Learning climate in dental hygiene education: a longitudinal case study of a Japanese and Canadian programme

To cite this article:
Int J Dent Hygiene
Saito A, Sunell S, Rucker L, Wilson M, Sato Y, Cathcart G. Learning climate in dental hygiene education: a longitudinal case study of a Japanese and Canadian programme. Abstract: Educational climates have been found to have important influences on learning, but little feedback has been obtained from dental hygiene students. The purpose of this study was to gain an understanding of the learning climate in Japanese and Canadian dental hygiene programmes for the purpose of making positive changes. A survey instrument with 10 dimensions relating to learning climate was adapted from business and dental models, and designated as the Dental Hygiene Student Learning Climate Survey (DHS‐LCS). Higher scores indicated a more positive and supportive learning climate, and lower scores indicated an environment that is potentially less desirable. Students enrolled in a Japanese and a Canadian dental hygiene programme participated in this four‐year study from 2005 to 2008. A total of 402 surveys were returned for an average response rate of 62%. The mean total DHS‐LCS score of Canadian students was statistically significantly higher than that of Japanese students (P < 0.001) in all years tested, indicating that the Canadian students’ perceptions of their learning environment were more favourable than those of the Japanese students. Based on the analyses of the DHS‐LCS data, interventions to improve learning climates were designed and implemented. There were statistically significant improvements (P < 0.01) in DHS‐LCS scores of Japanese and Canadian students over the years of the study, suggesting that student‐centred interventions improved the perceived learning environment. The instrument appears to be helpful in identifying student concerns and can be used to implement interventions to help support a healthier learning climate.     

Development of an International Collaborative Dental Hygiene Programme between Japan and Canada

Abstract: This paper reports the development of an international dental hygiene educational programme between Japan and Canada, and the evaluation of its outcomes. In 2004, a unique collaborative programme with Canadian dental hygiene schools was introduced as part of a 3‐year dental hygiene curriculum. This international programme mainly consists of three parts: a spring (full Japanese faculty and student exchange to Canada), fall (select Japanese faculty and student exchange to Canada for focused professional development) and summer (select Canadian student exchange to Japan) component. The spring component provides an opportunity for all Japanese students to visit the Canadian dental hygiene schools at the end of their second year. Students and faculty members share information about their programmes and culture through instructional presentations, chair‐side hands‐on clinical simulations, and table clinic presentations. For the fall component, selected Japanese students and faculty re‐visit the Canadian school for more extensive learning and exchange with Canadian students. Workshops are held for faculty on educational and research topics. For the summer component, selected second year Canadian students visit Japan. The Japanese students’ basic knowledge of Canada and Canadian dental hygiene showed statistically significant improvement (P < 0.001) as assessed by pre‐ and post‐tests. Other programme evaluations including faculty and students’ surveys have so far identified positive outcomes in learning and research. The programme has offered opportunities for faculty professional development and joint research projects. In conclusion, the findings reported here demonstrate that incorporation of the international collaborative programme can be a significant addition to dental hygiene education.     

Halitosis and oral health-related quality of life: a case report

To cite this article:
Int J Dent Hygiene 10 , 2012; 3–8
DOI: 10.1111/j.1601‐5037.2011.00512.x
Buunk‐Werkhoven YAB, Dijkstra‐le Clercq M, Verheggen‐Udding EL, de Jong N, Spreen M. Halitosis and oral health‐related quality of life: a case report. Abstract: Objectives: This is a clinical case of a 36‐year‐old Dutch male, patient in the Dr. S. van Mesdag Forensic Psychiatric Centre in Groningen. It demonstrates a short‐time effect of a tailored oral hygiene self‐care intervention in three sessions over a period of 3 months on halitosis and a patient’s oral health‐related quality of life (OH‐QoL). Methods: In addition to a dental screening and professional oral hygiene care, a semi‐structured interview was conducted by the dental hygienist, and questionnaires were administered. The questionnaires included were; the Dutch version of the Oral Health Impact Profile‐14 (OHIP‐14‐NL; used as a measurement of OH‐QoL), scales for expected social outcomes for having healthy teeth, attitudes towards oral hygiene behaviour (OHB) and dental anxiety. Results: Clinical observations showed an improvement in patient’s OHB, while the extreme foetor‐ex‐ore was reduced to an acceptable level. A retrospective assessment showed that patient’s attitude towards the recommended OHB together with his self‐perceived OH‐QoL had positively increased. Conclusions: This case highlights the value of professional individual oral hygiene instructions performed by a dental hygienist. It also illustrates that a patient’s effective OHB may play an important role in the reduction in halitosis and self‐perceived OH‐QoL. Finally, the retrospective version of the OHIP‐14‐NL may be an adequate method to assess self‐perceived OH‐QoL within a relative short period of time.     

