Showing papers in "European Journal of Dental Education in 2020"

COVID-19: The immediate response of european academic dental institutions and future implications for dental education.

Abstract: The COVID-19 pandemic has had an immediate and dramatic impact on dental education. The Association of Dental Education in Europe decided to carry out an investigation to assess the immediate response of European Academic Dental Institutions. An online survey was sent to both member and non-member dental schools to investigate the impact on non-clinical and clinical education, assessment and the well-being/pastoral care measures implemented. The preliminary findings and discussion are presented in this paper, for the responses collected between the 25 March and 5 April 2020. The survey at this time of publication is ongoing, and detailed results can be accessed https://adee.org/covid-19-european-dental-education%E2%80%99s-immediate-response.

COVID-19 is a challenge for dental education-A commentary.

Abstract: The COVID-19, which appeared to originate in China in December 2019, has spread worldwide pandemically. In this commentary, authors described this new challenge for dental education using the recent literature and experience gained in the Italian University of Catanzaro.

The impact of COVID-19 on dental education in North America-Where do we go next?

Abstract: During the COVID-19 pandemic, the dental education community faced unprecedented challenges. In this commentary, we share the perspectives of faculty clinicians, residents and students in academic dental institutions in the United States and Canada. We discuss COVID-19's impact on various aspects of academic dentistry including patient care, education, research and raise key concerns regarding the future of dental education post-pandemic.

Impact of COVID-19 epidemic on live online dental continuing education.

Abstract: INTRODUCTION: This study aimed to assess live online dental continuing education during COVID-19 epidemic in China. METHODS: Twenty-one institutions providing live online dental courses in China during COVID-19 epidemic enrolled in this study. Their online and/or offline course provision before and during the epidemic was retrospectively inquired. If live online education was provided, the number of courses, duration and number of participants per week were further investigated. Time distributions of live online dental courses were recorded and classified as within working time and out of working time. The test period of COVID-19 epidemic was for two weeks between 16 February and 29 February 2020. The control period of pre-COVID-19 epidemic was for ten weeks between 01 November 2019 and 09 January 2020. RESULTS: The percentages of offline and online courses provided by 21 dental continuing education institutions before COVID-19 epidemic were 95.2% (20 out of 21) and 28.6% (6 out of 21), respectively. All the institutions suspended offline courses whilst providing two live online courses, on average, per week with 188 minutes duration and 7290 participants during the epidemic. The total number of online courses for 10 weeks before the epidemic was 33, and that for two weeks during the epidemic was 119. The proportion of courses provided within working time raised from 6.1% (2 out of 33) of pre-COVID-19 to 46.2% (55 out of 119) during COVID-19. There were significant differences between before and during the epidemic (P < .001). CONCLUSION: The dental continuing education transferred from offline to online dramatically, and live online dental continuing education increased significantly during COVID-19 epidemic in China.

Evaluation of HoloHuman augmented reality application as a novel educational tool in dentistry

Abstract: Aims: To investigate dental student’s perception of the augmented reality (AR) head and neck anatomy application and to determine whether the learning environment was beneficial for students compared with traditional cadaver learning. Methods: A total of 88 students participated in a self‐administered questionnaire prior to and after the use of AR. This was conducted during anatomy classes for second year dentistry students. Descriptive data analysis was performed to determine the perceptions of experience gained through AR. Results: The study revealed that over two‐thirds of participants perceived that it would assist in their learning with 52.3% of participants who agreed and 35.2% of participants who strongly agreed. After the use of HoloHuman, it was found that 43.5% of participants agreed that the 3D anatomical structures improved their understanding of anatomy and 36.5% agreed that they felt more confident about their anatomy skills. The results also demonstrated that only 34.1% agreed that it added value in training compared to relying solely on traditional methods. Overall, 75.3% of participants agreed that HoloHuman teaching should not replace traditional cadaver training. Conclusion: This study suggested that the use of AR offers an additional mean of dental anatomy training; however, it cannot be used as a replacement for traditional modes of cadaver anatomy training. AR has the potential to be used as an adjunct tool in the learning of dental head and neck anatomy as it has demonstrated increased student engagement and enjoyment however limitations with the device still remain.

