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.     

Undergraduate students’ experiences of outreach placements in dental secondary care settings

Introduction: Outreach teaching is delivered as part of the undergraduate curricula of many dental schools. Evaluations of outreach in primary care settings have found learning opportunities beyond those available in the dental school setting, but less is known about secondary care placements. The aim of this evaluation was to assess dental students’ experiences of an undergraduate outreach placement in secondary care. Materials and methods: Questionnaire survey based on a single cohort of final‐year undergraduate dental students at Cardiff University who had completed a 1‐week outreach secondment to a District General Hospital. Results: Fifty‐five of the 57 eligible students completed the questionnaire. Outreach placements in secondary care were experienced to provide positive additional educational benefit and were considered to be worthwhile by many (but not all) students. Clinical opportunities and staff teaching varied by site. Discussion: In the current programme, the variability of student experience during secondments to secondary care means that some students report more benefit than others. However, even apparently negative experiences, such as cancelled operating lists, can contribute to the overall outcome in that they accurately reflect the reality of hospital practice. Conclusion: Careful management of secondary care undergraduate secondments is needed to ensure worthwhile learning experiences.     

Swedish and Finnish dental practitioners'' opinions of their undergraduate education

Recently qualified dentists from a dental school in Stockholm, Sweden (n = 259) and the dental school in Kuopio, Finland (n = 103) were sent a questionnaire designed to obtain information concerning the perceived relevance of their undergraduate education to the practice of dentistry. The response rate was 71% for Stockholm and 82% for Kuopio. Except for minor differences, probably mainly due to economic resources and traditions in choice of treatment, the graduates in the two countries had comparable views of their basic education. In general, clinical dental subjects were highly valued, while basic science subjects but also subjects in medical and behavioral sciences were given low values. Our results indicate that, although prevention and behavioral sciences are stressed more and more in undergraduate education, the practice of clinical dentistry remains essentially unchanged and restorative dentistry is still very highly valued among recent graduates of these two dental schools.     

Teaching the placement of posterior resin-based composite restorations in Spanish dental schools

Objectives: In an area of esthetic dentistry such as posterior composites, in which new materials and techniques are being devolved continuously, it is important to confirm that dental students have a clear understanding of the basic principles of clinical application of this knowledge. Considering that the preparation of dental graduates in Spain may be of interest to competent dental authorities and employers with whom they can work worldwide, this study investigated the teaching of posterior composite restorations in Spanish dental schools. Study design: In late 2009⁄ early 2010, a questionnaire seeking information on the teaching of posterior composites was emailed to the professor responsible for teaching operative dentistry in each of the fifteen dental schools having complete undergraduate dental degree programs in Spain. Results: The response rate was 100%. Most investigated topics did not show noteworthy differences depending on whether the schools were public or private. Variations were found among Spanish dental schools in both the amount and content of the teaching programs concerning posterior composite restorations. Differences were recorded in the teaching of cavity design, contraindications to composite placement, indications for liners and bases, matrix and wedging techniques, composite and bonding systems, light curing and finishing procedures for composite restorations. More consistency was observed in teaching methods of moisture-control, indirect composites and amalgam bonding. Conclusions: As recommended in previously surveyed countries, efforts must be made to promote harmonization of dental curricula to make it easier for graduates to work elsewhere, and to ensure they meet the needs of their patients on entering independent practice. Key words:Aesthetic dentistry, composite restoration, dental education, teaching program, undergraduate dental student.     

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.     

Academics for dental primary care

Driven by the need to address integrated dental care, many UK dental schools have recognised the advantages of teaching dental practice, or dental primary care (DPC), as a separate and defined subject area. In such schools, DPC may be taught alongside specialist subjects such as restorative dentistry, oral surgery, oral medicine and those traditionally forming elements of the dental undergraduate curriculum. As a result, departments or units of general dental practice or DPC have been established.     

