The assessment of suturing skills of dental undergraduates

Introduction: To improve the assessment of suturing skills, we firstly developed a checklist based assessment. As an aid to the teaching of suturing skills a video was subsequently developed. Materials and methods: To validate the checklist a cohort of 57 final year students were videoed performing the formative suturing assessment which was assessed by two examiners independently. Two cohorts of third year students took part in the formal assessment but only the second cohort of students would have access to the video. Results: The first cohort of 58 third year students’ success rate was 93% and 1 year later 94% of 53 third year students were successful. One hundred per cent of the first cohort and 98% of the second cohort thought that the exam was a fair assessment of suturing skills. The majority of students thought that the checklist was helpful (94% and 93%). However, 62% and 55% thought that the assessment was a stressful experience. However, only 80% of the first cohort compared with 98% of the second cohort thought that they could now place sutures in intra‐oral wounds. Conclusion: Our findings suggest that checklist based assessments of suturing skills were well received by the students and improved the objectivity and transparency of the assessment process. Further work is required to determine if teaching initially on a tabletop model can be transferred to the dental clinical situation.     

Creating effective and engaging information literacy programmes for the dental curriculum

In this time of rapid expansion of the scientific knowledge base, subject matter runs the risk of becoming outdated within a relatively short time. Instead of adding more content to already crowded curricula, the focus should be on equipping students to adapt to their changing world. The ability to access, evaluate and apply new knowledge for the benefit of patients has been acknowledged as an important goal for dental education. Information literacy is key to achieving this. A template for an Information Literacy programme for undergraduate students is described. This was embedded within a compulsory course for each of the first and second years of the Bachelor of Oral Health programme and consisted of a hands‐on workshop (attendance voluntary), information literacy quiz, self‐evaluation and a summative assessment task, with the second year of the programme building upon the learning of the previous year. Effectiveness was measured in terms of demonstration of information literacy skills and confidence in using these skills. Integration of this programme within the learning activities and assessment of first‐ and second‐year courses resulted in enhanced information literacy skills and confidence. Self‐perceived high skill levels may be a potential barrier to student engagement with information literacy programmes.     

Use of Web-based formative assessment to support student learning in a metabolism/nutrition unit

In 2002, an integrated basic science course was introduced into the Bachelor of Dental Sciences programme at the University of Queensland, Australia. Learning activities for the Metabolism and Nutrition unit within this integrated course included lectures, problem-based learning tutorials, computer-based self-directed learning exercises and practicals. To support student learning and assist students to develop the skills necessary to become lifelong learners, an extensive bank of formative assessment questions was set up using the commercially available package, WebCT. Questions included short-answer, multiple-choice and extended matching questions. As significant staff time was involved in setting up the question database, the extent to which students used the formative assessment and their perceptions of its usefulness to their learning were evaluated to determine whether formative assessment should be extended to other units within the course. More than 90% of the class completed formative assessment tasks associated with learning activities scheduled in the first two weeks of the block, but this declined to less than 50% by the fourth and final week of the block. Patterns of usage of the formative assessment were also compared in students who scored in the top 10% for all assessment for the semester with those who scored in the lowest 10%. High-performing students accessed the Web-based formative assessment about twice as often as those who scored in the lowest band. However, marks for the formative assessment tests did not differ significantly between the two groups. In a questionnaire that was administered at the completion of the block, students rated the formative assessment highly, with 80% regarding it as being helpful for their learning. In conclusion, although substantial staff time was required to set up the question database, this appeared to be justified by the positive responses of the students.     

Development of a structured clinical operative test (SCOT) in the assessment of practical ability in the oral surgery undergraduate curriculum

Competence in undergraduate oral surgery involves assessment of the students' knowledge, practical skill and attitude. The assessment of practical skills can be achieved using a formative assessment method such as the structured clinical operative test (SCOT) which uses a checklist for the assessment of a clinical task. The aim of this study was primarily to determine whether SCOTs could be integrated into the oral surgery undergraduate course, and secondarily to collect feedback from both the students and the staff on this assessment. A validated checklist was used by trained examiners to assess the performance of 49 students in their second clinical year undertaking simple exodontia. Feedback was collected from the students by questionnaire and from the staff by interview. The SCOT was well received by both students and staff. The main problem highlighted by the students was the perceived inter-examiner variability and by the staff, the disruptive effect on the clinics. The checklist must be objective enough to prevent misinterpretation. Despite these limitations, the SCOT provides a more objective assessment and serves to highlight weaker students, allowing them to be targeted for closer supervision and instruction as well as providing the students with a tool to measure their progress in oral surgery. The use of peer assessment by students may alleviate the burden on the staff.     

