Challenges and Opportunities for Dental Education from COVID-19

With the ongoing COVID-19 pandemic, dental education has been profoundly affected by this crisis. First of all, COVID-19 brought physical and psychological health problems to dental students and educators. In addition, both non-clinical teaching and clinical-based training experienced challenges, ranging from fully online educational content to limited dental training, students’ research was delayed in achieving project milestones and there was hesitancy in respect of the COVID-19 vaccine. On the other hand, the COVID-19 pandemic has increased the demand for teledentistry and dental emergency treatment, and brought awareness of the advantages and high-speed development of distance education. This review aims to present these challenges and opportunities for dental education, and suggest how dental institutions should prepare for the future demand for dental education.

Consolidating human disease learning in the Dental Emergency Clinic

INTRODUCTION

Dental undergraduates typically learn and are assessed on aspects of human disease (HD) in the early part of their programme, but it is not until later in the programme that their HD knowledge is put into practice when they provide courses of treatment for numerous patients over multiple visits. The teaching of HD provides core knowledge on medical conditions and medications and is therefore essential in allowing newly graduated dentists to provide safe treatment for medically compromised patients or those taking medications. We wanted to examine the medical complexity of patients attending a university hospital dental emergency clinic to determine whether this was a suitable group that would help students to consolidate their HD learning in the context of a single visit where treatment was also provided.

MATERIALS AND METHODS

We examined the medical history of 200 patients attending the dental emergency clinic in the University Dental Hospital, Cardiff, using a previous study as a benchmark. Anonymous data were collected using the medical history proforma, and included age, gender, medications, types and number of medical conditions/disorders.

RESULTS

Patients attending the clinic were more medically complex than those in the comparator study and the demographics reflect wider population data showing increasing numbers of older patients with greater medical morbidity.

DISCUSSION/CONCLUSIONS

The emergency dental clinic is the place where most patients are new to the hospital, have a dental history, medical history, investigations, diagnosis and treatment in a single visit, and offers excellent opportunities for consolidating HD learning in a one-stop clinical treatment episode, guided by suitable instructors.

Community partnerships within a novel dental school urgent care center: Student perceptions

PURPOSE/OBJECTIVES

Oral health inequities and limited access to care cause patients to seek dental treatment in hospital emergency departments. In addition, conventional clinic models and curricular limitations may result in inadequate experiences for students learning urgent dental care. The aim of the current study was to investigate student perceptions of a novel dental school urgent care clinic model.

METHODS

A mixed-methods, cross-sectional study design was used to survey third-year and fourth-year students at a Midwest dental school in spring 2020 about their experiences providing patient care in the school's internal urgent care center. Along with a structured curriculum, the urgent care clinic model incorporates an on-site partnership with a community health center and a hospital emergency department affiliation that serves as a referral base to provide students with their learning experiences.

RESULTS

Of 81 students, 78 completed the survey (96% response rate). The majority of students treated 50 or more patients. From their urgent care experiences, a majority of students felt prepared to manage patients with acute dental pain and swelling (72/77, 94%), and reported a better understanding of interprofessional collaborations in dentistry (42/77, 55%) and the importance of providing urgent dental care to underserved patients (72/77, 94%). Most students (64/75, 85%) were more likely to offer urgent dental care services to underserved populations in future practice.

CONCLUSION

This collaborative school-based urgent care clinic model incorporating community partnerships provided transformative learning experiences, positively impacted student perceptions of their learning, and influenced future practice behaviors related to urgent dental care.

Utilization of and Dental Students' Perceived Benefits of an Urgent Care Clinic in a Dental School

The aims of this study were to describe patient utilization of an urgent care clinic (UCC) in a dental school for one year and to assess dental students' perceptions of the benefits of training in this clinic. Aggregate clinic data from July 3, 2017, through July 6, 2018, were used to determine number of patients, number of new patients, number of new patients who elected to transfer their primary dental care to the university, number who were seen for a follow-up, and service/clinic to which each patient was referred. Student evaluations were used to determine the benefits students perceived in their training in the UCC. Results showed that 1,674 patients were seen in the UCC during the study period. Of these, 67% were new patients, and 53% of these new patients opted to transfer their primary dental care to the university. An average of 7.03 patients were treated per day, and 2.48 new patients per day were generated for the predoctoral student clinic. The most common referrals were to oral surgery (37%), endodontics (30%), and the predoctoral dental clinic (28%). Among these patients, 39% scheduled follow-up appointments, and the attendance rate was 69%. About 80% of eligible students (40/50) completed the questionnaire, and many provided optional comments. Over 80% of the responding students responded favorably regarding the learning experiences and assessments during the UCC rotation. This study found that establishment of the UCC increased the pool of patients and provided students the necessary experiences in triaging and treating dental emergencies.

Dental student self-assessment of a medical history competency developed by Oral and Maxillofacial Surgery Faculty

PURPOSE

To develop a standardized competency exam to evaluate dental student knowledge of patients with complex medical histories. Analysis was performed to determine if there is a difference between dental student self-assessment of the exam compared to oral surgery faculty. The overall goal is to enhance student comprehension of advanced medical patients in the pre-doctoral oral and maxillofacial surgery clinic and make changes based on student responses.

METHODS

The exam took place in a simulation laboratory containing two-way mirrors where the student could not see the evaluator. Three standardized patients (trained actors) were given different medical history scenarios to learn prior to the exam. Students were randomly assigned to interview one patient. The graders consisted of senior and junior level faculty. In real time (live) randomized manner, faculty assessed each student using a standardized rubric to assign a score of 1 to 4. Immediately afterwards, students assessed their own performance using the same scale.

RESULTS

Students gave themselves significantly higher grades (P < 0.001) on the exam (10.7 ± 0.12) compared to the faculty (9.2 ± 0.17). There was no significant difference in student (P = 0.16) or faculty assessment (P = 0.29) between the three different medical scenarios. There was no significant difference between faculty in assessment of student performances (P = 0.16).

CONCLUSION

These results suggested that students overestimated their performance compared to the faculty assessment. This could be due to that students assessed their performance based on memory and self-confidence; that exceeds their expectations. Internal calibration of student performances and faculty grading using standardized criteria may produce more accurate and reliable outcomes in student scoring.

A survey of dental school's emergency departments in Ireland and the UK: provision of undergraduate teaching and emergency care

AIM

Emergency dental care is a vital service that new graduates should be prepared to offer. There are few published data relating to emergency dental care education. To assess this, and to gain a profile of accident and emergency departments (A&E) in dental schools, an online survey was sent to all of the dental schools in the Republic of Ireland and the UK.

SETTING

The survey addressed the school's A&E curriculum, teaching methods, undergraduate exposure and departmental details.

RESULTS

The majority of A&E departments operated during normal working hours with a minority offering an out-of-hours service. Teaching of A&E topics, and undergraduate experience, vary significantly between schools. A&E departments were diversely named and exhibited significant regional variation. Approximately half employed a triage system. It is unclear what represents an adequate level of undergraduate exposure, and more research is required in this area.

CONCLUSIONS

Assessment of undergraduates following time in clinic is an important component of any A&E module. We consider a reflective portfolio to represent a suitable form of assessment, and would recommend their introduction. In addition, we recommend that dental hospitals consider a nurse-led triage system.