CASE STUDY

Dentistry VR

Local Anesthesia Modules

NYU IT Teaching and Learning with Technology and the College of Dentistry approached the NYU Usability Lab to evaluate the design and efficacy of a series of virtual reality (VR) simulation modules designed to train NYU Dentistry students on how to administer local anesthesia.

Project Background

The Usability Lab collected and analyzed feedback from students around the usability of the virtual instructional modules in order to evaluate their effectiveness and usefulness, especially in relation to other instructional tools such as plastic manikins traditionally used in their preclinical curriculum.

Product: Virtual Reality (VR) simulation modules on Oculus Quest VR kits - Participating students completed two practice instructional modules: Module 1: Armamentarium Prep (Syringe Assembly) and Module 2: Inferior Alveolar Nerve Block (IANB) Procedure. The virtual instructional modules were designed with Unity, using an Oculus Rift virtual reality headset.

Project timeframe: 2 months, September 16 to November 6, 2020.

Audience: 10 students who are current 3rd or 4th year students at NYU College of Dentistry and they have prior experience using a plastic manikin head for learning.

Stakeholder: NYU IT Teaching and Learning with Technology unit and the College of Dentistry.

The Study

Research Method: Contextual Inquiry with Think Aloud

Research Sessions: Facilitators asked students to complete a series of tasks using the Oculus Quest VR kits on the VR modules. As the participant completed the tasks, they narrated out loud their thought processes and opinions.

During sessions, participants were asked to:

Answer brief questions about current and past experiences with local anesthesia training
Perform an Inferior Alveolar Nerve Block in the VR modules
Completed two practice instructional modules: Module 1: Armamentarium Prep (Syringe Assembly) and Module 2: Inferior Alveolar Nerve Block (IANB) Procedure.

Sessions lasted 45-60 minutes and were held physically in a lab with the VR equipment and recorded remotely via Zoom for post-session analysis.

After the Research - Analysis: After speaking with a participant, the facilitator and note-taker debriefed and reviewed notes on key takeaways from each session. Cumulative success rates and user pathways were collected, along with anecdotal quotes to help measure the overall usability of the VR modules and highlight user pain points.

Key Takeaways

Instructions: All users struggled with reading the instruction board because it was located outside of their field of vision when they were focused on the patient or trays. Additionally, instructional text that was located at the bottom of the board was overlooked when they focused on the top of the board for information.

Recommendation: Consider having instructions overlay on the screen so that users will not need to adjust their positioning in order to see the instructions (see images below).

Figure 1. As the student is performing the injection, they were no longer able to see the instruction board for next steps.

Figure 2. Mockup of Usability Lab's recommendation to have instructions overlayed on the screen.

System Feedback: The virtual reality modules lacked tactile sensations crucial for learning how to perform syringe assembly and the IANB procedure.

Recommendation: Include haptic feedback in areas where users are asked to feel the patient to locate an injection site or to check numbness. Vibrations could intensify as users are getting close to the targeted areas.

Instructional Feedback: It was not always clear when the user was successful in completing a task.

Recommendation: Make system feedback more consistent. For example, if using chimes, a chime should be included every instruction change.

Impact

From observations and interviews, we found students’ feedback on the Local Anesthesia instructional virtual simulations to be generally positive. They believed that the VR modules could help build confidence in those who are still learning these procedures, and would be a great complement to the traditional manikin heads.
The next steps for this project are to improve upon the design to address all the participant’s feedback and initiate a formal research study to determine learning outcomes from the use of the VR local anesthesia simulation.
Additionally, planning for the collection of data from student interactions in the form of log files will provide students and faculty with detailed information for further guidance and assess student improvement over time.

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