Publications
Bioinformatics for Dentistry
Abstract
Genes strictly regulate the development of teeth and their surrounding oral structures. Alteration of gene regulation leads to tooth disorders and developmental anomalies in tooth, oral, and facial regions. With the advancement of gene sequencing technology, genomic data is rapidly increasing. However, the large sets of genomic and proteomic data related to tooth development and dental disorders are currently dispersed in many primary databases and literature, making it difficult for users to navigate, extract, study, or analyze. We have curated the scattered genetic data on tooth development and created a knowledgebase called ‘Bioinformatics for Dentistry’ (https://dentalbioinformatics.com/). This database compiles genomic and proteomic data on human tooth development and developmental anomalies and organizes them according to their roles in different stages of tooth development. The database is built by systemically curating relevant data from the National Library of Medicine (NCBI) GenBank, OMIM: Online Mendelian Inheritance in Man, AlphaFold Protein Structure Database, Reactome pathway knowledgebase, Wiki Pathways, and PubMed. The accuracy of the included data was verified from supporting primary literature. Upon data curation and validation, a simple, easy-to-navigate browser interface was created on WordPress version 6.3.2, with PHP version 8.0. The website is hosted in a cloud hosting service to provide fast and reliable data transfer rate. Plugins are used to ensure the browser’s compatibility across different devices. Bioinformatics for Dentistry contains four embedded filters for complex and specific searches and free-text search options for quick and simple searching through the datasets. Bioinformatics for Dentistry is made freely available worldwide, with the hope that this knowledgebase will improve our understanding of the complex genetic regulation of tooth development and will open doors to research initiatives and discoveries. This database will be expanded in the future by incorporating resources and built-in sequence analysis tools, and it will be maintained and updated annually.
URL for Full Article: https://doi.org/10.1371/journal.pone.0303628
Abstract
Objectives: Dental students study the genetics of tooth and facial development through didactic lectures only. Meanwhile, scientists’ knowledge of genetics is rapidly expanding, over and above what is commonly found in textbooks. Therefore, students studying dentistry are often unfamiliar with the burgeoning field of genetic data and biological databases. There is also a growing interest in applying active learning strategies to teach genetics in higher education. We developed a secondary database called “Genetics for Dentistry” to use as an active learning tool for teaching genetics in dentistry programs. The database archives genomic and proteomic data related to enamel and dentin formation.
Methods: We took a systematic approach to identify, collect, and organize genomic and proteomic tooth development data from primary databases and literature searches. The data were checked for accuracy and exported to Ragic to create an interactive secondary database.
Results: “Genetics for Dentistry,” which is in its initial phase, contains information on all the human genes involved in enamel and dentin formation. Users can search the database by gene name, protein sequence, chromosomal location, and other keywords related to protein and gene function.
Conclusions: “Genetics for Dentistry” will be introduced as an active learning tool for teaching genetics at the School of Dentistry of the University of Alberta. Activities using the database will supplement lectures on genetics in the dentistry program. We hope that incorporating this database as an active learning tool will reduce students’ cognitive load in learning genetics and stimulate interest in new branches of science, including bioinformatics and precision dentistry.
URL for Full Article: https://doi.org/10.4258/hir.2022.28.4.387
Dental AR
Abstract
Objectives: The study of biological materials under a microscope is known as histology, which is one of the most challenging subjects for students. Our objective was to develop a learning tool that can reduce the extrinsic load of studying histology and make learning enjoyable and flexible. We used augmented reality (AR) to create a cellphone application called Dental AR. With Dental AR, students can use their cellphones as dynamic flashcards to hide or reveal the annotations of a histology slide. Our application enables students to study, practice, and self-test oral histology knowledge at their own pace.
Methods: We used Unity3D with Vuforia to develop Dental AR. To generate a set of target images, oral histology glass slides were scanned and converted to digital images. Annotated versions of the slides were used as output for the corresponding target images. To understand user experiences and satisfaction with Dental AR, first-year dentistry students were invited to complete an online survey.
