Game-based learning in orthodontic education: a systematic review.

OBJECTIVE: To evaluate educational impact of game-based learning (GBL) in orthodontic education. METHODS: A systematic search was undertaken across four databases (Scopus, PubMed, ProQuest Dissertations & Theses Global, and Google Scholar) to identify relevant articles published from January 2000 to December 2023. Additionally, the reference lists of identified literature were examined to further search for relevant literature. The last search was performed on 28 January 2024. RESULTS: Following the article selection process, seven articles were included in this systematic review, comprising four randomized control trials and three questionnaire surveys. Six articles were assessed to have a moderate risk of biases, whereas one research exhibited a low risk of bias. GBL interventions assessed in five articles were designed in digital format, while one study implemented evaluated traditional learning, and another employed a card game format. Two RCTs indicated a greater effectiveness of GBL in enhancing learner performance compared to traditional learning methods, while one article found no significant difference. Across all articles, positive perceptions of GBL were consistently highlighted at both undergraduate and postgraduate levels. CONCLUSION: This systematic review supports the potential of GBL in orthodontic education. The implementation of GBL is recommended to integrate entertaining and educational elements, fostering learner performance within engaging learning environments. However, it is imperative to acknowledge that the overall quality of evidence is limited, primarily due to the moderate risk of biases identified in six of the included articles. Consequently, further high-quality experimental studies are required to validate the effectiveness of GBL in orthodontic education.

Muskox status, recent variation, and uncertain future.

Muskoxen (Ovibos moschatus) are an integral component of Arctic biodiversity. Given low genetic diversity, their ability to respond to future and rapid Arctic change is unknown, although paleontological history demonstrates adaptability within limits. We discuss status and limitations of current monitoring, and summarize circumpolar status and recent variations, delineating all 55 endemic or translocated populations. Acknowledging uncertainties, global abundance is ca 170 000 muskoxen. Not all populations are thriving. Six populations are in decline, and as recently as the turn of the century, one of these was the largest population in the world, equaling ca 41% of today's total abundance. Climate, diseases, and anthropogenic changes are likely the principal drivers of muskox population change and result in multiple stressors that vary temporally and spatially. Impacts to muskoxen are precipitated by habitat loss/degradation, altered vegetation and species associations, pollution, and harvest. Which elements are relevant for a specific population will vary, as will their cumulative interactions. Our summaries highlight the importance of harmonizing existing data, intensifying long-term monitoring efforts including demographics and health assessments, standardizing and implementing monitoring protocols, and increasing stakeholder engagement/contributions.

How families prepare their children for tooth extraction under general anaesthesia: Family and clinical predictors of non-compliance with a 'serious game'.

OBJECTIVE: To explore family and clinical factors for usage of an online serious game designed to prepare children with ECC for dental treatment under general anaesthesia. DESIGN: Observational study. Secondary data of 60 children, aged 5-to-7, randomised to the intervention group in a phase-III randomised controlled trial [NIHR Portfolio 10006, ISRCTN: 18265148] testing the efficacy of the serious game http://www.scottga.org (available online). Usage was captured automatically, with each click, in real time. The total number of replays and total number of missing slides per game-run performed by the child, were recorded and used to monitor usage. Compliance outcomes were: total time running the game and number of completely missed slides. RESULTS: 57/60 played the game. Median age of parent/carer was 32. For 74% of the families, fathers resided at home and for 65% the parent/carer had A-levels-to-university education. At recruitment, 70% of the children were reported as anxious/highly-fearful and 37% as "significantly psychologically disturbed". CONCLUSIONS: Factors for non-compliance were absence of a father at home (P = 0.01) and higher child-anxiety (P = 0.01) and, to a lesser extent, a low parent/carer education level (P = 0.09). Interactive cartoons featuring dental assessment, oral health messages and modelling featured in the more popular slides.

Assessment of Behavioral Health Concerns in the Community Affected by the Flint Water Crisis - Michigan (USA) 2016.

