Development and evaluation of a questionnaire to evaluate clinical dental teachers (ECDT)

OBJECTIVES: To develop and test the psychometric properties (validity and reliability) of a questionnaire to evaluate clinical dental teachers. METHODS: An item (question) pool was generated with the use of a literature review, feedback from faculty staff, and from focus group discussions with dental students. Following factor analysis the validity and reliability of a revised questionnaire was assessed. This involved 148 dental students and 453 assessments of 29 clinical dental teachers. RESULTS: Effective clinical dental teaching (ECDT) scores were associated with 'global ratings' of the effectiveness of clinical dental teaching (P<0.01), indicating strong criterion validity. In comparison analysis there was strong agreement between students regarding ratings of individual clinical dental teachers, indicating good construct validity. Reliability was assessed by examining internal consistency of sub-scales and overall ECDT scale, and found to be good (Cronbach alpha's > 0.80). CONCLUSION: A valid and reliable measure to evaluate clinical dental teachers has been developed for use in a clinical academia setting, and has potential use as a quality assurance measure.     

Student perspectives and opinions on their experience at an undergraduate outreach dental teaching centre at Cardiff: a 5-year study

Aim:  Outreach teaching is now regarded as a desirable component of undergraduate dental teaching programmes in the UK. A purpose-built undergraduate dental outreach-training centre was opened in Cardiff in 2002. The aim of this paper is to report student perspectives and opinions on their experience at this unit over a 5-year period.
Methods:  Final year dental students at Cardiff University were invited to report their comments on the St David's Primary Care Unit at various times during their placement there. Information was recorded for undergraduate students who commenced final year in 2003, 2004, 2005, 2006 and 2007 ( n = 257).
Results:  After 1 year, the most common favourable aspects reported by students included the availability of a suitably trained nurse for all procedures ( n  = 191), ready access to helpful/approachable teaching staff ( n  = 145), and closeness of learning experience to subsequent practice ( n  = 122). Many students commented on their growing confidence in their own abilities whilst in the unit.
Conclusion:  Overwhelmingly, students reported their enthusiasm for training in an outreach teaching unit, preferring it to traditional dental school environments. Inherent in the comments recorded for each student was a sense of growing confidence in their abilities and development of reflective practice. Further work is needed to identify the impact of this form of dental student training on subsequent practices in Vocational Training and independent clinical careers.     

Development of a rural outplacement programme for dental undergraduates: students' perceptions

Objectives:  To describe the development and implementation of a new rural dental outplacement module in the final year curriculum and report initial student perceptions.
Methods:  The Melbourne Dental School, University of Melbourne, introduced a required 4-week rural outplacement [termed Rural Dental Rotation (RDR)] in July 2006 to provide education and clinical training to all final year students. Seventy dental students (Bachelor of Dental Science and Bachelor of Oral Health) were rostered in groups of 6—10 students to Shepparton (Victoria, Australia), from July 2006 to June 2007 for 4 weeks per group. Students were introduced to the culture and oral health needs of the indigenous population in the region, and were involved in oral health promotion in specific health programmes. At the end of each roster students provided feedback of their experiences through a voluntary anonymous questionnaire.
Results:  The RDR offered a rural learning experience to all final year dental undergraduates and also provided dental services to the local community on a continuing basis. Students agreed that the RDR was a worthwhile experience (mean 4.77 ± 0.46 on 1—5 scale) and was 'enjoyable' (mean 4.71 ± 0.45). There was only one student who did not consider rural practice in future. This was because of family reasons. The majority (79.1%) expressed definite affirmation, whereas some (19.4%) indicated the possibility of taking up rural practice.
Conclusions:  Overall feedback indicated that the students found it a very positive and enjoyable experience. It provided an opportunity to appreciate cultural safety and understand the specific oral health needs of indigenous Australians. The key benefit of such a programme to the community is the increased likelihood of attracting new dental graduates to rural areas.     

