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.     

Examining the effects of early patient care and biomedical science integration on predoctoral dental student competence and confidence

Introduction

Our study investigates early experiential learning as a method of curricular integration by allowing students to begin their clinical experience in the first year of the programme, as well as distributing biomedical classes throughout the predoctoral dental school curriculum.

Materials and Methods

This study utilises a quasi-experimental design with two different groups, Standard Curriculum Group and Integrated Curriculum Group, n = 87. Data were collected from 2017 to 2021.

Results

We found that, on average, it took 608 h less for the participants in an integrated curriculum group to reach clinical competence in comparison to peers who did not experience the same methods of integration in their programme. These data were collected through daily faculty evaluations of students' progression as well as participants' own self-assessment. Our results indicate that participants in the Integrated Curriculum Group also experienced a positive effect on their confidence in their ability to apply the biomedical sciences to patient care.

Discussion/Conclusion

Our findings demonstrate that predoctoral dental programmes may be able to bring about positive outcomes for students' clinical confidence and competence by providing patient care opportunities early in the programme and sequencing the biomedical sciences throughout the curriculum. As such, it appears that early experiential learning may be a viable option for curricular integration that can have a positive effect on both students' confidence in their clinical abilities and their progression to clinical competence.     

Behavioural video to navigate predoctoral dental students toward safer practice (revision of EJE-21-4739)

Introduction

Local anaesthesia is considered essential knowledge within the dental profession as it helps to address pain management. Operator percutaneous needlestick injuries associated with the delivery of dental anaesthesia are common for dental healthcare providers. The study proposes a supplemental technique to reduce self-inducing novice operator needlestick injury to complement existing pedagogies for the preclinical local anaesthesia curriculum. The purpose of the study is to evaluate whether a local anaesthesia behavioural video can navigate students to safer clinical practice. Further, a supplemental technique is proposed in whether assessing instrument retraction technique in clinical patient care leads to decreased self-inducing intraoral needle stick injury for novice predoctoral dental operator.

Materials and Methods

Beginning in 2011, predoctoral dental students were asked to view a “what not to do” video within a summative assessment and identify at least five behaviours that were unacceptable errors for delivering local anaesthesia. Operator intraoral needlestick injury was also tracked per the bloodborne exposure reports within predoctoral patient clinics.

Results

Data from the learners' responses identified progression in recognising unacceptable errors from behavioural video. Intraoral needlestick injury, 8 and 9 years prior and after the introduction of video showed significance with a low correlation coefficient.

Conclusion

More data need to be gathered and evaluated in other dental school settings to determine whether this supplemental educational video decreases needlestick injury in novice operators. Results suggest this behavioural video may guide novice operators to overall safer clinical practice.     

Structures,processes and outcomes of objective structured clinical examinations in dental education during the COVID-19 pandemic: A scoping review

Introduction

Objective structured clinical examinations (OSCEs) are an essential examination tool within undergraduate dental education. Fear of spread of the COVID-19 virus led to dental institutions exploring alternative means of conducting OSCEs. The aim of this scoping review was to investigate what structures, processes and outcomes of dental OSCEs were reported during the COVID-19 pandemic.

Materials and Methods

This scoping review was conducted and reported adhering to the Preferred Reporting Items for Systematic Reviews and Meta-analyses extension for scoping review guidelines (PRISMA-ScR). Published literature was identified through a systematic search of PubMed, Embase, Cumulative Index to Nursing and Allied Health Literature (CINAHL), Education Resources Information Center (Eric), ProQuest and Google Scholar. Identified articles were independently reviewed by two authors (KS, AD), followed by synthesis in terms of the reported structures, processes and outcomes. Articles reporting cancellation or rescheduling were also included, extracting data on reasons and any suggestions/recommendations.

