The value of stereoscopic three-dimensional vision on dental students' performance in a virtual reality simulator.

PURPOSE/OBJECTIVES: The aim of this study was to quantitatively investigate the impact of stereoscopic three-dimensional (3D) vision on students' performance when compared with that of two-dimensional (2D) vision in a 3D virtual reality (VR) simulator. METHODS: Twenty-four dental students (second- and fourth-year BDS) were assigned to perform three operative tasks under 3D and 2D viewing conditions on a Virteasy (HRV) simulator. Groups were crossed over and all students performed the same tasks under the alternate viewing conditions. The performance was evaluated by (1) accuracy, (2) outside target area removal, and (3) tooth cutting time, automatically using the generated feedback. RESULTS: Twenty-one participants completed all sessions. The results revealed a statistically significant effect of 3D vision over 2D vision on students' performance in terms of accuracy (p = 0.035). Stereoscopic 3D vision showed significant effect on outside target area removal in the first task (p = 0.035). Tooth cutting time was the same under both conditions (p = 0.766). The findings revealed improvement in accuracy score and reduction in outside target area removal over the course of the experiment under both conditions. Comparing the difference in 3D effect in the early and advanced learning groups revealed no significant difference among the groups (p > 0.05). CONCLUSION: Utilizing stereoscopic 3D vision in the training session improved students' perception of depth which led to more accurate tooth cutting within the target area, and less outside target area removal. However, 3D shows a limited impact on task completion time.

Enhancing specimen collection skills for dried blood spots through an immersive virtual learning environment: a cross-sectional study.

OBJECTIVE: The quality of dried blood spot (DBS) specimens impacts newborn screening (NBS) results, hence proper training is crucial for DBS specimen collection. To address this, a training module for Allied Health Professionals (AHPs) and nurses was created on Moodle, a virtual learning environment (VLE). The purpose of this research was to determine the feasibility and effectiveness of this module. METHODOLOGY: Participants were trained on-site (March to December 2019), through online training sessions (January to June 2020), and the two training strategies were compared. Data analysis included the total number of participants, cost-effectiveness, trainer engagement, and the number of unacceptable samples collected by nurses/AHPs trained by the two strategies. RESULTS: A total of 55 nurses/AHPs were trained on-site, while 79 nurses/AHPs completed the online module and received certificates through online VLE-based training. The trainer engagement and cost were more for onsite training. After online training, the specimen rejection rate was reduced from 0.84% (44 rejected out of 5220 total specimens collected) to 0.38% (15/3920). CONCLUSIONS: This study shows that using VLE-based DBS specimen collection training is feasible and effective for training nurses and AHPs.

A comparison of pre- and post-clinical education learning preferences among medical students who elected to dissect compared to those who did not during the COVID-19 pandemic.

Anatomy instructional methods varied widely during the COVID-19 pandemic and programs are assessing innovations for retention. Learning preferences were assessed among medical students dichotomized as elective dissectors (ED) or non-dissectors (ND) during the COVID-19 partial re-opening in 2020 (preclinical) and again in 2022 after clinical exposure (post-clinical) to assess the viability of elective dissection post-pandemic. A mixed-method approach was used for the assessment of test scores, learning preference surveys, learning activities rankings, and thematic analyses. No significant differences occurred in anatomy examination scores. Dissection was considered useful by both preclinical groups but significantly more so by ED, while the presence of an instructor was significantly preferred by ED although a majority of ND agreed. Elective dissection was significantly preferred by ND but also by a large minority of ED students. Pre- and post-clinical ND believed that elective dissection offered more academic flexibility, did not hinder clinical learning, and did not negatively impact medical education. The corresponding ED stated that confidence improved, clinical experiences were enhanced, and dissection was irreplaceable. Preclinical ND preferred self-learning, while ED students preferred online learning, but these differences largely disappeared post-clinically. Learning activity rankings were not significantly different among all groups (ND, ED, preclinical, and post-clinical). A hybrid laboratory with a virtual learning environment ranked highest across groups and preferences increased over time suggesting that students benefited from this instructional method during clinical exposure. The absence of laboratory experience ranked lowest, and preference decreased over time suggesting that anatomy dissection is valued.

Virtual learning in maxillofacial surgery in the post-COVID world: where are we now?

