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

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

The teaching of fixed partial dentures in undergraduate dental schools in Ireland and the United Kingdom

Summary All areas of the practice of dentistry are evolving at a considerable pace. One area in particular which has seen a rapid revolution is the oral rehabilitation of partially dentate adults. The aim of this study was to describe the contemporary teaching of fixed partial dentures (FPDs) in dental schools in Ireland and the United Kingdom. An online questionnaire which sought information in relation to the current teaching of FPDs was developed and distributed to 15 Irish and UK dental schools with undergraduate teaching programmes in Spring 2009. Responses were received from 12 schools (response rate = 80%). All schools offer teaching programmes in relation to FPDs. The number of hours devoted to pre‐clinical/phantom head teaching of FPDs ranged from 3 to 42 h (mean: 16 h). The staff/student ratio for pre‐clinical teaching courses in FPDs ranged from 1:6 to 1:18 (mode: 1:12). Cantilever resin‐retained FPDs were the most popular type of FPD provided clinically (average = 0·83 per school; range = 1–2). Five schools (42%) report that they have requirements (e.g. targets, quotas, competencies) which students must complete prior to graduation in relation to FPDs. Fixed partial dentures form an important part of the undergraduate teaching programme in UK and Irish dental schools. While this teaching is subjected to contemporary pressures such as lack of curriculum time and a lack of available clinical facilities and teachers, there is evidence that teaching programmes in this area are evolving and are sensitive to current clinical practice trends and evidence‐based practice.     

Application of behavioural sciences teaching by UK dental undergraduates

From 1990, Behavioural Sciences have become a requisite subject of dental undergraduate curricula across the UK (2). However, subject matter taught varies from school to school (4). The aim of this study was to determine the views and experiences of senior dental undergraduates in applying their behavioural sciences teaching across a range of clinical situations. A questionnaire survey was designed in which 5 UK Dental Schools were included to provide a countrywide geographic distribution and where >75% of senior students in each Dental School participated. The questions required the students to evaluate their psychosocial skills in 4 main areas: dentist/patient interactions; enhancing preventive behaviour; anxiety management; coping with personal stress. 252 students participated, 43% were male. In general, students valued their behavioural sciences teaching and 84% rated its inclusion in the curriculum as important. Some patient management situations had been infrequently encountered in their clinical experience and their confidence in dealing with these situations was low. The data was entered into a stepwise logistic regression to determine which factors explained the variation in reported confidence. In relation to dentist-patient interactions and preventive aspects (9 aspects), significant variables were how well students felt they were taught and how often they encountered the situations. Gender contributed to explaining variation in 4 of these aspects. In dealing with patient aggression, men were over 7x more confident than women (Odd's ratio 7.32), but in changing patients' attitudes to oral health, women were more than 2x as confident as men (Odd's ratio 2.08). In anxiety management and dealing with personal stress, additional variables entered the model and these were age, gender and Dental School. For most aspects of confidence in anxiety management, the quality of teaching to manage these situations was the key variable. In conclusion, this survey has provided an evaluation of UK students' perceived psychosocial skills in a range of clinical settings. This should encourage educators to improve curricular content to support the development of clinical competency in this area.     

Comparison of undergraduate endodontic teaching programmes in the United Kingdom and in some dental schools in Europe and the United States

The pattern of teaching root canal therapy within dental schools of the UK was determined and compared with that carried out within several dental schools in Europe and the USA. Although it appeared that 'teachers of endodontics' in the UK were advocating techniques adopted elsewhere, it was clear that, within the dental undergraduate curriculum as a whole, the teaching of root canal therapy was given a lower priority than that in some schools in Europe and the USA. Recommendations to remedy this unsatisfactory position are provided.     

The undergraduate dental radiology curriculum.

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

A survey of the teaching of partial denture construction in dental schools in the United Kingdom.

Previously reported work has suggested that there is a disparity between what is taught to undergraduates regarding the design and construction of metal-based partial dentures and what is done by the practising dentist. A survey of the eighteen dental schools in the United Kingdom (seventeen undergraduate and one postgraduate) was carried out by means of a one postgraduate) was out by means of a postal questionnaire. The purpose of this was to elucidate what is taught concerning the design and construction of partial dentures. A one hundred per cent response was achieved.The results provide evidence that much common ground exists in the teaching of different schools, and comparison with previously reported work supports the hypothesis that there is a divergence between teaching and practice.     

