How competent do our graduates feel?

Comparison of self-perceived competence of recent dental graduates from the Universities of Otago and Dalhousie

INTRODUCTION

This study investigates and compares the self-perceived competencies of recent dental graduates from the University of Otago (UoO) (Dunedin, New Zealand) and Dalhousie University (DU) (Nova Scotia, Canada).

MATERIALS AND METHODS

A validated survey was emailed to recent graduates from the UoO (December 2019) and DU (May 2020). Chi-squared statistical analysis examined the differences between groups.

RESULTS

The response rate was 73% from the UoO class and 75% from the DU class. Out of 59 competencies, 11 items showed a significant difference. Orthodontics and the surgical aspects of dentistry were the main areas where significant differences have been observed between the two cohorts. Out of the four items in orthodontics, a significantly higher proportion of DU graduates felt more competent than graduates from UoO in three items ("performing orthodontic treatment planning," "performing space maintenance/regaining" and "performing orthodontic full-arch alignment"; p < .001). Similarly, graduates from DU felt significantly more competent in three of the eight items in the oral and maxillofacial surgery domain ("managing complications of oral surgery," "performing soft-tissue biopsies" and "managing trauma to the dentofacial complex"; p < .001), all requiring surgical training and skills.

CONCLUSION

Of the differences identified, graduates from DU reported higher levels of self-perceived competence compared with their UoO counterparts, especially in the orthodontics and oral and maxillofacial surgery domains. This could be because DU students have more practice in these specialties during their training. The results suggest that increased exposure for UoO students in these areas may be beneficial to their self-perceived competence.

Exploration of Mental Readiness for Enhancing Dentistry in an Inter-Professional Climate

Competencies required for dentistry go far beyond the academic or scientific spheres. They incorporate important mental readiness concepts at its core with an appropriate balance of operational readiness (i.e., technical, physical, mental readiness). The aim of this exploratory study was to investigate the importance of mental readiness for optimal performance in the daily challenges faced by dentists using an Operational Readiness Framework. One-on-one interviews were conducted with a select group of seasoned dentists to determine their mental readiness before, during and after successfully performing in challenging situations. Quantitative and qualitative analyses of mental readiness were applied. Study findings were compared with a Wheel of Excellence based on results from other high-performance domains such as surgery, policing, social services and Olympic athletics. The analysis revealed that specific mental practices are required to achieve peak performance, and the balance between physical, technical and mental readiness underpins these dentists' competency. Common elements of success were found-commitment, confidence, visualization, mental preparation, focus, distraction control, and evaluation and coping. This exploration confirmed many similarities in mental readiness practices engaged across high-risk professions. Universities, clinics and hospitals are looking for innovative ways to build teamwork and capacity through inter-professional collaboration. Results from these case studies warrant further investigation and may be significant enough to stimulate innovative curriculum design. Based on these preliminary dentistry findings, three training/evaluation tools from other professions in population health were adapted to demonstrate future application.

A city-wide survey of dental students' opinions on undergraduate oral surgery teaching

PURPOSE

This study aimed to carry out a city-wide survey to evaluate undergraduate students' opinions on their oral surgery training by measuring their self-confidence.

MATERIALS AND METHODS

A cross-sectional survey of 383 3rd year, 412 4th year and 363 5th year undergraduate dental students from six dental schools in Istanbul with a mean age of 22.73 ± 1.55 was conducted towards the end of the academic year. A web link to the questionnaire was sent to the contact person at the participating dental schools. The questionnaires were anonymously evaluated. Descriptive statistics were calculated, and Chi-square tests were performed to examine the data. A P-value of <.05 was considered to be statistically significant.

RESULTS

In total, 1158 responses were returned, representing 67% of the overall students in the 2018-2019 academic year. The male respondents were significantly more self-confident than females in the general aspects of surgical skills. More than half of the respondents (53%) felt confident in oral surgery knowledge to undertake independent practice. Although 5th year respondents felt more confident in the general aspect of the questionnaire, their ability of differentiation of odontogenic and non-odontogenic pain was lower than their counterparts. The majority (86%) of the participants disagreed that the only knowledge required for oral surgery was that of tooth and jaw anatomy.