During the COVID-19 pandemic we developed a post-graduate virtual learning environment (PGVLE) in the West Midlands region for higher trainees in oral and maxillofacial surgery. We continued to develop this following the pandemic and sought to examine the trainee experience with this resource as restrictions eased. The PGVLE comprises a total of nine semesters mapping General Medical Council (GMC) learning objectives in the specialty across a total of 63 events using BigBlueButton™. Webinars are delivered on a weekly basis by subspecialty experts. Trainee feedback was sought using SurveyMonkey™ examining self-assessed confidence levels using visual analogue scores (VAS) and Likert items regarding trainers and content. A focus group was convened and the transcript analysed using grounded theory analysis (GTA). Likert items revealed overwhelmingly positive responses, with 96.2% (n = 281) of responses being positive regarding content and 97.5% (n = 475) agreeing with positive comments regarding faculty. VAS scores improved by an average of 39.0% and improvements were statistically significant for most sessions. The focus group highlighted the relevance of teaching to GMC learning objectives, the achievement of consistently high standards, the potential for conflict with clinical commitments and issues surrounding peer interaction. Satisfaction scores remain high with the PGVLE programme, which is very much here to stay in the post-graduate education of our trainees. With the easing of restrictions, we have moved to a hybrid method of learning with the potential for 'flipped classroom' methodology moving forwards.

In-between worlds: Chilean university lecturers' experiences of teaching transition between face-to-face and virtual reality contexts during the COVID-19 pandemic.

The advent of new technology is breaking the boundaries of traditional teaching and learning patterns with virtual worlds (VW) creating new frontiers in education. Previous research has explored the use of VW within educational settings. However, limited studies have investigated the transition processes that educators experience by adopting VW based online tools during the COVID-19 pandemic. This qualitative exploratory study investigated 18 Chilean lecturers' teaching experiences using a three-dimensional computer-mediated environment: Second Life. Findings suggest that changing from traditional to virtual teaching context is a complex process, which (re)shaped the lecturers' various senses of identity and agency towards different instructional approaches resulting in the sense of in-betweenness with multiple digital competencies. These changes indicated that they taught in an 'in-between' mode mapped by different teaching mediations. The participants' teaching experiences of shaping a sense of in-betweenness could provide a unique theoretical lens to explore instructors' teaching experiences from traditional to a technology-mediated online setting.

Comparing Learning Outcomes in Cardiopulmonary Resuscitation (CPR) and/or Automated External Defibrillator (AED) Training for Laypeople in Face-to-Face, Online, and Mixed Training Methods: An Integrative Literature Review.

Cardiovascular diseases and cardiac arrest (CA) are the main causes of death worldwide. This review aims to identify publications on the learning outcomes for the use of an automated external defibrillator (AED) and/or cardiopulmonary resuscitation (CPR) to train laypeople (LP), the method of training used, the year of publication and their recommendations. We employed Miller's assessment pyramid to describe learning outcomes as knowledge, skills, and confidence. The methods of training are face-to-face, online, and mixed. The evidence found in this study will be used to support the development and validation of a simulation-based training program to teach LP to operate AEDs delivered by drones in rural and remote (R&R) locations. This article is an integrative literature review with a quantitative and qualitative research design and is composed of seven steps: research question, inclusion and exclusion criteria, search and selection of studies, the role of a second reviewer of the findings, data analysis, interpretation and discussion of the results, and finally knowledge synthesis. The results of this review demonstrate that there are no significant differences in the learning outcomes of the different training methods. Since these findings suggest good results in all methods, the development of a training program based on face-to-face, online, and mixed, especially for places with few resources such as R&R places, indicates all methods can be used as good practices to develop training programs.

A Collaborative Virtual Walkthrough of Matera's Sassi Using Photogrammetric Reconstruction and Hand Gesture Navigation.