Results

The search yielded a total of 290 studies of which 239 sources were excluded after removal of duplicates, leaving 51 studies for title and abstract evaluation. Thirty-four articles were excluded as they did not report on the topic of interest, leaving 17 for full-text evaluation, of which nine were analysed according to the pre-set themes. All dental OSCEs taking place (n = 6) were conducted online whilst the remaining (n = 3) were either cancelled or rescheduled. Data on structures reported specific online videoconferencing software used and provision of staff and student training. Processes on the execution of online OSCEs varied significantly from one study to the other, providing rich data on how dental institutions may carry out such assessments tailored to their need. Information regarding outcomes was sparse, as little attention was paid to the results of the students compared to pre-pandemic, lacking investigation into reliability and validity of online dental OSCEs.

Conclusion

Dental OSCEs could be conducted online implementing well-planned structures and processes; however, further evidence is needed to prove its reliability and validity based on outcomes. Dental institutions may need to consider alternative methods to assess practical competencies if online OSCEs are to take place.     

Adapting the German version of the dental environment stress questionnaire

Aims

To develop a German version of the Dental Environment Stress (DES) questionnaire, and to evaluate its reliability and validity.

Methods

The original English DES questionnaire was translated into German using a forward–backward translation process. To evaluate construct stability, a subgroup of dental students (n = 43) completed the DES twice (interval: 1 week). To evaluate how the DES responds to anticipated changes in stress, all dental students' (n = 64) DES scores and saliva cortisol levels administered from a clinical study were compared between holiday and term time. Furthermore, the Depression, Anxiety and Stress Scale (DASS) and a stress self-assessment were used to determine the validity of the DES. Reliability analyses were calculated using Kendall's tau correlations. To estimate reliability strength, correlation coefficients and intraclass correlations (ICCs) were used.

Results

Regarding construct stability, 24 of 25 DES items had at least moderate correlations, and most items showed strong correlations. Correlations for the seven subdomains were good (range: 0.778–1.000). The same was true for the total DES score (ICC: 0.944). Correlations for response to term-time stress were weaker and more varied. Validity analyses revealed fair correlations between the DES and students' self-assessment (Pearson's r = .592) and DASS score (Pearson's r = .392), suggesting satisfactory validity. Stress levels were quite similar between baseline and follow-up.

Conclusion

The German DES is a reliable tool for evaluating stress in dental students. Because it can be used to identify individual stressors in various categories, it might enable the detection of specific stress situations in educational situations and facilitate solutions (adjustment of curricula, tailored consulting services).     

Impact of public health and higher education policies on the profile of final-year Brazilian dental students: Challenges and future developments

Introduction

Brazil has experienced transformations in higher education and health services, including launching more inclusive public policies focused on these two areas.

Objective

To evaluate the profile of final-year dental students from a Brazilian public university from 2010 to 2019, accompanied by changes in public health and higher education policies.

Methods

A prospective observacional study was carried out with final-year dental students. A self-applicable semi-structured questionnaire was applied.

Result

Six-hundred and seventy-seven students participated, of which 71.5% were women, 72.9% aged between 21 and 25 years, 96.2% single, and 96.4% were without children. Over ten years, it was possible to identify trends in the profile explained by implementing public policies toward more inclusive access to Brazilian higher education by socioeconomically disadvantaged individuals. Students who completed the course between 2018 and 2019 did not have the state capital city (the wealthiest area) as their origin city and had lower parental education and income levels than dental students graduating between 2010 and 2011. Moreover, working as a primary care dentist in the Brazilian National Health System was considered a professional possibility by 61.4% of the students, and has gained prominence significantly over time, ranging from 21.1% in 2010 to 72.9% in 2019 (p < .05).

Conclusion

Over the study period, concomitantly to advances in public health and higher education policies in Brazil, more diverse access to public dental education was observed, allowing students from low socioeconomic positions to take the education. Changes have also impacted the students' perspectives regarding the need for postgraduate training and a career in public health dentistry. However, these trends need to be consolidated, and public policies continued and strengthened.     

Students' attitudes and knowledge on pain and pain management in paediatric dentistry—An observational study

Introduction

The dental and dental hygienist educational programs prepare students with knowledge on children's prophylactic pain treatment and pain management. Observing the students' understanding could help educational efforts to be more student oriented. The aim was to evaluate dental and dental hygienist students' knowledge and attitudes on pain prevention and pain management in children and adolescents, applying a multidimensional questionnaire previously used on general dental practitioners.