Perceptions of the dental profession: a comparative analysis through scale development

Dentistry is a science‐based profession that has a close interaction with people and society. However, despite this close interaction, perceptions of the dental profession by both patients and dental professionals have received little research attention. The purpose of this study was to compare the perceptions of dentists, dental students, and patients toward the dental profession through the development and testing of the Dental Profession Perceptions Scale (DPPS). The DPPS contains a total of 17 items measured on a 5‐point Likert response scale. The DPPS showed excellent internal reliability (Cronbach's α = 0.92) and test–retest reliability (r = 0.93). Explanatory and confirmatory factor analyses of the DPPS showed that dentists’, dental students’, and patients’ perceptions of the dental profession could be grouped according to ‘status’, ‘human’, and ‘scientific’ factors. There were no statistically significant differences between participants’ DPPS total or sub‐scale scores according to dental group, gender, or income. The DPPS developed can be used in future studies as a psychometrically sound measuring tool. Further studies should examine the factors that may affect the perceptions of the dental profession in different societies and cultures.     

Dental hygiene students’ part‐time jobs in dental practices in the Netherlands

To cite this article:
Int J Dent Hygiene
DOI: 10.1111/j.1601‐5037.2009.00415.x
Poorterman JHG, Dikkes BT, Brand HS. Dental hygiene students’ part‐time jobs in dental practices in the Netherlands. Abstract: Objective: Many students have paid employment while studying. In the Netherlands, the Individual Health Care Professions Act (IHCP Act) allows dental hygiene students to work under certain conditions in a dental practice. The aim of the study was to determine how many dental hygiene students have part‐time job employment in dental practice and which professional tasks they carry out. We also asked the dental hygiene students their opinion of the IHCP Act. Methods: All the enrolled dental hygiene students (n = 341) at a School of Health in the Netherlands received a questionnaire by email. Results: The response was 52% (176 students). Of the responding students, 75% had paid employment in addition to their study. A proportion of the students (35%) worked in a dental practice. The median number of hours worked per week was eight. Study year, age and prior education were positively related to working part‐time in dental practice. Activities frequently performed were giving oral hygiene instruction, fluoride applications, scaling and root planning, providing chair side assistance and giving local anaesthesia. Although the self‐reported knowledge about the IHCP Act was high, almost half of the students expressed the need for more detailed legal information. Conclusions: Many dental hygiene students work in a dental practice, taking over a number of tasks usually performed by the dentist. More information in the dental hygiene curriculum about the requirements of the IHCP Act seems desirable.     

Education about treating patients with HIV infections/AIDS: the student perspective

This study investigated dental and dental hygiene students' a) perceptions of their education about treating patients with HIV infections/AIDS, b) knowledge of universal precautions, c) attitudes towards treating these patients and patients perceived to be at risk for HIV infections, and d) evaluations of potential curricular activities such as discussion groups with HIV-infected patients. Data were collected with self-administered questionnaires from 315 dental and 89 dental hygiene students. On average, dental students reported having learned about this topic in fever courses than dental hygiene students. However, dental students answered significantly more knowledge questions about universal precautions correctly than did dental hygiene students. This knowledge increased over the program course. Male students had significantly stronger negative attitudes towards patients at risk for or with HIV infections/AIDS than female students. Overall, dental and dental hygiene students responded positively to the suggested methods for including more material about patients with HIV infections/AIDS such as case studies, discussion groups, and closely supervised clinical experiences. This study shows that dental and dental hygiene students are interested in learning more about treating patients with HIV infections/AIDS. It also adds information to previous research on factors involved in the dental healthcare providers' decisions to treat patients at risk for or with HIV infections/AIDS. The implications of these findings for curriculum development efforts are discussed.     

