運用虛擬實境觸覺回饋牙科訓練模擬器預測牙醫系學生臨床前牙冠修磨表現之回溯性世代研究

牙科教育中，手部靈巧操作的培養對臨床技能發展至關重要，特別是在牙冠修磨等高精度操作項目中。然而，傳統訓練環境往往難以完整模擬真實臨床情境，進而影響學生適應能力。Simodont虛擬實境觸覺回饋牙科訓練模擬器(Nissin Inc., Nieuw-Vennep, Netherlands) 能夠提供即時回饋與多元化的學習體驗，近年來已成為牙科技能訓練的重要輔助工具之一。本回溯性世代研究樣本為84名民國110年入學(110級)的牙醫系四年級學生( 42名男性，42名女性 )，分析其在三個項目上的操作表現：二年級時於Simodont上的手部靈巧練習、四年級初於Simodont上的牙冠修磨練習與四年級期末於模擬人頭上的牙冠修磨測驗。研究採用Spearman等級相關係數、簡單線性迴歸分析，以檢驗三組表現之間的關聯性。進一步將三個項目的成績劃分為高/低表現兩組，並運用卡方檢定與勝算比進行分析。此外，將學生分為男性與女性兩個次群體，並使用相同方法檢驗性別差異對預測力的影響。研究結果顯示，整體而言，二年級在Simodont手部靈巧表現與四年級模擬人頭測驗表現呈現正相關( rs (82) = 0.358, P < 0.01 )，而四年級Simodont牙冠修磨成績與模擬人頭測驗成績亦具有顯著相關性( rs (82) = 0.326, P < 0.01 )。Simodont手部靈巧練習對Simodont牙冠修磨練習的解釋力最強。在Simodont測驗中表現優異的學生，在模擬人頭測驗中獲得高分的機率為3.6至5.6倍。性別分層分析顯示，男性學生在Simodont手部靈巧練習與模擬人頭測驗之間展現了最高的相關性( rs (40) = 0.546, P < 0.001)，其表現優異者在實體測驗中獲得高分的勝算為6.3至13.3倍，且手部靈巧成績能解釋模擬人頭測驗成績變異量的 17.5%。然而，女性學生在三個不同測驗項目之間並未發現顯著相關性。綜合而言，本研究數據顯示，Simodont在預測牙醫學生後續模擬人頭牙冠修磨測驗表現方面具有潛力，且對男性學生而言，預測效果更為顯著。

Manual dexterity training is essential for dental students. The implementation of virtual reality haptic-based dental simulator Simodont (Nissin Inc., Nieuw-Vennep, Netherlands) can provide the real-time feedback in pre-clinical learning. The aim of this study was hypothesized that Simodont may act as a valuable assessment tool in predicting the performance of pre-clinical crown preparation. This retrospective cohort study was to analyze total 84 dental students’ performance among manual dexterity exercises on Simodont, crown preparation on Simodont, and crown preparation test on phantom head. Spearman's correlation coefficient (rs) and simple liner regression were used to examine the relationships of performances among three groups. Subgroup analysis with dichotomous performance (low/high) and sex difference were further analyzed by chi-square test. Positive correlation was found between crown preparation test in phantom head and manual dexterity exercises on Simodont (rs = 0.390, P < 0.001) and crown preparation on Simodont (rs = 0.326, P < 0.01), respectively. Manual dexterity exercises on Simodont was the strongest predictor of crown preparation on Simodont. Odds ratio analysis showed that students who scored highly with manual dexterity exercises on Simodont were 5.6 times more likely to be high performance in conventional crown preparation test in phantom heads (P < 0.001). Moreover, male students were shown to have stronger correlation between the performances on Simodont and phantom head test (P < 0.001). However, there were no significant correlations among three different test groups were found in female students. Taken together, our data revealed the potential of Simodont in the prediction of dental students’ subsequent crown preparation test in conventional phantom head.