Students’ perception of a problem‐based learning scenario in dental nurse education

Background: In July 2008, The General Dental Council implemented mandatory registration for Dental Nurses in the United Kingdom, recognising them as legally responsible for patient care. As dentistry comes to terms with the impact registration has on dental nurses, sustained advances in the teaching of students in other healthcare disciplines demonstrate the way in which the role of pedagogy in dental nurse education has been underdeveloped. In an attempt to see dental nursing stand in line with other progressive healthcare professionals, the authors have implemented Problem‐Based Learning (PBL) into a dental nurse program in NHS Education for Scotland, Glasgow. Aim: The aim of the research is to assess the perceptions of dental nurse students with regard to participation in active learning. Materials and Methods: The study is facilitated by a short PBL package which offers introductory exposure to this method of learning. A qualitative approach has been taken to gather experiential data using a questionnaire. Thematic analysis took place to reveal emergent themes. Results: Analysis reveals that the participants found PBL to be an enjoyable experience that could be valuable in the acquisition of deep knowledge and improved patient care. The participants raised concerns with regard to confidence in their own knowledge acquisition in PBL sessions and highlighted a need for improved feedback. Discussion and conclusion: While the participants enjoyed the self directed nature of PBL, it is important to note that the need for facilitator guidance was considered imperative, especially where the students had little or no experience of PBL, as in this study.     

Quality assessment of amalgam restorations provided by Israeli dentists

Abstract The purpose of the present study was to assess the quality of silver amalgam restorations rendered by Israeli dentists. A group of 433 new army recruits, 18–20 years of age was selected for the study. A total of 707 amalgam restorations were examined in an army dental clinic, under standardized conditions by the same observer. The quality of amalgam restorations was assessed according to an index devised for this purpose. The quality of restorations was relatively low. Approximately two-thirds of the fillings exhibited satisfactory quality when marginal adaptation of the filling material was examined. Three-fifths of the fillings followed the principles of extension for prevention. A relatively high percentage (75%) of the fillings did not extend beyond the cavosurface margin at any point or did not fall short of it. However, in only 47% of all fillings was appropriate occlusion restored. The fillings were found to be porous in about 60% of the cases and almost none of the fillings were polished. Overhangs were detected in about one-quarter of the restorations (22.8%); inflammatory reactions of the gingival tissue were noticeable in more than half of the cases (51.3%). An attempt was made to study the various characteristics of the amalgam filling as categorized by the index presented in this study, and discuss its effect on the filling's overall quality. It was suggested that lack of standardization of performance levels in Israel is reflected, in part, in the observed low quality of amalgam restorations. The conclusions of this investigation point to interventions which can be initiated through the dental education, financing and public health planning sectors of the society, to increase awareness of this problem and define specific interventions to improve the quality of restorative dental cave delivered in general practice in Israel.     

Students’ engagement with their group in a problem‐based learning curriculum

Introduction: In a new enquiry‐based learning dental curriculum, problem‐based learning (PBL) was chosen as a central methodology because it promotes a collaborative and constructive approach to learning. However, inevitably, some groups function worse than others. This study explores the relationship between group functionality and individuals’ results on knowledge‐based assessment. It also sought to establish whether using the Belbin team role theory could improve group functionality. Methods: Students completed the Belbin team role inventory that assigns individuals to a team role type and were allocated to either an ideal Belbin group or a control group. To evaluate the functionality of the groups, Macgowan’s group engagement measure was completed after 18 and 31 weeks for each student by their group facilitator. The scores were summed and averaged giving a group engagement score for each group. Relationships between group engagement, individual performance in assessment in weeks 18 and 31 and Belbin and non‐Belbin teams were investigated. Results: Individual group engagement scores and performance in the knowledge tests had a statistically significant positive relationship despite the small number of students involved (62). However, no correlation was shown between Belbin groups and group engagement scores. Conclusions: Those students who engaged most with the PBL process performed markedly better in assessments of knowledge. Using Belbin’s team role theory to place students in PBL groups in an effort to increase group functionality had no effect when compared with non‐Belbin control groups.     

The transition to self‐regulated learning for first‐year dental students: threshold concepts

Research shows that when students arrive at university they are often not prepared for independent learning. New students enter a period of transition during their first year, which is often characterised by emotional destabilisation, as they move towards becoming more self‐regulating in their new learning environment. In this small‐scale qualitative study, data from an in‐depth pair interview were triangulated with data from a questionnaire, to explore participants' experiences of self‐regulated learning in the first year of a Dental Surgery course. Five threshold concepts relating to learning in transition emerged from the analysis of the data. These concepts were as follows: learning how to learn using a range of self‐chosen sources instead of a single textbook, learning how to organise incoming information without guidance, distinguishing between main ideas and detail during revision, coping with a heavy workload, and knowing what to expect from examinations and coursework. Strong emotions (feeling confused, overwhelmed and scared) were associated with negotiating these threshold concepts. However, the study illustrates how the participants adopted new cognitive and metacognitive strategies to become more self‐regulating over time. The findings of the study suggest that lecturers, tutors, study advisers and peers all have an important role to play in explicitly guiding first‐year students as they grapple with troublesome threshold concepts relating to self‐regulated learning. Furthermore, structural changes to the content‐heavy, lecture‐based curricula often associated with first‐year Medical and Dental courses would help ease students’ transition to independent learning, which may make an impact on student attainment.     

