Extended Abstract
1. Objectives
Given the increasing number of elderly people, it is essential for dentists to receive necessary training to prevent and treat oral diseases in this group of people. The topic of gerontology has just become a theoretical unit which has been added to the dental curriculum in Dentistry Colleges  in Iran and in that direction those colleges are planning educational programs. On the other hand, with the development of information technology, medical education methods have been transformed and currently use of newer methods such as virtual tutorials is being stressed for knowledge transfer [1]. Reducing spatial and temporal constraints for education, validating repeatability of the learning process, tracking student activity more easily, and changing teacher-centered to student-centered education are the benefits of virtual education [2]. Therefore, this study was conducted with the aim of design, implementation, and evaluation of virtual education of elderly dentistry topic for dentistry graduate students of Medical University of Tehran in the academic year of 2016-2017 and comparing it with the traditional method.
2. Methods and Materials
The Ethics Committee of Tehran University of Medical Sciences confirmed this study with no. IR.TUMS.REC.1395.2415. In this study, graduate students in Tehran University of Dentistry was evaluated by census method. A total of 64(82%) out of 78 students participated in the study. Traditional training group and virtual education group comprised of 33 and 31 students, respectively. Training program was performed as a workshop in three sessions and introduced within a week in the form of the society-centered credit 3. Data were collected using pre-test/post-test design (pre-test, before the first session in both groups; post-test, after the third session in both groups). 
At the first session of educational content, two 45-minute speeches were presented by two professors from the Department of Oral Health and Social Dentistry for traditional teaching group. In the virtual training group, the content placed on the system of university symbols. The educational content provided was same in both groups. Second session of the educational program was carried out for students in both traditional and virtual groups in the form of an educational field (urban health center affiliated to Tehran municipality). Students of both groups (separately) tried filed examination, correct communication, receiving biographies, oral health assessment, studying the therapeutic needs, and providing elderly health education. At the third session, students of both groups provided a report on the activities undertaken and sent it to the professors and at the end of the educational course, post-test was given. The duration between pre-test and post-test was seven days. The questionnaire included knowledge and attitude toward aging and knowledge, and attitude and practice related to oral health of the elderly people. Data were analyzed in SPSS (version 21) software using covariance, paired t-test and regression tests.
3. Result
Pre-test and post-test questionnaires were completed by 64 students, among which 28 were boys and 36 were girls. Average ages of students participating in the traditional and virtual education groups were 23.9±0.72 and 24.1±1.2 years, respectively. The lowest age of participants in both groups was 23; while the highest ages were 29 years in the virtual training group and 25 years in the traditional education group. Pre-intervention scores for both groups in the general knowledge section of old age was 41.7±45.6 and 41.7±19 (out of 100), respectively; whereas in the field of knowledge related to oral health of the elderly, it was 54.2±19 and 49.2±18.2, respectively. In addition, in the general attitude toward old age, traditional and virtual education groups scored 67.7±6.8 and 68.1±9.3, respectively. 
Moreover, pre-intervention scores in the section of oral health of the elderly in traditional and virtual education groups were 76.8±12 and 78.5±13.2, respectively. In the self-expressive performance section these scores were 45.4±20.7 and 52.9±20.3, respectively. There was no significant difference between the two groups in terms of the mean and standard deviation of pre-test scores.
Regression test was used to examine the relationships between underlying factors and knowledge scores and also between attitude and performance of students before the intervention. Background variables included age, gender, marital status, settlement status, living with an elderly person, the history of treating elderly patients, first-degree relatives being dentist, being interested in the field of study, and the average. None of the underlying variables had significant relationship with the general knowledge of old age, knowledge of oral health of the elderly people, attitude toward elderly oral health, and oral health function in old age. 
Only the general attitude associated with old age found to have relationships with gender factor (P=0.009) and “life with an elderly person at the moment” (P=0.044). Girl students and those who lived with an elderly person at that moment had a better attitude. Covariance test was used to investigate the effect of traditional and virtual teaching methods on post-test scores of students in terms of the level of knowledge, attitude, and performance of students. Difference in scores after intervention by traditional and virtual learning group was not significant in any of the areas examined except for self-expressive performance related to oral health function in old age. There was a significant difference between the scores in the self-explanatory section between the virtual training and the traditional education groups after intervention (P=0.017).
4. Conclusion
The developments in medical knowledge along with a variety of teaching and learning approaches have created new responsibilities for managers and instructors in the higher education system. One of the main pillars of this responsibility is the choice of the most appropriate method of teaching and learning. The results of this study show that virtual training can meet the educational goals in dental topics including “senior dentistry” section. Our results suggest that given the benefits of virtual training, it can be used as a substitute for the traditional teaching style in teaching elderly dentistry topics. In this study, there was no improvement in attitude levels of students in both groups compared with their level of attitudes before intervention. It appears that change in the attitude of students requires longer training programs compared with the elderly attitudes. Increasing educational-therapeutic communication and adding practical training fields for students in society are other approaches for promoting attitude and this will be an introduction in improving performance in this area.
Acknowledgments
This research was extracted from a MD dissertation in the Department of Community Oral Health, School of Dentistry, Tehran University of Medical Sciences.
Conflict of Interest
The authors declared no conflicts of interest.


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