Materials and Methods

Three hundred and four dental and dental hygienist students at Swedish universities were eligible for the survey. Written and oral information was given about the study's aim, methods, anonymity and voluntary participation. The multidimensional questionnaire included 47 closed questions.

Results

The total responding rate was 65.4%; dental students 61.1% and dental hygienist students 92.8%. The total mean of knowledge and attitudes, beneficial for the treating of patient pain, varied between 57.1% and 83.3%. The biggest knowledge gap was identified regarding the items: Children under 2 years of age experience less pain than children over 2 years undergoing similar treatment(34.3%), The dentist is better suited than the parent to judge if a child is in pain (29.4%), and usually the child's pain experience diminishes when the parents are present (24.2%).

Conclusion

Dental and dental hygienist students reported vastly spread knowledge and attitudes regarding pain prophylactic and pain management in children and adolescents, as measured by a multidimensional questionnaire previously used on GDPs. Knowledge on students' understanding of the young patient's pain could help educational efforts to be more student oriented. The questionnaire must be further modified and more extensively tested to meet each participating students' program level.     

Design of an interactive system for access cavity assessment: A novel feedback tool for preclinical endodontics

Introduction

A software program was developed to provide visual, guided feedback to students for access cavity preparations in preclinical learning. The specific aim of the study was to investigate students' overall experiences with the new learning method and compare their experiences with traditional teaching.

Materials and Methods

A workflow based on freely available software was designed to interactively register three-dimensional models of molars with access cavities, and to metrically compare these to instructor-prepared standard cavities. Third-year students practicing molar endodontics access cavity preparation in the preclinical course were then surveyed. A total of 44/79 students completed self-administered questionnaires prior and after the use of the feedback software to gauge their learning experience.

Results

The results of the post-training questionnaire illustrated that all surveyed students agreed/strongly agreed that the software assisted their learning in access cavity preparation. In addition, 86 and 89%, respectively, of students agreed that the use of the software improved their skills of access cavity preparation and felt more confident about their access cavity preparation skills after using the software package, 3D Dental Align.

Discussion

The presented software solution permitted setting and comparing access cavity preparations by students against a standard access prepared by an instructor. The process of data acquisition and registration was fast and straightforward. Student feedback was very positive and suggested the integration of this type of experiential learning into the preclinical curriculum.

Conclusion

This feasibility study demonstrated the utility of the new technology to assist dental students' access cavity preparation learning.     

Clinical Response to COVID-19 and Utilization of an Emergency Dental Clinic in an Academic Institution

IntroductionThe spread of coronavirus disease 2019 (COVID-19) in the spring of 2020 resulted in the temporary suspension of elective dental procedures and clinical dental education in academic institutions. This study describes the use of the Tufts University School of Dental Medicine emergency dental clinic during the peak surge in COVID-19 cases in Massachusetts, highlighting the number of endodontic emergencies.MethodsAggregate data from clinical encounters and call records to an emergency triage phone line from March 30 through May 8, 2020, were used to describe the characteristics of dental emergencies, clinical encounters, and procedures performed.ResultsA total of 466 patient interactions occurred during this period, resulting in 199 patients advised by phone and 267 clinical encounters. The most common dental emergencies were severe dental pain from pulpal inflammation (27.7% of clinical encounters) followed by a surgical postoperative visit (13.1%). The most frequent procedures were extractions (13.9% of clinical encounters) and surgical follow-up (13.5%); 50.2% of the clinical encounters were categorized as aerosol generating, and 86.1% of encounters would have required treatment in a hospital emergency department if dental care was not available. There were no known transmissions of severe acute respiratory syndrome coronavirus-2 among clinic providers, patients, or staff during this period.ConclusionsThese results highlight the importance of endodontic diagnosis and treatment in the provision of emergency dental care during a pandemic and demonstrate that dental treatment can be provided in a manner that minimizes the risk of viral transmission, maintaining continuity of care for a large patient population.     