CONCLUSION

This survey revealed perceived confidence in tooth and retained root extraction. The male respondents were found to be more self-confident. There is a need for improvement in surgical skills, recognition of malignancies and differentiation of the origin of the pain.

Knowledge, attitude, and practice of senior dental students toward management of complications in exodontia

Introduction

Dental graduates have a professional responsibility of being competent in managing the complications in exodontia, a very commonly performed procedure.

Aim

The aim of this paper was to assess the knowledge, attitude, and practice of senior dental students toward the management of complications in exodontia.

Materials and Methods

Four hundred dental students participated in the study voluntarily. Verbal consent was obtained after elaborating the purpose of the study. A short validated questionnaire consisting of 12 close-ended multiple choice questions was distributed to all the students. The questionnaires were collected back and results from fully filled questionnaires were tabulated in Microsoft Excel 2007.

Results

Nearly 93.4% of the students perform extractions in their practice on a routine basis. Among those 32.5% of the students have encountered complications, out of which only 20% of the students are confident in managing them. The remaining 64.8% of students who have not encountered complications are not confident in managing the same.

Conclusion

This study revealed the need for increase in cases which will in turn help the students to transfer their theoretical knowledge into professional skills.

In Vivo Multimodal Optical Imaging: Improved Detection of Oral Dysplasia in Low-Risk Oral Mucosal Lesions

Early detection of oral cancer and oral premalignant lesions (OPL) containing dysplasia could improve oral cancer outcomes. However, general dental practitioners have difficulty distinguishing dysplastic OPLs from confounder oral mucosal lesions in low-risk populations. We evaluated the ability of two optical imaging technologies, autofluorescence imaging (AFI) and high-resolution microendoscopy (HRME), to diagnose moderate dysplasia or worse (ModDys⁺) in 56 oral mucosal lesions in a low-risk patient population, using histopathology as the gold standard, and in 46 clinically normal sites. AFI correctly diagnosed 91% of ModDys⁺ lesions, 89% of clinically normal sites, and 33% of benign lesions. Benign lesions with severe inflammation were less likely to be correctly diagnosed by AFI (13%) than those without (42%). Multimodal imaging (AFI+HRME) had higher accuracy than either modality alone; 91% of ModDys⁺ lesions, 93% of clinically normal sites, and 64% of benign lesions were correctly diagnosed. Photos of the 56 lesions were evaluated by 28 dentists of varied training levels, including 26 dental residents. We compared the area under the receiver operator curve (AUC) of clinical impression alone to clinical impression plus AFI and clinical impression plus multimodal imaging using k-Nearest Neighbors models. The mean AUC of the dental residents was 0.71 (range: 0.45-0.86). The addition of AFI alone to clinical impression slightly lowered the mean AUC (0.68; range: 0.40-0.82), whereas the addition of multimodal imaging to clinical impression increased the mean AUC (0.79; range: 0.61-0.90). On the basis of these findings, multimodal imaging could improve the evaluation of oral mucosal lesions in community dental settings. Cancer Prev Res; 11(8); 465-76. ©2018 AACR.

Knowledge About Chronic Orofacial Pain Among General Dentists of Kermanshah, Iran

Background and Objective:

Diagnosis and treatment of chronic orofacial pain are one of the most challenging issues in dentistry. The purpose of this study was to assess the knowledge of general dentists regarding orofacial pain in Kermanshah, Iran.

Methods:

This cross-sectional study was conducted in 2016 including general dentists of Kermanshah city. A researcher-designed questionnaire was administered to collect demographic data as well as measuring knowledge of the dentists in four sections including etiology, clinical presentations, physical examination, and treatment of chronic orofacial pain. The questionnaire had acceptable validity (content validity > 0.9) and reliability (intraclass correlation coefficient= 0.857 for test re-test; Cronbach’s alpha= 0.72 for internal consistency). The data were analyzed by the SPSS software (ver. 18.0) using Spearman’s correlation coefficient (P < 0.05).