A national study on the attitudes of Irish dental faculty members to faculty development

Introduction:  International studies suggest that dental faculty are resistant to the concept and practice of faculty development. This paper analyses the demographic and educational profile of Irish Dental Faculty, exploring their attitudes to educational initiatives.
Methods and materials:  Irish dental faculty were invited to participate in a national study on perceived educational needs. A custom-designed questionnaire was distributed using a 'mixed-method' approach, incorporating both quantitative and qualitative components. Overall response rate was 64.6%.
Results:  Analysis of the demographic profile of Irish dental faculty reveals a male dominated regime (64%). Whilst faculty possess many professional qualifications and extensive clinical experience, most have little or no training in how to teach. Many had attended teacher training programmes; however, 92% merely attended infrequent, informal sessions. Less than a third (30%) of the part-time staff had attended teacher training ( P  ≤ 0.05), few faculty members had any formal teacher training. Whilst the study revealed a low level of engagement with existing teaching support services, there appeared to be considerable support for the concept of faculty development as 75% were willing to attend teacher training courses. This refutes previous suggestions that dental educators are resistant to educational concepts. Attitudes to faculty development varied significantly with age, gender and time since last qualification. This report presents a detailed analysis of learning needs, and a review of the perceived barriers/inducements to participation.
Conclusion:  This study indicates that targeted educational interventions, with content and delivery tailored to the specific needs of recipients, are most likely to succeed.     

Developing a primary dental care outreach (PDCO) course – part 2: perceptions of dental students

Background:  The perspective of participating students in a primary dental care outreach (PDCO) course, with regard to clinical and educational value, has informed course development and delivery.
Objectives:  To evaluate students' perception of the PDCO experience including clinical experience gained, teaching and learning and the teaching environment.
Methods:  Likert Scale-based questionnaires were completed: (A) prior to the start of PDCO teaching, (B1) after one term, (B2) after one year and (C) for entry year 2001 students at completion. Additionally, a cohort of entry year 2000 students with no PDCO experience was surveyed at the end of their 4th year. Factor Analysis with Crohnbach's alpha was used to investigate perception of (i) confidence and skills in treating child patients, (ii) confidence and skills in treating adult patients; (iii) general clinical skills and experience; (iv) team working. Data from entry years 2000–2003 were analysed using ANOVA and independent sample t- tests.
Results:  For entry years 2001 and 2002, perceived confidence and skills in treating child patients and general clinical experience increased, although for entry year 2002 students the levels of perceived general confidence and skills achieved after 1 year were similar to the entry year 2000 cohort who had received no PDCO teaching. There was consistently high satisfaction with teamworking. After 2 years in PDCO, 11 of the 13 overall satisfaction scores were over 70%.
Conclusion:  The majority of students perceive PCDO as a valuable component of professional training and development. Further evaluation, including analysis of value for money, would help to inform funding decisions and further curriculum development.     

Pre-clinical endodontics: a survey amongst German dental schools

Aim To evaluate the state and level of pre‐clinical endodontic education in German dental schools and to evaluate differences with regard to intensity and extent of teaching, time devoted to teaching pre‐clinical endodontics, personnel resources in teaching and technical equipment. Methodology Twenty‐eight questionnaires were e‐mailed to those in charge of pre‐clinical endodontic education in German dental schools. The extent of education, the student–teacher ratio, the teaching content as well as the application of teaching materials and technologies were asked. If, after 4 weeks, no response had been received, the questionnaire was sent out by e‐mail again. In the absence of a reply, a phone call was made to the corresponding university to conduct the survey by phone. Results With feedback from 27 of 28 dental schools, the response rate was 96%. Pre‐clinical endodontic education at German universities varied considerably. Theory classes ranged from 5 to 30 h (13.3 h mean), practical classes from 12.5 to 60 h (45.4 h mean). The student to staff ratio varied between 9 : 1 and 30 : 1 (16 : 1 mean). Forty‐eight per cent of the universities had a specialist in endodontics or a teacher with a special interest. A dental microscope was available for pre‐clinical teaching purposes in 38% of the universities. The majority (63%) of universities taught root canal preparation with rotary nickel titanium instruments. Conclusion Pre‐clinical endodontic education varied considerably between German universities because of differences in programme design, staff and course content.     