Oral surgery undergraduate teaching and experience in the United Kingdom: a national survey

The aim of this work was to determine the structure, mode of delivery, mode of assessment and staffing of the oral surgery undergraduate curriculum within UK dental schools. A questionnaire was distributed by e-mail in January 2006 to each of the 15 dental schools with undergraduate dental degree programmes in Ireland and the UK. Those providing feedback then met to clarify any areas as required. Thirteen completed questionnaires were returned. There were a total of 55 academics involved in the teaching of oral surgery at these 13 institutions. Over the three clinical years the mean number of clinical sessions was 51. The mean staff student ratio for supervision of forceps exodontia was 1:5. On average 51 teeth were extracted by each student in the clinical years. The mean staff student ratio for surgical extractions was 1:2. The mean number of surgical extractions for each student was 6. All schools formatively assessed competency in forceps exodontia and 9 of 13 assessed surgical extractions. Summative assessment of exodontia was done in six schools and surgical extractions in 4 of 13 schools. All 13 schools deliver teaching programmes designed to meet the requirements of the frameworks governing the central curriculum. There were, however, variations between individual schools in the content and delivery of the oral surgery clinical teaching programmes. There were dramatic variations in the numbers of academic staff involved and some institutions relied on their NHS colleagues to deliver the clinical teaching.     

A review of teaching ethics in the dental curriculum: challenges and future developments

This study considers the role and status of the teaching of ethics on the dental undergraduate curriculum. The study reviews current developments in the delivery of dental ethics education and in particular focuses on the development of new pedagogies and curricula content. The study then critically considers the consequences of a squeezed curricula and the consequent reliance on professional regulation as shorthand for the ethical development of students. The study concludes that, although great strides have been made in improving the teaching of ethics in dental education, further dialogue is needed to better include patient views and develop a more theoretically robust approach to self‐reflection.     

Teaching of posterior composite resin restorations in undergraduate dental schools in Ireland and the United Kingdom

PURPOSE: The aim of this study was to investigate the current teaching of posterior composite resin restorations to undergraduate dental students in Ireland and the United Kingdom (UK). The investigation was a follow-up to a survey undertaken in 1997. MATERIALS AND METHODS: A questionnaire was distributed by e-mail to the Heads of Departments of Restorative Dentistry/Units of Operative Dentistry in each of the 15 dental schools with undergraduate dental degree programmes in Ireland and the UK. The questionnaire sought information relating to the teaching of posterior composite resin restorations in each dental school. RESULTS: Fifteen completed questionnaires were returned (response rate = 100%). All schools (n = 15) taught the placement of composite resin restorations in occlusal cavities, 14 schools taught composite resin placement in two-surface occlusoproximal cavities and nine schools taught composite resin placement in three-surface occlusoproximal cavities. Respondents anticipated that the amount of preclinical teaching of posterior composite resin placement will increase twofold over the next 5 years, whilst the corresponding teaching of amalgam will fall to two-thirds its current level. Variation was found between dental schools in the teaching of the principles of cavity design, contraindications to placement, indications for lining and basing techniques, matrix and wedging techniques, and the use of curing lights. CONCLUSIONS: The amount of teaching of posterior composite resin restorations in undergraduate dental schools in Ireland and the UK has increased since the time of a previous survey in 1997. Composite resin may soon equal or overtake amalgam as the material of choice when restoring posterior cavities in Irish and UK dental schools. There was, however, much variation in the nature and extent of the teaching and the techniques taught.     

Teaching of direct composite restoration repair in undergraduate dental schools in the United Kingdom and Ireland

Aim: To investigate aspects of the teaching of restoration repair as a minimally invasive alternative to the replacement of defective direct composite restorations in teaching programmes in undergraduate curricula in dental schools in the United Kingdom and Ireland. Methods: An online questionnaire which sought information in relation to the current teaching of composite restoration repair was developed and distributed to the 17 established UK and Irish dental schools with undergraduate teaching programmes in Spring 2010. Results: Completed responses were received from all 17 schools (response rate= 100%). Fifteen schools reported that they included teaching of repair techniques for defective direct composite restorations in their programme. Of the two remaining schools, one indicated that it would introduce teaching of repair techniques during the next five years. The most common indication for a composite repair was that of ‘tooth substance preservation’ (15 schools). The defects in restorations considered appropriate for repair rather than replacement by the largest number of schools included partial loss of restoration (13 schools) and marginal defects (12 schools). The most commonly taught surface treatment when performing a repair was mechanical roughening of the existing composite with removal of the surface layer (14 schools). Thirteen schools taught etching and the application of an adhesive bonding agent to the prepared surfaces, while the most commonly taught material for completing the repair was a hybrid composite resin (12 schools). Popular finishing implements included diamond finishing instruments (13 schools) and finishing discs (11 schools). Conclusion: Not withstanding reluctance amongst general dental practitioners, the teaching of repair of a defective composite restoration, rather than total restoration replacement, is firmly established within UK and Irish dental school programmes. Repair techniques have clear advantages for patients, not least including a minimally invasive approach to treatment and avoidance of unnecessary loss of tooth tissue and pulpal damage. Dental practitioners should look more to repair techniques when managing defective composite restorations and clinical dental teachers should continue to research and refine composite repair techniques.     

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.