The effect of viewing video clips of paediatric local anaesthetic administration on the confidence of undergraduate dental students

Introduction

Dental treatment for children requires not only technical skills, but also the knowledge and confidence to provide behaviour management to support children of differing ages and stages of development. It is not surprising then that dental students find treating children especially stressful. Paediatric dentistry training is therefore a vital element of the undergraduate dental curriculum.

Materials and Methods

Eighty‐six fourth‐year undergraduate dental students received standard lectures and seminars about behaviour management techniques for children having local anaesthetic. The students were then randomly divided into groups using cluster randomisation. The intervention group received an intervention‐based around video clips (VCs) demonstrating behaviour management techniques (BMTs) for children receiving local anaesthetic The intervention and control groups completed self‐administered questionnaires to determine their level of confidence in managing local anaesthetic for children.

Results

There was a statistically significant difference in the level of confidence between the groups immediately after the teaching intervention (P=.003) and at 4 months (P=.001) in favour of the video group.

Discussion

Previous studies on the use of video as a teaching aid have reported favourable results in terms of both student attitudes and learning outcomes. The results from this study confirm the benefits of this style of teaching paediatric behaviour skills in the undergraduate dental curriculum, and the benefits were maintained at 4 months.

Conclusion

This study has demonstrated that VCs as an additional teaching aid are an effective method in improving students’ confidence for BMTs when delivering local anaesthetic.     

Clinical experience improves academic outcomes in dental Oral surgery education

Introduction

This paper aimed to determine if the level of a dental student's clinical experience in oral surgery influences the student's oral surgery academic outcomes.

Materials and Methods

The oral surgery clinical activity and academic outcomes for all students who completed their dental training in 2017, 2018, 2019 and 2020 from the University of Sydney were analysed for correlation.

Results

The clinical activity performed by 313 students was recorded. There was a weak, but statistically significant, Pearson correlation between total dental extractions and academic outcomes (r = .243, p = <.001). The total number of dental extractions performed was the only statistically significant variable on academic outcomes with linear regression analysis (β = .227, p = .005; model R² = .077). The increase of a student's clinical experience from less than 45 to more than 65 dental extractions raised their oral surgery academic results by an average of 6.4%. There were no academic benefits to earlier clinical experience.

Conclusion

An increase in experience with dental extractions resulted in an increase in oral surgery academic outcomes, plateauing at 65 dental extractions. There was no academic advantage to dental student's having earlier clinical experience.     

Using storytelling in undergraduate dental education: Students' experiences of emotional competence training

Aim

The aim of the study was to explore the use of storytelling as a teaching method for emotional competence interventions within undergraduate dental curriculum (dental and dental hygiene students).

Materials and Methods

Students participated in five sessions related to emotional competence: one theoretical and four practical. During the latter, divided in small groups, students told individually two stories: a story about a clinical situation in which they had an emotional experience and a story concerning a patient's experience of the same emotion. Each session focused on a single emotion: happiness, fear, anger and shame. A questionnaire was used to collect perceptions about enjoyment, how stories were chosen, what was learned and if the sessions were stimulating in any way. A focus group was organised to collect reflections about the learning environment, process of learning and specific skill set developed during these sessions.

Results

The majority of the students enjoyed listening, telling and preparing the stories. They reported to experience social support and feeling a sense of community during the sessions. The students believed that stories helped them to reflect on their clinical work and to regulate their emotional experiences more efficiently in clinical situations. Regarding the learning environment, the dental students pointed out the distinctiveness and dissimilarities between the dental and dental hygiene students, but also expressed that they had a desire to learn more about the other student group.

Conclusion

Storytelling used as part of an emotional competence course appears to have benefits for students' reflection about their role as dental health professionals. This teaching method was well-perceived by the students included in this study.     

Student experiences of professionalism and role models in an oral and maxillofacial surgery internship: A qualitative study

Introduction

Dental students have a clear concept of professionalism and the importance of role models. Our aim was to determine how dental students experience their first oral and maxillofacial surgery internship in terms of their concept of professionalism and their perception of role models.

Methods

From June to August 2020, semi-structured telephone interviews were conducted with 22 dental students in their eighth and ninth semesters at the Medical Faculty of the University of Ulm. The interviews were transcribed and evaluated by qualitative content analysis according to Mayring.

