{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,24]],"date-time":"2026-09-24T08:00:20Z","timestamp":1790236820189,"version":"4.1.0"},"reference-count":56,"publisher":"Wiley","license":[{"start":{"date-parts":[[2026,9,24]],"date-time":"2026-09-24T00:00:00Z","timestamp":1790208000000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/creativecommons.org\/licenses\/by-nc-nd\/4.0\/"},{"start":{"date-parts":[[2026,9,24]],"date-time":"2026-09-24T00:00:00Z","timestamp":1790208000000},"content-version":"tdm","delay-in-days":0,"URL":"http:\/\/doi.wiley.com\/10.1002\/tdm_license_1.1"}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["Int Endodontic J"],"abstract":"ABSTRACT<\/jats:title>\n \n Aim<\/jats:title>\n To evaluate changes in undergraduate dental students' self\u2010perceived competence and post\u2010training self\u2010efficacy in endodontic access cavity preparation following implementation of a revised preclinical course incorporating haptic virtual reality simulation (HVRS) prior to training on extracted human teeth (NT).<\/jats:p>\n <\/jats:sec>\n \n Methodology<\/jats:title>\n \n This prospective cohort study was conducted during the 2025\u20132026 academic year at ACTA. All fourth\u2010year undergraduate dental students enrolled in the preclinical endodontics course completed a baseline questionnaire assessing self\u2010perceived competence before HVRS training, using the Simodont dental trainer, during which students performed access cavity preparations on six virtual tooth types. Subsequently, students performed complete root canal treatments on NT mounted in simulated clinical conditions. Self\u2010perceived competence was reassessed after completion of the training sequence, together with students' perceptions of both training modalities. Self\u2010efficacy was measured at the end of the training using an adapted Endodontic General Self\u2010Efficacy Scale. Pre\u2010post differences in self\u2010perceived competence were analysed using the Wilcoxon signed\u2010rank test and correlations using Spearman's rank correlation coefficient, with Benjamini\u2010Hochberg correction for multiple comparisons. Statistical significance was set at\n p<\/jats:italic>\n \u2009<\u20090.05.\n <\/jats:p>\n <\/jats:sec>\n \n Results<\/jats:title>\n \n The response rate was 100% (\n n<\/jats:italic>\n \u2009=\u200986). Self\u2010perceived competence scores increased significantly from a median of 17 (IQR 15\u201319) at baseline to 22 (IQR 20\u201324) after completion of the combined training sequence (Z\u2009=\u2009\u22127.47,\n p<\/jats:italic>\n \u2009<\u20090.001,\n r<\/jats:italic>\n \u2009=\u20090.81). The mean post\u2010training self\u2010efficacy score was 28.4\u2009\u00b1\u20094.1. Both training modalities were rated positively, although NT training was perceived as more effective than HVRS (median 4 vs. 3; Z\u2009=\u2009\u22127.62,\n p<\/jats:italic>\n \u2009<\u20090.001,\n r<\/jats:italic>\n \u2009=\u20090.82), with 84.9% of students favouring NT and none favouring HVRS. Self\u2010efficacy showed a moderate positive correlation with post\u2010training self\u2010perceived competence (\n \u03c1<\/jats:italic>\n \u2009=\u20090.62, 95% CI 0.48\u20130.74,\n p<\/jats:italic>\n \u2009<\u20090.001).\n <\/jats:p>\n <\/jats:sec>\n \n Conclusions<\/jats:title>\n A preclinical curriculum where HVRS was combined with training on extracted human teeth was associated with significant improvements in students' self\u2010perceived competence and fair levels of post\u2010training self\u2010efficacy in endodontic access cavity preparation. The students stated that both HVRS and training on NT contributed to their skills development in preparing endodontic access. The combination may have a cumulative effect on the students' preparedness for clinical training.<\/jats:p>\n <\/jats:sec>","DOI":"10.1111\/iej.70279","type":"journal-article","created":{"date-parts":[[2026,9,24]],"date-time":"2026-09-24T07:26:14Z","timestamp":1790234774000},"update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":0,"title":["Self\u2010Perceived Competence and Self\u2010Efficacy Following a Sequential Preclinical Endodontic Curriculum Combining Haptic Virtual Reality Simulation and Extracted Natural Teeth for Access Cavity Preparation: A Prospective Cohort Study"],"prefix":"10.1111","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-3473-5801","authenticated-orcid":false,"given":"Jo\u00e3o Filipe Brochado","family":"Martins","sequence":"first","affiliation":[{"name":"Department of Endodontology Academic Centre for Dentistry Amsterdam University of Amsterdam and Vrije Universiteit Amsterdam Amsterdam the Netherlands"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-1869-2338","authenticated-orcid":false,"given":"Annemarie","family":"Baaij","sequence":"additional","affiliation":[{"name":"Department of Endodontology Academic Centre for Dentistry Amsterdam University of Amsterdam and Vrije Universiteit Amsterdam Amsterdam the Netherlands"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-4917-6176","authenticated-orcid":false,"given":"Beliz","family":"Ozel","sequence":"additional","affiliation":[{"name":"Department of Endodontology Academic Centre for Dentistry Amsterdam University of Amsterdam and Vrije Universiteit Amsterdam Amsterdam the Netherlands"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"311","published-online":{"date-parts":[[2026,9,24]]},"reference":[{"key":"e_1_2_12_2_1","doi-asserted-by":"crossref","first-page":"e72","DOI":"10.1111\/eje.12223","article-title":"Students' Perceptions of Pre\u2010Clinical Endodontic Training With Artificial Teeth Compared to Extracted Human Teeth","volume":"21","author":"Al\u2010Sudani D.","year":"2017","journal-title":"European Journal of Dental Education"},{"key":"e_1_2_12_3_1","doi-asserted-by":"crossref","first-page":"613","DOI":"10.1111\/eje.70013","article-title":"Evaluating Haptic Virtual Reality Simulator for Pulpotomy Training in Primary Teeth: A Pilot Study on Dental Student Pespectives","volume":"29","author":"Aura\u2010Tormos J. 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