Benefits of using virtual reality in cariology teaching.

BACKGROUND: Virtual Reality (VR) has been widely used as an useful educational tool in modern dentistry and is considered as an alternative training tool adjunct to conventional training methods. OBJECTIVE: This study was designed to investigate the effectiveness of VR haptic-enhanced simulators for training undergraduate dental students during practical cariology pre-clinical caries excavation sessions. METHODS: A total number of 76 students were recruited for this study. Students were randomly divided into 2 groups (38 students each). The experimental group (VR-Start group), students performed caries removal at the VR haptic-enhanced simulator prior to practicing on natural extracted teeth. Conversely, the control group (Natural Tooth-Start Group), students exposed to VR simulation training after practicing on extracted natural teeth. An evaluation questionnaire was disseminated among students to evaluate their self-confidence, perceived clinical skills and their perception of providing better care to patients in the future. They were also invited to express their opinions on the usefulness of VR simulator in comparison with conventional learning methods. RESULTS: The outcome of Chi-square test showed no significant difference in students' response among this study groups (p > 0.05). Moreover, the outcome of this study revealed that both student groups considered virtual reality as a useful learning tool. Majority of students (90%) superiorly ranked experience gained from practicing on natural carious teeth. They also clearly stated that virtual reality allowed them to practice more and improve their self-confidence level as well as eye-hand coordination. CONCLUSIONS: Virtual reality simulator is a useful learning tool which can benefit undergraduate dental students at their pre-clinical stage; but, it cannot totally replace the conventional caries excavation.

Development and validation of a cadaveric porcine Pseudotumor model for Oral Cancer biopsy and resection training.

OBJECTIVE: The gold standard of oral cancer (OC) treatment is diagnostic confirmation by biopsy followed by surgical treatment. However, studies have shown that dentists have difficulty performing biopsies, dental students lack knowledge about OC, and surgeons do not always maintain a safe margin during tumor resection. To address this, biopsies and resections could be trained under realistic conditions outside the patient. The aim of this study was to develop and to validate a porcine pseudotumor model of the tongue. METHODS: An interdisciplinary team reflecting various specialties involved in the oncological treatment of head and neck oncology developed a porcine pseudotumor model of the tongue in which biopsies and resections can be practiced. The refined model was validated in a final trial of 10 participants who each resected four pseudotumors on a tongue, resulting in a total of 40 resected pseudotumors. The participants (7 residents and 3 specialists) had an experience in OC treatment ranging from 0.5 to 27 years. Resection margins (minimum and maximum) were assessed macroscopically and compared beside self-assessed margins and resection time between residents and specialists. Furthermore, the model was evaluated using Likert-type questions on haptic and radiological fidelity, its usefulness as a training model, as well as its imageability using CT and ultrasound. RESULTS: The model haptically resembles OC (3.0 ± 0.5; 4-point Likert scale), can be visualized with medical imaging and macroscopically evaluated immediately after resection providing feedback. Although, participants (3.2 ± 0.4) tended to agree that they had resected the pseudotumor with an ideal safety margin (10 mm), the mean minimum resection margin was insufficient at 4.2 ± 1.2 mm (mean ± SD), comparable to reported margins in literature. Simultaneously, a maximum resection margin of 18.4 ± 6.1 mm was measured, indicating partial over-resection. Although specialists were faster at resection (p < 0.001), this had no effect on margins (p = 0.114). Overall, the model was well received by the participants, and they could see it being implemented in training (3.7 ± 0.5). CONCLUSION: The model, which is cost-effective, cryopreservable, and provides a risk-free training environment, is ideal for training in OC biopsy and resection and could be incorporated into dental, medical, or oncologic surgery curricula. Future studies should evaluate the long-term training effects using this model and its potential impact on improving patient outcomes.

Questionnaire survey on hands-on simulation training using a dental humanoid robot (SIMROID®).