Results

The students' concept of dental professionalism was shaped by the elements of a good approach to patients, professional competence, and manual skills. This perception was not changed by the internship. Having a role model was seen as an important learning strategy, and role models were perceived in both positive and negative ways. Role models were perceived as positive if they corresponded to the student's concept of professionalism and as negative if they did not correspond to this concept, especially with regard to social interaction or the approach to patients. Students' reactions to discrepancies between their own moral values and the role models' behaviour were characterised by passivity and withdrawal. With regard to potential future careers, positive internship experiences supported student goals, whereas negative experiences raised doubts about them.

Conclusion

Supervising dentists may still underestimate the considerable impact of internships, and their awareness of this impact needs to be increased. Students' reactions to conflicts between reality and their own values do not appear to be constructive. One approach to solving this problem may be to include discussions of professional development in curricula.     

What is the association between income loss during the COVID-19 pandemic and children’s dental care?

BackgroundThe degree to which children experience unmet need for dental care during the COVID-19 pandemic and its association with pandemic-related household job or income loss are unknown.MethodsThe authors performed a cross-sectional household survey of 348 families in Pittsburgh, Pennsylvania, from June 25 through July 2, 2020. Unmet need for child dental care and pandemic-related household job or income loss were assessed using caregiver self-report.ResultsCaregivers reported that the greatest unmet child health care need during the COVID-19 pandemic was dental care (16%), followed by medical care for a well visit or vaccination (5%). Approximately 40% of caregivers reported job loss or a decrease in household income due to the COVID-19 pandemic. The authors found a significant association between the probability of unmet child dental care and pandemic-related household job or income loss (P = .022). Losing a job or experiencing a decrease in income due to the COVID-19 pandemic was associated with unmet child dental care (relative risk, 1.77; 95% confidence interval, 1.08 to 2.88).ConclusionsIn this sample, 3 times as many households reported unmet dental care for a child compared with unmet medical care. Unmet child dental care was more common in households where pandemic-related job or income loss occurred.Practical ImplicationsIf unmet dental care continues as a result of the COVID-19 pandemic, nontraditional strategies for delivering dental care can be considered to improve access to dental care for children, such as teledentistry and oral health prevention services in primary care settings.     

The graduate entry generation: a qualitative study exploring the factors influencing the career expectations and aspirations of a graduating cohort of graduate entry dental students in one London institution

Background

Dentistry in the UK has a number of new graduate-entry programmes. The aim of the study was to explore the motivation, career expectations and experiences of final year students who chose to pursue a dental career through the graduate entry programme route in one institution; and to explore if, and how, their intended career expectations and aspirations were informed by this choice.

Method

In-depth interviews of 14 graduate entry students in their final year of study. Data were transcribed verbatim and analysed using framework analysis.

Results

There were three categories of factors influencing students' choice to study dentistry through graduate entry: 'push', 'pull' and 'mediating'. Mediating factors related to students' personal concerns and circumstances, whereas push and pull factors related to features of their previous and future careers and wider social factors. Routes to Graduate Entry study comprised: 'early career changers', 'established career changers' and those pursuing 'routes to specialisation'. These routes also influenced the students' practice of dentistry, as students integrated skills in their dental studies, and encountered new challenges. Factors which students believed would influence their future careers included: vocational training; opportunities for specialisation or developing special interests and policy-related issues, together with wider professional and social concerns. The graduate entry programme was considered 'hard work' but a quick route to a professional career which had much to offer. Students' felt more could have been made of their pre-dental studies and/or experience during the programme. Factors perceived as influencing students' future contribution to dentistry included personal and social influences. Overall there was strong support for the values of the NHS and 'giving back' to the system in their future career.

Conclusion

Graduate entry students appear to be motivated to enter dentistry by a range of factors which suit their preferences and circumstances. They generally embrace the programme enthusiastically and seek to serve within healthcare, largely in the public sector. These students, who carry wider responsibilities, bring knowledge, skills and experience to dentistry which could be harnessed further during the programme. The findings suggest that graduate entry students, facilitated by varied career options, will contribute to an engaged workforce.