Technology-enhanced simulation-based learning in orthodontic education: A scoping review

ABSTRACT Introduction: Technology-enhanced simulations seem to be effective in dentistry, as they can support dental students to improve competencies in simulated environments. However, implementation of this technology in orthodontic education has not been reviewed. Objective: This scoping review aimed to comprehensively summarize the use of technology-enhanced simulations in orthodontic practice. Methods: A systematic search was conducted to identify literature on technology-enhanced simulation-based learning in orthodontic education published from 2000 to 2021. The search was conducted up to September 2021 to identify articles from Scopus, Embase, PubMed, ProQuest Dissertations & Theses Global, Google Scholar and the reference lists of identified articles. Results: The search identified 177 articles. Following the inclusion and exclusion criteria, 16 articles of 14 digital simulators were included in this review. The findings demonstrated an increasing use of technology-enhanced simulations in orthodontic education. They were designed in several formats, including three-dimensional virtual format, augmented reality, virtual reality, automaton, haptic, and scenario-based simulations. These simulations were implemented in varied areas of orthodontics including diagnosis and treatment planning, bracket positioning, orthodontic procedures, facial landmark, removable appliance and cephalometric tracing. Most included articles demonstrated the development process without outcome evaluation. Six studies provided outcome evaluations at reaction or learning levels. None of them provide the evaluation at behaviour and results levels. Conclusion: Insufficient evidence has been generated to demonstrate the effectiveness of technology-enhanced simulations in orthodontic education. However, high-fidelity computer-based simulations together with robust design research should be required to confirm educational impact in orthodontic education.摘要 引言：技术增强模拟（technology-enhanced simulations）在牙科学中颇具应用成效，其可辅助牙科医学生在模拟环境中提升临床能力。然而，目前尚未有针对该技术在正畸教育中应用的综述研究。 目的：本范围综述（scoping review）旨在全面梳理技术增强模拟在正畸临床中的应用现状。 方法：本研究针对2000年至2021年发表的正畸教育领域基于技术增强模拟的学习相关文献开展系统检索，检索时限截至2021年9月，检索数据库涵盖Scopus、Embase、PubMed、ProQuest Dissertations & Theses Global、Google Scholar，同时纳入已检索文献的参考文献列表。 结果：本次检索共获取177篇文献。经纳入与排除标准筛选后，最终纳入涉及14款数字模拟器的16篇文献。研究结果显示，正畸教育中技术增强模拟的应用呈逐年增长趋势。此类模拟系统涵盖多种形式，包括三维虚拟格式、增强现实、虚拟现实、自动化装置、触觉反馈模拟以及基于场景的模拟。其应用场景覆盖正畸学（orthodontics）多个领域，包括诊断与治疗规划、托槽定位、正畸操作、面部标志点识别、可摘矫治器应用以及头影测量描记。纳入的多数文献仅阐述了系统开发流程，未开展效果评估。其中6项研究开展了反应层面或学习层面的效果评估，暂无研究涉及行为层面与结果层面的评估。 结论：目前尚无足够证据证明技术增强模拟在正畸教育中的应用成效。不过，未来需开展高保真计算机模拟系统相关研究，并辅以严谨的研究设计，以验证其在正畸教育中的教学成效。