Dental plaque mass and acid production activity of the microbiota on teeth

With the purpose of elucidating the effect of dental plaque thickness on the acid production activity in dental plaque, we studied the prevalence of acid anions in dental plaque of children harbouring different amount of plaque on their teeth. On two occasions, the occurence of plaque on the dentition was scored (Silness‐Löe's index), and plaque on available smooth surfaces was collected and the wet weight determined. On the first occasion, the amount of acid anions in resting plaque, and on the second occasion, the acid anions of sucrose‐exposed plaque were analysed with isotachophoresis. Mean value of plaque wet weights per individual dentition was 11.7±9.0 mg (first occasion) and 11.1±8.9 mg (second occasion). Dominating anions in resting plaque were acetate相似文献   

The relationship between formative and summative assessment of undergraduates in oral surgery

Introduction: Regular, on‐going formative assessments or a more comprehensive end of program summative assessment can be used to assess student’s progress. The literature is scarce regarding the use of both types of assessment coincidentally and if the outcomes of formative assessments can predict the grades achieved summatively. This paper investigates whether there is any correlation between the formative assessments used in routine clinical contacts in the Newcastle course and the final summative assessment grade. Materials and methods: The logbooks of 72 third year dental students were examined to collect data on the gradings achieved for formative and summative assessments. The categories of history and presentation, local anaesthesia, extraction and overall grades for each were compared using Spearman’s Rho. Results: Six logbooks were incomplete so were omitted from analysis (n = 66). In the formative assessment, the total number of teeth extracted was 1913, giving a mean per student of 29 (SD = 6.88). In the summative assessment, 15 students failed on their first attempt but all subsequently passed on resit. Discussion: Positive correlation was found within each of the two types of assessment but no correlation was found between the overall grades for the formative and summative assessment. The overall grade achieved by a student in the formative assessment does not appear to predict their grade in the summative. The use of both assessments is beneficial, however, their use together must be considered carefully to avoid confusing students.     

Development and evaluation of a cd-rom to support student learning in dentist–patient communication

The interaction between dentist and patient is central to the provision of effective healthcare. A multidisciplinary team containing expertise in the social and behavioural sciences, medicine, dentistry, education and information technology was formed to design a CD-ROM to support more traditional teaching and learning in this area. The final version of the program consists of a 'virtual' patient from whom students are asked to take a medical history. The 'patient' interacts with the student and responds to the style of their questioning by changes in anxiety, or degree of annoyance. To date, the CD-ROM has been evaluated in two stages. The first stage was a predictive formative evaluation by the research/development team, and the second stage was a formative evaluation by 144 dental students of the first full prototype. A third stage, to be conducted next year, will involve measuring the longer term impact of the CD-ROM through the assessment of students' abilities to communicate with patients. The evaluation had two components: students made rates of how useful and easy to use they found the program, and students' attitudes towards interacting with patients were evaluated adopting constructs from the theory of Planned Behaviour. Students were positive about the use of the CD-ROM, though they requested some changes in the functionality of the program. Compared to a sample of students who had not used the CD-ROM, the students who used the CD-ROM felt more positive about communicating with their patients, at the end of the course, and expressed stronger intentions to communicate well with patients.
We conclude that the CD-ROM we have developed in a useful adjunct to learning in dentist–patient communication .     

The effect of repeated testing vs repeated practice on skills learning in undergraduate dental education

Objectives

Recent studies in undergraduate medical education have demonstrated the advantage of repeated testing over repeated practice with regard to knowledge and skills retention. The aim of this study was to investigate whether this “testing effect” also applies to skills retention in undergraduate dental education.

Methods

In this prospective, randomised controlled trial, fourth‐year dental students at Göttingen University Medical Centre participated in a training session on surgical suturing in winter term 2014/2015. Following this, they were either assigned to two sessions of additional skills training (group A) or two sessions of skills assessment with feedback (group B). These sessions were spaced over a period of 4 weeks. Skills retention was assessed in a summative objective structured clinical examination (OSCE) at the end of term, that is 6 months after the initial teaching session.