Results: Dental AR was successfully developed and released on both the Apple and Google Play online app stores. The survey of dentistry students indicated overall satisfaction with Dental AR and willingness to use similar applications in other subjects.
Conclusions: Dental AR can be used for in-class activities, gamification, and providing students with practice questions to study and self-test outside the classroom. This application can be expanded in the future to incorporate more target images, videos, and interactive components to make learning histology less challenging and more enjoyable.
URL for Full Article: https://e-hir.org/journal/view.php?doi=10.4258/hir.2022.28.2.170
Abstract
Objectives: Flashcards are one of the most popular and optimized ways to learn factual knowledge and improve memory performance. Students of modern age, who use smart technology and mobile devices in their daily lives, often lack the time and motivation to create and use flashcards effectively. We aim to use the inseparable relationship between university students and their smartphones to create new options for higher education, converting their cellphones into flashcards. We have used this new technology to develop a simple application (app) to convert the smart mobile devices of students into flashcards.
Methods: We have developed an augmented reality (AR) flashcard application using Unity3D, which requires the user to identify a target image. Once the target image is identified, it can be replaced by any other digital output, i.e., 2D image, 3D models, or videos. We used images of histological sections of oral mucosa, which dentistry students study as a part of an oral biology course.
Results: The AR flashcard application worked on both iOS and Android systems. It was able to detect the target image and replace it with the output image on the device screen.
Conclusions: Using this application, students will be able to independently learn and self-test their learning at their own convenience. Instructors can use the application to provide additional study aids for the students. Our application, which is being developed as a pilot project, will be expanded and applied as a learning tool for students studying dentistry at the University of Alberta.
URL for Full Article: https://e-hir.org/journal/view.php?doi=10.4258/hir.2020.26.3.238
Digital Escape Room
Abstarct
Problem: The application of digital educational escape rooms (DEERs) is becoming increasingly popular in higher education, positively impacting cognitive, behavioral, and affective skills. However, reports of actual use of DEERs in the training of oral health professionals are scarce. One reason for this may be the resources and costs involved in developing DEERs. Fostering active learning and student engagement in online courses may be challenging for instructors; however, well-designed and easy-to-develop DEERs can greatly benefit the student learning experience.
Solution: We developed a DEER using Google slides and Google forms for an online biochemistry course offered to the second year dental hygiene (DH) students. The aim was to create an engaging game that can serve as a self-assessment tool for students and a formative assessment tool for the instructor to gauge student understanding. The traditional structure of an escape room was followed to create our DEER game, called “The Biochemist’s Island.” It was based on a storyline, where students were required to solve puzzles and discover hidden clues to progress through the storyline to reach the final goal. The puzzles were organized sequentially, students must solve one puzzle correctly for the next task to open. Solving each puzzle provided a code needed in the last step to solve the mystery. The game was posted in the Learning Management System (LMS) of the online synchronous biochemistry course. The LMS data were analyzed to assess students’ engagement with the escape room. The LMS, however, reports the number of instances of interactions with the DEER only, without providing the time of engagement. A survey, adapted from the validated Gameful Experience Scale (GAMEX) was incorporated at the end of the escape room to evaluate students’ gaming experience and their perception of the DEER as a teaching and learning tool. This study was approved by the University of Alberta Research Ethics Board (ID: Pro00138302).
Results: The biochemistry course enrolls 28 DH students and runs for 15 weeks. The escape room was posted on week 3 to supplement the lecture materials on amino acids. This material was tested on week 6 in a noncumulative exam. Seventy-five percent (75%) of the class (n = 21) interacted with the DEER. High student engagement with the DEER occurred between week 5 and week 6, immediately prior to the exam. Eleven percent (11%, n = 3) of the class participated in the survey. The survey participants indicated that the escape room game was fun, helpful for learning, and made them feel adventurous and active.