A survey of the teaching of conscious sedation in dental schools of the United Kingdom and Ireland

AIM: To assess and compare, for the first time, the quantity and quality of dental undergraduate teaching in conscious sedation in the dental schools of the UK and Ireland. This was achieved using a prospective, questionnaire-based survey. METHODS: Questionnaires were designed to collect information about undergraduate sedation education from teaching staff and final year dental undergraduates at the 16 dental schools in the UK and Ireland. Staff questionnaires were distributed to a nominated sedation teacher at each dental school and sought details of didactic and clinical sedation teaching methods, plus the quantity and perceived quality of sedation teaching. Student questionnaires were distributed to 5th year dental students and enquired about the quantity and quality of clinical sedation teaching received. The survey was undertaken during May-June 1998. RESULTS: Thirteen dental schools returned staff questionnaires (81%). Seven also provided a student response (44%). The proportion of final year students within the 7 schools who returned completed questionnaires was 38%. Sedation teaching was undertaken primarily by oral surgery and paediatric dental departments. Three schools also utilised anaesthetic departments and 2 schools had dedicated dental sedation departments. All but 2 schools provided didactic teaching on sedation (mean: 4.2 lectures, 1.8 seminars). Of the 7 schools which returned staff and student questionnaires, all provided some clinical training using inhalational and intravenous demonstration cases (mean 5.1 and 4.4 cases, per student, respectively). All but one school provided hands-on inhalational sedation experience (mean 2.6 cases per student) but only two schools provided any hands-on intravenous sedation experience. The quantity of hands-on experience was greater at the two dental schools with dedicated dental sedation departments. Across the schools students rated the overall quality of sedation teaching at average or above, but most staff graded the overall quality of teaching at below average. CONCLUSION: Dental undergraduate sedation teaching shows considerable variation across the dental schools surveyed. At most schools students gained little or no hands-on experience in sedation, especially in intravenous techniques. The undergraduate foundation for sedation education must improve if conscious sedation is to become the principal alternative to general anaesthesia in dental practice.     

A comparison of sensation-seeking between dental and biological science students

Aim:   The aim of this study was to compare sensation-seeking behaviour amongst dental students and age-, sex-matched students studying for a standard 3-year degree in biological sciences at the Manchester University.
Methods:   A total of 268 sensation-seeking questionnaires were distributed to second- and third-year male and female dental and biological science students, studying for a degree at the University of Manchester. Each questionnaire was scored against Zuckerman's sensation-seeking scale.
Results:   A total of 268 questionnaires were distributed, 175 were returned. The return rate was 65%. The primary findings were:

• • 

  Biological Science students were more sensation-seeking in the dimensions of disinhibition and experience-seeking than dental students ( P  < 0.05).

       
  
  

The use of the Internet within a dental school

The Internet is an increasingly popular medium for delivering educational material. The aim of this study was to determine the attitudes of students and their clinical teachers to the use of the Internet within a dental school in the UK. Questionnaires were distributed to undergraduate dental students in the three clinical years and to all their clinical academic teachers. All students and staff have access to computers and Internet at the university. The majority (72%) of students have access to a computer and 53% also have access to the Internet at home. Of the academic staff, 91% have a computer and 68% have access to the Internet at home. The reasons for use of the Internet differed between staff and students. Whilst equal proportions of students used the Internet for dentistry (38%) and for pleasure (35%), a higher proportion of staff used the Internet more for dentistry (36%) than for pleasure (14%). Students highlighted cost and time as barriers to Internet use, whereas staff lacked confidence in their ability to use the Internet. Less than half (44%) of the students are confident in the accuracy of information from the Internet compared to almost two-thirds (64%) of staff. This study revealed differences in the attitudes of staff and students to the use of Internet as a resource for dentistry. Students are positive to the suggestion that lectures should be presented on the web. Most students (74%) did not see that this would influence attendance at lectures whilst 91% of staff stated that it would decrease lecture attendance. In conclusion, this study revealed differences in the attitudes of staff and students to the use of Internet as a resource for dentistry.     

