Endoscopy is an involved clinical practice requiring considerable skill in performing the procedure. Virtual reality together with haptics offers immersive, flexible, and cost-effective platform for training in endoscopic procedures. In this thesis, we present mechanical design, control, characterization, and integration of a novel endoscopic haptic simulator with three degrees of freedom. Related ideas, computations, and experiments that support endoscopy and endoscopic simulator are also investigated in this thesis. The haptic device is designed to reflect forces in the three important directions, namely, longitudinal, rotational, and radial directions. The mechanical design of the haptic device overcomes some of the limitations of the existing systems. The device provides large sustained output force and possesses low friction, low inertia and zero backlash. Dynamics-based feed-forward control algorithm is developed to achieve high fidelity and transparency in force-feedback. Tracking performance, transparency, and nonlinearity are all quantified using experiments designed to validate the control structure and to characterize the developed haptic device. The device is shown to apply a maximum continuous force of 11 N in the longitudinal direction, maximum continuous torque of 196 mN.m in the rotational DoF, and a maximum force of 1.5 N (at each of the four radial pads) in the radial direction. Furthermore, we also present the design of a novel compliant mechanism for the radial DoF. The circumferentially actuated compliant (CAC) mechanism is a planar, reversible, and single degree-of-freedom compliant mechanism that emulates controlled and responsive circularly shaped opening. The mechanism is designed in view of the anatomy of the throat and the special manoeuvre required for intubation of the endoscope into the oesophagus by avoiding the trachea. As part of the auxiliary work for the endoscopic simulator, we developed a computational technique for simulating the shape of the entire endoscope during endoscopy. Strain measurements made at discrete locations along the length of endoscope are used in the method. Strain measurement, stain interpolation, and shape reconstruction based on strain information are discussed. Furthermore, a method to predict the location of point forces acting on the endoscope tube during endoscopy is proposed. A novel concept of haptic playback for endoscopy is also investigated in this work. Haptic playback aids the endoscopists to recall both visual as well as haptic information from an earlier endoscopic session. The endoscopic playback concept is evaluated using psychophysical experiments. Through these experiments, we quantified haptic perception through the endoscope, the effect of temporal separation on haptic memory, and the interaction between haptic and visual information in sensory processing.

Few general dentists feel comfortable treating very young children 0-5-years old due to inadequate training and exposure. Over the past few years, there is an increasing demand on providers to be culturally competent and meet the health needs of the culturally diverse population. OBJECTIVE: Assess the gained knowledge, perception and confidence in providing clinical dental care to vulnerable populations, pregnant adolescents and to very young children 0-5-years old following the enhancement of the predoctoral pediatric dental curriculum and training which was aimed to prepare future practitioners to be culturally competent in providing pediatric dental care to the current culturally diverse population. METHODS: This is a retrospective cross-sectional analysis conducted among the predoctoral students including the Doctor of Dental Medicine-(DMD) and Advanced Standing-(AS) who underwent pediatric dental training between 2017-2022 at Boston University Henry M. Goldman School of Dental Medicine, Boston, Massachusetts. Predoctoral students participated in the pre/post training surveys of the implemented didactic training program in cultural competency and oral health literacy lectures. The students completed questionnaires on their knowledge and confidence level on treating children 0-5-years old following the novel simulation scenario discussion after the Haptic simulator training and following clinical training in the pediatric dental clinic. Descriptive statistics were calculated, univariate and multivariate analysis were used to analyze the differences in the level of knowledge gained by program type, year of training and demographic characteristics such as age and gender. Statistical significance was set at p-value<0.05. RESULTS: The cultural competency training improved the students’ knowledge and perception. DMD-students performed better to have a higher level of knowledge in the post training survey compared to AS-students (OR=4.724;p<0.001). Based on the post training questionnaires, the haptic simulator session and novel simulation scenarios increased the students’ knowledge and confidence to treat pediatric patients. Student’s confidence to treat children 0-5-years and pregnant adolescents improved after completing the trainings. CONCLUSION: The new enhanced training program increased the predoctoral students’ knowledge and confidence to treat children 0-5-years. This can be beneficial when used in dental departments to support predoctoral graduates to be culturally competent who can be better prepared to manage the diverse population.