OBJECTIVES: The Flint Community Resilience Group (Flint, Michigan USA) and the Centers for Disease Control and Prevention (CDC; Atlanta, Georgia USA) assessed behavioral health concerns among community members to determine the impact of lead contamination of the Flint, Michigan water supply. METHODS: A Community Assessment for Public Health Emergency Response (CASPER) was conducted from May 17 through May 19, 2016 using a multi-stage cluster sampling design to select households and individuals to interview. RESULTS: One-half of households felt overlooked by decision makers. The majority of households self-reported that at least one member experienced more behavioral health concerns than usual. The prevalence of negative quality of life indicators and financial concerns in Flint was higher than previously reported in the Michigan 2012 and 2014 Behavioral Risk Factor Surveillance System (BRFSS) survey. CONCLUSIONS: The following can be considered to guide recovery efforts in Flint: identifying additional resources for behavioral health interventions and conducting follow-up behavioral health assessments to evaluate changes in behavioral health concerns over time; considering the impact of household economic factors when implementing behavioral health interventions; and ensuring community involvement and engagement in recovery efforts to ease community stress and anxiety. FortenberryGZ, ReynoldsP, BurrerSL, Johnson-LawrenceV, WangA, SchnallA, PullinsP, KieszakS, BayleyegnT, WolkinA. Assessment of behavioral health concerns in the community affected by the Flint water crisis - Michigan (USA) 2016. Prehosp Disaster Med. 2018;33(3):256-265.

On-line preparatory information for children and their families undergoing dental extractions under general anesthesia: A phase III randomized controlled trial.

BACKGROUND: Family-centered interactive on-line games are increasingly popular in healthcare, but their effectiveness for preoperative preparation needs further research. www.scottga.org is the new on-line version of a proven nonweb-based game for children and parents/caregivers. AIMS: The aim of this study was to evaluate if www.scottga.org improved children's anxiety and families' satisfaction compared with controls. METHODS: In this phase III double-blind randomized controlled trial, children/parents/caregivers received (i) www.scottga.org, (ii) standard care, or (iii) a placebo hand-washing game. The intervention and placebo games were available online for home usage and provided again on the ward before surgery. All children were accompanied by parent/caregivers at induction and observed and scored using validated measures. Stratified randomization and generalized linear models were used. An intention-to-treat approach was adopted. RESULTS: Overall, 52/176 children had baseline "psychological disturbance." Children's anxiety increased preinduction, but there were no differences between groups (Facial Image Scale: video-standard OR = 1.08, P = .82, 95% CI [0.56, 2.1]; video-placebo OR = 0.9, P = .77 95% CI [0.46, 1.8]). There were no differences in induction behavior (visual analog scale: video mean = 3.5; standard care mean = 3.5; placebo mean = 3.7: video-standard OR = 2.0, P = .42, 95% CI [-0.6, 1.3]; video-placebo OR = 1.53, P = .65, 95% CI [-0.8, 1.1]) or induction anxiety (modified Yale Preoperative Anxiety Scale: video-standard OR 1.02, P = .97, 95% CI [0.61, 2.6]; video-placebo OR 1.38, P = .49, 95% CI [0.87, 3.81]). Families favored the intervention regarding the "child handling the visit better" (Treatment Evaluation Inventory: video-standard OR = 12; 95% CI 4.7-32; P < .001; video-placebo OR = 8.2; 95% CI 3-22; P < .001) and "improving the child's ability to cope" (Treatment Evaluation Inventory: video-standard OR = 21; 95% CI 8-56; P < .001 and video-placebo OR = 13; 95% CI 5-34; P < .001). CONCLUSION: Families believed that a video-game preparation helped their child's perioperative anxiety, but there were no objective measures of behavioral improvement associated with this intervention.

Improving access to preparatory information for children undergoing general anaesthesia for tooth extraction and their families: study protocol for a Phase III randomized controlled trial.

BACKGROUND: Children can find anaesthesia induction especially distressing and postoperative psychological and physical morbidity are common. Preparation programmes for general anaesthesia (GA) are highly effective in reducing this distress. A Phase II study has already verified the effectiveness of a prototype preoperative GA-coping computer game to help children cope with induction in a dental GA setting. The biggest patient users of pediatric GA services in the UK are children who need to have teeth removed (estimated to be 100,000 yearly). Tooth decay is the most common disease in children worldwide. This study is a Phase III randomized controlled trial (RCT) and will evaluate the effectiveness of the new internet version of this game. METHODS/DESIGN: The Phase III RCT will use a double-blind three-armed design. The clinical trial will recruit up to 210 children and will compare the web-based game against standard care and another non-medical game. At least 53 patients in each group will be required for 90% statistical power. Distress will be assessed through an evaluation of the child's behaviour during the visit and later parental reports of physical and psychological morbidity. The satisfaction of parents and children will be measured; the mode of usage of the web-based game will be automatically recorded and the impact on the service (for example, recovery time and throughput) will be reported.The Phase III study primary outcome will measure: (1) patient experience: acceptance of anaesthetic induction, child cooperation and distress, reduction of peri- and postoperative morbidity, child and family satisfaction, and (2) service improvement: anaesthetic time and improvement in throughput. Measures will be administered at baseline, at the time of the GA treatment visit, and at 48 hours and one week postoperatively. DISCUSSION: This study aims to determine the effectiveness of an online GA-coping game for children and families undergoing tooth extraction under GA. TRIAL REGISTRATION: ISRCTN18265148 (registered 24 November 2013).