Students’ perceptions of the educational environment in a Greek Dental School,as measured by DREEM

Aim: The aim of this study was to estimate the dental students’ perceptions of their educational environment and to identify any differences related both to their gender and semester of studies. Materials and methods: The translated and validated in Greek Dundee Ready Education Environment Measure (DREEM) questionnaire was distributed to all 2nd‐ to 5th‐year students of the Athens Dental School. The questionnaire consisted of 50 statements organised in five subscales (perceptions of learning, teachers, atmosphere, academic self‐perceptions and social self‐perceptions). Internal validity was checked with Cronbach alpha. Confirmatory factor analysis (CFA) was performed under the same conditions as the original inventory. Mean statement, subscale and overall scores were calculated and given as percentages. Results: The response rate was 64%. Overall Cronbach alpha was 0.93 (excellent). CFA produced five meaningful subscales, not matching the original ones. The overall DREEM mean score was 56%. Gender did not influence the findings. The students’ perceptions of the educational environment with the exception of the academic self‐perceptions were more positive in the pre‐clinical years. Statistically significant differences were revealed only for the ‘learning’ subscale between the 3rd‐ and the 4th‐year students. Seventy‐eight percent of the statements were in the positive side. The lowest scores were related to students’ stress, tiredness and lack of appropriate feedback from the teachers, and the highest were related to accommodation, school friends and perceptions that they feel socially comfortable in class. Conclusions: Students’ perceptions of the educational environment were reasonably positive, with no gender difference. However, some weaknesses were identified, particularly in the clinical years. Further research is needed to clarify appropriate interventions.     

Edentulousness and oral rehabilitation: experiences from the patients' perspective

The psychological effects of tooth loss in the permanent dentition are relatively unknown. Complete edentulousness is a serious life event in terms of readjustment. The aim of the study was to describe the process patients with deteriorating dental status had gone through before treatment with a fixed prosthesis (Brånemark System, Novum), and to describe what living with a fixed prosthesis means to the patients themselves. In‐depth interviews were carried out with 18 patients, and the interviews were transcribed verbatim and analysed in open, axial and selective coding processes according to Grounded Theory. In the analysis, four categories were developed and labelled: ‘alterations in self‐image’, ‘becoming a deviating person’, ‘becoming an uncertain person’ and ‘becoming the person I once was’. ‘Alterations in self‐image’ was identified as the core category and was related to the other three categories. The core category describes the changes in self‐image starting with the subjects' increasingly worsened dental status, followed by a period of them having to live and cope with a denture and, finally, their living with a fixed prosthesis. The motive power for the decision to undergo treatment with a fixed prosthesis seems to be a desire to restore dental status and also to recapture attractiveness, self‐esteem and a positive self‐image.     

Oral health‐related quality of life and its relationship with health locus of control among Indian dental university students

Objectives: The objectives of this study were to assess the relationship between Oral Health‐Related Quality of Life (OHRQoL) and Health Locus of Control (HLC) among students in an Indian dental school. Materials and methods: A cross sectional study design was used. Three hundred and twenty‐five dental students returned completed forms containing the 14 item Oral Health Impact Profile (OHIP‐14) and the 18 item Multidimensional Health Locus of Control Scale (MHLC). Results: The results showed that the perceived OHRQoL differed among students studying in different stages of the dental course. The OHRQoL dimensions of ‘Social Handicap’ and ‘Handicap’ were significantly (P < 0.01) lower among the later years of the course than the freshman year students. There was a sharp increase in Self‐reported dental problems, in particular, Malocclusion, Tooth decay, Calculus among the third year and final year students respectively. The OHIP‐14 scores were significantly higher among those with self‐reported oral problems. Correlation analysis between the OHIP‐14 and the MHLC scores also showed a statistically significant (P < 0.01) correlation between the ‘Chance’ dimension of the MHLC and OHIP‐14 scores. Conclusions: The results of this study underscored the relationship between the OHRQoL and HLC and of importance of assessing health attitudes and their impact on OHRQoL among the dental student community.     