Results

A total of 32 students completed the study. With regard to suturing, OSCE performance was significantly better in group B than group A (81.9±13.1% vs 63.0±15.4%; P=0.001; Cohen's d=1.33). There was no significant OSCE performance difference in the two groups with regard to other learning objectives that were addressed in the end‐of‐term examination. Thus, the group difference was specific to suturing skills.

Conclusions

This is the first study to demonstrate that in dental education, repeated testing produces more favourable skills retention than repeated practice. Test‐enhanced learning might be a viable concept for skills retention in undergraduate dentistry education.     

Extramural clinic in comprehensive care education

The interaction between dentist and patient is central to the provision of effective healthcare. A multidisciplinary team containing expertise in the social and behavioural sciences, medicine, dentistry, education and information technology was formed to design a CD-ROM to support more traditional teaching and learning in this area. The final version of the program consists of a 'virtual' patient from whom students are asked to take a medical history. The 'patient' interacts with the student and responds to the style of their questioning by changes in anxiety, or degree of annoyance. To date, the CD-ROM has been evaluated in two stages. The first stage was a predictive formative evaluation by the research/development team, and the second stage was a formative evaluation by 144 dental students of the first full prototype. A third stage, to be conducted next year, will involve measuring the longer term impact of the CD-ROM through the assessment of students' abilities to communicate with patients. The evaluation had two components: students made rates of how useful and easy to use they found the program, and students' attitudes towards interacting with patients were evaluated adopting constructs from the theory of Planned Behaviour. Students were positive about the use of the CD-ROM, though they requested some changes in the functionality of the program. Compared to a sample of students who had not used the CD-ROM, the students who used the CD-ROM felt more positive about communicating with their patients, at the end of the course, and expressed stronger intentions to communicate well with patients.
We conclude that the CD-ROM we have developed in a useful adjunct to learning in dentist–patient communication .     

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.     

Dental student suturing skills: a multicentre trial of a checklist‐based assessment

Background: The assessment of clinical skills is essential to determine whether an undergraduate is competent to perform the tasks outlined in the curriculum. Such assessments in dentistry have historically not been subjected to large scale validity and reliability testing due the relatively small student numbers at each institute. The aims of this study were to test the validity and reliability of a standardised, checklist‐based, suturing objective structured clinical examination (OSCE) and then to perform a multicentre trial to determine its performance over a large cohort of students. Materials and methods: A total of seven UK schools agreed to take part in the trial. To test the validity and reliability of the checklist, the examiner at each institution reviewed and scored video footage of 10 students performing the assessment. Each institution then carried out the assessment providing a checklist score and a global score for each of their own students. Results: The assessment was well received by the staff, with acceptable inter‐examiner variability. In total, 496 students completed the suturing OSCE with a success rate of 81% with a variation between schools of between 66% and 96%. A significant correlation was found between the checklist score and the global score (r = 0.361, P = 0.000). No one item on the checklist was found to be a determinant factor in the outcome of the OSCE. Conclusions: This checklist‐based assessment of suturing skills was found to have face and content validity. Its reliability was promising, but merits further investigation. There may be an argument for the standardisation of the assessment of this core surgical skill throughout several UK‐based dental schools.     

The effects of an interactive software application on the self-assessment ability of dental students

A randomised controlled trial was designed to test an Internet‐based interactive application as a stand‐alone support for the development of self‐assessment skills among second‐year dental students at the Faculty of Dentistry, University of Malmö, Sweden. Fifty‐two students were randomised into an experimental (n = 26) and a control group (n = 26). Both groups went through four identical learning cases in elementary clinical Periodontology during a period of 1 month. The experimental group received the cases with the interactive software, while the control group received them through a static web page. After the end of the learning phase, both groups were assessed blindly by two assessors during the interactive examination methodology. There was a moderate agreement between the two assessors, but both failed to find any significant differences between the two groups with regard to self‐assessment skills and overall performance of the students. Students positively received the Internet support, but several attitude differences were observed between the two groups during the study. Time on task and competence with computers were positively correlated to assessment results for both groups. On the basis of these findings, it remains unclear if computer‐based applications with automated feedback can constitute an effective remedial support for the improvement of self‐assessment skills of students. In addition, for such applications to be successfully accepted, two factors are critical: students must have a clear perception of the benefits deriving from the use of the software and the use of the software should be integrated in the curriculum, replacing some of the existing workload.     