Attitudes of Italian dental and dental hygiene students toward tobacco-use cessation

Objective:  The aim of this study was to investigate the smoking habits of Italian dental and dental hygiene students and to assess their knowledge on the health effects of cigarette smoking and their attitudes toward tobacco-use cessation (TUC) in dental practice.
Materials and methods:  Data was collected from 220 students attending the Dental and Dental Hygiene Schools (DS and DHS, respectively) at the University of Palermo (Italy).
Results:  The percentage of smokers amongst DS and DHS students was similar (32.78% vs. 32.5%) with 67.77% of DS students and 77.5% of DHS agreeing that the damages to health caused by smoking were covered in their didactic course work. A high percentage of DS (63.33%) and DHS (67.5%) students reported the relationship between smoking and a number of associated health conditions. Both DS and DHS students showed poor knowledge of TUC interventions. Both DS and DHS students reported to be conscious of their own role as a counsellor, with DHS students feeling more comfortable in approaching counselling in clinical practice. Although DS and DHS students reported a positive attitude toward TUC interventions, almost half of the students had some concerns about the effectiveness of smoking cessation activities.
Discussion:  The introduction of a comprehensive tobacco education curriculum in DS and DHS programs could further improve students' perceptions and attitudes and provide knowledge and clinical experience which would lead to the incorporation of TUC into subsequent professional practice.     

Blood mercury levels of dental students and dentists at a dental school.

OBJECTIVE: To determine the blood mercury levels in dental students and clinical teaching staff in a dental school using amalgam as a restorative material. SETTING: A dental school in Ege University, Turkey surveyed during one academic year. SUBJECTS AND METHODS: Cross-sectional study of groups of dental students (n=92) in years I to V, clinical teachers in restorative dentistry (n=16) and controls (n=14). Mercury concentration was estimated in venous blood samples using a cold vapour atomic absorption method at the commencement and end of the academic year. Daily air mercury levels were determined in clinical and teaching areas by measuring the darkening of palladium chloride discs using spectrophotometry. RESULTS: There were statistically significant increases (p<0.001) in plasma mercury concentration between measurements in all groups at the end of the academic year. Red cell mercury levels were also consistently elevated. Although the highest levels of mercury were recorded in persons working with amalgam, increased levels were also found in subjects working in the teaching classrooms but not with amalgam (controls and first year students). CONCLUSION: Increased mercury levels appeared to be due to background exposure from spillage of mercury and amalgam residues on floors. Increased mercury hygiene and regular control of working atmosphere should be implemented to prevent mercury exposure in the dental pre-clinical laboratory.     

The role of pathophysiological explanations in clinical case representations of dental students and experts

Introduction:  Teaching of biomedical knowledge lays the foundations for the understanding and treatment of diseases. However, the representation of pathophysiological explanations in the management of clinical cases differs for various levels of medical expertise and different theories have been proposed to explain this phenomenon. The present study investigated for the first time how biomedical knowledge is used in clinical reasoning in dental medicine.
Materials and methods:  In an experimental study 20 experts in the field of Periodontology and 61 students of different levels of training produced written pathophysiological explanations after having studied three different clinical cases. By comparing the written protocols to a visualised expert-made 'canonical' explanation the concepts used in the pathophysiological explanation were counted and classified as well as the links between concepts.
Results:  The statistical analysis by MANOVA showed significant differences between third- and fourth-year students, students of intermediate expertise level (fifth-year) and experts for various parameters qualifying concepts or links of the written pathophysiological explanations. The participants of intermediate expertise level produced a high rate of concepts and links; however, characteristic findings for knowledge encapsulation in the different levels of expertise were not evident. The analysis showed that the design of the clinical cases and of the canonical explanations significantly influenced the outcomes.
Conclusion:  The present study demonstrated the pathophysiological representations of clinical cases in dental students and experts to be different from other medical disciplines. It could be assumed that this observation is based on different contents for teaching of practical skills and diagnostic procedures in dental compared with medical education.     

