Psychological stress in undergraduate dental students: baseline results from seven European dental schools

OBJECTIVES: To determine the degree of psychological distress, the experience of emotional exhaustion, and the extent of stress associated with course work in dental students and to compare these measurements among seven European dental schools. DESIGN: Multi-centred survey. SETTING: Dental Schools at Amsterdam, Belfast, Cork, Greifswald, Helsinki, Liverpool and Manchester. PARTICIPANTS: 333 undergraduate first-year dental students. MEASURES: General Health Questionnaire (GHQ12), Maslach Burnout Inventory (MBI), Dental Environment Stress Questionnaire (DES), demographic variables. PROCEDURE: Questionnaire administered to all students attending first year course. Completed questionnaires sent to central office for processing. RESULTS: Seventy-nine percent of the sampled students responded. Over a third of the students (36%) reported significant psychological distress (morbidity) at the recommended cut-off point (>3 on GHQ). These scores were similar to those reported for medical undergraduates. Twenty-two percent recorded comparatively high scores on emotional exhaustion. A wide variation in these 2 measurements was found across schools (p's<0.001). Stress levels indicated by the DES were less variable (p>0.5). Some evidence showed that contact with patients and the level of support afforded by living at home may be protective. CONCLUSION: Higher than expected levels of emotional exhaustion were found in a large sample of first-year undergraduate dental students in Europe.     

The undergraduate dental radiology curriculum.

This paper reviews and analyzes the undergraduate dental radiology curriculum as suggested by the American Academy of Dental Radiology and the Oral Radiology Section of the American Association of Dental Schools. In addition, pertinent findings of the 1976 curriculum study conducted by the American Dental Association are discussed.     

Competency assessment for infection control in the undergraduate dental curriculum

OBJECTIVES: This study aimed at investigating the introduction of an infection control competency assessment on undergraduate dental student's awareness and knowledge of infection control. METHOD: A short course, including an introductory lecture and a three component competency based assessment exercise testing student's knowledge and ability in infection control measures was incorporated into the previously established training programme. The assessment exercises included a written test of students' knowledge of the Infection Control Policy, a unit management exercise and a hand hygiene assessment. The infection control competency was initially incorporated into the final term of the second year in 2004 and is now an established part of the 5-year dental undergraduate degree programme. Re-assessments were scheduled (at the start of third year) for students failing to meet the required standard as successful completion of this course was compulsory prior to students being allowed to treat their first patients. Student performance over the last 2 years on this course and during their first year on clinic were analysed to determine potential improvements in student knowledge and application in infection control. Examination results from the year 3, infection control spot test were compared with those of earlier years. In addition, the opinions, as assessed by questionnaire analysis, of dental staff and students on the infection control competency were obtained. RESULTS: All students successfully completed the infection control competency (either at first or second attempt) and were subsequently allowed to enter clinical training in year 3. Significant improvements were seen in students passing the course at their initial attempt, 42% and 78%, in the 2004 and 2005 academic years, respectively. Also subsequent testing of these students during their first year on clinic showed marked increases in awareness and knowledge of the infection control protocols. Staff and student feedback on this course was also found to be highly supportive of the introduction of the infection control competency. CONCLUSION: Incorporation of additional formal pre-clinical teaching and introduction of an infection competency potentially provides enduring knowledge and clinical application benefits.     

A communication skills course for undergraduate dental students

Sixty-seven third-year dental students in Dunedin, New Zealand, participated in a communication skills course, using simulated patients, case-based scenarios, videotaped interviews, and class roleplays. The course introduced active listening techniques, taking a medical history, and emotion-handling skills. This course was adapted from an existing course for medical students run by the Department of Psychological Medicine, Dunedin School of Medicine. The results of the student evaluation questionnaire (n = 59) indicated that students rated the course very highly. Retrospective ratings indicated that the students considered communication skills to be significantly more important as a component of their undergraduate training after completion of the course than prior to it. As might be expected, students whose ratings were higher after the course also reported that the course helped them to develop new communication skills and techniques; increased their interest in the subject and their self-confidence; rated the tutor as more effective and the course materials as more helpful; and considered the course to be significantly more stimulating than those students whose ratings of the importance of communication skills remained the same or decreased.     

