Impact of Guidance and Multitasking on Manual Dexterity Skills in Dentistry.

OBJECTIVES: This study investigated the effect of learning by observation on the development of fine motor skills related to endodontic manual instrumentation. We evaluated if learning by observation with guidance had any influence upon operator performance under tense or taxing conditions. MATERIALS AND METHODS: Dental students prepared standardized simulated root canals of varying morphology. Learning involved silent video with hand guidance (n = 23), audiovisual combined with oral instructions (n = 23), or silent video (n = 13). Undergraduates who previously completed conventional preclinical endodontics provided comparative data as a control group (n = 16). During investigations, a root canal of a lower molar plastic tooth was shaped, beginning with a primary task, and followed by multitasking conditions. The performance of the students was assessed by evaluating the accuracy of dental canal shaping and time taken to complete the task. STATISTICAL ANALYSIS: Differences were analyzed using ANOVA (p < 0.05). RESULTS: Performance was similar during learning between the three experimental groups. Accuracy of the performance did not differ within each group for the two tests nor between the groups at each test (p > 0.05). CONCLUSIONS: These findings demonstrated that performance subsequent to learning by observation without instructions was comparable to learning with instructed observation. The results also identified that the performance of the experimental group (1.5- to 2-hour practice) was comparable with the conventional control group (15- to 20-hour practice). Alternative approaches to learning dexterity skills in dentistry may provide improved outcomes, especially in demanding situations.

Understanding Motor Skill Learning as Related to Dentistry.

Learning dental procedures is a complex task involving the development of fine motor skills. The reported use of theories and/or evidence for designing learning activities to develop the fine motor skills needed for dental practice is limited. The aim of this review is to explore the available body of knowledge related to learning motor skills relevant to dentistry. Evidence from studies investigating motor skill learning highlights the negative impact of self-focus and self-regulation on learning outcomes, particularly during the early stages of learning. The development of activities and schedules that enable novices to demonstrate characteristics similar to experts, without the reported long period of 'deliberate practice', is clearly of value. Outcomes of learning implicitly are important in dentistry because working under stressful conditions is common, either during undergraduate study or in practice. It is suggested that learning implicitly in the simulation stage can reduce disrupted performance when transitioning to clinical settings. Therefore, further investigation of effective methods for learning dental fine motor skills is indicated, using approaches that result in robust performance, even under stressful conditions.

How to Improve Fine Motor Skill Learning in Dentistry.

INTRODUCTION: Restorative dental treatment is a complex task involving various procedures which require the development and integration of both theoretical knowledge and fine motor skills. It aims to provide the theoretical background and role of key factors in learning these skills. MATERIALS AND METHODS: The following electronic databases were searched to identify relevant articles to our topic: PubMed, Medline, Google Scholar, and Scopus. Generic keywords, that is, factors, fine, performance, and dentistry, and MeSH terms, that is, "learning," "instruction," "patient simulation," "motor skills," "perception," "tactile," "neurophysiology," and "working memory" were used to conduct our comprehensive search. Results and Conclusions. Several techniques are used in performing different restorative procedures in dentistry, that is, root canal preparation, root planning, and minor oral surgery procedures. Mastering these techniques requires a good understanding of the underpinning cognitive, sensory, and neuromuscular processes. Factors including the amount and timing of instructions provided, cognitive abilities, and practice schedule of learning trials may have significant implications on the design of fine motor skill learning exercises.

Effect of errorless learning on the acquisition of fine motor skills in pre-clinical endodontics.

This study aimed to evaluate the impact of errorless and errorful learning, on acquisition of root canal hand-instrumentation skills. Dental students prepared standardised canals of different diameters and curvatures. Learning involved minimising (errorless: n = 21) or maximising errors (errorful: n = 21). Students who had completed accredited pre-clinical activities provided comparative data (n = 17). During testing, the distal canal of a plastic mandibular molar was prepared, first as a single task and then under multi-tasking conditions. Performance was assessed by preparation accuracy and time. Differences were assessed using anova (P < 0.05). Performance in the experimental groups was similar during learning. When multi-tasking, errorful learners showed a deterioration in preparation accuracy (P < 0.05). In contrast, preparation accuracy and completion times for the errorless and comparative groups remained stable when multi-tasking. Errorless learning resulted in stable performance under multi-tasking conditions. Investigation of alternative approaches to learning motor skills in dentistry is warranted as such approaches may provide better outcomes, especially under demanding conditions.

Investigating an errorless learning approach for developing dental operative technique skills: A pilot study.