Results:

There were 121 male (72.9%) and 45 female (27.1%) dentists with mean (SD) age of 40.55 (8.03) years and mean (SD) practice history of 13.28 (8.43) years. Mean (SD) knowledge score was 10.54 (2.36) (maximum possible score= 15). 48.2% of dentists had good knowledge in overall. 48.2% about etiology, 45.2% about clinical presentations, 36.1% about physical examination, and 7.8% about treatment had good knowledge. Knowledge had direct and significant relationship with age (r = 0.179; P = 0.022) and practice history (r = 0.18; P = 0.021).

Conclusion:

The results showed that the studied dentists did not have enough knowledge about chronic orofacial pain especially in the treatment field. Therefore, it is recommended to implement educational programs to improve their knowledge.

A national follow-up survey of UK graduates opinion of undergraduate oral surgery teaching

INTRODUCTION

A national follow-up survey was undertaken to determine whether dental graduates from 2009 perceived that their undergraduate oral surgery education had equipped them for general dental practice 4 years after graduating.

MATERIALS AND METHODS

Graduates from the same 13 United Kingdom dental schools who had taken part in the original survey were invited to take part in this follow-up online survey. Their contact details were identified via the general dental council register, social media and alumni groups.

RESULTS

In total, 161 responded (2009b) which represents 16% of the graduates of the original survey in 2009a. A similar percentage of these respondents perceived that the teaching in oral surgery had given them sufficient knowledge to undertake independent practice (83% and 79% in 2009a and 2009b, respectively). Most respondents (99% in both years) reported confidence in undertaking simple forceps exodontia. Confidence in surgical exodontia was poor in both surveys, but one area that appeared improved in the follow-up related to the sectioning of teeth (84% in 2009b compared with 49% in 2009a). Areas of weakness identified in 2009 were reported to be improved in the follow-up.

CONCLUSION

This follow-up survey supports the findings of the original survey. Future longitudinal studies would allow institutions to identify possible weaknesses in their curriculum and to track the career development of their graduates and facilitate robust data collection.

[Professional profile analysis of dentists graduated at Bauru dental School - University of São Paulo between 1996 and 2000]

The aims of this study were to determine the professional profile of the 248 dentists graduated at Bauru Dental School - University of Sao Paulo between 1996 and 2000, verify if they accomplish educational and collective measures and determine the level of professional satisfaction. The material was a self-applicable questionnaire containing both multiple choice and open questions. The return rate was 39.5%. Analysis of data showed that the dentists, who were predominantly males, chose Dentistry as a profession because they felt comfortable with it, and evaluate the graduate course as good. Results showed that the practitioners still do not focus on the need of education and prevention in oral health, especially at the collective level. It was concluded that the predominant professional profile was to work at their dental office (38.8%) or at a peer's dental office, receiving an amount of the total profile (25.5%); 26.5% work with health mutual support and 12.2% work at public service. Although 63.3% are professionally realized, only 12.2% are economically realized. The great difficult is the increase in the competition between dentists and saturation of the dental work market.

Self-perceived preparedness for dental practice amongst graduates of The University of Hong Kong's integrated PBL dental curriculum

OBJECTIVES

To determine how prepared for dental practice graduates from the integrated problem-based learning (PBL) dental undergraduate curriculum at The University of Hong Kong (HKU) perceive themselves to be and to identify factors associated with self-perceived preparedness.

MATERIALS AND METHODS

A postal questionnaire was sent to five cohorts of dentists who had graduated from HKU's integrated PBL curriculum between 2004 and 2008. Using a 4-point Likert scale, the questionnaire assessed the self-perceived level of preparedness in 59 competencies grouped in nine domains. Responses were dichotomised into 'poorly prepared' and 'well prepared'.

RESULTS

The response rate was 66% (159/241). The mean proportion (±standard deviation) of respondents indicating well-preparedness was 72.0±15.1% overall, and for each domain was as follows: general patient management, 93.1±12.1%; practice management, 81.0±22.2%; periodontology and dental public health, 73.5±19.3%; conservative dentistry, 92.5±13.1%; oral rehabilitation, 62.8±24.0%; orthodontics, 23.0±32.9%; managing children and special-needs patients, 64.8±28.9%; oral and maxillofacial surgery, 52.2±25.2%; and drug and emergency management, 84.7±22.6%. The odds of self-perceived well-preparedness were increased for cohorts graduating in 2004 and 2005 and graduates working in a non-solo dental practice.