Clinical medical sciences for undergraduate dental students in the United Kingdom and Ireland – a curriculum

The technical aspects of dentistry need to be practised with insight into the spectrum of human diseases and illnesses and how these impact upon individuals and society. Application of this insight is critical to decision‐making related to the planning and delivery of safe and appropriate patient‐centred healthcare tailored to the needs of the individual. Provision for the necessary training is included in undergraduate programmes, but in the United Kingdom and Ireland there is considerable variation between centres without common outcomes. In 2009 representatives from 17 undergraduate dental schools in the United Kingdom and Ireland agreed to move towards a common, shared approach to meet their own immediate needs and that might also be of value to others in keeping with the Bologna Process. To provide a clear identity the term ‘Clinical Medical Sciences in Dentistry’ was agreed in preference to other names such as ‘Human Disease’ or ‘Medicine and Surgery’. The group was challenged to define consensus outcomes. Contemporary dental education documents informed, but did not drive the process. The consensus curriculum for undergraduate Clinical Medical Sciences in Dentistry teaching agreed by the participating centres is reported. Many of the issues are generic and it includes elements that are likely to be applicable to others. This document will act as a focus for a more unified approach to the outcomes required by graduates of the participating centres and act as a catalyst for future developments that ultimately aim to enhance the quality of patient care.     

Perspectives on being a mentor for undergraduate dental students

As part of the new study programme in Dentistry, an obligatory mentor programme was introduced during autumn 2005 for all student dentists at Karolinska Institutet, Sweden. The aim of the programme is to provide support and guidance for the students in their professional role as dentists. All mentors in the programme are licenced dentists and lecturers at the Department of Dental Medicine. The mentors follow three to five mentees throughout the entire 5 year programme. This study aims to evaluate the programme from the mentors’ perspective and to explore the perceived effects of being a mentor. Following an exploratory focus group, questionnaires were distributed to all mentors (n = 66, response rate 83%). The results of the evaluation of the programme show that being a mentor is perceived to be rewarding in many different ways, including an increased understanding of the students’ situation and some professional development as a teacher.     

Social nicotine dependence in Australian dental undergraduate students

Objectives: This study aimed to investigate dental undergraduate students’ tobacco usage and social nicotine dependence in Australia. A special interest was to identify the role of factors such as age, gender, year of dental education and cohabitants’ smoking status for social nicotine dependence. Materials and methods: A sample of 252, first‐to‐fifth year undergraduate students in an Australian dental school was used. Each completed a self‐administered questionnaire. Results: The smoking rate was 4.8%. Current smokers displayed higher social nicotine dependence than those that had never smoked (t = 3.1, df = 244, P = 0.002). Dental undergraduate students that showed higher social nicotine dependence (P = 0.001, OR = 1.3, 95% CI: 1.1–1.6), or that had smoking cohabitants (P = 0.016, OR = 4.8, 95% CI: 1.3–17.0), were more likely to smoke. Students’ social nicotine dependence increased with year of dental study (P = 0.043, β = 0.4, t = 2.0). Social nicotine dependence enhanced tobacco usage among Year‐1‐to‐4 students (P = 0.005, OR = 1.4, 95% CI: 1.1–1.7) but not Year‐5 undergraduates (P = 0.432). Conclusions: Social nicotine dependence has become a developing issue in dental education. Tobacco control should be highlighted in the dental curriculum. Future investigations into the effects of dental education on social nocotine dependence and tobacco usage are indicated.     

Insights on selection of undergraduate dental students

Introduction

The goal of selection to dental education was to find those with the greatest aptitude for dentistry. Recently, schools have introduced a variety of tools; however, these have often been adopted without appropriate evaluation regarding existing evidence for fairness, reliability or validity. We explore dental admissions staff beliefs about the quality of different selection tools, with the objective of exploring their decision-making in implementing selection practices.

Methods

This qualitative study is underpinned by a social constructionist epistemology, in which our principal concern is “explicating the processes by which people come to describe, explain or otherwise account for the world (including themselves) in which they live.” We conducted individual interviews with 15 of the 16 UK dental admission leads to elicit their views around admissions processes and aims. Data coding and analysis were initially inductive, using thematic analysis. After the themes emerged, we applied a deductive framework of affordances to group themes and then examined these for heuristics.

Results and Discussion

We identified three main themes; “Selection Tool Use,” “Widening Participation Practices,” and “Professionalising the Admission Lead Role.” Admission leads spoke favourably of tools that allowed a “holistic” view of the applicants “potential”. Selection tools were favoured if they enabled “Gut feeling”. Leads spoke of evaluating candidates, making sure they were “rounded”, and “know what dentistry is all about.” In justifying the use of elements of their procedure, the use of heuristics was prominent.

Conclusion

In order to minimise the potential consequences of poor selection decisions, it is important to acknowledge that dental admission leads are at risk of depending on sub-optimal heuristics to make judgements about effective selection (shaped by previous practices) rather than using more rational decision-making processes based on the extant evidence (regarding the quality of different selection tools). Future research may be usefully informed by the knowledge translation literature to offer solutions for improving selection practices in dental education.