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346 Musawi et al. | Journal of Clinical and Translational Research 2024; 10(6): 343-347
is higher than that of students in other nations, due to the scores. No statistically significant differences between scores
differences in the admission criteria and processes followed in for the BOT-2 and LAP II were found for the other two BOT-2
the USA. Results suggested that the manual dexterity subtest of subtests, i.e., fine motor precision and fine motor integration.
BOT-2 was able to differentiate between students with excellent Our findings support a previous study by Boushell
(innate hand skills) and poor (no innate hand skills) LAP II et al., [12] which reported the potential benefits of using LAP II
as a predictive training tool of psychomotor performance in an
Table 1. Comparison of Bruininks–Oseretsky test of motor operative dentistry course. However, in that study, [12] students
proficiency 2 (BOT-2) scores from two different classes were instructed to independently prepare LAP II patterns within
BOT‑2 subtest Median (IQR) P‑value the pattern lines and at a specified depth only. In the current
D11 D12 study, we had students prepare a flat pulpal floor, produce a
Fine motor precision 40 (2) 40 (2) 0.4 proper outline form, achieve a proper cavity wall angulation
Filling in shape (circle) 3 (0) 3 (1) 0.7 (convergence), and reach the ideal pulpal depth (2 mm) and
Filling in shape (star) 3 (0) 3 (0) 0.3 smoothness, allowing us to compare the various components of
Drawing lines through a path (crooked) 7 (0) 7 (0) 0.3 cavity preparation to better clarify the predictive value of LAP II.
The findings of the current study contradict the results of a
Drawing lines through a path (curved) 7 (1) 7 (0) 0.0007 similar study by Musawi et al. [7] In that study, [7] BOT-2 was
Connecting dots 7 (0) 6 (1) < 0.0001 not a reliable predictor of the hand skills of new dental students.
Folding paper 7 (0) 7 (0) 0.2 However, the study [7] compared the BOT-2 scores of 1 -year
st
Cutting out a circle 7 (0) 7 (0) 0.4 and 2 -year students to determine a correlation. The study
nd
Fine motor integration 37 (3) 38 (3) 0.4 found no differences, which may be due to the different hand
Copying a circle 4 (1) 4 (0) 0.7 skill levels between the two groups of students. [7] Therefore,
Copying a square 5 (0) 5 (0) 0.09 the current study only compared the scores of 1 -year students.
st
Copying overlapping circle 5 (1) 6 (1) 0.03 The current study had several limitations. The main limitation
Copying a wavy line 4 (0) 4 (0) 0.1 was our small sample size of 42 students. Since data from one
Copying a triangle 5 (0) 5 (0) 0.2 student were excluded, data from only 41 students were included
Copying a diamond 5 (0) 5 (0) 1.0 in our analyses. A larger sample size or repeating the study with
Copying a star 4 (1) 4 (1) 0.3 more classes would be useful to verify current findings. The wide
Copying overlapping pencils 5 (0) 5 (1) 0.3 age range of the participants might also be an influential factor
Manual dexterity 34 (3) 35 (4) 0.007 in the results of the study. Although our findings for student
Making dots in a circle 9 (1) 9 (1) 0.3 performance during the LAP II activity were similar to those
Transferring pennies 7 (1) 8 (2) 0.08 of Boushell et al. and Khalaf et al., [12,13] the results may not
Placing pegs into a pegboard 6 (2) 6 (1) 0.08 accurately represent the actual hand skills of students. Instead,
Sorting cards 7 (0) 7 (1) 0.1 our results may be a better representation of their hand skill level
Stringing blocks 5 (0) 5 (1) 0.07 and comprehension of the provided instructions for preparing the
Overall 110 (8) 112 (6) 0.09 cavity. To better determine the source of LAP II results, future
Note: D11 denotes the D1 class of 2017; D12 denotes the D1 class of 2018. studies should investigate student comprehension of instructions.
Abbreviation: IQR: Interquartile range. Data from such studies would be particularly useful for dental

Table 2. Correlation between Bruininks-Oseretsky test of motor proficiency 2 (BOT-2) scores and students’ performance on the Learn-A-Prep II
(LAP II) block
BOT‑2 subtest LAP II performance comparison Mean difference P‑value 95% CI
Lower bound Upper bound
Fine motor precision Overall F-test - 0.1 - -
Excellent versus moderate 0.01 1.0 −1.2 1.3
Excellent versus (major) poor 1.2 0.2 −0.3 2.7
Moderate versus poor 1.2 0.2 −0.4 2.7
Fine motor integration Overall F-test - 0.4 - -
Excellent versus moderate −1.0 0.5 −3.0 1.0
Excellent versus poor 0.1 1.0 −2.4 2.5
Moderate versus poor 1.1 0.6 −1.4 3.6
Manual dexterity Overall F-test - 0.01 - -
Excellent versus moderate 1.3 0.3 −0.9 3.5
Excellent versus poor 3.5 0.01 0.7 6.2
Moderate versus poor 2.2 0.1 −0.6 5.0
Abbreviation: CI: Confidence interval.

DOI: http://doi.org/10.36922/jctr.24.00009