Simulation training for ceramic crown preparation in the dental setting using a virtual educational system

Abstract: OBJECTIVES The aim was to evaluate the effectiveness of a pre-clinical training of ceramic crown preparation using the Virtual Educational System for Dentistry. MATERIAL AND METHODS Fifty-seven dental students were recruited to prepare a ceramic crown under the guidance of the Real-time Dental Training and Evaluation System (RDTES) in order to collect pre-learning data. They participated in the online virtual learning course independently on the Virtual Learning Network Platform (VLNP). One week later, the students were invited to complete their post-learning crown preparation with the RDTES. A questionnaire survey explored students' perceived benefits or drawbacks of the virtual educational system. Students were allocated into Group A (n = 15), B (n = 24) and C (n = 18) based on their pre-learning performance. Differences of assessment results amongst different groups were evaluated by ANOVA and Kruskal-Wallis tests. The pre- and post-learning assessment results in all groups were compared using paired t tests or Wilcoxon signed rank tests. RESULTS The error scores for four assessment items (instrument selection, preparation section, preparation reduction, preparation surface and profile) and total score of outcome assessment after the virtual learning were significantly different with those before the virtual learning (P < 0.05). There were significant interactions between time and student group in the mean scores of process and outcome assessments (P < 0.001), except for the assessment item "damage of adjacent teeth." CONCLUSION The application of a Virtual Educational System for Dentistry with the VLNP and RDTES in pre-clinical operative training helps students improve their clinical skills.

Effect of augmented reality simulation on administration of local anaesthesia in paediatric patients.

Abstract: BACKGROUND Augmented reality (AR) is a simulation of a three-dimensional environment created using hardware and software that provides the user with realistic experiences and ability to interact. The aim of the study was to evaluate the impact of AR simulator on the perception of learning and acute stress level in students administering local anaesthesia to paediatric patients relative to standard teaching methods. MATERIAL AND METHODS The prospective study included 21 fourth- and fifth-year students enrolled in 5-year dental programme. In addition to conventional training, the students of the study group used the augmented reality simulator in a dental office 2 hours weekly in 2 weeks. The level of salivary cortisol was measured before and after the anaesthetic procedure as one of the indicators of acute stress. RESULTS A statistically significant shorter time to perform infiltrative anaesthesia technique for the anterior superior alveolar nerve was observed in students using the AR technique (28.91 ± 9.06 seconds in the study group and 39.80 ± 9.29 seconds in the control group). The level of cortisol before and after anaesthesia was statistically significant in all subjects (cortisol concentration was 0.53 μg/dL before anaesthesia and 2.44 μg/dL after the procedure); however, there was no statistically significant difference between the groups. CONCLUSION The AR concept may influence better manipulation and control of the syringe in students administering their first anaesthetic injection to paediatric patients, but may not reduce acute stress.

3D printed patient individualised models versus cadaveric models in an undergraduate oral and maxillofacial surgery curriculum: Comparison of students' perceptions.

Abstract: Background Recent advances in 3D printing technology have enabled the emergence of new educational and clinical tools for medical professionals. This study provides an exemplary description of the fabrication of 3D-printed individualised patient models and assesses their educational value compared to cadaveric models in oral and maxillofacial surgery. Methods A single-stage, controlled cohort study was conducted within the context of a curricular course. A patient's CT scan was segmented into a stereolithographic model and then printed using a fused filament 3D printer. These individualised patient models were implemented and compared against cadaveric models in a curricular oral surgery hands-on course. Students evaluated both models using a validated questionnaire. Additionally, a cost analysis for both models was carried out. P-values were calculated using the Mann-Whitney U test. Results Thirty-eight fourth-year dental students participated in the study. Overall, significant differences between the two models were found in the student assessment. Whilst the cadaveric models achieved better results in the haptic feedback of the soft tissue, the 3D-printed individualised patient models were regarded significantly more realistic with regard to the anatomical correctness, the degree of freedom of movement and the operative simulation. At 3.46 € (compared to 6.51 €), the 3D-printed patient individualised models were exceptionally cost-efficient. Conclusions 3D-printed patient individualised models presented a realistic alternative to cadaveric models in the undergraduate training of operational skills in oral and maxillofacial surgery. Whilst the 3D-printed individualised patient models received positive feedback from students, some aspects of the model leave room for improvement.

3D printed patient individualized models versus cadaveric models in an undergraduate Oral and Maxillofacial Surgery curriculum

Abstract: BACKGROUND Recent advances in 3D printing technology have enabled the emergence of new educational and clinical tools for medical professionals. This study provides an exemplary description of the fabrication of 3D printed individualized patient models and assesses their educational value compared to cadaveric models in Oral and Maxillofacial Surgery. METHODS A single-stage, controlled cohort study was conducted within the context of a curricular course. A patient's CT scan was segmented into a stereolithographic model and then printed using a fused filament 3D printer. These individualized patient models were implemented and compared against cadaveric models in a curricular Oral Surgery hands-on course. Students evaluated both models using a validated questionnaire. Additionally, a cost-analysis for both models was carried out. P-values were calculated using the Mann-Whitney U-Test. RESULTS Thirty-eight 4th year dental students participated in the study. Overall, significant differences between the two models were found in the student assessment. While the cadaveric models achieved better results in the haptic feedback of the soft tissue, the 3D printed individualized patient models were regarded significantly more realistic with regard to the anatomical correctness, the degree of freedom of movement and the operative simulation. At 3.46 € (compared to 6.51 €), the 3D printed patient individualized models were exceptionally cost efficient. CONCLUSIONS 3D printed patient individualized models presented a realistic alternative to cadaveric models in the undergraduate training of operational skills in Oral and Maxillofacial Surgery. Whilst the 3D printed individualized patient models received positive feedback from students, some aspects of the model leave room for improvement.

