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A comparison of student performance in a simulation clinic and a traditional laboratory environment: three-year results.

With simulation clinics, dental schools have improved their preclinical laboratories to provide a more realistic clinical teaching environment. However, there is very little data to support the assumption that these facilities actually improve student performance of technical skills. This study compared the scores of two fixed preparations for full cast crowns by third-year dental students. One of the preparations was made in the simulation clinic manikin, and the other was prepared on the bench top. Three prosthodontic faculty members scored the preparations in the areas of occlusal reduction, axial reduction, resistance and retention, and margination. The study also compared the performance of three classes of dental students: one class with no experience in the simulation clinic, one with one year of experience, and one with two years of experience. The amount of time since completing the fixed prosthodontics course among the students was also evaluated. This was done because the third-year students at the University of Iowa rotate through a series often-week clerkships rather than a comprehensive care model. (Therefore, not all students start clinical prosthodontics at the same time.) In addition, all student participants completed a questionnaire that addressed their perception of their clinical readiness prior to treating their first fixed prosthodontic patient. When we compared the classes of years 1, 2, and 3 by average preparation score, we found a significant difference among the scores for teeth prepared on the bench top (p = 0.0001) but not for the teeth prepared in the mannequin (p = 0.1176). For Year 1 (no simulation clinic experience), the amount of elapsed time following completion of the fixed prosthodontic course was not significant for the tooth prepared on the bench top or in the manikin (p = 0.57113 and 0.0661). For Year 2 (one year of simulation clinic experience), the elapsed time following completion of the fixed prosthodontic course was significant for the tooth prepared on the bench top (p = 0.0482), but it was not significant for the tooth prepared in the manikin (p = 0.2968). For Year 3 (two years of simulation clinic experience), the amount of elapsed time following completion of the fixed prosthodontic course was not significant for the tooth prepared on the bench top or in the manikin (p = 0.7275 and 0.6007). The questionnaire revealed that, in general, the majority of the students perceived their clinical readiness as more than adequate. These results are mixed in that students with more bench top experience scored better on the bench top, and students with more manikin experience scored equally in both environments.