Back to the Future of Dental Education: "Lock up your libraries if you like, but there is no gate, no lock, no bolt that you can set upon the freedom of my mind"Virginia Woolf, A Room of One's Own, 1929.

Our students are like beacons, a bright light on the horizon, but with some way to go. Our educational methods that bring them safely into harbour have seen the test of time, but do we allow them enough freedom and creativity to sail their boats in the climate change of the digital era? Our students are chosen because they are smart and capable and we hope will bring credit to our institutions, but do we maximize their potential educationally? We need to go back to the future to begin to consider this.

Lifelong learning for nurses-building a strong future.

Lifelong learning is a key issue for the nursing profession. The literature reports effective collaboration between nurses and health sciences librarians to develop evidence-based programs for hospital staff nurses. In this collaboration the nurse provides the real-time practice issues and the health sciences librarian provides the expertise to retrieve the information from the literature. This column presents a current overview of the participation of health sciences librarians, particularly hospital librarians, in the development of programs and resources for nurses' lifelong learning.

Framework for e-learning assessment in dental education: a global model for the future.

The framework presented in this article demonstrates strategies for a global approach to e-curricula in dental education by considering a collection of outcome assessment tools. By combining the outcomes for overall assessment, a global model for a pilot project that applies e-assessment tools to virtual learning environments (VLE), including haptics, is presented. Assessment strategies from two projects, HapTEL (Haptics in Technology Enhanced Learning) and UDENTE (Universal Dental E-learning), act as case-user studies that have helped develop the proposed global framework. They incorporate additional assessment tools and include evaluations from questionnaires and stakeholders' focus groups. These measure each of the factors affecting the classical teaching/learning theory framework as defined by Entwistle in a standardized manner. A mathematical combinatorial approach is proposed to join these results together as a global assessment. With the use of haptic-based simulation learning, exercises for tooth preparation assessing enamel and dentine were compared to plastic teeth in manikins. Equivalence for student performance for haptic versus traditional preparation methods was established, thus establishing the validity of the haptic solution for performing these exercises. Further data collected from HapTEL are still being analyzed, and pilots are being conducted to validate the proposed test measures. Initial results have been encouraging, but clearly the need persists to develop additional e-assessment methods for new learning domains.

UDENTE (Universal Dental E-Learning) a golden opportunity for dental education.

The incorporation of technological advancements in higher education has started to bridge the gap in local, national and global delivery of dental courses. This gap, including the global decrease in senior clinical academics, has influenced the development of new teaching and learning techniques. Institutional virtual learning environments (VLE) and other e-learning resources are now in higher demand. This paper describes how one such innovative solutions has been IVIDENT (International Virtual Dental School), has enabled secure and seamless access to high quality e-content and tools through an innovative, universal flexible learning platform. IVIDENT, now UDENTE (Universal Dental E-learning) has been shown to offer new learning experiences for students of dentistry, but its approach can apply across all educational domains. UDENTE also benefits staff as it allows them to contribute and access resources through peer reviewed publishing processes, which ensure the highest quality in education. UDENTE was developed thanks to a £2.3 million grant from the Higher Education Funding Council for England (HEFCE) and the Department of Health. http://www.udente.org. This academically led educational research project involved dental schools in seven countries. An initially scoping of requirements was followed by elaboration of the tools needed. Pilot testing of the tools, systems and learning resources in particular and the impact of the UDENTE in general were carried out. The pilots revealed evidence of positive impact of a space for learning, teaching, development and communication, with tools for planning of electives and administrative support. The results of these initial pilots have been positive and encouraging, describing UDENTE as an accessible, user friendly platform providing tools that otherwise would be difficult to access in a single space. However, attention to supporting faculty to embrace these new learning domains is essential if such technology enhanced learning (TEL) is to be viewed as a golden opportunity in Higher Education.