Attitudes of dental students towards patients with special healthcare needs: Can they be improved?

Abstract: INTRODUCTION Lack of knowledge and skills as well as negative attitudes towards patients with special healthcare needs may adversely affect the services available to this group. In 2010, a line on the treatment of patients with special healthcare needs has been implemented in the dental curriculum at the Medical University of Vienna, including five seminars and a practical course. In this study, we examine to what extent the programme helps improve attitudes towards persons with special healthcare needs and positively impacts the readiness to engage in treating this clientele. MATERIALS AND METHODS In 2017 and 2018, all students who were in their fourth study year participated in the study. Students' attitudes were assessed before the first seminar, after the last seminar and after the practical course. At all three time points, the same fully structured questionnaire was used, including established instruments for the assessment of emotional reactions and the desire for social distance plus ad hoc questions for assessing students' future intention to treat patients with special healthcare needs. The data were analysed by means of linear fixed models. RESULTS At the end of the line devoted to patients with special healthcare needs, students tended less to express negative emotions and showed more positive emotional reactions than before the start of the programme. However, students' social acceptance of such patients and their readiness to engage in treating them did not change significantly. DISCUSSION While our programme was able to improve students' emotional reactions to people with special healthcare needs, it proved unable to reduce the desire for social distance and to lower the barrier when it comes to treatment. It is planned to further develop our programme which, hopefully, will then succeed in increasing students' readiness to treat this clientele. CONCLUSION Improving dental students' emotional reactions to patients with special healthcare needs does not necessarily translate into greater readiness to treat this clientele.

Educational gaming for dental students: Design and assessment of a pilot endodontic‐themed escape game

Abstract: INTRODUCTION The concept of escape games dedicated to dental students is a new learning experience that has not yet been extensively explored. The aim of this pilot study was to assess the impact and perceived value of an endodontic-themed escape game as assessed by fourth-year dental students. METHODS This study was conducted at the University of Nantes, Faculty of Dental Surgery using a cross-sectional pre- and post-test research design to assess students' changes in performance. Students in the fourth year of dental surgery study (n = 18) were divided in four groups for this study. The answers to the pre-test/post-test were 50 true/false questions. Moreover, a 20-question perception survey was given to all the participants after completion of the escape game. The study data were collected in May 2019. An unpaired t test analysed the mean differences between the groups. RESULTS The results showed a statistically significant increase in post-test results (75.33% ± 10.17% of correct answers) compared to the pre-test results (67.33% ± 5.94% of correct answers) P < .05. Analysis of variance revealed that this change in score was not significantly different between the four groups. The students perceived the endodontic-themed escape game to be relevant. A one-sample t test indicated that students' mean (SD) perception 4.4 (0.7) was statistically significantly higher than the mean value of the evaluation scale P < .001. The students found this educational game to be a useful experience that helped them recall/apply knowledge whilst promoting teamwork. CONCLUSION Therefore, this type of game can enhance students' learning and motivation.

Perceptions of interprofessional collaboration in education of dentists and dental hygienists and the impact on dental practice in the Netherlands: A qualitative study

Abstract: Introduction The purpose of this study was to evaluate the perceptions of dentists and dental hygienists regarding their own and each other's roles in interprofessional collaboration following a clinical interprofessional educational programme (CIEP) as part of their graduate programme at Radboud university medical center (Radboudumc) and HAN University of Applied Sciences (HAN UAS), Nijmegen, the Netherlands, respectively. Perceptions were obtained at the end of their study (2014) and two years after their graduation (2016). Methods A qualitative study was conducted using a questionnaire with open-ended questions. Sixty-two dentists and thirty-eight dental hygienists were invited. Theory-based analyses were applied in combination with principles of Grounded Theory to analyse and synthesise the collected data from the open-ended questions. Results At baseline, 100% responded. At follow-up, thirty-two dentists (51.6%) and twenty-six dental hygienists (68.4%) responded; twenty-seven dentists (43.5%) and eighteen dental hygienists (47.4%) were included. Many similarities were found between baseline and follow-up regarding perceptions of each other's expertise and responsibility, learning from and with each other, and the behaviour of students and the "novice" professionals in interprofessional collaboration. Both dentists and dental hygienists experienced the CIEP as useful for interprofessional collaboration. The "novice" dentists and dental hygienists indicated that in dental practices interprofessional collaboration was less common. Conclusion The CIEP resulted in more understanding amongst dentists and dental hygienists with regard to interprofessional roles, but in practice the "novice" dentists and dental hygienists face difficulties in applying the interprofessional roles.

