Effect of tutorial input in addition to augmented feedback on manual dexterity training and its retention.

Virtual reality (VR) simulators can be used as tools in manual dexterity training. The visual feedback guides the subject towards proper performance but creates, at the same time, some dependency on this feedback. To overcome this drawback, the effect of adjunct tutorial input on motor learning behaviour was examined. Novice dental students were randomly assigned to one of two training groups or to a non-training control group, given the task of preparing a geometrical class 1 cavity in phantom teeth. The feedback (FB) group trained under augmented visual feedback conditions, provided by the VR system (DentSim). The feedback-plus (FB+) group received, in addition, standardised expert input to enrich the augmented feedback information. The control group, consisting of same year students, did not participate in any training programme. All preparations were evaluated by the VR scoring system. Performance analyses revealed an overall trend towards significant improvement with practice for the training groups. Performance of the FB+ group was most accurate across training. After 1 day and 3 weeks of no practice, both training groups outperformed the control group. After 4 months, however, only the FB+ condition was significantly more accurate than the control group. The same tendency was noted for the transfer tests. Consequently, cavity preparation experience on a VR system under the condition of frequently provided feedback supplemented with expert input was most beneficial to long time learning.