CONCLUSIONS

Dental graduates of HKU's integrated PBL curriculum felt well prepared for the most fundamental aspects of dental practice. However, apparent deficiencies of training in orthodontics and oral and maxillofacial surgery will need to be addressed by continuing education, postgraduate training and planning for the new 6-year undergraduate curriculum in 2012.

Dentists reflect on their problem-based education and professional satisfaction

AIM

To determine the way in which Malmö University dental graduates perceive their problem-based dental education and evaluate their professional satisfaction.

METHOD

The first five cohorts (graduating in years 1995-1999) of the problem-based curriculum were invited to participate. Of 166 graduates, 77% responded to a questionnaire comprising 20 questions on aspects of their dental education, professional situations and interest in postgraduate education. They were asked to rank their perception of their dental education and satisfaction with their professional situation on a visual analogue scale (VAS) with endpoints ranging from 'Not at all' (1) to 'Very well' (10). For other statements, the markings were made on a Likert scale from 1 (not important/not satisfied) to 5 (very important/very satisfied). There were also open-ended questions.

RESULTS

Most respondents perceived their education to prepare them well for a career in dentistry (median score VAS 8), and 90% rated above six on a VAS for their professional satisfaction as dentists. Importance and satisfaction were highly correlated with principles of the curriculum: holistic view, oral health, lifelong learning, integration between theory and clinic, and clinical competence. Forty-five per cent of the graduates noted the problem-based learning approach as the most valuable asset of their education, and 19% cited training in oral surgery as a deficit. Of the respondents, 77% expressed interest in specialist training and 55% in research education.

CONCLUSION

Problem-based education was perceived to prepare graduates well for their profession, and their professional satisfaction was high.

Clermont-Ferrand dental school curriculum: an appraisal by last-year students and graduates

OBJECTIVE

Last-year students and young graduates of the Clermont-Ferrand dental school (France) assessed their professional skills in order to shed light on those which are perfectly mastered and those which are not, with the aim of improving the undergraduate training given by the school.

METHODS

A questionnaire was handed out to students in their last two years and to young graduates (n = 170). They were asked to appraise their self-assessed level concerning 52 skills using a 0-10 visual analogue scale. The respondents also had to highlight the five skills which, according to them, needed to be improved during the programme.

RESULTS

Thirteen skills obtained a score lower than 5/10 showing a need of more thorough training, notably in the fields of implantology, paradontal surgery, temporomandibular joint disorders and dental practice financial management. Among these, five skills were found that demand in depth acquisition according to respondents. However, these five skills are not necessarily the ones which obtained the lowest scores.

CONCLUSIONS

Our school needs to improve the quality of its training, notably by reorganising some of its courses and by intensifying student' training in outreach programmes, particularly in private practice, where skills like the financial management of a dental practice could be more easily acquired than in a hospital environment.

Student self-assessment of essential skills in dental surgery

OBJECTIVE

To assess whether student self-assessments of essential skills in dental surgery are reliable indicators of the strengths and weaknesses of the clinical aspects of the dental school curriculum. This was done as part of an ongoing evaluation of the curriculum of the Faculty of Dental Sciences of the University of Peradeniya in Sri Lanka.

DESIGN

Cross-sectional surveys of 5 different classes of students using a pre-tested questionnaire.

SETTING

The Faculty of Dental Sciences of the University of Peradeniya, Sri Lanka, which is the only dental school in the island.

MATERIALS & METHODS

A questionnaire was developed specifically for the purpose of eliciting student self-confidence in 46 essential skills on a three point scale. It was administered to 5 different classes of students, immediately or soon after their respective Final BDS examinations. The 5 classes had followed similar curricular formats. The surveys were conducted on a voluntary and anonymous basis.

RESULTS

Results show a remarkable consistency in the self-ratings done by the five different classes of students who followed the same curriculum during five different time periods. Students were least confident in the skills related to the management of medical emergencies and of oral manifestations of systemic diseases while they were most confident in skills related to the care of periodontal disease and caries.

CONCLUSION

Student self-assessments of skills is a useful tool for evaluating the clinical training provided in the dental school curriculum. Students were most confident in managing problems that they most frequently encountered in the dental school. The areas in which they were least confident require curricular reform.