Surface free‐energy measurements as indicators of the bonding characteristics of single‐step self‐etching adhesives

Inoue N, Tsujimoto A, Takimoto M, Ootsuka E, Endo H, Takamizawa T, Miyazaki M. Surface free‐energy measurements as indicators of the bonding characteristics of single‐step self‐etching adhesives.
Eur J Oral Sci 2010; 118: 525–530. © 2010 Eur J Oral Sci This study examined the surface free‐energy of dentin treated with the single‐step self‐etching adhesives Bond Force, Clearfil tri‐S Bond, and G‐Bond Plus. The labial dentin surfaces of bovine mandibular incisors were wet ground with #180‐, #600‐, and #2,000‐grit silicon carbide paper. The adhesives were applied to the ground dentin, and then rinsed with acetone and distilled water. The surface free‐energies were determined by measuring the contact angles of three test liquids placed on the adhesive‐treated dentin. The surface free‐energies of the samples treated with the G‐Bond Plus and Clearfil tri‐S Bond adhesives increased as the surface roughness decreased. No significant differences in the surface free‐energy were found for the samples treated with the Bond Force adhesive, regardless of the surface roughness. These results indicated that dentin surfaces treated with adhesives did not promote a higher surface‐energy state, and that differences in the components of surface energy were apparent for the adhesives tested.     

Improving clinical assessment: evaluating students’ ability to identify and apply clinical criteria

Aim: There is ongoing concern by health educators over the inability of professionals to accurately self‐assess their clinical behaviour and standards, resulting in doubts over a key expectation of effective self‐regulation in the health professions. Participation by students in the assessment process has been shown to increase the understanding of assessment criteria in written assessment tasks. How this might transfer to the clinical setting is the focus of this study. This paper is part of an ongoing investigation of the impact on learning of a series of activities that provides students with opportunities to discuss and apply criteria and standards associated with self‐assessment in clinical dentistry. Our aim was to evaluate whether participation in these assessment activities improved the ability of first‐year dental students to recognise behaviours demonstrated by ‘peers’ in videos of clinical scenarios and to relate these to the assessment criteria. Materials and methods: A series of three workshops in conjunction with weekly clinical assessment activities in Semesters 1 and 2 were use to support first‐year students’ learning of clinical assessment criteria. The design of the workshops was based on the principles of social constructivist theories of learning and the concept of tacit knowledge. Accordingly workshop activities were planned around videos that were specifically constructed to illustrate procedures and behaviours typical of those observed by staff and tutors in the first year of the dental course at The University of Adelaide, Australia. First‐year students viewed the videos prior to and after the workshops and recorded observed behaviours that related to the assessment criteria that were used in their clinical practice course. Student learning outcomes were assessed 10—14 weeks after the initial workshop and again up to 42 weeks later. To check whether learning resulted from repeated viewing of the videos without formal discussion, a reference group of third‐year students who did not attend the workshops also viewed the videos two times, separated by 12 weeks, and recorded observations in the same way. Results: There was no consistent evidence that repeat viewing of the videos in isolation resulted in improved recognition of ‘peer’ behaviours by third‐year dental students. Results for the first‐year students indicated that the workshops and clinical assessment activities had a significantly positive effect on the ability of students to identify ‘peer’ behaviours related to the criteria used for clinical assessment. In particular, students’ recognition in others of knowledge and professional behaviours improved significantly. This improvement was retained over the year and students were able to recognise these behaviours in other scenarios relevant to their year level. Conclusions: This early exposure to the process of clinical assessment, coupled with ongoing self‐assessment and tutor feedback throughout first year, improved the ability of first‐year students to identify and apply some key assessment criteria to observed ‘peer’ behaviour, and this ability was retained over time.     

Dental student perception and assessment of their clinical knowledge in educating patients about preventive dentistry

In today's dental school curricula, an increasing amount of time is dedicated to technological advances, and preventive dentistry topics may not be adequately addressed. Freshman (D1) students participated in a new Introduction to Preventive Dentistry course, which consisted of didactic lectures, active learning breakout sessions and case‐based studies. The goal of this study was to determine if D1 dental students completing the course had a better knowledge and comfort level with basic preventive dentistry concepts and caries risk assessment than the upcoming graduating senior dental students. Following the completion of the course, D1 students were administered a survey that assessed their comfort level describing preventive dentistry topics to patients. This was immediately followed by an unannounced examination over the same topics. Senior (D4) students, who had not taken a formal course, reported statistically significant higher comfort levels than D1 students. However, the D4s scored significantly lower in all of the examination areas than the D1 students. Higher scores in D1s may have been due to recent exposure to the course material. However, the basic nature of the content‐specific questions should be easily answered by novice practitioners educating their patients on oral disease prevention. As the current data shows lower content‐specific scores of basic preventive dentistry knowledge amongst graduating D4 students, this may indicate a need for more guidance and education of students during the patient care. This study showed that implementation of a formalised course for D1 students can successfully ameliorate deficiencies in knowledge of preventive dentistry topics.