INTRODUCTION: Explicit instruction (conscious knowledge/rules) is generally used for learning dental operative skills; however, recent work has demonstrated advantages of learning skills implicitly with minimal accrual of conscious knowledge and reduced attentional demands. Therefore, this study examined the effects of learning handpiece manipulation skills explicitly (errorful) and implicitly (errorless: limited error detection/correction) under conditions of increased attentional demands (ie multitasking and additional instructions). MATERIALS AND METHODS: Non-dental university students were randomly assigned to errorless (n = 11) or errorful (n = 8) groups. They used pencil lead instead of a bur, with errorless learners shading shapes from simple (small circle) to complex (cross), while errorful learners shaded the shapes in reverse. During testing, they completed simulated cavities in baseline, additional instructions and multitask conditions. Learning performance was calculated as per cent of the shape shaded successfully. Test performance was computed as error in cavity length/depth and was compared with dental students who had completed their operative technique course (n = 14). RESULTS: Errorless learners were more accurate than errorful learners especially when shading difficult shapes (P = 0.042). With additional instructions, errorless and errorful learners did not differ in cavity depth (P = 0.057) or length (P = 0.540). When multitasking, errorless learners prepared the cavity length (P = 0.048) but not depth (P = 0.920) more accurately than errorful learners. Overall, performance of errorless learners was comparable to dental students. CONCLUSIONS: These preliminary findings suggest handpiece skills can be acquired implicitly via errorless learning, and it is less attentionally demanding than errorful learning, as evident by maintenance of preparation performance when processing additional relevant instructions and multitasking.

Sociodemographic backgrounds and career decisions of Australian and New Zealand dental students.

This article describes the sociodemographic and career selection characteristics of dental students in Australia and New Zealand. A total of 672 dental students participated in the study. The survey covered age, language proficiency, type of school attended, place of residence, parental occupation, and level of education. The respondents had an average age of twenty-two years, with a range of eighteen to fifty. Fifty-six percent of respondents were female, and approximately half had completed secondary education in private schools with 44.3 percent having finished in public schools. The majority of students lived with their parents, with only a few respondents reporting a rural home address (6.8 percent). The majority of students (65.3 percent) had placed dentistry as their first career choice and had most likely made the decision after leaving high school or near the end of high school (81.4 percent), with self-motivation being the major influence on their decision. This study provides a description of the sociodemographic profile of Australian and New Zealand dental students and provides a better understanding of career decision issues. It also highlights areas for further investigation and management by educational institutions and public policy.

Cultural consistency in Australian dental students from two different ethnic backgrounds.

The objective of this study was to examine the value orientations of dental students from different ethnic backgrounds studying in Australian dental schools. A ninety-eight-item questionnaire was used to collect the data, including fifteen subscales developed consistent with the Kluckhohn and Strodtbeck value orientation model. To compare the value orientation structure and to determine if any ethnic differences existed, a multivariate analysis of variance called profile analysis was performed on the fifteen value subscales. Of the 401 participants, 30.2 percent were Anglo-Australian and 44.9 percent were Asian. The remainder (24.9 percent) were "Other-background residents" or "Other-international students." This article presents data from Asian (n=184) and Anglo-Australian (n=124) background respondents. Mean age was 21.7 years (s.e. 0.35 years) among Anglo-Australian and 20.8 years (s.e. 0.17 years) among Asians. Asians born overseas represented 70.7 percent (n=130) of this group. Of Australia-born Asians (n=54), 90.6 percent were first-generation Australians. When comparing their value profile, we found a significant association between ethnicity and value orientation profile scores (p<0.05). Despite the significant overall result, the strength of the association (eta(2)=0.007) indicated that this effect was trivial relative to the unexplained variance in value orientation. The findings suggest that, behind an apparent ethnic diversity, a single distinctive value profile might exist to which the majority of dental students subscribe.

Negotiating the Maze: Case based, Collaborative Distance Learning in Dentistry.

The module was developed as an elective to give motivated senior dental students an opportunity to expand their horizons in planning oral rehabilitation. It comprised one tutor and 12 students, from five universities world-wide, communicating on the World Wide Web (WWW), to develop oral rehabilitation plans for simulated patients. Trigger material came from one of two Case Profiles and consisted of diagnostic casts and details of the clinical and radiographic examination in WWW/CD-ROM form. No background material was supplied as to the "patient's" age, sex, history or main concern(s). Students worked in groups of three, each student from a different location. Individual students were given a role within the group: 'Patient', who developed a "personal background" belonging to the trigger examination material, "Academic" who identified state-of-the-art treatment options available for the dental treatment needs identified by the group and "General Practitioner" who tailored these options to the "patient's" needs and wants. Student feedback focused on their perception of their experience with the program in response to a questionnaire comprising 11 structured and four "open" questions. All students felt that the program increased their confidence in planning oral rehabilitation. Ten students felt that the "best thing about the program" was the interaction with students from other universities and the exposure to different philosophies from the different schools. Eight students mentioned their increased awareness of the importance of patient input into holistic planning. Under the heading "What was the worst thing', students cited some technical hitches and the snowball effect of two sluggish students who were not identified early enough and thus impacted negatively on the working of their groups. Student feedback showed that the module succeeded in its aims but needed modification to improve the logistics of working with an extended campus.