URL for the Full Article: https://onlinelibrary.wiley.com/doi/10.1002/jdd.13671
Gamification
Problem
Review sessions in didactic teaching improve students’ learning and academic performance. However, without proper planning and active participation of students, review sessions often become disjointed ‘Question and Answer sessions’, benefiting only a few motivated students. Formative assessments help review concepts and identify gaps in students’ knowledge, assisting instructors in making instructional decisions. Unfortunately, with increased work and class loads, many instructors cannot devote additional time to review previously covered material.
Solution
We gamified formative assessments in a 1st-year Doctor of Dental Surgery class using in-class fishing games from Gimkit to review and reinforce oral biology concepts. Gimkit allows instructors to create quiz-based games and host the live game in class. In-game credits are awarded for each correct answer, which is used to buy power-ups and boosters to get ahead of others. Fishtopia is a popular game of Gimkit, where students answer questions correctly to get bait for fishing and sell the fish for in-game currency. Students can enter the live game from any internet-connected device without registration.
Tooth-microanatomy and oral histology are two challenging topics for students. Class time is insufficient to present multiple micrographs of histological sections. Gimkit’s Fishtopia is an opportunity to review these concepts in a quick, fun, and interactive manner. The game was played twice in class, with questions about recognizing tissue sections. The questions were randomly repeated, helping to reinforce concepts. If a question is answered incorrectly, the correct answer is presented, so students can improve their game scores by answering the same question correctly when given next time. Students’ performances in the exam questions were analyzed; an anonymous survey was conducted to evaluate students’ gaming experiences. The University of Alberta Research Ethics Board approved the study (Pro00124923).
URL for Full Article: https://onlinelibrary.wiley.com/doi/10.1002/jdd.13441
Abstract
Introduction: Higher educational institutions increasingly focus on incorporating games to enhance student engagement. Gimkit is a recent addition to gamified learning that allows instructors to create quiz games with randomly repeated questions.
Case description: The study of nutrition requires memorization of facts. Gimkit was incorporated into a dental hygiene class to teach nutrition and support rote learning. Anonymous data on student performance and satisfaction were collected. Descriptive statistics were applied to summarize the survey results; the difficulty and discrimination indices were analyzed to evaluate students’ academic performance.
Results: Ten percent of the class participated in the voluntary survey; academic performance was analyzed for the whole class. The study identified Gimkit as a potential learning tool, especially for content areas that require memorization and learning of facts.
Conclusion: Data show a positive impact of in-class gaming on knowledge acquisition and retention.
URL for Full Article: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10662428/
Problem
Active learning strategies in face-to-face teaching can improve student performance, motivation, and satisfaction. However, active learning strategies to engage students online, are scarce and difficult to implement, especially for asynchronous courses. Gamified learning is gaining popularity as a student engagement tool, though there are few reports of this approach in dental education.
Solution
The School of Dentistry offers an online asynchronous oral biology course. Gamified homework is incorporated in this course using Gimkit, a platform that creates quiz games as assignments that can be posted in the learning management system (LMS). Gimkit has several homework modes, where students must correctly answer quiz questions to be rewarded with resources to achieve specific goals. Students can invest ‘in-game credits’ to get score-boosting power-ups and upgrades to achieve goals faster. At the beginning of the winter term, one Gimkit homework (Gimkit HW) and in the 2nd part of the term, three Gimkit HW tasks were posted in the LMS. To evaluate the impact of Gimkit HW assignments on students’ learning and knowledge retention, some of the questions from the Gimkit HW were used in Exam-II. Note that, 16% of questions in Exam-II were previously used in the Gimkit HW with identical wording, 9% with modified wording, and 19% of the exam questions challenged students to apply knowledge previously learned through homework. Note that, 56% of questions in Exam-II were not used in the homework.
The class averages between the two exams were compared. The difficulty and discrimination indices were calculated for questions in Exam-II. All the students were invited to participate in a survey to measure their attention, relevance, confidence, and satisfaction with the Gimkit HW. The study design was approved by the University of Alberta Research Ethics Board.