Psychometric analysis of a measure of acceptance of new technologies (UTAUT), applied to the use of haptic virtual simulators in dental students

Abstract: Background The aims of this study are (a) to assess the psychometric quality of an instrument of acceptance of new technologies adapted from the UTAUT model, (b) to validate the UTAUT model as a valid measure to be applied in dental education, and (c) to determine which factors of the UTAUT model predict the behavioural intention of using a haptic virtual simulator (HVS). Methods A cross-sectional design study with a sample of 265 dentistry students was carried out. Results Using structural equation modelling, confirmatory factor analysis verified the adequacy of four-factor model, although the only factor that directly predicts behavioural intention is performance expectancy. Internal consistency coefficients of each factor ranged from 0.800 to 0.969. Discussion These findings, as well as the predictive power of performance expectancy on behaviour intention, are in line with previous evidence found in the literature. Conclusion These findings suggest that the UTAUT scale has adequate reliability and construct factorial validity; therefore, UTAUT model could be a valuable approach to assess haptic virtual simulator acceptance in dental education.

Final year dental students' self-assessed confidence in general dentistry.

Abstract: BACKGROUND: Self-assessment is an important introspective skill that dental professionals will utilise throughout their professional career. Its value lies in its ability to help individuals identify areas of strengths and weakness, and subsequently seek further development of professional skills where needed. The aim of this study was to investigate the correlation between self-assessed confidence and the assessment grade of final year dental students based on the professional attributes and competencies of newly qualified dentists outlined by the Australian Dental Council (ADC). METHODS: Ethical approval was obtained prior to distribution of a questionnaire with 45 statements to final year dental students. The survey was created based on the learning outcomes of the ADC guidelines in the domains of "scientific and clinical knowledge" and "patient care." Participants indicated their level of self-assessed confidence by marking "X" on a visual analogue scale (VAS) from zero ("No Confidence") to 10 cm ("Very Confident"). The assessment grade was based on OSCE, viva voce, case report and written paper. RESULTS: A total of 58 (71.6%) dental students participated in the survey. The reported self-assessed confidence over two domains were under "patient care": clinical information gathering 8.92 ± 1.07 cm (range =3.94-10.0 cm: n = 58; 100%), clinical diagnosis and management planning 8.26 ± 1.34 cm (range =0.50-9.95 cm: n = 55; 94.8%), clinical treatment and evaluation, 6.07 ± 1.69 cm (range =0-10.00 cm: n = 55; 94.8%), and "scientific and clinical knowledge": 6.98 ± 1.58 cm (range =0-10.00 cm: n = 58; 100.0%). Within these categories, high confidence was reported for routine dental care (caries management and preventive care) whilst lower confidence was reported for the management of oral medicine and pathologies, dental emergencies, trauma, paediatric dentistry and prosthodontics. Correlation between the assessment grade and the overall score of self-assessed confidence is low positive (r = .225) and not statistically significant (n = 46; P = .132, Spearman'sρ). CONCLUSIONS: The final year dental students appear to have good overall self-assessed confidence in core areas of general dentistry. However, confidence seems to be over-estimated when compared with summative assessment.

Digital assessment of a retentive full crown preparation-An evaluation of prepCheck in an undergraduate pre-clinical teaching environment

Abstract: Introduction Acquiring practical skills is essential for dental students. These practical skills are assessed throughout their training, both formatively and summatively. However, by means of visual inspection alone, assessment cannot always be performed objectively. A computerised evaluation system may serve as an objective tool to assist the assessor. Aim The aim of the study was to evaluate prepCheck as a tool to assess students' practical skills and as a means to provide feedback in dental education. Methods As part of a previously scheduled practical examination, students made a preparation for a retentive crown on the maxillary right central incisor-tooth 11. Assessments were made four times by two independent assessors in two different ways: (a) conventionally and (b) assisted by prepCheck. By means of Cohen's kappa coefficient, agreements between conventional and digitally assisted assessments were compared. Questionnaires were used to assess how students experienced working with prepCheck. Results Without the use of prepCheck, ratings given by teachers differed considerably (mean κ = 0.19), whereas the differences with prepCheck assistance were very small (mean κ = 0.96). Students found prepCheck a helpful tool for teachers to assess practical skills. Extra feedback given by prepCheck was considered useful and effective. However, some students complained about too few scanners and too little time for practice, and some believed that prepCheck is too strict. Conclusion prepCheck can be used to assist assessors in order to obtain a more objective outcome. Results showed that practicing with feedback from both prepCheck and the teacher contributes to an effective learning process. Most students appreciated prepCheck for learning practical skills, but introducing prepCheck requires enough equipment and preparation time.

