Immersive Virtual Reality and Deliberate Practice for Complex Skills Acquisition During Inferior Alveolar Nerve Block Training

Abstract

Introduction: This study aimed to determine construct and transfer validity of a virtual reality inferior alveolar nerve (VRIAN) injection simulation to improve the technique of inferior alveolar nerve block (IANB) delivery for novice students. Methods: Second year dental students (n = 44) were randomized into VR and control groups. At baseline (T1), both groups completed the traditional lecture instruction for IANB injections. During the educational intervention (T2), the VR group underwent additional training with VRIAN completing 10 injections sequentially. At T3, both groups participated in the peer-to-peer injection exercise with student mentors. Descriptive and comparative statistics on the data and mean improvement of IANB accuracy over time were performed (p < 0.05). Results: Over the 10 sequential injection attempts, the VR group was able to improve their injection positioning by a mean of 0.63 mm when evaluating the 3D distance (p = 0.004). In the x dimension (anterior, posterior), VR group started more anteriorly with their first attempt and moved more posteriorly by a mean of 0.55 mm (p < 0.001). There was no significant improvement in the y (superior, inferior) and z dimensions (medial, lateral). The VR group improved their confidence from T1 (0.4 ± 0.80) to T2 (7.6 ± 1.46) and at T3, the VR group felt more confident in delivering the IANB (8.0 ± 1.33) compared to the control group (7.0 ± 1.36) (p = 0.011). Both groups were similarly successful at providing anesthesia during the peer-to-peer exercise. Conclusions: Although the participants found the peer-to-peer injection training important for IANB skills training, the VRIAN injection simulation may be an effective adjunct in improving students' learning experiences, self-confidence and IANB injection technique through deliberate practice.