URL for Full Article: https://onlinelibrary.wiley.com/doi/10.1002/jdd.13361
H5P Content
Abstract
Background: Presently, dental hygiene education is primarily divided into classroom lectures, simulation labs, and clinical experiences. Although the recent surge of curriculum renovation in dental and medical schools centres around enhancing student engagement and active learning, classroom teaching remains teacherfocussed, involving students mainly as passive learners. H5P is an open platform for creating and sharing interactive HTML5 learning content. A large set of H5P content was created and provided to students through the learning management system as supplementary material for an oral biology course in the dental hygiene program at a Canadian university. This study was conducted to evaluate the impact of this interactive H5P content on the students’ learning experiences.
Methods: The third-year dental hygiene students enrolled in the oral biology course were invited to participate in the study. Anonymised student performance data from the summative exam were analysed, and a survey regarding the student experience with the supplementary H5P content was administered.
Results: Students performed better on questions for which H5P supplements were provided. The results from the survey showed satisfaction and perceived benefit of using H5P as supplementary content in didactic lectures.
Discussion: The H5P content allowed students to apply knowledge and reproduce understanding, promoting active learning in the didactic oral biology course. Students appreciated the content’s interactive nature and expressed willingness to have similar experiences in other courses. Conclusion: Using H5P, interactive learning content can promote self-directed and personalized learning. This open learning platform has the potential to redefine didactic teaching by fostering an active learning environment.
URL for Full Article: https://files.cdha.ca/profession/journal/2814.pdf
Problem
Case-based learning (CBL), with clinical cases and a set of measurable learning outcomes, promotes deep learning and critical thinking in health professional education. Traditionally, in a CBL session, an instructor provides the clinical case and facilitates group discussions to meet learning objectives.1 With the growing popularity of online and self-paced learning among medical students, it is necessary to identify alternative ways to conduct CBL in a self-paced manner.
Solution
We have used the H5P to create interactive self-paced CBL modules for the Doctor of Dental Surgery (DDS) program and implemented them asynchronously. The DDS curriculum of the school has been renewed to integrate iterative revisiting of foundational topics throughout the years and a vertical integration of basic science and clinical knowledge. The CBL modules were created for 1st year DDS students to provide an interactive, patient-based, self-paced learning platform to integrate foundational science knowledge with clinical experiences. The CBL modules were named ‘Tier-based learning (TBL) modules’, highlighting their spiral nature and aim towards reinforcing students’ understanding across the years.
URL for Full Article: https://onlinelibrary.wiley.com/doi/10.1002/jdd.13595
Problem
Students studying in Dentistry and Dental Hygiene Programs receive a significant portion of their dental education through didactic lectures. Although the recent rise of curricular transformations in dental schools aims to improve students’ learning experiences by introducing innovative teaching techniques and technologies, in most cases, the didactic lectures remain in their traditional format, lacking opportunities for active learning.
Solution
We have created a series of interactive HTML5 learning content using H5P to supplement foundational science didactic lectures in the Doctor of Dental Surgery (DDS) program at the University of Alberta. H5P is a plugin tool that facilitates the creation and distribution of various interactive learning content.
URL for Full Article: https://onlinelibrary.wiley.com/doi/10.1002/jdd.13391
Histoscope
Problem
Students in the Doctor of Dental Surgery (DDS) program at the University of Alberta historically studied oral histology through didactic lectures and light microscope (LM) labs. For decades, a single instructor taught a lab of 32 students. Two to three students shared one microscope; 8–10 students shared a glass slide (tissue section). Teaching oral histology with LMs mandated one-on-one time between students and the instructor to identify the correct microanatomical structures. Obtaining high-quality tissue sections was challenging because most slides were decades-old, deteriorating, rare, and irreplaceable.
Solution
To archive rare, decades-old tissue slides and to create an interactive teaching environment, we developed a virtual microscope called Histoscope (www.histoscope.com). The tissue sections were scanned at 20X or 40X magnification and 25 layers of z-stacking (a method of taking multiple images at different focal distances), to produce in-focus images under high magnification.