The COVID-19 pandemic has underscored the need for real-time, collaborative virtual tools to support remote activities across various domains, including education and cultural heritage. Virtual walkthroughs provide a potent means of exploring, learning about, and interacting with historical sites worldwide. Nonetheless, creating realistic and user-friendly applications poses a significant challenge. This study investigates the potential of collaborative virtual walkthroughs as an educational tool for cultural heritage sites, with a focus on the Sassi of Matera, a UNESCO World Heritage Site in Italy. The virtual walkthrough application, developed using RealityCapture and Unreal Engine, leveraged photogrammetric reconstruction and deep learning-based hand gesture recognition to offer an immersive and accessible experience, allowing users to interact with the virtual environment using intuitive gestures. A test with 36 participants resulted in positive feedback regarding the application's effectiveness, intuitiveness, and user-friendliness. The findings suggest that virtual walkthroughs can provide precise representations of complex historical locations, promoting tangible and intangible aspects of heritage. Future work should focus on expanding the reconstructed site, enhancing the performance, and assessing the impact on learning outcomes. Overall, this study highlights the potential of virtual walkthrough applications as a valuable resource for architecture, cultural heritage, and environmental education.

A Collaborative Metaverse based A-La-Carte Framework for Tertiary Education (CO-MATE).

The paper aims to propose a futuristic educational and learning framework called CO-MATE (Collaborative Metaverse-based A-La-Carte Framework for Tertiary Education). The architectural framework of CO-MATE was conceptualized in a four-layered approach which depicts various infrastructure and service layer functionalities. CO-MATE is a technologically driven educational metaverse environment involving loosely coupled building blocks to provide an a-la-carte model for platform designers. For this, the authors had undertaken a systematic mapping study of the pre/post-COVID period to review the application of various emerging technologies. Further, the paper also discusses the core attributes and component offerings of CO-MATE for a technology-driven and automated immersive-learning environment and exemplifies the same through various use cases.

Effectiveness of an online continuing education course in infant hearing health for primary care professionals.

OBJECTIVE: To evaluate the effectiveness of an online continuing education course on infant hearing health for primary care professionals. DESIGN: A prospective longitudinal study with interrupted time series pre-test/post-test design. The effectiveness of the online course was assessed by comparing pre- vs. post-training performance and analysing responses to evaluations of the quality of the course. STUDY SAMPLE: The sample comprised individuals enrolled between September 2018 and August 2019 in a Ministry of Health course, "Actions in primary care for the early identification of hearing impairment" offered on the AVASUS platform. RESULTS: Of the 2908 individuals registered, 1842 (63.3%) completed the course. Their ages ranged from 18 to 77 years, and 67.4% of them were females. Students and doctors were overrepresented among the enrollees. All Brazilian states were included in the sample. Comparisons of pre- and post-training performances showed a significant improvement in knowledge, and 99.3% of the participants provided positive comments regarding the quality of the course. CONCLUSIONS: The course is an effective distance learning tool on infant hearing health for primary care professionals. The online course circumvents the limitations posed by geographical barriers and also facilitates decentralisation.

COVID-19 Adaptations with Virtual Microscopy.

This chapter aims to discuss and compare the different approaches used to teach histology to dental students before and during the COVID-19 pandemic and reflect on the best practices to be retained. Prior to the COVID-19 pandemic, the University of Glasgow School of Dentistry converted its large and unique collections of microscopy slides into digital files to curate this unique asset and protect it for prosperity. Initially, a virtual microscopy (VM) educational platform was purchased to allow digital teaching of histology, oral biology, and oral pathology. Prior to COVID-19, dental undergraduate students received VM teaching via a blended learning approach with theoretical content preceding a practical discussion session using VM. Some teachers in later years of the dental course experimented with flipped class strategies. At the beginning of 2020, with the lockdown restrictions imposed, the teaching content all had to move to remote online learning with virtual sessions, recorded video classes, online content, videotelephony, and online chat, allowing the students to undertake the content asynchronously and remotely. To overcome the interactive limitations of online delivery, a Microsoft Team was created in some sessions and used to support active small group learning and teaching of general histology allowing students to share histological annotations with their peers and tutors. The experience of teaching histology using only virtual and online content has had a positive academic outcome for the students as all first year students had passed their exams. However, we also recognise several limitations, such as the restrictive interpersonal interaction using videotelephony and online chat as well as the ad hoc feedback. The processes used and the challenges and benefits of VM will be discussed in this chapter.

Research on the design of panoramic virtual learning environment screen elements.