INTRODUCTION: A dental humanoid robot, SIMROID®, is able to replicate the actions characteristic of human beings and enable training for communicating with patients and coping with unexpected situations. This study assessed user experiences via a survey questionnaire following hands-on training on the SIMROID®. MATERIALS AND METHODS: A total of 112 participants, consisting of 50 high school students who visited AUSD (Asahi University School of Dentistry) to participate in open campus events, 42 fourth-year students at AUSD and 20 dental students from Mexico State Autonomy University, University of Siena and Peking University took the survey. The participants observed the movements and reactions of a SIMROID® robot placed on a dental unit for approximately 20 min after which they completed a questionnaire survey. Both Japanese and English versions of the questionnaire were prepared for local and visiting foreign dental students. The questionnaire comprised 8 items, with a further two items for those undertaking dental training and an open comment field. RESULTS: All participants who observed the SIMROID® completed the questionnaire giving a 100% response rate. Generally, simulation training with SIMROID® was highly appreciated by all participants. The comprehensive evaluation score for SIMROID® was 4.56 ± 0.50 points for high school students, 4.05 ± 0.82 points for students at AUSD and 4.70 ± 0.47 points for foreign dental students, showing all participants had a very positive experience and impression of the SIMROID®. CONCLUSIONS: Therefore, simulation training using SIMROID® seems beneficial learning tool.

Simulation training for medical emergencies: Evaluation of dentists' long-term learning skills and confidence.

INTRODUCTION: As the population ages and more patients experience medical emergencies during dental treatments, dentists must competently and confidently manage these situations. We developed a simulation training course for medical emergencies in the dental setting using an inexpensive vital sign simulation app for smartphones/tablets without the need for an expensive simulator. However, the duration for which this effect is maintained is unclear. This study was performed to evaluate the long-term educational effect at 3, 6, and 12 months after taking the course. MATERIALS AND METHODS: Thirty-nine dental residents participated in this course. Scenarios included vasovagal syncope, anaphylaxis, hyperventilation syndrome, and acute coronary syndrome, each of which the participants had to diagnose and treat. The participants were evaluated using a checklist for anaphylaxis diagnosis and treatment skills immediately after and 3, 6, and 12 months after the course. The participants were also surveyed about their confidence in diagnosing and treating these conditions by questionnaire before, immediately after, and 3, 6, and 12 months after the course. RESULTS: The checklist scores for anaphylaxis were significantly lower at 3, 6, and 12 months after the course than immediately after the course. The percentage of participants who provided a correct diagnosis and appropriate treatment for vasovagal syncope, hyperventilation syndrome, and acute coronary syndrome was lower at all reassessments than immediately after the course. CONCLUSION: Because medical emergency management skills and confidence declined within 3 months, it would be useful to introduce a refresher course approximately 3 months after the initial course to maintain skills and confidence.

Evaluation of a digital game for teaching behavioral aspects of clinical communication in dentistry.

INTRODUCTION: Traditionally, dental students learn the skills for dentist-patient interaction and communication via on-site contact with patients, when they start clinical training. However, preclinical students (who have not started clinical practice) have fewer chances to realize the context of dentist-patient interaction. It has remained unclear if a gamification approach via digital media, i.e., a computer role-playing game, can help to learn clinical communication skills. The intervention-based study investigates the effectiveness of the clinical dentist-patient communication (CDPC) game on students' motivation, beliefs, and self-efficacy to learn behavioral issues of clinical communication. METHODS: Fifty-two dental students (Preclinical group) and 18 dental interns and dentists (Clinical group) played the CDPC game, which consists of 16 scenes of clinical context about dentist-patient communication (less than 40 min for playing), via web browsers. Pre-test and post-test questionnaires were used to assess their motivation, beliefs, and self-efficacy to learn behavioral issues of clinical communication. The effectiveness was examined by comparing pre-test and post-test scores within-subject and between-group difference was compared between Preclinical and Clinical groups, via non-parametric statistical tests. RESULTS: (A) In the Preclinical group, participants showed a significant increase in motivation and self-efficacy in learning after playing the CDPC game (p < 0.05, adjusted of multiple comparison). (B) In contrast, the Clinical group did not show a significant difference before vs. after playing the game. (C) After playing the game, the Preclinical group showed a significant association between motivation and beliefs (p = 0.024) and between motivation and self-efficacy (p = 0.001); the Clinical group showed a significant association between motivation and beliefs (p = 0.033). CONCLUSIONS: The current evidence suggests that gamification of learning helps preclinical students to understand the context of clinical dentist-patient interaction and increase their motivation and self-efficacy to learn behavioral issues of clinical communication.

Accuracy assessment of implant placement with versus without a CAD/CAM surgical guide by novices versus specialists via the digital registration method: an in vitro randomized crossover study.