Disaster Information Specialist Pilot Project: NLM/DIMRC.

Medical librarians have often been overlooked as important contributors to hospital disaster preparedness. Recognizing the importance of medical libraries and their potential in disaster planning and management, the National Library of Medicine (NLM), Disaster Information Management Research Center (DIMRC), formed a pilot Disaster Information Specialist Project. This paper describes the preliminary activities of Bishopric Medical Library's Director, Patricia Reynolds, at Sarasota Memorial Health Care System, as a disaster information specialist in the hospital's disaster planning and preparedness.

Percepción de los adolescentes de la población Mineros San Juan, con relación a educación, salud y expectativas de vida / Perception of adolescent population Mineros San Juan, in relation to education, health and life expectancy

La mayor parte de la población de adolescentes del asentamiento Mineros "San Juan", se encuentra cursando estudios secundarios o técnicos acordes a su edad, sin embargo, un porcentaje menor ha dejado de estudiar debido a la falta de recursos económicos que les ha obligado a trabajar para aportar a los ingresos familiares, pero mantienen la esperanza de retornar a sus estudios en el futuro. Las aspiraciones de alcanzar algún tipo de profesión, muestran la situación de la mujer aún relegada que asumiendo la limitación social, aspira a niveles inferiores de profesionalización en comparación con los hombres. Las expectativas futuras de los adolescentes de ambos sexos, están dirigidas hacia el logro de una mejor situación socioeconómica por medio de los estudios y el trabajo. Perciben que una profesión puede mejorar el nivel de ingresos económicos y sus esfuerzos se encaminan a culminar sus estudios. Llama la atención, que la mayor parte de los adolescentes de ambos sexos, expresan su conformidad con su situación actual de vida, pese a las condiciones de graves carencias básicas en las que se encuentran. Este resultado abre un sinnúmero de preguntas e hipótesis que merecen ser investigadas. Demandan y anhelan que sus padres apoyen sus expectativas, compartan sus sueños y esperanzas, y si bien reconocen que el apoyo económico es importante para conseguir sus logros, le asignan un segundo lugar entre las demandas que hacen a sus padres. Los problemas de salud que presentan están relacionados con la situación de pobreza y carencia de servicios básicos de la zona. Las demandas a la posta de salud, se centran en la necesidad de mayor información y participación sobre la prevención y resolución de los problemas que les aquejan, y principalmente en la necesidad de encuentros entre jóvenes para compartir sus problemas e inquietudes. La demanda de una mayor privacidad durante la atención en la posta expresa la necesidad de tomar en cuenta las necesidades propias de su edad y problemática

4.1 Web-based interactive learning programmes.

In the future, the training of competent dentists will need to take advantage of up-to-date digital technologies and learning practices. In order to accomplish this, the following goals should be considered: i) the design of 'customizable' web-based curriculum matrices that accommodate the training philosophies and resources of individual dental schools; ii) the development of digital instructional modules that can be incorporated or downloaded into specific parts of a curriculum; iii) the establishment of an e-consortium, which provides peer view and guidance in the design of teaching modules, and which is responsible for the storage, maintenance, and distribution of teaching modules within the consortium; iv) the development of central human and physical resources at each dental school to enable the seamless delivery of instructional modules in a variety of learning environments; and v) the assessment and provision of ICT training to students and faculty with respect to the use of computers and related digital technologies and educational software programmes. These goals should lead to the creation of a 'virtual dental school'. Within this project summative and formative evaluations should be performed during both the production and development of teaching material (e-learning material) and the learning process. During the learning process the following aspects should be measured and evaluated: i) students' behaviour; and ii) effectiveness, retention and the transfer of e-learned material into the clinical situation. To obtain evidence of the efficacy of e-learning material a certain amount of research has to be done in the near future. It is suggested that all parameters currently known have to be implemented during the development of a learning programme. Previous workers have evaluated the following elements with e-learning: i) planning, ii) programming and technical development, iii) learning behaviours, iv) learning outcomes of both the programme and the student, v) the acquisition of knowledge, skills and attitude and vi) the transfer of e-learned skills into clinical situations.