Internet-based Remote Communication for Clinical Dental Education

Methods: Clinical case-discussions based on fictitious patients were held between a 'learner' and an 'expert' using the three communication modalities. The learner presented a clinical scenario to the experts, with the aid of a prop (partially dentate cast, digitised for AV3D), to obtain advice on the management of the clinical case. Each communication modality was tested in timed exercises in a random order amongst one of three experts (Senior clinical restorative staff) and a learner (from a cohort of 15 senior clinical undergraduate students), all from School of Clinical Dentistry, University of Sheffield. All learners and experts used in turn each communication modality with no prior training. Video recording and structured analysis was used to ascertain learner behaviour and levels of interactivity; evaluation questionnaires were completed by experts and learners immediately after the experiment to ascertain effectiveness of information exchange and barriers/facilitators to communication.

Results: The video recordings showed that learners were more relaxed in [AV] and [AV3D] than [FTF] (p=0.01). The evaluation questionnaires showed that learners felt they could provide (p=0.03) and obtain (p=0.003) more information using the [FTF] modality, followed by [AV] and then [AV3D]. Experts also ranked [FTF] better than [AV] and better than [AV3D] for providing (p=0.012) and obtaining (p=0) information to/from the expert.

Conclusions: Physical face-to-face learning is a more effective communication modality for clinical case-based discussions between a learner and an expert. Remote, internet-based discussions enable a more relaxed discussion environment. 3D supported communication might require prior training to be effective.