BACKGROUND: Many studies demonstrated that surgical guides might reduce discrepancies compared with freehand implant placement. This randomized crossover study aimed to assess the effects of approaches, practitioners' experience and learning sequences on the accuracy of single tooth implantation via digital registration method. No similar study was found. METHODS: This in vitro randomized crossover study enrolled 60 novice students (Group S) and 10 experienced instructors (Group I). Sixty students were randomly and evenly assigned to two groups (Group SA and SB). In Group SA, 30 students first performed single molar implant on a simulation model freehand (Group SAFH), and then with a CAD/CAM surgical guide (Group SASG). In Group SB, another 30 students first performed guided (Group SBSG) and then freehand (Group SBFH). Ten instructors were also divided into Group IAFH/IASG (n = 5) and IBSG/IBFH (n = 5) following the same rules. The accuracy of implant placement was assessed by the coronal and apical distance (mm) and angular (°) deviations using the digital registration method. T tests and nonparametric tests were used to compare the results among different groups of approaches, experience and sequences. RESULTS: For students, the coronal and apical distance and the angular deviations were significantly lower in surgical guide group than freehand group in total and in learning freehand first subgroup, but for learning surgical guide first subgroup the apical distance deviation showed no significant difference between two approaches. For students, the angular deviation of freehand group was significantly lower in learning surgical guide first group than learning freehand first group. For instructors, the coronal and apical distance and angular deviations showed no significant difference between two approaches and two sequences. For freehand approach, the coronal and apical distance and the angular deviations were significantly higher in student group than instructor group, while not significantly different between two groups for surgical guide approach. CONCLUSIONS: For novices, using a surgical guide for the first implant placement may reduce the potential deviations compared with freehand surgery, and may reach a comparable accuracy with that of specialists. For simple single molar implantation, the surgical guide may not be significantly helpful for experienced specialists.

The integration of haptic training into the QMUL dental curriculum.

The Pandemic has challenged clinical dentistry globally with the dental education sector seeking alternative training environments. Virtual reality (VR) is gaining recognition as a valuable tool for training dental students and its use by dental schools around the world is growing. The continuous improvement of haptic VR dental trainers provides a platform where irreversible procedures can be safely and unlimitedly practised. This driver has led to the exploration and investment into virtual technology to improve education outcomes in dental students. The aim of this study was to share the early experience of a dental school in the United Kingdom that has initiated the process of embedding haptics into their simulation training within the dental curriculum. This paper explores the process of embedding and operationalising haptic training within the undergraduate curriculum. Using current knowledge of education pedagogy, the school aligned to an evidence-based, best-practice framework which utilised the concept of deliberate practice in the development of the Haptics curriculum which was adaptable and iterative in design. This paper contextualises the implementation of haptic training in a UK dental education setting by providing an outline of the framework used to develop the curriculum. Virtual reality haptics trainers have created unique opportunities and challenges for dental schools. Dental educators have sought to utilise this technology in a structured framework to enhance training.

Patient-specific 3D printed models for enhanced learning of immediate implant procedures and provisionalization.

INTRODUCTION: This study aimed to describe the fabrication, implementation and evaluation of 3D-printed patient-specific models for unskilled students to enhance learning in immediate implant procedures and provisionalization. MATERIALS AND METHODS: The individualized simulation models were designed and processed based on CT and digital intraoral scanning of a patient. Thirty students performed simulation implant surgery and provisionalized the implant sites on the models and answered questionnaires to assess their perceptions before and after the training. The scores of the questionnaires were analysed using the Wilcoxon signed-rank test. RESULTS: Significant differences before and after training were found in the students' responses. Students reported better results in understanding of surgical procedures, knowledge in prosthetically driven implantology, understanding of minimally invasive tooth extraction, confirming the accuracy of surgical template, usage of the guide rings and usage of the surgical cassette after simulation training. The overall expenditure on the simulation training involving 30 students amounted to 342.5 USD. CONCLUSIONS: The patient-specific and cost-efficient 3D printed models are helpful for students to improve theoretical knowledge and practical skills. Such individualized simulation models have promising application prospects.

PROFESSIONAL TRAINING OF MASTERS OF DENTISTRY WITHIN QUARANTINE RESTRICTIONS AND MARTIAL LAW: A COMPARATIVE ANALYSIS OF EDUCATIONAL PROCESS.