窝洞预备技能评价系统在牙体牙髓病学实验教学中的应用

目的研究窝洞预备技能评价系统（CPSES）用于牙体牙髓病学窝洞预备实验教学的教学效果。方法针对2009级口腔本科学生,在牙体牙髓病学窝洞预备实验教学中采用传统授课及教师目测方法评估学生预备窝洞技能,针对2010级口腔本科学生应用CPSES系统软件评估。统计2010级口腔本科学生窝洞预备实验课理论与操作考核成绩,与2009级口腔本科学生的窝洞预备实验课理论与操作考核成绩进行比较,并对2010级学生进行问卷调查,以评价该系统应用效果。结果窝洞预备实验课考核成绩分析显示,2010级学生窝洞预备知识点掌握情况较好,问卷调查结果可见学生对窝洞预备技能评价系统的应用反响很好,直观易懂,对窝洞预备知识掌握及技能训练很有帮助。结论 CPSES软件用于牙体牙髓病实验教学,辅助教师评分,可加深并强化学生对洞形预备要求的理解,有助于提高教学质量。     

Cardiopulmonary resuscitation skills of dental personnel.

This study assessed the cardiopulmonary resuscitation (CPR) skills of 25 dental personnel. Theory was tested by multiple choice questionnaire (MCQ) and practical skills assessed using a recording Resusci-Anne manikin. The assessment was based upon the recommendations of the Resuscitation Council of the UK. Seven of the 16 dental students and six of the nine house officers tested passed the MCQ examination. All failed the practical assessment. It is concluded that more emphasis should be placed upon CPR instruction in undergraduate dental courses and that regular update courses are advisable to maintain CPR skill.     

Experiences in adding multiple‐choice questions to an objective structural clinical examination (OSCE) in undergraduate dental education

In the University of Oulu, the competencies of fourth‐year dental students have traditionally been assessed with a written examination before they go to work for the first time as dentists outside the Institute of Dentistry. In 2009, the objective structural clinical examination (OSCE) modified with multiple‐choice questions was introduced as a tool for assessing clinical competencies. The aim of the study was to evaluate the validity of the modified OSCE (m‐OSCE) by measuring the attitude of examiners (teachers) and dental students towards the m‐OSCE and to evaluate whether the OSCE is preferred to the written examination in the assessment of knowledge and clinical skills. Additionally, the aim was to evaluate the reliability of the multiple‐choice examination. Altogether 30 students (86%) and 11/12 examiners (92%) responded to the questionnaire. Most of the students considered the multiple‐choice questions easy, but complained about the complex formulation of the questions. The test stations were easy for 87% of the students, but the time allocated was too short. Most of the students (73%) and examiners (91%) preferred the m‐OSCE to the written examination. All students and examiners found the immediate assessment of the tasks good. Based on the evaluations of m‐OSCE, it could be concluded that both students and examiners preferred the m‐OSCE to the pure written examination in assessment, which indicate that m‐OSCE had good face validity. Combining multiple methods in assessment of knowledge and clinical skills whilst simultaneously taking into account the feasibility and available resources provides more valid results.     

An Approach to Interdisciplinary Training in Postgraduate Education

Aims To demonstrate a formative assessment process for new dental graduates in general practice which includes seven key skills which are the foundation of good clinical practice and teamwork. Methods and materials The key skills identified are: clinical record keeping; radiography; infection control; risk management and communication; legislation and good practice guidelines; team training and medical emergencies. Learning is by compilation of portfolios for each key skill for each individual and their practice. Supporting educational material is by a CD Rom for each key skill. Assessment is by external validation (Faculty of General Dental Practitioners) and local evaluation. Results Each graduate will submit their key skills portfolios for assessment at the end of their vocational training year or agreed period. Support will be from their practices, study groups and tutors with access to the key skills CD Roms. Young graduates will be able to demonstrate knowledge and insight of general practice and show evidence of their own understanding of the seven key skills Satisfactory completion of the key skills portfolios may be used for the MFGDP(UK) coursework module as part of continuing professional development. The seven key skills portfolios CD Roms will contribute to the GDC verifiable CPD requirements. Conclusions When students make the transition from dental school to general practice it is essential they understand the key requirements for high quality patient care and also the importance of teamwork in providing that care. The seven key skills portfolio learning not only helps new graduates do that but also make them more aware of their own practice and the many requirements of good safe care for patients and their staff. The seven key skills portfolios also contribute to further professional development as part of further professional examinations as well as being a good model of assessment of new dental graduates     