URL for Full Article: https://onlinelibrary.wiley.com/doi/10.1002/jdd.13358
Abstract
Virtual microscopes are computer or web-based programs that enable users to visualize digital slides and mimic the experience of using a real light microscope. Traditional light microscopes have always been an essential teaching tool in health science education to observe and learn cell and tissue structures. However, studies comparing virtual and real light microscopes in education reported learners’ satisfaction with virtual microscopes regarding their usability, image quality, efficiency, and availability. Although the use of virtual or web-based microscopy is increasing, there is no equivalent decrease in the number of schools utilizing traditional microscopes. We conducted a scoping review to investigate the comparative impact of conventional and virtual microscopes on different aspects of learning. We report a relative effect of virtual and light microscopy on student performance, long-term knowledge retention, and satisfaction. Our results show that virtual microscopy is superior to traditional microscopes as a teaching tool in health science education. Further studies are needed on different learning components to guide the best use of virtual microscopy as a sole teaching tool for health care education.
URL for Full Article: https://cjlt.ca/index.php/cjlt/article/view/28270
Abstract
Objectives: Histology, the study of tissue structure under a microscope, is one of the most essential yet least engaging topics for health professional students. Understanding tissue microanatomy is crucial for students to be able to recognize cellular structures and follow disease pathogenesis. Traditional histology teaching labs rely on light microscopes and a limited array of slides, which inhibits simultaneous observation by multiple learners, and prevents in-class discussions. We have developed an interactive web-based microscopy tool called “Histoscope” for oral histology in this context.
Methods: Good quality microscope slides were selected for digital scanning. The slides were scanned with multiple layers of z-stacking, a method of taking multiple images at different focal distances. The digital images were checked for quality and were archived on Histoscope. The slides were annotated, and self-assessment questions were prepared for the website. Interactive components were programmed on the website to mimic the experience of using a real light microscope.
Results: This web-based tool allows users to interact with histology slides, replicating the experience of observing and manipulating a slide under a real microscope. Through this website, learners can access a broad array of digital oral histology slides and self-assessment questions.
Conclusions: Incorporation of Histoscope in a course can shift traditional teacher-centered histology learning to a collaborative and student-centered learning environment. This platform can also provide students the flexibility to study histology at their own pace.
URL for Full Article: https://pubmed.ncbi.nlm.nih.gov/34015880/
Interactive 3D Protein in PowerPoint
Problem
The molecular genetics of tooth development is a complex and rapidly evolving field of study. Tooth eruption, the last stage of tooth development, is one of the least understood areas. Dental students spend extensive time learning the genetics of tooth development through didactic lectures and textbooks, while genomic data rapidly expands with the advancement of gene sequencing technology. Students studying the genetics of tooth development in a traditional manner may not receive the most up-to-date knowledge on recently identified mutations and gene regulation. Moreover, opportunities for active learning are rare in the study of tooth development.
Solution
We used protein homology modeling and Molsoft’s ICM-Browser software to create an interactive learning resource for students to study the genetics of tooth eruption. This teaching and learning resource consists of:
– A ‘Genomic Table’ with curated human genes involved in tooth eruption and mutations linked to eruption-related disorders.
– A set of ‘Interactive PowerPoints’ with selected homology models of wildtype and mutant proteins.
URL for Full Article: https://onlinelibrary.wiley.com/doi/full/10.1002/jdd.13421
Jawnatomy
Abstract
Objectives: The knowledge of anatomy is an integral part of dental and medical education that builds the foundations of pathology, physiology, and other related disciplines. Traditional three-dimensional (3D) models used to teach anatomy cannot represent dynamic physiological processes and lack structural detail in the oral regions relevant for dental education. We developed an interactive computer program to teach oral anatomy, pathology, and microbiology in an integrated manner to improve students’ learning experiences.