OBJECTIVE: The aim: To present a comparative analysis of the educational technologies effectiveness that were used in the process of professional training of masters of dentistry during quarantine restrictions and martial law. PATIENTS AND METHODS: Materials and methods: To perform the set tasks, the following the empirical methods of scientific research were used: quantitative data were collected based on analyzing the results of students' educational achievements, as well as implementing special questionnaire that was sent to the students of the Faculty of Dentistry of NMU; qualitative data were collected with the help of several focus groups formed from students and teachers of the faculty. Analysis was undertaken using statistical methods (Pearson's test), and qualitative data were analyzed descriptively. RESULTS: Results: This paper analyzes the effectiveness of educational technologies used during quarantine restrictions and martial law, the role of phantom classes in providing professional training of dentistry specialists, summarizes the results of a comprehensive analysis of scientific literature, teaching experience at the dental faculty and the results of sociological research (student surveys, discussion in focus groups). CONCLUSION: Conclusions: The outbreak of the COVID-19 pandemic and the full-scale war unleashed by the russian federation in Ukraine forced to quickly find and implement mixed forms of teaching future masters of dentistry, which, in combination with digital technologies, enables implementing high-quality and effective training.

Congenital Heart Surgery Skill Training Using Simulation Models: Not an Option but a Necessity.

Congenital heart surgery (CHS) is technically demanding, and its training is extremely complex and challenging. Training of the surgeon's technical skills has relied on a preceptorship format in which the trainees are gradually exposed to patients in the operating room under the close tutelage of senior staff surgeons. Training in the operating room is an inefficient process and the concept of a learning curve is no longer acceptable in terms of patient outcomes. The benefits of surgical simulation in training of congenital heart surgeons are well known and appreciated. However, adequate surgical simulation models and equipment for training have been scarce until the recent development of three-dimensionally (3D) printed models. Using comprehensive 3D printing and silicone-molding techniques, realistic simulation training models for most congenital heart surgical procedures have been produced. Newly developed silicone-molded models allow efficient CHS training in a stress-free environment with instantaneous feedback from the proctors and avoids risk to patients. The time has arrived when all congenital heart surgeons should consider surgical simulation training before progressing to real-life operating in a similar fashion to the aviation industry where all pilots are required to complete simulation training before flying a real aircraft. It is argued here that simulation training is not an option anymore but should be a mandatory component of CHS training.

3D printed versus commercial models in undergraduate conservative dentistry training.

INTRODUCTION: The treatment of carious lesions is one of the most fundamental competencies in daily dental practice. However, many commercially available training models lack in reality regarding the simulation of pathologies such as carious lesions. 3D printed models could provide a more realistic simulation. This study provides an exemplary description of the fabrication of 3D printed dental models with carious lesions and assesses their educational value compared to commercially available models in conservative dentistry. MATERIALS AND METHODS: A single-stage, controlled cohort study was conducted within the context of a curricular course. A stereolithographic model was obtained from an intraoral scan and then printed using fused deposition modelling. These models were first piloted by experts and then implemented and compared against commercial models in a conservative dentistry course. Experts and students evaluated both models using a validated questionnaire. Additionally, a cost analysis for both models was carried out. RESULTS: Thirteen dentists and twenty-seven 5th year dental students participated in the study. The 3D printed models were rated significantly more realistic in many test areas. In particular, the different tactility and the distinction in colour was rated positively in the 3D printed models. At 28.29€ (compared to 112.36€), the 3D printed models were exceptionally cost-efficient. CONCLUSIONS: 3D printed dental models present a more realistic and cost-efficient alternative to commercial models in the undergraduate training of conservative dentistry.

The impact of an electronic guide on students' self-directed learning in simulation clinic.

INTRODUCTION: Simulation training on high-fidelity simulated models have been used to provide a safe and effective training platform for dental students to develop the skills necessary to treat patients. To surpass challenges of traditional pedagogies in simulation training and reinforce self-directed learning, a bespoke computer application, PerioPal, was designed to complement training of dental students in periodontal instrumentation. MATERIALS AND METHODS: This study evaluated the impact of PerioPal on a cohort of 92 second-year dental students at an Australian University. During the first semester in 2019, they received traditional simulation periodontal instrumentation training (control semester). In the following semester, PerioPal was implemented as a technological teaching adjunct (intervention semester). Student perceptions of their learning experiences were gathered through a qualitative and quantitative questionnaire. Impact on student performance was evaluated through comparing periodontal instrumental assessment results in control and interventionsemesters. RESULTS: With introduction of PerioPal, students perceived that the simulation clinic learning environment, better contributed to the speed at which they learnt new instrumentation as well as being able to self-pace their work. They commented that instructional videos and independent learning were most beneficial. Interestingly, students suggested that PerioPal aided their preparation for theoretical assessments more than their practical assessments. After introduction of PerioPal a minor improvement of average practical assessment marks was observed but could not be statistically confirmed as significant. CONCLUSION: Although the computer-supported learning did not lead to improvement of the students' practical performance a positive effect on the student self-paced learning experience and engagement in simulated environment were observed.