Introduction of a new teaching concept for dentin post preparation with 3D printed teeth

Abstract: Introduction The preparation for dentin posts is difficult and hard to learn. There are currently no reproducible simulation models to train this clinical procedure. The purpose of this study was the design, feasibility and evaluation of a three‐dimensional (3D) printed tooth model for the pre‐clinical teaching of students. Materials and methods A printable tooth was designed and printed by a stereolithographic printer. A total of 48 fourth‐year dental students in the first clinical course in prosthodontics were trained in a voluntary hands‐on course on 4 similar printed teeth. The students used standard model teeth and real‐teeth models during their education. They had experience in caries removement and root canal treatment on real patients. Root perforations were counted for every attempt. The different benefits of the 3D printed tooth were evaluated by a questionnaire using German school grades from 1 (best) to 6 (worst). Results The overall rating of the printed tooth was O1.9 ± 0.3. The item “suitable exercise option” was rated O2.0 ± 0.8, and the teeth were “easy to use” O1.9 ± 0.9. The item “realistic approach to dentin post preparation” was rated O2.1 ± 0.8, and the teeth showed the “shortcomings at a root perforation” O1.5 ± 0.6. The students reported to have much more motivation and enthusiasm to improve their skills with the printed teeth O2.1 ± 0.9. They had a strong desire to include these teeth in their pre‐clinical education before the first patient treatment O1.6 ± 0.8. The success rate of the dentin post preparation was significantly better for the second 25% (P = .047) and fourth 48% (P = .04) attempt. Conclusions The feasibility of this teaching concept was confirmed. The students had the possibility to learn a correct dentin post preparation on a printed tooth model. The learning effect with this tooth model was rated as good to very good by the questionnaire.

Teaching Orthodontic Emergencies Using The “Flipped Classroom” Method Of Teaching – A Mixed Methods RCT

Abstract: INTRODUCTION In the United Kingdom, the General Dental Council requires newly graduated dentists to be competent in managing orthodontic emergencies. Undergraduate students typically receive limited exposure to orthodontics, with teaching primarily delivered via conventional lectures. Flipped teaching involves knowledge being acquired in students' own time, with class time focussing on construction of meaning. METHODS A total of 61 undergraduate dental students were randomised into either a flipped or a conventional group. The conventional group (n = 30) attended a lecture describing the management of six common emergencies. The flipped group (n = 31) were given access to six videos via a virtual learning environment and later completed practical tasks related to the material. Both groups completed a single best answer assessment. Perceptions of flipped classroom teaching were explored via focus groups. RESULTS For questions on orthodontic emergencies, the conventional group had a mean examination result of 70.5% (SD 8.0%) compared with the flipped group of 72.8% (SD 12.9%). There was no significant difference between the groups (P = .532). For regular orthodontic questions, the conventional group had a mean examination result of 64.8% (SD: 19.9%) compared with 78.3% (SD: 21.7%). There was no significant difference between the groups (P = .083). Thematic analysis identified the following themes: ways in which videos encourages more effective learning, improved engagement, awareness of learning needs and proposed teaching/curriculum changes. The overarching theoretical perspective was facilitating an experiential learning cycle using flipped classroom teaching. CONCLUSIONS In the context of this investigation, the flipped classroom method of teaching resulted in comparable examination performance and improved levels of satisfaction.

Understanding dental students’ use of feedback

Abstract: Introduction Feedback can enhance learning and is thought to be highly valued by students; however, it is not clear from the literature how dental students actually use feedback. Aim This study aimed to explore how dental students use feedback in a variety of contexts. Methods Qualitative methods involving audio‐recorded focus groups were used to explore the use of feedback by undergraduate dental students studying at three UK dental schools. A purposive sampling strategy was used to ensure diverse representation across the undergraduate dental programmes in each of the schools. Results Six focus groups, involving a total of 72 students, were undertaken. Thematic analysis identified five main themes relating to the use of feedback: value, future applicability, accessibility, variability and understanding. The inter‐connectivity and interaction of the themes (along with their subthemes) were used to develop a model for optimising feedback with the aim of enhancing its potential use by students. Conclusion The use of feedback by students would appear to be strongly influenced by several factors. Understanding these factors and how they interlink may be helpful to education providers who are seeking to optimise their feedback processes.

Effectiveness of an Innovative and Interactive Smoking Cessation Training Module for Dental Students: A Prospective Study

Abstract: BACKGROUND Smoking is one of the world's major health problems and dental professionals are in a unique position to promote smoking cessation. However, according to the current literature, neither dental students nor dentists feel adequately prepared to counsel smokers. The purpose of this study was to develop and implement a teaching intervention on smoking cessation for fourth-year dental students and assess its effectiveness in terms of learning outcome on knowledge, communication skills and attitudes. MATERIALS AND METHODS In this prospective intervention study, students in the intervention group (n = 28) participated in a teaching module consisting of a podcast, an interactive lecture, a seminar, and small-group sessions with role-play interactions. Knowledge, communication skills and attitudes were measured using written examinations and an objective structured clinical examination (OSCE) at the end of the module and 6 months later. Results were compared with data from a historical control group (n = 27) receiving standard teaching. RESULTS Compared with the control group, students in the intervention group had higher scores in the knowledge test (67.1% vs 41.8%; P < .001; d = 2.8) as well as in the OSCE (74.9% vs 44.7%; P < .001; d = 2.3) and also retained more knowledge (52.7% vs 36.5%; P < .001; d = 2.0) and skills (71.8% vs 47.6%; P < .001; d = 2.5) over a period of 6 months. Attitudes were similar across groups and time-points. CONCLUSION The teaching intervention equipped dental students with specific knowledge and skills required to effectively counsel smoking patients. Further research is required to assess the transfer of these skills to the clinical setting.