Panoramic video and virtual reality technologies create learning environments that provide learners with an "immersive" experience. In recent years, panoramic video design to create immersive learning environments, in particular, has become an increasingly popular topic in teacher education and educational research. However, few studies have explored the elements of panoramic virtual learning environment screens regarding the design of learning environments. Therefore, this experimental study uses eye-tracking technology to investigate how learners are guided by panoramic video elements in a panoramic virtual learning environment. Participants (n = 90) were randomly assigned to one of six conditions: (1) no caption + live interpretation, (2) no caption + AI interpretation, (3) 120-degree caption + live interpretation, (4) 120-degree caption + AI interpretation, (5) static follow caption + live interpretation, and (6) static follow caption + AI interpretation. The results of the study show that when learners experience a panoramic virtual learning environment with different narration methods, the live interpretation method is more likely to attract learners' attention and bring better emotion and experience than the AI interpretation method. When experiencing a panoramic virtual learning environment with different caption presentation methods, the caption presentation methods induced learners' attention, learning emotions, and experiences in the order of no caption >120-degree caption > static following caption. Finally, the rules for optimizing the design of panoramic virtual learning environment screens are given based on the findings of the study, which provide new ideas for designing and developing panoramic video teaching resources.

Assessing Ability Recovery of the Sequential IRT Model With Unstructured Multiple-Attempt Data.

The unstructured multiple-attempt (MA) item response data in virtual learning environments (VLEs) are often from student-selected assessment data sets, which include missing data, single-attempt responses, multiple-attempt responses, and unknown growth ability across attempts, leading to a complex and complicated scenario for using this kind of data set as a whole in the practice of educational measurement. It is critical that methods be available for measuring ability from VLE data to improve VLE systems, monitor student progress in instructional settings, and conduct educational research. The purpose of this study is to explore the ability recovery of the multidimensional sequential 2-PL IRT model in unstructured MA data from VLEs. We conduct a simulation study to evaluate the effects of the magnitude of ability growth and the proportion of students who make two attempts, as well as the moderated effects of sample size, test length, and missingness, on the bias and root mean square error of ability estimates. Results show that the model poses promise for evaluating ability in unstructured VLE data, but that some data conditions can result in biased ability estimates.

Medical students' perception of e-learning approach (MeSPeLA) - a mixed method research.

There is a discrepancy between the research exploring e-learning at medical universities in Central/Eastern and Western European countries. The aim of the MeSPeLA study was to explore the understanding, experience and expectations of Polish medical students in terms of e-learning. Questionnaire containing open-ended and closed questions supplemented by focus group discussion was validated and performed among 204 medical students in Poland before COVID-19 pandemia. Several domains: understanding of e-learning definitions; students' experience, preferences, expectations and perceptions of e-learning usefulness, advantages and disadvantages were addressed. The qualitative data were analyzed using an inductive approach. 46.0% of students chose a communication-oriented definition as the most appropriate. 7.4% claimed not to have any experience with e-learning. 76.8% of respondents indicated they had contact with e-learning. The main reported e-learning advantages were time saving and easier time management. The most common drawback was limited social interactions. The acceptance of the usage of e-learning was high. Medical undergraduates in Poland regardless of the year of studies, gender or choice of future specialization showed positive attitudes towards e-learning. Students with advanced IT skills showed a better understanding of the e-learning definition and perceived e-learning to be a more useful approach. The expectations and perceptions about e-learning in Polish medical schools seems similar to some extent to that in Western European and the United States so we can be more confident about applying some lessons from these research to Poland or other post-communist countries. Such application has been accelerated due to COVID-19 pandemia.

Crash Course in Orthopaedics: Development and Evaluation of a 12-Week Online Trauma and Orthopaedics Teaching Program for Medical Students During the COVID-19 Pandemic.