A study of personality factors and interaction in 4th-year dental students and their teachers

No previous investigation has considered dental student and teaching staff opinions on their relationship with each other. In a day when students are increasingly asked for feedback on the quality of teaching by staff, such investigations are of particular interest. This exploratory study was designed to compare the personality characteristics of a clinical year of dental students with those of the teaching staff they most frequently encountered, and to investigate these factors for possible associations with the quality of perceived teaching-learning interaction between the 2 groups. A complete 4th year of dental students (n = 87), and those teachers whom they met regularly (n = 80), were asked to participate. Subjects completed a form of the Myers-Briggs personality questionnaire simplified for use in education, and were asked to assess their relationship with persons in the other group. All the students and 75% of the staff, after follow-up, returned usable data. There was close similarity between staff and student personality profiles, and perception of working relationships by both groups was largely independent of personality factors and temperament. There were differences in staff perception of their relationship with extrovert and introvert students. Students showed minor differences in their perception of staff relationships with respect to two other personality factors. These findings indicate a substantial similarity between staff and students, and suggest a mature and stable relationship between people in the 2 groups.     

Perceived sources of stress amongst Indian dental students

Introduction:  Dental students have to face the additional stress of their studies in addition to the stresses related to dentistry as a profession. Furthermore, increasing stress may result in declining student performance. The aim of the present study was to assess perceived sources of stress amongst dental undergraduate students at a private dental institution in India.
Materials and methods:  A modified dental environment stress (DES) questionnaire which consisted of 38 questions was used to assess the levels of stress.
Results:  The first major stressor for all the students was examination and grades with a mean score of 2.86 (SD 1.06) followed by full working day, receiving criticism from supervisors about academic or clinical work, amount of cheating in dental faculty, rules and regulations of the faculty and fear of unemployment after graduation. Amongst the six highest stressors in each year, at least three were dental faculty related. There was a significant difference in stress perception between genders with a predilection for males. Twelve of the 38 questionnaire items had significant differences across the year groups including clinical DES items.
Conclusion:  The primary sources of stress as perceived by nearly 275 students at one private dental school in India were examinations and grades followed by full working day and receiving criticism from supervisors about academic or clinical work. It appears there is a need for the establishment of student advisors and counsellors combined with a faculty advising system in addition to student-oriented programmes.     

The teaching of fixed partial dentures in undergraduate dental schools in Ireland and the United Kingdom

Summary All areas of the practice of dentistry are evolving at a considerable pace. One area in particular which has seen a rapid revolution is the oral rehabilitation of partially dentate adults. The aim of this study was to describe the contemporary teaching of fixed partial dentures (FPDs) in dental schools in Ireland and the United Kingdom. An online questionnaire which sought information in relation to the current teaching of FPDs was developed and distributed to 15 Irish and UK dental schools with undergraduate teaching programmes in Spring 2009. Responses were received from 12 schools (response rate = 80%). All schools offer teaching programmes in relation to FPDs. The number of hours devoted to pre‐clinical/phantom head teaching of FPDs ranged from 3 to 42 h (mean: 16 h). The staff/student ratio for pre‐clinical teaching courses in FPDs ranged from 1:6 to 1:18 (mode: 1:12). Cantilever resin‐retained FPDs were the most popular type of FPD provided clinically (average = 0·83 per school; range = 1–2). Five schools (42%) report that they have requirements (e.g. targets, quotas, competencies) which students must complete prior to graduation in relation to FPDs. Fixed partial dentures form an important part of the undergraduate teaching programme in UK and Irish dental schools. While this teaching is subjected to contemporary pressures such as lack of curriculum time and a lack of available clinical facilities and teachers, there is evidence that teaching programmes in this area are evolving and are sensitive to current clinical practice trends and evidence‐based practice.     