Dental sleep medicine: Time to incorporate sleep apnoea education in the dental curriculum.

Abstract: Dental sleep medicine is a discipline that includes conditions such as sleep breathing disorders (eg snoring and sleep apnoea), sleep bruxism, orofacial pain and sleep-related complaints, and to some extent gastro-oesophageal reflux disorder and/or insomnia. Obstructive sleep apnoea (OSA) is a life-threatening condition that dentists need to identify and manage when indicated in order to increase patient well-being and to be taken in consideration in the dental curriculum. The main objective of this paper is to highlight the relevance of dental sleep medicine in the context of dental education, and to discuss potential educational content for integration in the dental curriculum with a focus on OSA, a condition that is not yet integrated in many dental training curricula around the world.

Implementing magnification during pre-clinical training: Effects on procedure quality and working posture

Abstract: Objective The objective of this study was to evaluate the effects of magnification on the quality of two pre-clinical procedures, class I cavity preparations and composite resin restorations, and to evaluate the working posture. Methods This was an experimental laboratory study. The response variables were the quality of cavity preparations and Class I restorations as well as the working posture adopted during the execution of these procedures. The independent variables were the magnification system under four levels (unaided visualisation, the use of a simple loupe, the use of a Galilean loupe and the use of a Keplerian loupe) and the artificial teeth treated. Class I cavity preparations and restorations (N = 320) were performed using standardised procedures, and the quality achieved was evaluated using pre-established criteria. Working posture was recorded using digital video cameras and was evaluated using the Compliance Assessment of Dental Ergonomic Posture Requirements (CADEP). A two-factor analysis of variance (ANOVA) and multiple comparison test were performed (α = 0.05). Results The quality of cavity preparation did not differ significantly amongst the different magnification systems (P = 0.082). Galilean and Keplerian systems had a positive impact on restoration quality only for the left mandibular first molar (P = 0.04). Higher posture scores were observed when Galilean and Keplerian loupes (P = 0.01) were used, regardless of the tooth being treated. Conclusion The use of Galilean and Keplerian magnification lenses did not affect the quality of the pre-clinical procedures performed whilst improved the scores of ergonomic posture.

How is paediatric dentistry taught? A survey to evaluate undergraduate dental teaching in dental schools in the United Kingdom

Abstract: Introduction The quality assurance of undergraduate dental education in the UK is regulated by the General Dental Council who describe the competencies expected of the newly qualified dentist or "safe beginner" Whilst the literature has explored the level of undergraduate training in a number of dental specialties within the UK, there is a paucity of information on the UK curriculum for undergraduate paediatric dental teaching Aims This study aimed to assess the undergraduate teaching of paediatric dentistry within dental schools in the UK Methods An anonymous questionnaire was distributed to all 16 UK dental schools via email Results Twelve questionnaires were completed, giving a response rate of 75% First exposure to both academic teaching and clinical teaching in paediatric dentistry ranged from years 1-4 Whilst there were broad similarities between units with regard to core components of the curricula, there were notable differences including the teaching of regenerative endodontics (75%) and the use of the titanium trauma splint (58%) Silver diamine fluoride was only used clinically in one unit (8%), and non-vital pulpotomy was taught by two units (16%) There was also considerable heterogeneity in assessment methods between universities Conclusion The undergraduate paediatric dental curriculum is broadly similar between UK dental schools However, there are discrepancies in assessment methods and the teaching of new advances

Validation of a three-dimensional printed model for training of surgical extraction of supernumerary teeth.

Abstract: Introduction This study aimed to validate a three-dimensional (3D) printed model to provide training for supernumerary teeth (SNTs) extraction. Materials and methods Each of the 30 participants, grouped as experienced and without experience, conducted two identically simulated surgeries on a 3D-printed replica of human mixed dentition with a SNT. The surgery time, area of bony window and volume of removed material were measured; subsequently, responses to a five-item questionnaire were recorded. The collected data were statistically analysed. Results The surgery time was 228.37 ± 141.53 seconds and 125.47 ± 53.03 seconds in the first and second surgery, respectively. The training significantly decreased the surgery time in the participants without experience (P = .000). However, there were no significant differences in the area of window opening (P = .271) and volume of removed material between the two surgeries (P = .075). The participants who perceived educational benefits accounted for more than 60% of the respondents for every question. Participants without experience in SNT extraction showed a tendency to rate a higher score than did those with experience. Conclusions A 3D-printed model for surgical extraction of a SNT can improve surgical skill and, especially, shorten the learning curve in beginners.