Students' perceptions of effective classroom and clinical teaching in dental and dental hygiene education

Effective teaching behaviors have been studied in various arenas in higher education. However, there is limited research documenting effective teaching behaviors in dentistry and dental hygiene. Our qualitative study attempts to define effective teaching in both the classroom and clinic for dentistry and dental hygiene students. A total of 175 dental and dental hygiene undergraduate students nominated a total of forty instructors for teaching awards, providing a total of 695 qualitative statements reflecting their teaching in two learning contexts: the classroom and the clinic. Seven categories of effective teaching qualities were identified: individual rapport, organization, enthusiasm, learning, group interaction, exams and assignments, and breadth. Based on the frequency of the themes, effective teaching in the classroom was best defined by organization and rapport, whereas in the clinic, rapport was the most frequently described behavior. Moreover, dentistry students perceived enthusiasm as an effective teaching quality more frequently than did dental hygiene students, whereas dental hygiene students provided more responses to learning. These findings can provide guidance in preparing undergraduate dental and dental hygiene educators to enter the teaching environment. The ultimate goal to be achieved from identification of effective teaching qualities, as determined in this study, is improvement in clinical and classroom teaching for dentistry and dental hygiene programs.     

Community dentistry in Nordic dental schools

Approximately a decade after the first plans for the teaching of community dentistry were made in the Nordic countries, a questionnaire survey of Nordic dental schools was conducted to find out to what extent community dentistry subjects had been introduced in undergraduate curricula. Replies were received from the 12 dental schools in Denmark, Finland, Norway and Sweden. These schools admitted 915 students in 1982-83. Seven had a department of community dentistry, and at least two others had plans to start one. About 100 h of teaching were given on community dentistry subjects during the 5-yr course of study, mostly on the traditional subjects of epidemiology, statistics, law and ethics. In some schools health education and other behavioral sciences subjects received a large amount of curriculum time. Decisionmaking theory and political science were not reported taught at any school. Three departments had attached clinics, with widely differing functions. The Nordic textbook in community dentistry was widely used, and separate examinations were held in community dentistry at most schools. Full-time postgraduate courses were offered at three schools. Although schools in all four countries expected the number of dental students to decrease in coming years, several schools expected community dentistry to expand with regard to curriculum time and staff, in keeping with trends in other countries.     

Predoctoral implant dentistry curriculum survey: European dental schools

PURPOSE: In 2002 a survey of European dental schools was conducted. The purpose of the survey was to determine the curricular structure, teaching philosophies and materials used in predoctoral implant dentistry courses. MATERIALS AND METHODS: Fifty-six European dental schools were randomly selected from the Association for Dental Education in Europe representing 33 countries. A questionnaire was mailed to the predoctoral implant dentistry director/chairperson of the selected European dental schools. Of these, 40 schools returned the completed survey, resulting in a response rate of 71%. The mean, median and range of responses were computed where applicable. RESULTS: The results from this survey show that 80% of the responding schools required a course in implant dentistry. Between 1997 and 1999 over a third of responding schools (36%) incorporated a predoctoral implant dentistry course into their curriculum. Eighty-seven per cent of the schools have some prosthodontists teaching the course. Thirty-seven per cent of schools are offering a laboratory course in conjunction with the implant course. Sixty-three per cent of the schools are not restoring implant cases at the predoctoral level. However, 68% of schools reported students are required to be present during implant surgery. Ten per cent of schools require that the implant-related laboratory work be completed by the students. CONCLUSIONS: Predoctoral implant dentistry educational programmes vary from school to school. Yet a large percentage of schools agree on certain topics, including the importance of including implant education in predoctoral dental programmes.     

The teaching of Class I and II restorations in primary molars: a survey of North American dental schools.

PURPOSE: The purpose of this study was to obtain an overview of materials and restoratives techniques taught for Class I and Class II restorations in primary molars in different pediatric dentistry departments in North America. METHODS: A form with response alternatives was mailed to 63 dental schools in the United States and Canada. The forms were addressed to the chairman/undergraduate program director of the department of pediatric dentistry. Questions regarding the restorative materials taught, indications and contraindications for the use of tooth-colored materials and the type of cavity preparation indicated for those materials were among the topics assessed. RESULTS: Eighty-six percent of the dental schools responded to the survey. Amalgam continues to be the material of choice for Class I and II restorations in primary molars, although hybrid composites and compomers are gaining some popularity. When tooth-colored materials were indicated, the slot-type of cavity preparation was the preferred one. CONCLUSIONS: The diversity in teaching may reflect uncertainty related to requirements for optimal restorations of primary teeth. Data from dental schools of other countries may be important to obtain to establish universally accepted criteria and standards for restorative techniques of primary teeth.     

