MEDEV

School of Medical Sciences Education Development

Introduction

A potential solution to the difficulties of clinical teaching in dentistry is currently under evaluation at Dundee Dental School and Hospital. Here Graham Chadwick reports on recent activity.

It is well known that watching a clinical procedure being undertaken either in real time or upon playback is a valuable teaching aid for both teacher and learner1,2.Traditionally this has been achieved by either small groups of students observing a qualified dentist treating a patient or the dental teacher watching a student carry out a procedure.Neither situation is ideal as the confined space of the oral cavity compromises the view. Furthermore it is incredibly labour intensive to watch a student perform an entire operative procedure from start to finish.Although observing a procedure at predefined interim stages (such as cavity preparation, lining and restoration) is commonly used to optimise the use of staff resources only snapshots of performance are gleaned. Valuable opportunities for learner support are thus missed and the teacher has little idea of how the end point was achieved.

Solution

A potential solution currently under evaluation in Dundee Dental School and Hospital is that of a head mounted video camera system. This is mounted upon a headband worn by the student or staff operator. Illumination of the operating area is provided by two bright white LED headlamps.

Laser beams

A small red laser beam allows the wearer to target the camera upon the area of work. For portability this is all battery powered and a radiofrequency transmitter, incorporated in the device, permits real time images to be sent to a receiver for display on either a monitor or capture on a recording device for later playback.This arrangement obviates the need for trailing cables. For all members of the dental team we are currently seeing if this technology:

• Improves the level of detail observed when observing dental procedures being undertaken
• Improves the level of feedback to learners
• Provides better learner support.

Monitors

Subject to a satisfactory evaluation it is envisaged that in the future the activities of an entire teaching clinic may be viewed by the teachers on a bank of monitors and verbal feedback given by means of a radio earpiece and chairside visits as required. It will also make demonstrations of dental procedures more accessible to a large group of students who all will be able to view it from the operators perspective.

Evaluation

The evaluation process has raised a number of challenges in its design.A single questionnaire has been formulated that is both suitable for all members of the dental team to complete from the perspectives of either device wearer or viewer.

It is constructed so that the evaluation of the usefulness of this technology is kept separate from suggestions for technical modifications. This is important for our perceptions influence our evaluation of service quality3.

The results of the full evaluation will reveal if wearing the camera, to have their work observed, is acceptable and helpful to the students.

Feedback upon equipment design will be fed back to the development team. This is important for design is an iterative process.

It is intended to hold a Subject Centre funded open day in Dundee towards the end of the year where delegates will have access to the full evaluation and be given the opportunity to try the device for themselves.

Acknowledgements

Acknowledgements

The ongoing work reported here would not have been possible without the input of Mark Tulley, Patrick Carena and Bryan Hunter of the Medical Physics Department of Ninewells Hospital, Dundee supported also by the engineering students Marco Steinberg and Jan Hoppner of the Technische University of Ilmenau, Germany.They turned the initial concept into reality. We are also grateful for some financial support for evaluation from the Subject Centre.