WHO surgical safety checklist training: An alternative approach to training in local safety standards for invasive procedures.

BACKGROUND: Despite efforts to promote the effective use of the WHO surgical safety checklist, wrong tooth extractions have continued to occur within dentistry. METHOD: A training initiative combined methods of teaching comprising of a presentation, video and simulation to deliver LocSSIP training at an Oral Surgery Department of a UK dental hospital. Participant feedback was analysed to determine their perception of using combined methods to deliver the training. RESULT: Overall feedback was very positive with regard to relevance of the training, and its ability to meet the learning needs of all participants. Participants advocated that there should be regular re-training and incorporation of this training into the local induction programme. Almost About 94% of staff members Strongly Agreed or Agreed that they would recommend this format of training to other departments. CONCLUSION: Effective training is essential to maintain safe clinical practice within health care, and training methods that are inclusive of various learning styles are well received.

3D-printed patient individualised models vs cadaveric models in an undergraduate oral and maxillofacial surgery curriculum: Comparison of student's perceptions.

BACKGROUND: Recent advances in 3D printing technology have enabled the emergence of new educational and clinical tools for medical professionals. This study provides an exemplary description of the fabrication of 3D-printed individualised patient models and assesses their educational value compared to cadaveric models in oral and maxillofacial surgery. METHODS: A single-stage, controlled cohort study was conducted within the context of a curricular course. A patient's CT scan was segmented into a stereolithographic model and then printed using a fused filament 3D printer. These individualised patient models were implemented and compared against cadaveric models in a curricular oral surgery hands-on course. Students evaluated both models using a validated questionnaire. Additionally, a cost analysis for both models was carried out. P-values were calculated using the Mann-Whitney U test. RESULTS: Thirty-eight fourth-year dental students participated in the study. Overall, significant differences between the two models were found in the student assessment. Whilst the cadaveric models achieved better results in the haptic feedback of the soft tissue, the 3D-printed individualised patient models were regarded significantly more realistic with regard to the anatomical correctness, the degree of freedom of movement and the operative simulation. At 3.46 € (compared to 6.51 €), the 3D-printed patient individualised models were exceptionally cost-efficient. CONCLUSIONS: 3D-printed patient individualised models presented a realistic alternative to cadaveric models in the undergraduate training of operational skills in oral and maxillofacial surgery. Whilst the 3D-printed individualised patient models received positive feedback from students, some aspects of the model leave room for improvement.

Preclinical dental training: Association between difficulty in performing restorative procedures and the adoption of ergonomic posture.

OBJECTIVE: The aim of this study was to determine any correlations between difficulty in performing restorative procedures and the adoption of ergonomic posture by dental students in a preclinical course. METHODS: The sample was composed of second-year undergraduate students enrolled in the School of Dentistry of São Paulo State University (UNESP), Araraquara (n = 56). The data were collected from weekly records in which students who had participated in training in a preclinical restorative dentistry laboratory registered the difficulty they experienced performing given proposed preclinical procedures and adopting ergonomic posture (positioning of students' legs, thighs, spine, arms, and forearms, as well as the positioning of both the dental light and the dental mannequin's head, the distance between the operating field and the operator's eyes, and the location of the instruments used in the procedures). Answers were provided on a scale of zero to ten points (zero = no difficulty; 10 = maximum difficulty). A descriptive statistical analysis was performed. The correlation between the level of difficulty in performing the restorative procedures and in the adoption of ergonomic posture was estimated using the Pearson correlation coefficient (r), and its significance was tested using Student's t test. To evaluate the effect of time on students' perceived difficulties in implementing ergonomic posture, the first 2 weeks of training was defined as the initial time, whilst the last 2 weeks was defined as final time (scores from these periods were averaged). After the normality assumptions were verified, Student's t test for paired samples was performed. The significance level adopted was <5%. RESULTS: A correlation was found between the difficulty students experienced performing the preclinical procedures and their difficulties implementing ergonomic posture; the correlation was significant, though the correlation ranged from slight to moderate (P < 0.001; r = 0.38-0.63). In addition, the data also showed that the students' perceptions of how difficult it was to implement these posture items decreased significantly over time (P < 0.001). CONCLUSION: The correlation between perceived difficulty in performing the preclinical restorative dentistry procedures and the application of ergonomic posture was slight to moderate, and the students' perceived difficulties in maintaining ergonomic posture decreased over the course of the school year.