Undergraduate dental education in New Zealand: 2007-2009 final-year student feedback on clinical learning environments

Dental education is a unique form of health professional education. This is because the clinical training component largely occurs within the dental school and involves students carrying out irreversible patient interventions early in their education. Perhaps not surprisingly, previous research indicates that dental education (and particularly the clinical component) is stressful for many students. In their responses to an annual clinical learning environment survey, final-year Bachelor of Dental Surgery (BDS) students at the University of Otago have suggested that teaching staff play a key role in mitigating or compounding stressors associated with students' clinical work. In 2007-2009 questionnaire responses, students identified the kinds of staff feedback which they found constructive or unhelpful while working in patient clinic settings, described their responses to feedback received, and identified ways in which students' clinical learning experiences might be improved. This paper outlines 2007-2009 University of Otago Faculty of Dentistry clinical learning environment survey findings, and relates these to the literature on effective teaching and clinical teaching. It then describes programmatic changes and research initiatives developed in response to student feedback.     

Predoctoral Implant Dentistry Programs in US Dental Schools

Surveys of US dental schools over the last 20 years have reported a continual increase in the number and types of predoctoral and postdoctoral implant dentistry programs being taught. The purpose of the following article is to report on the results of a survey intended to update the status of predoctoral programs with respect to their curricular placement, departmental jurisdictions, and course contents. In June 1993, 54 US dental schools received the implant dentistry curriculum survey, and 50 of the schools (93%) returned responses. Results indicate that the trend toward implementation of more predoctoral implant dentistry programs has been sustained, with 86% of schools reporting the existence of implant curricula. This compares with 33% and 73% of US schools having such programs in 1974 and 1989, respectively. The major reasons that schools gave for not having implant dentistry courses for predoctoral students are a lack of curriculum time and scarce financial resources. The dental disciplines most frequently guiding such programs are oral surgery and periodontics. Schools offer varying degrees of lectures, laboratories, and clinical experiences in predoctoral implant dentistry, with the number of curriculum hours peaking in years three and four. General curricular topics most commonly include a historical overview of implant dentistry, diagnosis and treatment planning, classifications and types of dental implants, and surgical and prosthodontic procedures. Seventeen percent of schools require some form of undergraduate clinical implant dentistry exposure for all of their students.     

A qualitative investigation of the influence of time since graduation on English dentists' approach to the care of young children

BACKGROUND: In the UK, general dental practitioners (GDPs) provide the majority of dental care to young children. The approach to undergraduate teaching of paediatric dentistry varies across UK dental schools. There is no understanding of how undergraduate teaching influences practice in the first few years after qualification and how this influence behaves over time as dentists mature as clinicians. OBJECTIVE: The aim of this paper is to gain a deeper understanding of the influence of time since graduation on how GDPs manage the dental care of their child patients. DESIGN: A qualitative study, with three interviewers conducted 93 interviews with GDPs practising in the north-west of England. Interviews were transcribed verbatim and content analysis was used with the purpose of identifying themes from the data. RESULTS: Findings showed that formal postgraduate education was not a great influence upon the GDPs' approach to care over time. Change in approach was influenced by experiential learning over a GDP's career and external influences such as policy change, but this was not underpinned by any formal reflective practice. CONCLUSIONS: Education is just one of many influences on clinical practice over the whole of a clinician's career. A gradual change in clinical practice is influenced by the personal experience of dentists treating children.     

Undergraduate teaching and clinical use of rotary nickel-titanium endodontic instruments: a survey of French dental schools

AIM: To evaluate the impact of rotary nickel-titanium (NiTi) instruments on undergaduate teaching and clinical use in French dental schools and to evaluate the impressions of dental students when learning and using these techniques. METHODOLOGY: A questionnaire was mailed to all 16 French undergraduate dental schools. Data were gathered on a range of issues concerning teaching and use of NiTi endodontic techniques. RESULTS: The response rate was 100%. The need for teaching NiTi techniques to dental students was agreed by all schools. Lectures and laboratory courses for rotary NiTi techniques were organized in all of the schools. In 13 of the 16 teaching hospitals, students could use rotary NiTi techniques for canal preparation under the supervision of teaching staff. Similarities were observed in the majority of responses, e.g. type of rotary system taught and used clinically. Some differences were also observed, e.g. the association of hand files to rotary NiTi instruments and at what stage in the undergraduate curriculum rotary instruments were introduced. CONCLUSION: There was a national consensus over the need for undergraduate teaching of rotary NiTi systems in France. These techniques had made a substantial impact in endodontic teaching and were widely taught and used in French dental schools.     

