According to Prof. Margaret J. Cox, the successful adoption of immersive technologies depends on structured planning, staff involvement and dedicated time for faculty development—not simply on purchasing the technology. (Image: King’s College London)

The survey drew responses from 130 educators at 115 institutions in 57 countries. It found that phantom heads and benchtop exercises dominate reported clinical training time, accounting for around 81% overall, compared with about 14% for haptic virtual reality and mixed reality technologies—roughly six times as much reported training time.

According to the survey results, resource constraints were the main barrier to wider adoption of immersive technologies in dental education, followed by resistance from staff and students. Besides these external barriers, individual-level barriers such as limited confidence or proficiency in using the technology, lack of training and lack of supporting evidence were reported, but to a lesser extent.

“Resource limitations, especially high initial costs for hardware, software licences, maintenance and faculty training, are the primary barriers to implementation of haptic virtual reality technologies. These issues particularly affect low- and middle-income countries, hindering hybrid model adoption,” co-author Dr Szabolcs Felszeghy, a clinical lecturer at the Institute of Dentistry of the University of Eastern Finland in Kuopio, told Dental Tribune International.

Senior author Dr Margaret J. Cox, emeritus professor of information technology in education in the Faculty of Dentistry, Oral and Craniofacial Sciences at King’s College London, explained that the cost barrier is not simply about acquiring the technology, but about securing sufficient resources to purchase enough devices to ensure fair access for students. Some institutions may have only a few virtual reality units for cohorts of more than 50 students, making it difficult to organise equitable training sessions. Another concern in this regard is that expensive equipment may quickly become outdated and require further investment.

Commenting on resistance from staff and students to the adoption of immersive technologies, Dr Felszeghy noted that educators trained in traditional methods may need additional support to build confidence in digital tools. However, he stated that student enthusiasm for virtual reality-based training appears to have grown alongside digital fluency.

“Forty years of research has shown that teachers at all levels of education tend to resist major changes to their pedagogical methods. Adopting new technologies requires time and commitment and often incurs additional costs, and teachers are rarely given sufficient time to learn new approaches. They also frequently lack the confidence to abandon well-tested methods for newer technologies,” said Prof. Cox.

Discussing why adoption is higher in undergraduate than postgraduate training, Prof. Cox said that undergraduate programmes are driven by national accreditation requirements and supported by large teams of educators, extensive planning and resource allocation. She said that haptic virtual reality technologies are therefore introduced at programme level and embedded into the wider undergraduate curriculum. By contrast, she said postgraduate programmes are often developed and delivered by smaller teams, have narrower learning objectives and are not always supported by the same level of resources as undergraduate programmes.

Similarly, Dr Felszeghy explained that immersive tools are more often used in preclinical undergraduate training, where they help bridge the gap between theoretical learning and clinical skills. He told Dental Tribune International: “This suggests lower adoption in postgraduate programmes, where advanced clinical focus and fewer structured preclinical phases limit integration compared with undergraduate curricula.”

The survey also found that higher socio-economic status of countries was associated with greater use of haptic virtual reality in undergraduate education, suggesting that access to immersive training is uneven internationally. “Lower-income settings show reduced adoption due to financial constraints, exacerbating a digital divide in training access and outcomes,” Dr Felszeghy added.

“Evidence varies on differences between higher- and lower-income settings, but studies show that lower-income countries are often limited to basic essentials. They face unreliable power supplies, fewer trained staff and insufficient technical support, hindering the widespread, sustained adoption of advanced technologies in dental schools,” Prof. Cox explained.

Looking ahead, the researchers said that wider adoption of immersive technologies such as haptic virtual reality and mixed reality would require strategic, collaborative and sustainable implementation. Dental schools could improve affordability by working together to negotiate lower purchasing prices, share simulation resources and create common repositories of digital cases, teaching materials and assessment benchmarks. Additionally, the researchers highlighted the need for shared faculty development, multicentre research to strengthen the evidence base and phased hybrid models combining traditional simulation with immersive technologies and artificial intelligence-supported learning and assessment to make implementation more sustainable.

According to Prof. Cox, it is far easier for new dental schools to adopt immersive technologies during the planning stage, when resources, curricula, teaching staff and learning progression are being established. “To address adoption barriers in existing schools, leaders or managers must first involve all teaching staff in planning course delivery and assessment changes, as well as in structured continuing professional development programmes, including dedicated time for learning new teaching methods,” she concluded.

The survey, titled “Immersive technologies in dental education: Global adoption patterns from a 2025 survey”, was published online on 11 April 2026 in the Journal of Dental Education, ahead of inclusion in an issue.