Methods: The computer program, Jawnatomy, was developed as a 3D human head. Cognitive load theory guided the design of the tool, with the goal of reducing the heavy cognitive load of learning anatomy and integrating this knowledge with pathology and microbiology. Keller’s attention, relevance, confidence, and satisfaction (ARCS) model of motivational design was used while creating the tool to improve learners’ motivation and engagement. Blender was used to create the graphics, and Unity 3D was used to incorporate interactivity in the program. The 3D renderings of oral anatomy and progression of tooth decay were created with the input of content experts.
Results: Jawnatomy will be launched in our institution’s dentistry and dental hygiene program to support project- and team-based learning. This program will also be introduced to students as a self-directed learning tool to help them practice and strengthen their anatomical knowledge at their own pace.
Conclusions: Surveys and focus groups will be conducted to evaluate and further improve the computer program. We believe that Jawnatomy will become an invaluable teaching tool for dental education.
URL for Full Article: https://pubmed.ncbi.nlm.nih.gov/34788914/
Whiteboard Animation
Abstract
Background: Combining visual thinking and storytelling makes whiteboard animation an effective educational tool. However, the impact of whiteboard animation is understudied in health science education. We explored the current literature to identify the application and impact of whiteboard animation for teaching in health science education.
Method: A comprehensive electronic literature search was conducted on five databases: PubMed, Google Scholar, CINAHL, Web of Science, and Education Research Complete to include full-text research articles published in English between 2013 and 2024. Articles were screened to match inclusion criteria, and data were extracted from the eligible studies.
Results: After two rounds of screening, six articles were included in the review, all focusing on evaluating the impact of whiteboard animations in dental, medical, and other health science education. All studies reported positive impacts of whiteboard animation on student satisfaction and knowledge acquisition. A correlation between the number of video views and students’ longitudinal exam performance was also reported.
Discussion and Conclusion: The concise and engaging animations explaining concepts in a storytelling manner offer an alternative mode of presenting teaching material, reducing the extrinsic cognitive loads on the learners. Further studies are needed to evaluate the impact of this powerful tool on health science education.
URL for Full Article: https://files.cdha.ca/Profession/journal/earlyView/CJDH_Early_View–SHARMIN_et_al–Whiteboard_animation.pdf
Problem
Whiteboard animation is a specific type of animation where line drawing and narration are used to explain concepts. The combination of visual thinking and storytelling makes whiteboard animations a unique and effective educational tool. Storytelling is a multimodal teaching approach that simultaneously engages listeners’ thinking, emotions, and imagination.1 However, this powerful tool is underutilized in higher education, particularly science education.1 Whiteboard animations, powered by storytelling, have successfully explained complex health-related topics to pharmacology students2 and positively impacted the retention, engagement, and enjoyment of university-level students.3 We planned to create whiteboard animations for dental students to explain complex science topics using graphics and storytelling. However, we have encountered two challenges while attempting to make whiteboard animations as an educator: (1) Making a good quality whiteboard animation requires paid software, which can be expensive. (2) Most whiteboard animation software is designed for business advertising and does not provide the graphics gallery needed to explain health science-related topics. The graphics gallery of the software do not have images representing the microanatomy of the tooth, oral cavity, and cellular processes.
Solution
As a solution, we have used traditional PowerPoint and hand-drawn digital images to mimic whiteboard animation. Procreate, a stylus pen, and an iPad were used for drawings that were exported into PowerPoint. The built-in animations of PowerPoint were used to animate the images and supporting text. Screen-capture software was used to record the animation screen as a video with a voice-over narration. Our whiteboard animation explains the types of epithelial cells in a storytelling manner. First-year dentistry students learn about the epithelium as part of histology. The animation starts with the story of a boy who wants to eat cereal and milk with a fork. The narration then draws a connection between the structure-function relationships of a utensil to the structure-function relations of cells in the epithelium. We have incorporated interactive self-assessment questions allowing viewers to assess their learning.
URL for Full Article: https://onlinelibrary.wiley.com/doi/full/10.1002/jdd.13215