Development of e-portfolio in undergraduate clinical dentistry: How trainees select and reflect on evidence

Abstract: Introduction Self-reflection is a fundamental part of health professional development, especially in the unstructured clinical stage of dentistry, medical and health profession education, since it plays important role in experiential learning. A portfolio-both conventional and digital-records various aspects of knowledge, skills and attitudes over a long period of time to help students develop their professionalism by conducting self-reflection. This study aims to explore the process of selecting and reflecting on professionalism evidence recorded in e-portfolios during undergraduate clinical dentistry training. Method This pilot study is a qualitative study with a phenomenological design. The selection of respondents was conducted using a maximum variety sampling method. Following a 6-week pilot programme, a total of six in-depth interviews and five focus group discussions were conducted with undergraduate students representing different clinical rotations to explore the process conducted by undergraduate clinical dentistry students in e-portfolio development. The study of documents was also conducted on the respondents' reflective writing from the e-portfolio back-end data to explore their self-reflection skills. Result The results of the present study highlighted two different approaches used amongst trainees in developing a reflective e-portfolio: selective and non-selective. The observed reflective e-portfolio utilisation frequency and trainees' self-reflection skills were low, with several affecting factors identified. These identified factors consisted of external factors, such as the undergraduate clinical dentistry programme curriculum, the hidden curriculum, the availability of feedback, the availability of role models, and features of the e-portfolio and internal factors, such as understanding the self-reflection concept, the availability of time and mood, cultural factors, and understanding the content reflected. Conclusion Through the process of independently selecting and recording learning activities in e-portfolios as well as repeatedly conducting self-reflection, trainees can improve their overall reflective abilities. However, producing a systematic approach to forming a reflective learning environment is necessary to aid the implementation of reflective e-portfolios, especially at the early stage of e-portfolio implementation.

A Core Curriculum in the Biological and Biomedical Sciences for Dentistry

Abstract: Introduction The biomedical sciences (BMS) are a central part of the dental curriculum that underpins teaching and clinical practice in all areas of dentistry. Although some specialist groups have proposed curricula in their particular topic areas, there is currently no overarching view of what should be included in a BMS curriculum for undergraduate dental programmes. To address this, the Association for Dental Education in Europe (ADEE) convened a Special Interest Group (SIG) with representatives from across Europe to develop a consensus BMS curriculum for dental programmes. Curriculum This paper summarises the outcome of the deliberations of this SIG and details a consensus view from the SIG of what a BMS curriculum should include. Conclusions Given the broad nature of BMS applied to dentistry, this curriculum framework is advisory and seeks to provide programme planners with an indicative list of topics which can be mapped to specific learning objectives within their own curricula. As dentistry becomes increasingly specialised, these will change, or some elements of the undergraduate curriculum may move to the post-graduate setting. So, this document should be seen as a beginning and it will need regular review as BMS curricula in dentistry evolve.

Mixed-methods analysis of videoed expert-student dialogue supporting clinical competence assessments.

Abstract: INTRODUCTION This mixed methods study evaluates the use and perceptions of a novel video genre of authentic, in-the-moment expert-student dialogue to support student preparation for a summative clinical competence assessment. METHODS Expert-student dialogue videos were available on the university learning management system (Moodle) for self-directed access for a fixed prosthodontics course. These comprised 3 categories of video relating to dialogic episodes of previous student's performance relating to a clinical competence assessment. These were as follows: case suitability, case discussion and self-evaluation. Fourteen students who were taking the competence test and had watched the supporting videos were invited for focus group interviews. Twelve students participated in three focus groups within 24 hours of the assessment and the audio recordings were analysed. A thematic analysis was performed using an inductive approach. Video access data were also retrieved and analysed based on when the videos were watched. RESULTS Three key themes were identified: assessment preparation, enhanced learning and affordance phenomena. By accessing the videos, students gained insights into the case suitability, assessment process and criteria, and the examiners' expectations. They reported reduced uncertainty and stress, improved confidence and better preparedness for the assessment. Students also reported this video genre stimulated higher-order thinking and provided a broader clinical experience. A diverse array of viewing patterns was observed immediately before the assessment and across the year. For the focus group of students, they watched 65% of all their videos for the prosthodontics course one week before their competency testing periods. CONCLUSION The expert-student dialogue videos that captured peers clinical competence tests improved students' assessment literacy, increased their assessment preparedness, reduced stress and enriched their learning.