Influence of online formative assessment upon student learning in biomedical science courses

Research suggests that high-quality formative assessment has a strongly positive effect upon student learning. Unfortunately, formative assessment does not appear to be frequently used in didactic dental curricula. Our hypothesis was that providing students with practice online exam questions would enable those who voluntarily took the exam to perform better on subsequent summative exams than did students who did not utilize this opportunity. A test bank of exam questions was written for dental students enrolled in two different biomedical science courses. Half the questions were arbitrarily assigned to an electronic test site; the other half were used as a written summative classroom exam taken later. Students who took the online formative exam in the first semester course scored 8.8 percent higher on the summative exam than did those who did not take the practice exam. This represents almost a full letter grade higher for the formative exam-takers. Students who took the formative online exam in the second semester course scored 5.2 percent higher on the summative exam than did the non-takers. Both of these differences were statistically significant. Under these experimental circumstances, providing formative online exams appeared to promote student performance as reflected by higher scores on the summative exams.     

Practical skills training influences knowledge and attitude of dental students towards emergency medical care

Background: Medical emergencies in dental practice are generally perceived as being rare. Nonetheless, recent studies have shown that incidents occur on a regular basis. Therefore, patients have the right to expect necessary skills to manage life‐threatening situations from every dentist. Objective: To observe students’ attitude and self‐assessment towards emergency medical care (EMC) and its practical appliance. Material and methods: Students of dentistry took part in small group sessions for adult and paediatric basic life support. Participants filled out pre–post questionnaires regarding knowledge and attitude towards EMC (6, respectively, 10‐point Likert scale). Additionally, feedback was asked for the quality of course and tutors. Results: Forty dental students in their last 2 years of study registered for the EMC courses. The majority had never attended any first‐aid course; the mean age was 25% and 75% were women. A comparison between pre‐ and post‐evaluation showed that the participation in practical training easily enhances the students’ awareness of EMC importance as well as self‐confidence in managing emergencies. After the course, 71% shared the opinion that retraining should be obligatory for all medical personnel. At the same time, students’ self‐assessment of confidence for specific tasks got significant upgrades in every aspect. Conclusion: The evaluation data clearly show the participants’ needs to deal with topics of EMC within the curriculum of dentistry. The proposed course is able to change participants’ attitudes towards EMC and its importance for their daily practice. The considerable enhancement of self‐confidence in performing EMC‐techniques might also lead to more willingness to manage emergency situations.     

A mini-OSCE for formative assessment of diagnostic and radiographic skills at a dental college in India

The objective structured clinical examination (OSCE) is being widely used for assessment of skills in dental education around the world. In India, OSCE awareness is rising, and a few exploratory attempts have been made in its implementation. This article describes use of a five-station mini-OSCE for formative assessment of dental diagnostic and radiographic skills in an undergraduate curriculum. Besides gaining experience in OSCEs, the purpose of this project was to study their validity, objectivity, feasibility, acceptability to students and faculty, and impact on student performance. The mini-OSCE was found to be a fairly valid and reliable tool for formative assessment, though it required more planning, preparation, and resources than other means of assessment. A specially developed orientation module improved its feasibility. The nineteen students perceived it to be a meaningful examination and a fair method due to uniformity of tasks and time allocation; they found the scoring to be transparent and objective. The specific and immediate feedback received was appreciated by both students and faculty members.     

Teaching recognition skills to improve products

All 86 first year dental students in a Conservative Restorations course completed five sets of instructional tasks. Tasks followed a discrimination learning paradigm, a sequence based on the principal that recognition skills are a prerequisite for production skills. Recognition skill measures and production quality measures were collected for pre- and post-test Class 1 amalgam preparations. Significant improvement was found in three of the five recognition skill measures and in quality of production. Stepwise multiple regression analysis showed that a measure of student agreement with faculty evaluations accounted for 46.3 percent of the variance in post-test production scores whereas traditional admissions measures accounted for less than 4 percent of the variance. Additionally, students who improved recognition skill showed a corresponding improvement in products. The paradigmatic teaching model appears to be valid for Class 1 cavity preparations.