Impact of Haptic Virtual Reality Simulation on Dental Students' Clinical Endodontic Performance and Anxiety Management

Abstract

Aim: To evaluate the clinical impact of haptic virtual reality simulation (HVRS) on undergraduate dental students' performance during endodontic access cavity preparation on real patients, and to assess its effect on situational anxiety and perceived training value. Methodology: A controlled, parallel-group clinical study was conducted with fifth-year dental students enrolled in a clinical endodontics course. Participants were assigned to an experimental group (HVRS training followed by clinical procedure) or a control group (direct clinical procedure without HVRS). Clinical performance during access cavity preparation on real patients was evaluated using a structured rubric by two independent blinded evaluators. Situational anxiety was measured in both groups using the STAI-Y1 questionnaire before and after the clinical procedure. Satisfaction and perception were recorded post-intervention using a structured Likert-scale questionnaire. HVRS session time metrics were also collected. Results: Thirty students completed the study (15 per group). The experimental group showed significantly higher overall clinical performance scores compared to controls (p < 0.0001), with improvements in access cavity preparation and related tasks. Both groups experienced significant reductions in STAI-Y1 scores after the intervention, with the experimental group showing a greater relative decrease that approached statistical significance (p = 0.052). Students reported high satisfaction with the simulator, particularly regarding three-dimensional visualisation and perceived preparedness. Most students (86.7%) preferred a combined training strategy using both HVRS and artificial teeth. Simulation metrics indicated consistent training time and operative engagement across participants. Conclusion: HVRS training prior to clinical endodontic procedures would enhance student clinical performance and may contribute to a greater reduction in situational anxiety compared to standard practice, supporting its integration into undergraduate curricula as a complementary instructional tool.