Dental students’ part‐time jobs in dental practices in the Netherlands

Objective: In the Netherlands, the Individual Health Care Professions Act (IHCP Act) allows dental students, amongst other non‐qualified individuals, to work under certain conditions in a dental practice. The aim of the study was to determine how many dental students have part‐time employment in dental practice and which professional tasks they carry out. We also asked the dental students their opinion about the IHCP Act. Material and methods: All the enrolled dental students at the Academic Centre for Dentistry Amsterdam (ACTA) in the Netherlands received a questionnaire by e‐mail. Within 1 month, two reminders were sent. Results: The response was 44% (427 students). Of the responding students, 71% had paid employment in addition to their study. Twenty‐five per cent of all students worked in a dental practice, usually 8 h a week. Study year and age were positively related to working part‐time in dental practice. Activities frequently performed were providing chair side assistance, giving oral hygiene instruction, fluoride applications, scaling and root planning. The self‐reported knowledge about the IHCP Act was positively related to study year and working in a dental practice. Hardly any information about the requirements of the IHCP Act with regard to delegation of tasks was provided by the employer. Conclusion: Many Dutch dental students work in a dental practice, taking over a variety of tasks. Although the self‐reported knowledge about the IHCP Act was relatively high, many dental students expressed the need for more detailed information about the legal aspects of their tasks.     

Dental hygiene in Australia: a global perspective

Aim: This article reports on the practice of dental hygiene in Australia from a global perspective. The aim is to examine how access to qualified dental hygiene care could be improved and how current professional challenges might be met. Method: Secondary source data were obtained from a survey questionnaire presented to members of the House of Delegates of the IFDH or by fax and e‐mail to experts involved in the national professional and educational organization of dental hygiene in non‐IFDH member countries. Responses were followed‐up by interviews, e‐mail correspondence, visits to international universities, and a review of supporting studies and reference literature. Results: The introduction of dental hygiene in Australia was inspired by the delivery of preventive care in Great Britain. Today dental hygiene is a paramedical profession, generally studied at institutions of higher education. Study duration is 2 (diploma and associate degree programmes) and 3 years (Bachelor of Oral Health Programs). A recent trend to combine dental therapy and dental hygiene education poses the challenge to maintain a stand‐alone degree in dental hygiene as it is practiced worldwide. Low access to qualified dental hygiene care may be a result of insufficient funding for preventive services, social and cultural lack of awareness of the benefits of preventive care, and of limitations inherent in the legal constraints preventing unsupervised dental hygiene practice. These may be a result of gender politics affecting a female dominated profession and of a perception that dental hygiene is auxiliary to dental care. Changes are expected to reflect the global trend towards a decrease in supervision and towards higher education. An example of innovative practice of public health is the involvement of dental hygienists in the educational process of aboriginal health workers in order to promote access to oral health education for indigenous populations.     

Improving teamwork between students from two professional programmes in dental education

In Sweden, the National Board of Health and Welfare forecasts a decrease in dentists with 26% and an increase in dental hygienists with 47% until the year of 2023. This, together with changes in both epidemiology, especially of dental caries, and political priorities, calls for an effective and well‐developed cooperation between dentists and dental hygienists in future dentistry. Hence, the aim of this project was to investigate whether highlighting teamwork during the undergraduate studies of dental students and dental hygiene students could improve the students’ holistic view on patients as well as their knowledge of and insight into each other’s future professions. Thirty‐four dental students and 24 dental hygiene students participated in the study. At the beginning of their final year in undergraduate education, a questionnaire testing the level of knowledge of the dental hygienists’ clinical competences was completed by both groups of students. In addition, activities intending to improve teamwork quality included the following: (i) a seminar with a dentist representing the Public Dental Health Services in Sweden, (ii) dental students as supervisors for dental hygiene students, (iii) planning and treatment for shared patients and (iv) students’ presentations of the treatments and their outcomes at a final seminar. The project was ended by the students answering the above‐mentioned questionnaire for the second time, followed by an evaluation of the different activities included in the study. The knowledge of dental hygienists’ competences showed higher scores in almost all questions. Both groups of students considered the following aspects important: seminars with external participants, dental students acting as supervisors and planning and treating shared patients. By initiating and encouraging teamwork between dental students and dental hygiene students, it is possible to increase knowledge on dental hygienists’ competence and also to develop and strengthen a holistic view on patients and dental work, thereby preparing both groups of students for their professional life.     

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.     