Transition to dental practice: Newly graduated dentists' views of being successful in dental practice

Abstract: BACKGROUND The transition of dental graduates to the workforce is of interest to dental educators The ways dentists think about success and successful practice tend to be tied to business parameters, patient flow and job satisfaction These measures are narrow, however, and there is scant literature exploring success in ways that connects with professional identity formation This study aims to add to scholarly understanding about the experiences of newly graduated dentists by asking: What is the variation in the ways new graduate dentists experience success in practice? METHODS The qualitative methodology used in this study is phenomenography Phenomenography studies the variation in the way a group of people experience a common phenomenon In-depth, semi-structured interviews were conducted with 12 new dentists who had graduated from the University of Sydney RESULTS Five increasingly sophisticated, qualitatively distinct categories of description were identified: the day runs smoothly, keeping busy, providing quality patient care, generating personal meaning and having a sense of connection and belonging CONCLUSIONS This study gives insights into the complex ways newly graduated dentists think about successful dentistry It broadens our view of successful practice beyond commercial aspects to include practitioner identity Importantly, sense of responsibility, the practice environment and mentorship emerge as key players in this transitional career stage

How do we teach simulation‐based dental education? Time for an evidence‐based, best‐practice framework

Abstract: Historically, simulation-based dental education was taught using practical skills and the action of doing. An increased awareness of the importance of patient safety in healthcare education and delivery has seen considerable advances in the application of simulation-based education across several healthcare disciplines including medicine, nursing and anaesthetics. Dental simulation-based education requires improved standards of best-practice, and evidence-based, curriculum design that is based on theoretical frameworks, conceptual frameworks and educational theories. In this commentary, we explore the educational theory and the development of healthcare simulation, including internationally recognised standards of best practice and the simulation-based activity cycle. Given simulation-based education should be fit-for purpose, the components of these standards are examined within the specific context of dental education. We propose an evidence-based, best-practice framework that can be applied in the design and delivery of contemporary simulation-based dental curriculum.

Introduction of a new teaching concept for crown preparation with 3D printed teeth

Abstract: Introduction For both students and teachers, it is challenging to learn and teach a correct crown preparation. The purpose of this study was the design, feasibility and evaluation of a 3D printed tooth model with internal preparation for dental education in crown preparation and to analyse the quality of the prepared printed teeth in comparison with prepared standard model teeth. Materials and methods A printable tooth was designed and printed by a stereolithographic printer. 38 fourth-year dental students in the first clinical course in prosthodontics were trained in a voluntary course using printed teeth. Different aspects of the printed tooth were evaluated by a questionnaire using German school grades (1 best to 5 worst). The quality of the preparation with the printed teeth and standard training teeth was also rated in an evaluation form done by an expert group consisting of five experienced dentists. Results The workflow was feasible and cost-effective for the production of the teeth. The overall rating of the printed tooth was O 2.0 ± 0.34 in the questionnaire completed by the students. The students rated the printed tooth model (O 2.1 ± 0.85) as significantly better than the standard model tooth (O 3.3 ± 0.77; P = .000). The students reported great benefits in the use of this model tooth, for example valuable replacement of a standard model and real teeth, direct control of material loss. The quality of the preparation was evaluated by the expert group as significantly better with an overall mean grade of O 2.6 ± 0.37 for the printed teeth compared to O 2.9 ± 0.42 for the standard model teeth (P = .000). Conclusions The feasibility of this teaching concept was confirmed. The students favoured to work on the innovative 3D-teeth with internal preparation, emphasising the usefulness of this technique in dental education. The expert group confirmed also the significant training effect of this tooth model in contrast to a standard model tooth.

Learning programmes and teaching techniques to enhance oral health literacy or patient-centred communication for healthcare providers: A systematic review.

Abstract: Objective To investigate the learning programmes and teaching techniques used in interventions to enhance oral health literacy (OHL) or patient-centred communication (PCC) for healthcare providers. Materials and methods A systematic review of OHL and PCC were obtained from four electronic databases (PubMed, ScienceDirect, ProQuest and Scopus) was undertaken. These searches covered the period from January 2008 to December 2017. The quality assessment tool was the Joanna Briggs Institute Critical Appraisal tool for systematic reviews of effectiveness. Results The final review included nine studies amongst a total of 1475 studies. They showed three learning programmes (workshops, training and community-based rotation) and 17 related teaching techniques to promote OHL and PCC. The most commonly used learning programmes to enhance OHL and PCC for healthcare providers were workshops, and the teaching techniques included feedback and reflection. The intervention periods of the programmes took 20 minutes to half a day. The three studies did not have a follow-up, whilst the rest showed a follow-up range of 2 months to 3 years. Interestingly, there was one study, which applied double follow-ups to show the effectiveness of the programme. Conclusion Either workshops or training programmes with a combination of teaching techniques were effective in terms of enhancing their OHL or PCC. The more frequent follow-up might increase the long-term effectiveness of the learning programme.