Bridging the Preclinical-Clinical Transition in Dentistry with Extended Reality

The transition towards clinical training presents several challenges for the different healthcare educational programs. Specifically in dentistry, where patient care is an integral part of the undergraduate programs, often including invasive and irreversible procedures, this transition challenges dental educators. Traditionally, following progressive theoretical and skills training at a preclinical level, novice dental students deliver surgical patient care, within relatively unknown clinical situations, as part of their undergraduate learning and training. Crucial safety and ethical questions arise about the traditional educational paradigm in dental education. Using adult learning theories in medical education together with general principals regarding the development of high-level skills and competences as framework, this doctorate research addressed the transition towards clinical training in dentistry from different perspectives. An educational assessment of the preclinical-clinical transition, both from the perspectives of teachers and students, was performed to provide a diagnostic description of the preclinical-clinical gap in dentistry. Opportunities to intervene this transition were found in digital haptic simulation technologies. To gain insight in the implementation progress of extended reality haptic simulation devices in dental education, the experiences of different schools using this technology were gathered. Several challenges and opportunities were reported while extended reality haptic simulation in dentistry keeps on growing and developing. Finally, a novel development in digital simulation for clinical training in dentistry is introduced: a patient-centered training module within extended reality haptic simulation, where digital models of a real patient can be provided for training. With this module trainees can develop their competences focusing on the specific set of clinical skills required for the real clinical procedure, in an environment that enables deliberate practice and repetition. The traditional educational/training workflow in dentistry shifts therefore, into a contextual, problem-based, and need-driven approach that provides students and clinicians with unlimited training opportunities. Moreover, the opportunity to beforehand identify and solve possible challenges of a real clinical procedure in a digital environment, increases safety for all stakeholders of clinical training in dentistry. This development has been rapidly incorporated into several extended reality-haptic-simulation devices integrating data with different CAD-CAM systems. The wide variety of opportunities of integrating technologies for clinical training, based on this development, have already resulted in several educational and clinical experiences available in the literature. The evolution towards creating close-to-reality digital twins of patients and a comprehensive digital training-treating integration in dental training is rapidly moving forward.