Developing an accurately sized tonsil tie simulator: a prospective, observational study to measure the anatomical distance from the incisor teeth to the inferior tonsillar pole in a paediatric population.

OBJECTIVE: The aim of this study is to measure the distance from the midline of the upper incisors to the lower pole of the tonsils in paediatric patients of varying ages. This will enable the design of accurately sized tonsil tie simulators. METHODS: Two hundred patients between 1 year and 16 years old were recruited in this prospective observational study. The patient's age and the mean distance from the midline of the upper incisors to the lower pole of the tonsils were plotted into a scatter plot and the line of best fit was calculated. RESULTS: The equation for the line of best fit was: distance (mm) = 1.9604 × age (digitalised years) + 72.436. CONCLUSION: This is the first study to measure the anatomical distance from the upper incisor teeth to the inferior tonsillar pole in a paediatric population. This can be used to accurately size tonsil tie simulators and enhance their fidelity.

Kern's six-step approach allows for meaningful implementation of an orthognathic surgery training course.

OBJECTIVES: This study investigated the effectiveness of simulation training in improving the confidence and competency of oral and maxillofacial surgery (OMS) residents in performing orthognathic surgery (OGS). METHODS: Kern's six-step approach was applied when designing the simulation training for OMS residents. The difficulties encountered by the residents when learning OGS were considered when designing the training program. A training course consisting of didactic sessions, hands-on training on three-dimensional training models, and an assessment tool was implemented for OMS residents. Improvement in the confidence and competence of OMS residents in performing OGS, fidelity of the three-dimensional models, and satisfaction with the course was evaluated. RESULTS: All OMS residents (10/10) completed the course. The perceived difficulty in learning OGS was mainly related to the manipulation of the jawbones. While there were improvements in the median confidence and competence scores (3/5 to 4/5), only the differences in competence were found to be statistically significant (p < 0.01, Wilcoxon signed-rank test). Improvements in confidence and competence did not correlate. The mean fidelity scores of both the maxillary and mandibular models were adequate at 3.2 out of 5. Overall, satisfaction with the course was high (5/5). CONCLUSIONS: The six-step approach provides a guided process for educators to formulate a training course directed toward the perceived needs of students. Targeted training can significantly enhance the students' competence. Greater efforts should also be put in place to allow simultaneous developments in the students' confidence along with their competence.

Development and evaluation of simulation-based scenario education program for professional oral hygiene care in intubated patient.

PURPOSE: This study was conducted to develop a professional oral hygiene care (POHC) simulation education program for intubated patients and to evaluate the suitability of education by evaluating the performance confidence (PC), critical thinking disposition (CT), and learning satisfaction (LS) of dental hygiene students. METHODS: This study developed a POHC simulation education program (theory, skill training, scenario education, and debriefing) for intubated patients through expert validation and consisted of a single-group pre- and postexperiment design. The subjects were 3rd and 4th year students at the Department of Dental Hygiene in Wonju City, and a total of 30 people were enrolled. The collected data were analyzed using the PASW Statistics version 23.0. The content validity test was measured by the CVI (Content validity index) value, and the PC, CT, and LS of the subjects before and after participating in the program were analyzed using a paired t-test. The significance level (α) was based on .05. RESULTS: After the program, the PC improved from 4.29 ± 0.43 to 4.54 ± 0.44, and there was a significant difference (p = .004). CT improved from 3.73 ± 0.36 to 3.84 ± 0.36, but there was no significant difference (p = .062), and prudence improved from 4.21 ± 0.33 to 4.43 ± 0.27, and there was significant difference. (p = .001). LS increased from 4.66 ± 0.36 to 4.90 ± 0.16 after education, and there was a significant difference (p = .002). CONCLUSION(S): Simulation education program improved dental hygiene students' POHC performance confidence. Various scenarios will need to be developed in the future, and it is necessary to evaluate simulation education within the dental hygiene curriculum and identify areas for improvement.