Evaluation of a predoctoral implant curriculum: does such a program influence graduates' practice patterns?

PURPOSE: Didactic predoctoral dental implant education is part of the curriculum in most US dental schools. However, fewer than half offer laboratory instruction, and only a few allow dental students to place and restore dental implants. The additional time necessary for laboratory and clinical experience encroaches on an already crowded curriculum. Is the additional time necessary in the curriculum for laboratory and clinical experience by dental students reflected by the practice patterns of graduates who have completed such a program over the past 10 years? MATERIALS AND METHODS: A survey was designed to determine the implant practice patterns of graduates of the Creighton School of Dentistry, Omaha, Nebraska, for the 10-year period 1988 to 1997. These graduates had all participated in a formal undergraduate didactic and laboratory curriculum in implant dentistry. Approximately half also had the opportunity to place and/or restore dental implants while students. The survey was also sent to graduates (also 1988 to 1997) from a midwestern dental school without a formal laboratory or clinical component (used as a control group). The data were analyzed statistically. RESULTS: In comparison to the control group (56% versus 23%), more than twice as many Creighton graduates restore dental implants as a part of their general practice, surgically place more dental implants, refer more implant patients to surgical specialists, and seek more continuing education hours related to implant dentistry. These conclusions were all supported by statistical analysis of the data. DISCUSSION: Student clinical experience with implant dentistry appears to significantly increase the incorporation of implant dentistry into future dental practices. Even if clinical experience was not an option, a school curriculum which included both didactic and laboratory participation still significantly increased the number of graduates who included implant dentistry in their practices. CONCLUSION: The inclusion of laboratory and clinical experience in implant dentistry in the CUSD undergraduate curriculum resulted in significantly greater participation in implant dentistry at the general practice level.     

Perceived relevance of oral biology by dental students

Objectives: This study investigated the perception that dental students have regarding the relevance of oral biology (OB) to dental education and dentistry in general. Moreover, this study analysed students’ attitude towards OB learning approaches and resources. Methods: A questionnaire based on a Likert scale was used to survey pre‐clinical/second (BDS2)‐ and final/fifth (BDS5)‐year dental students at the School of Dentistry of the University of Birmingham (United Kingdom). In comparison, a small group of postgraduate specialist registrars were surveyed to evaluate the attitudes of practising dentists. Results: The results show that all study groups expressed a high level of perceived relevance of OB to dentistry. Students’ perception of OB for dental education, clinical training and practice also scored high. More than 40% of undergraduate students and about 55% of the postgraduates indicated a perceived change in their attitude towards OB with time characterised by increased appreciation of the subject. Lectures were considered as the most important teaching approach, whereas ‘group poster projects’ ranked lowest. Of the different study resources, lecture handouts received the overall highest importance score. Conclusions: The results indicate that dental students considered OB relevant for dental education and dentistry and suggest a positive attitude towards the subject. This study also suggested that dental students prefer teacher‐centred/led teaching rather than student‐directed learning of OB. The article addresses the role of OB and science‐related research projects within the dental curriculum and discusses that close integration of basic sciences with dental education may enrich dental education and overall learning experience.     

A survey of undergraduate education in dental implantology in UK dental schools

The aim of this study was to ascertain knowledge on current teaching of implant dentistry in the undergraduate curriculum of Dental Schools in the UK. Information on the teaching modalities, including year of introduction of implant dentistry into undergraduate curriculum, departments involved in teaching, format of teaching, use of adjunctive teaching aids, and types of implant systems used in undergraduate teaching was collected by means of a questionnaire, which was sent to all undergraduate dental schools in the UK. Based on a 100% response rate, the findings indicate that all dental schools in the UK reported that they included dental implantology in their undergraduate curriculum; however there were marked variations in the content and delivery of the teaching.     

Teaching and learning in dental student clinical practice

Clinical learning in restorative dentistry is principally centred around the provision of patient care, yet we know very little about the learning processes occurring within the clinical environment. A study of undergraduate dental student clinical practice used a combination of group interview and questionnaire techniques to explore some of the characteristics of student/teacher interaction that students finds significant, and which they consider to affect their learning of clinical skills. Study data, when analysed, revealed three major categories of teacher or student behaviour which appear to be of importance to students. This paper focuses on one of these, describing a number of behaviours, grouped together under the category of 'teaching/learning behaviours'. The aim of the paper is to report these results and to discuss their application to clinical teaching of restorative dentistry.