Al-Saud Loulwa M, Mushtaq Faisal, Mann Richard P, Mirghani Isra'a, Balkhoyor Ahmed, Harris Richard, Osnes Cecilie, Keeling Andrew, Mon-Williams Mark A, Manogue Michael
Operative Division, Department of Restorative Dental Sciences, King Saud University College of Dentistry, Riyadh, Saudi Arabia.
School of Dentistry, University of Leeds, Leeds, UK.
BMJ Simul Technol Enhanc Learn. 2020 Sep 3;6(5):274-278. doi: 10.1136/bmjstel-2018-000420. eCollection 2020.
Prediction of clinical training aptitude in medicine and dentistry is largely driven by measures of a student's intellectual capabilities. The measurement of sensorimotor ability has lagged behind, despite being a key constraint for safe and efficient practice in procedure-based medical specialties. Virtual reality (VR) haptic simulators, systems able to provide objective measures of sensorimotor performance, are beginning to establish their utility in facilitating sensorimotor skill acquisition, and it is possible that they may also inform the prediction of clinical performance.
A retrospective cohort study examined the relationship between student performance on a haptic VR simulator in the second year of undergraduate dental study with subsequent clinic performance involving patients 2 years later. The predictive ability was tested against a phantom-head crown test (a traditional preclinical dental assessment, in the third year of study).
VR scores averaged across the year explained 14% of variance in clinic performance, while the traditional test explained 5%. Students who scored highly on this averaged measure were ~10 times more likely to be high performers in the clinical crown test. Exploratory analysis indicated that single-trial VR scores did not correlate with real-world performance, but the relationship was statistically significant and strongest in the first half of the year and weakened over time.
The data demonstrate the potential of a VR haptic simulator to predict clinical performance and open up the possibility of taking a data-driven approach to identifying individuals who could benefit from support in the early stages of training.
医学和牙医学临床培训能力的预测很大程度上取决于对学生智力水平的衡量。尽管感觉运动能力的测量是基于程序的医学专业安全高效实践的关键限制因素，但这方面的测量却滞后了。虚拟现实（VR）触觉模拟器能够提供感觉运动表现的客观测量，开始在促进感觉运动技能习得方面发挥作用，并且它们也有可能为临床能力的预测提供信息。
一项回顾性队列研究考察了本科牙科学习第二年学生在触觉VR模拟器上的表现与两年后涉及患者的临床操作表现之间的关系。将预测能力与头颅模型牙冠测试（传统的临床前牙科评估，在学习第三年进行）进行对比测试。
全年的VR分数平均解释了临床操作表现中14%的方差，而传统测试仅解释了5%。在这一平均测量中得分高的学生在临床牙冠测试中成为优秀者的可能性高出约10倍。探索性分析表明，单次VR分数与实际操作表现不相关，但这种关系具有统计学意义，且在上半年最强，随时间推移而减弱。
数据表明VR触觉模拟器在预测临床操作表现方面具有潜力，并为采用数据驱动方法识别那些在培训早期阶段能从支持中受益的个体开辟了可能性。