Introduction The COVID-19 pandemic caused significant disruption in clinical placements of medical students in the United Kingdom (UK), including trauma and orthopaedic surgery (T&O) rotations. Based on the British Orthopaedic Association (BOA) undergraduate syllabus, a 12-week online teaching program was designed to supplement T&O teaching for medical students across the UK while lockdown and social-distancing restrictions were in place. This study aims to describe the process of designing an online teaching program, evaluate the effectiveness of online education, explore medical student perceptions of the virtual learning environment, and report the lessons learned from this 12-week online program. Methods The "Crash Course in Orthopaedics" consisted of 12 webinars, with topics covering a range of acute and chronic T&O conditions, and was delivered through the online platform Zoom. Attendees were invited to complete a post-course questionnaire retrospectively and the results were used in this study. Qualitative data was assessed using thematic analysis. Quantitative data were presented as descriptive statistics.  Results The webinar series was attended by approximately 5150 participants, with the largest demographic group being clinical medical students (49%). Results from the survey revealed three broad themes which were: 1). Interactivity: question + answer (Q+A), multiple choice questions (MCQs), online tools 2). Content: case examples, orthopaedic examinations, objective structure clinical examination (OSCE) tips  3). Accessibility: slides, recordings, duration of the session. Our study found that the online teaching program improved students' clinical knowledge of T&O and they found learning through interactive methods such as polls, the chat function on zoom, and case-based discussions to be most useful. Also, from the results of this study, a guide on "How to Run a Successful Webinar Series for Medical Students" was developed. Conclusion Online webinars effectively supplement T&O teaching and experience for medical students whose T&O placements were disrupted during the COVID-19 pandemic. The results will be a helpful guide to those planning medical education webinars in the future.

An Overview of the Common Elements of Learning Management System Policies in Higher Education Institutions.

Learning management systems form an integral part of the learning environments of most universities and support a wide range of diverse activities and operations. However, learning management systems are often regulated by institutional policies that address the general use of Information Technology and Communication services rather than specific learning management system policies. Hence, we propose that learning management system environments are complex techno-social systems that require dedicated standalone policies to regulate their operation. This preliminary study examined a selection of learning management system policies from twenty universities in four countries to identify some of the elements that are considered necessary for inclusion in policy documents. Seventeen individual elements of learning management system policy documents were identified from a synthesis of the policies. These were classified into six policy categories: Accounts, Courses, Ownership, Support, Usage, and Protection. The study also identified three additional qualities of learning management system policy documents: standalone comprehensibility, platform-neutral statements, and contemporary relevance. The findings of this study will serve as a useful template for developing dedicated standalone policies for the governance of university learning management systems.

Can avatar homophily influence flow and exploratory behaviour of online users?

Virtual learning environments have been recognized as an area of particular importance by which educators can use to improve desirable learning behaviours. Investigating the impact of different virtual environments on learners' behaviours has become the centre of attention of researchers, especially during COVID-19. The homophily effect of avatar-identity on individuals' perceptions of an environment can be a key for understanding their learning behaviours. This study examined the relationship between key constructs related to avatar homophily (background and attitude) and learners' flow and exploratory behaviour. An online survey was distributed to 157 students (93 males and 64 females with age ranging from 19 to 21 years) who took part in an online learning activity using an avatar-mediated environment (Second Life). The results showed that users' flow experience can be influenced by the function of perceived background and attitude homophily in an avatar-mediated environment. Flow experience was found to mediate the relationship between avatar homophily and learners' exploratory behaviour. This study offers a conceptual understanding of the relationship between homophily and individual's flow state.

A Review of Virtual Medical Student Rotations During the COVID-19 Pandemic: Their Role, Advantages, Disadvantages, and Future Prospects.

The COVID-19 pandemic resulted in the pause of medical clinical rotations. As a result, virtual rotations were implemented. These are a form of remote learning that seeks to mimic the clinical learning environment that students were already accustomed to. This article seeks to review the published literature to explore which specialties adapted this format, what are the advantages and disadvantages observed, determine what were the responsibilities and involvements of students participating in these rotations, how well these rotations substituted for in-person rotations, and to evaluate if there is a continued role for them after, outside of COVID-19. Virtual rotations have been developed in almost every specialty. These rotations have been developed from small centers to large universities, and are widespread throughout the United States, and in other countries as well. These rotations are targeted toward medical students, medical residents, and physician assistants and range in length from one to four weeks. Responsibilities and scope of interaction varied according to rotation; some rotations allowed patient interaction, and observation of procedures and surgeries, whereas some were purely didactic. A mixture of inpatient and outpatient involvements was seen. Advantages included saving money and time, more flexibility, increased diversity, and participation of international medical graduates. Virtual rotations participants have been invited for interviews at the participating institution's residency programs and have matched there. Disadvantages included lack of assessment of practical skills, inability to receive credit, and inability to obtain a letter of recommendation. Virtual rotations have proven to be a good substitute for in-person rotations, with most medical students seeing a need for the rotations in the future. Due to widespread development and acceptance of these rotations, it is likely that these rotations will continue.