Attitudes to biopsy procedures in general dental practice

AIM

To investigate biopsy procedures in general dental practice.

OBJECTIVES

To assess the views and attitudes of: specialists on the dental specialist surgical registers; dentists in general practice (GDPs) and patients undergoing biopsy procedures.

METHOD

Questionnaires were sent to 98 oral and maxillofacial surgeons and surgical dentists, 335 general dental practitioners and 220 patients attending the Oral Medicine Clinic at the Dental Hospital, Manchester. Participation rates were 68 (74%), 227 (72%), and 158 (76%) respectively.

RESULTS

Specialists: 47 (70%) would discourage dental practitioners undertaking biopsies. Concerns were a lack of skills and delays in referral; 20 (30%) considered GDPs should be able to perform simple biopsies for benign lesions. Dentists: 33 (15%) reported they had performed oral biopsies in the last two years; 136 (60%) felt they should be competent to biopsy benign lesions. Their main concerns were lack of practical skills and the risk of diagnostic error.

PATIENTS

112 (65%) worried about their biopsy result, 67 (39%) would feel anxious if their dentist did the biopsy, although 40 (23%) were anxious when biopsied in the oral medicine clinic.

CONCLUSIONS

Both specialists on the dental surgical registers and GDPs feel there is a need for further training in biopsy technique for GDPs and better advertised and accessible pathology support. The current fee for biopsies may need upward revision. A main concern of patients is fear of an adverse biopsy report. Whilst patients are satisfied with specialist management any concerns were an insufficient reason for biopsy of a benign lesion not being undertaken in general practice.

Self-perceived competency at graduation: a comparison of dental graduates from the Adelaide PBL curriculum and the Toronto traditional curriculum

The first class to complete the new Adelaide problem-based learning curriculum graduated in 1997. Their self-perceived competence at graduation was assessed using a revised version of a questionnaire recently compiled and used in Toronto, and based on the global competencies for dental practice accepted in 1995 by all Canadian Faculties of Dentistry. 38 of the 45 Adelaide class members (84%) completed the survey, compared with 93/129 (72%) in Toronto, and their responses were largely similar to those of the Toronto students. At least 67% of the Adelaide and Toronto students felt well-prepared in 34 of the 55 competencies. Most felt well-prepared for the basic everyday items such as diagnosis, local anaesthesia and basic restorative, but less so for items that are not encountered as often in dental school, such as business matters, practice management, soft tissue biopsies and dentofacial trauma. Items showing significant differences between the 2 schools are discussed with reference to curricular and other dissimilarities in the schools, and some inferences are drawn about the importance of context to learning and feelings of competence.

A skills audit for the dental curriculum

OBJECTIVES

To identify the core skills required of dental graduates, and to identify if and when these skills had been acquired.

DESIGN

Postal questionnaire containing a stimulus list of clinical, technical and professional skills.

SUBJECTS AND SETTING

General Dental Practitioners (GDPs) registered as vocational trainers, Vocational Dental Practitioners (VDPs) starting their vocational training (VT) year and VDPs ending their VT year in the NHS Trent Region of England.

METHOD

The list of skills on the questionnaire was formulated following discussion with a group of 4 clinical academics and 5 GDPs working in the University of Sheffield School of Clinical Dentistry. The questionnaire was sent to the total population of GDPs and VDPs, and responses were requested on an anonymous basis. The purpose mirrored that of a previous survey undertaken in the University of Sheffield Medical School to identify core skills (1), initially in this present survey, defined as skills required by the majority of GDPs (> 50%) and/or used by VDPs (> 50%) in their VT year.

RESULTS

45 of the skills were identified by GDPs as those they expected of the new graduate. All these core skills had been acquired by > 50% of VDPs commencing their VT year with 32 of the skills acquired by > 75% of that group. Of the group ending their VT year, 90% and above had acquired the majority of these skills. At the time of graduation > 50% of VDPs had acquired 10 skills not expected by GDPs. At the end of the VT year, 6 of these unexpected skills had been acquired by > 75% of VDPs.

CONCLUSIONS

The survey enabled us to audit the skills required at the end of the undergraduate course and provided the basis for monitoring skills development in undergraduate dental students.