Special care dentistry for people with intellectual disability in dental education: an Italian experience

Aim:  This study documented: (i) the curriculum in special care dentistry in the Italian dental schools, as perceived by Deans and by students, (ii) the rate of satisfaction of dental students with their curricular education in special care dentistry, (iii) the attitude of the dental students towards special care dentistry and towards the 'Special Smiles' programme.
Methods:  The quality and amount of didactic and clinical training delivered by each dental school for subjects with intellectual disability (ID), the interest of students towards this health field and the 'Special Smiles' programme were collected. Self-administered surveys were sent to the Dean and to all the final year students of all dental schools in 20 Italian Universities.
Results:  Only four Deans of the 20 dental schools answered the survey, stating to provide didactic and clinical education in special care dentistry. A 51% of student response rate was obtained. Dental students reported to spend about 4% of didactic and 5% of clinical training in the dental care for ID subjects. Most students (83%) rated the training they had received on the topic to be poor. Over 50% of students expressed interest in working in dental offices specifically dedicated to ID patients and 25% of students wished to become Special Smiles volunteers.
Conclusions:  Although the paucity of didactic and clinical training in dental care for ID patients, this survey demonstrated a high level of student's interest in learning more about treating these subjects. The current results could suggest to revise the curricular standards of dental schools, by promoting ID-oriented education programmes.     

Evaluation of a U.K. community-based clinical teaching/outreach program by former dental students two and five years after graduation

Over the past few years, community-based clinical teaching/outreach teaching programs have been established in many dental schools in the United Kingdom. One such program was developed by Cardiff University at the local St. David's Hospital in 2002. Students visit this unit throughout their dental school program--as an assistant/observer initially, but gaining a significant amount of clinical operating experience within the unit during their final year of studies. While contemporaneous feedback from current dental students at this and other programs has been positive, very little information exists on the impact of this form of training on the subsequent clinical careers and working practices of qualified dentists. In autumn 2009, a postal questionnaire was distributed to dentists who graduated from the School of Dentistry at Cardiff in 2004 (n=41) and 2007 (n=51). Fifty-eight responses were returned, for a response rate of 63 percent: 2004 (66 percent), 2007 (61 percent). Forty-seven respondents (81 percent) reported that their learning experience at the St. David's outreach teaching program had been of significant assistance in their professional development in their subsequent clinical careers. Positive features of the program included the availability of a suitably trained dental nurse for all procedures (n=26, 45 percent), ready access to helpful/approachable teaching staff (n=24, 41 percent), and a good working atmosphere (n=23, 40 percent). Overwhelmingly, former dental students reported that the educational experiences they gained were positive and have had a beneficial effect on their subsequent clinical careers. Further development of community-based clinical teaching/outreach training as part of dental school training programs is encouraged.     

Stakeholder perceptions of chairside teaching and learning in one UK dental school

As a hands-on clinical educational programme, undergraduate dentistry is an anomaly in higher education. This study aimed to evaluate the perceptions of chairside teaching of dental team stakeholders, including dental nurses, dental students and dental tutors at a single UK dental school. From this sample the penetration of current learning and teaching innovations within higher education into the specialist field of clinical dentistry could be evaluated. This article is the first of a series of four which investigates the perceptions of stakeholders of chairside teaching at a single dental school. The second evaluates chairside teaching on a UK wide scale. The third provides educational tools to encourage collaboration and sharing good chairside teaching practice. A further accompanying article reviews some of the educational methodology and innovations in teaching and learning that may be applied to dentistry.     

Dental students' perceptions on the contribution and impact role of a clinical teacher

Objectives

This study was conducted in University of Malaya to evaluate student perceptions on the contribution and role of an effective clinical teacher based on the cognitive apprenticeship model in clinical practice.

Methods

Self‐administered questionnaires were distributed to 233 undergraduate dental students involved with clinical teaching. This modified and validated questionnaire focusing on students' learning environment was used in order to gain relevant information related to dental clinical teaching. Six domains with different criteria applicable to clinical teaching in dentistry were selected consisting of modelling (four criteria), coaching (four criteria), scaffolding (four criteria), articulation (four criteria), reflection (two criteria) and general learning environment (six criteria). Data analyses were performed using IBM SPSS Statistics 20.

Results

Majority of the students expressed positive perceptions on their clinical learning experience towards the clinical teachers in the Faculty of Dentistry, University of Malaya, in all criteria of the domains. Few negative feedbacks concerning the general learning environment were reported.

Conclusion

Further improvement in the delivery of clinical teaching preferably by using wide variety of teaching–learning activities can be taken into account through students' feedback on their learning experience.