Revisiting Pseudo-Haptics for Psychomotor Skills Development in Online Teaching.

In a centralized model of simulation-based education (Ce-SBE), the trainees practice clinical skills in simulated laboratories based on physical models, while in a decentralized model (De-SBE), the trainees practice these skills outside of these laboratories. Attention to De-SBE has drastically shifted to virtual learning environments (VLEs), serious games, and virtual simulations employing various digital technologies, including virtual, augmented, and mixed reality. In particular, remote learning has grown immensely during the COVID-19 pandemic as traditional in-person teaching and training activities are conducted online as a form of facilitating continuity in education. VLEs allow trainees to learn from virtual simulated health experiences in an interactive, engaging, and ethically safe manner, while providing educators the opportunity to implement simulated experiences to a larger number of learners. Despite these benefits, for certain types of clinical skills, such as psychomotor skills, VLEs have not yet reached their potential. This is primarily due to technical limitations and cost issues with the haptic devices required to simulate the sense of touch. Pseudo-haptic refers to the illusion of haptic stimulation in the absence of mechanical haptic interfaces and often combines the use of a passive input device (e.g., mouse) with visual and auditory feedback to simulate haptic properties (stiffness or friction of an object). Although the application of pseudo-haptics for psychomotor skills development is still in its infancy and currently trending due to the availability of consumer-level technologies, the potential to present haptic cues in the absence of active haptic devices may allow trainees to practice some tasks outside of research and training labs. The implications of pseudo-haptics are tremendous, particularly as remote learning becomes more widespread, and warrant further discussion.

Semisupervised Learning Method to Adjust Biased Item Difficulty Estimates Caused by Nonignorable Missingness in a Virtual Learning Environment.

In data collected from virtual learning environments (VLEs), item response theory (IRT) models can be used to guide the ongoing measurement of student ability. However, such applications of IRT rely on unbiased item parameter estimates associated with test items in the VLE. Without formal piloting of the items, one can expect a large amount of nonignorable missing data in the VLE log file data, and this is expected to negatively affect IRT item parameter estimation accuracy, which then negatively affects any future ability estimates utilized in the VLE. In the psychometric literature, methods for handling missing data have been studied mostly around conditions in which the data and the amount of missing data are not as large as those that come from VLEs. In this article, we introduce a semisupervised learning method to deal with a large proportion of missingness contained in VLE data from which one needs to obtain unbiased item parameter estimates. First, we explored the factors relating to the missing data. Then we implemented a semisupervised learning method under the two-parameter logistic IRT model to estimate the latent abilities of students. Last, we applied two adjustment methods designed to reduce bias in item parameter estimates. The proposed framework showed its potential for obtaining unbiased item parameter estimates that can then be fixed in the VLE in order to obtain ongoing ability estimates for operational purposes.

Shared Decision Making - A Key Competence of All Health Care Professionals. Evaluation and Adaptation of a Digitally Enhanced Learning and Teaching Unit.

The Covid-19 pandemic induced a radical shift towards digitally enhanced learning and teaching (DELT). Success of this adaptation depended on how much DELT had been provided before. The Bavarian Virtual University (BVU) is a university network to fund, promote and support DELT. The Ludwig-Maximilians-University Munich as a part of this network implemented the DELT course "Shared decision making (SDM) - a part of evidence-based medicine" in 2015. Based on regular evaluations and due to the latest developments, a media-didactic and content-related adaptation will be conducted now. Clinical cases will be embedded in a framework structure of SDM. Videos, podcasts and literature of doctor-patient interaction will be provided. To enable different health care professions to have a positive learning experience, the course will be linguistically adapted. The interaction between students and teacher will be enhanced by a transparent distribution of tasks and an issue-specific chat forum. SDM is an interdisciplinary general concept. With regard to the academization of different health care professions, the demand for DELT will increase. However, medical competencies can`t be taught fully online, since face-to-face patient interaction is mandatory. Communication skills can be practiced theoretically but have to be applied in reality.