Factors that effect dental caries status of medical students in Udaipur city,India

To cite this article:
Int J Dent Hygiene
DOI: 10.1111/j.1601‐5037.2009.00399.x
Kumar S, Gupta A, Dixit A, Solanki K, Balasubramanyam G, Duraiswamy P, Kulkarni S. Factors that effect dental caries status of medical students in Udaipur city, India. Abstract: Objective: To evaluate the effect of oral hygiene behaviour, dental anxiety, self assessed dental status and treatment necessity on dental caries status of medical students. Methods: The study was conducted among 345 medical students of Udaipur city, India who had provision for free dental services and the study was based on a questionnaire which consisted of two parts, first part containing questions regarding self assessment of dental status and treatment necessity along with oral hygiene behaviour and the later part comprised of Corah Dental Anxiety scale (DAS). Clinical examination was based on the WHO caries diagnostic criteria. Results: Females perceived greater dental anxiety than males. Individuals claiming poor dental status had higher mean decayed, missing and filled teeth (DMFT) score (6.67) than good (2.89) and fair (4.44). The mean decayed component among the anxious students (5.4) was almost twice that of less anxious (2.77) student population. DAS constituted the first major contributor for missing component followed by smoking status which alone explained a variance of 7.1%. The cumulative variance explained by all the independent variables on the DMFT status accounted to 56.4% with self assessed dental status alone contributing a variance of 44.9%. The most significant (P < 0.001) contributor for filled component was self assessed dental status (14.5%). Conclusions: Oral hygiene behaviour, dental anxiety, self assessed dental status and treatment necessity significantly affected the dental caries status of medical students.     

P42 Subjective symptoms and knowledge of oral malodor on dental students in Thailand

The purpose of this study was to investigate subjective symptoms about oral malodor and the knowledge and attitude for bad breath on dental students. The subjects were 213 students from 1st to 6th year undergraduate course of one dental school in Thailand (male: 70, female: 143). Their mean (s.d.) age was 21.0 (1.9). Questionnaire survey was conducted in November 2003. Questionnaire items were subjective symptoms about oral malodor and dry mouth, the knowledge and attitude for bad breath, oral hygiene practice, smoking/drinking habits, and life stress. Five students (2.3%) answered that they concerned their oral malodor often and 87.8% reported sometimes. Of them, 72.9% wanted to receive treatment for their malodor and 70.8% said they suffer from bad breath in daily life. Two‐thirds of students perceived strong oral malodor when waking up. There were no significant differences of the self‐perceived malodor rates between gender or among year of study. More than half of the students did not know that oral diseases and poor oral hygiene are the major causes of bad breath. The students’ attitudes for bad breath were different if the target was family members or friends. The majority of the students (88.7%) answered they perceived dry mouth. Perception of dry mouth was significantly related with self‐reported oral malodor prevalence (P < 0.05). However other oral or behavioral factors did not relate to the self‐reported malodor rates. In this study, dental students perceived bad breath in high prevalence. However the knowledge for bad breath was not enough even the students who already provided dental treatment to the patients. It would be necessary to give them adequate knowledge and methods in education program for managing not only patients’ but also their own oral malodor problem.     

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

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

Prevalence and correlates of musculoskeletal disorders among Australian dental hygiene students

Abstract: Introduction: Although musculoskeletal disorders (MSD) have been identified as a significant occupational health issue for dental hygienists, few studies have explored this problem among the dental hygiene student population. Aim: The aim of this study was to investigate the prevalence and correlates of MSD among a selection of undergraduate dental hygiene students in Australia. Methodology: A self‐reporting questionnaire was distributed to dental hygiene students at an Australian university during 2008, from which a response rate of approximately 72% was achieved. Results: Musculoskeletal disorders were most commonly reported by students at the neck (64.29%), lower back (57.94%) and shoulder (48.41%) regions. Logistic regression indicated various correlations with MSD. Students who did not undertake regular exercise every week experienced an increased risk of lower back pain [Odds Ratio (OR): 4.88, 95% Confidence Interval (CI): 1.75–14.9]. Students undertaking 16–20 h of desk‐based study per week were much more likely to report neck pain (OR: 19.7, 95% CI: 1.34–378.94). Working 6–10 h on a computer each week was a risk factor for shoulder (OR: 7.03, 95% CI: 1.42–39.49) and upper back pain (OR: 5.29, 95% CI: 1.21–25.56). Conclusions: Overall, this study suggests that MSD are a reasonably common problem for dental hygiene students in Australia. As such, further studies are required to establish epidemiological patterns of MSD, and our profession will need to carefully consider preventive strategies to help minimize the impact of this important occupational health issue on the next generation of dental hygienists.