I.A., Swamy M. Does current provision of undergraduate education prepare UK medical students in ENT? A systematic literature review. BMJ Open. 2016;6:e010054. doi: 10.1136/bmjopen-2015-010054.

Source: PubMed

Sponsorzy i współpracownicy

Warunki medyczne

Interwencje lekowe

3
Subskrybuj