Impact of simulated patients on students' self-assessment of competency in practice of geriatric dentistry

A multi-faceted construct to guide geriatric dental education: Findings from a scoping review with consultation

BACKGROUND AND OBJECTIVES

Older adults report unmet oral health care needs and barriers in access to care, due in part to provider attitudes and discomfort towards treating older patients. Our study asked: What is known from the literature about the use of undergraduate dentistry programmes to influence dental students' attitudes, perceptions and comfort towards treating geriatric patients? And how can interdisciplinary care facilitate the ability of dentists to work with geriatric patients?

MATERIALS AND METHODS

A scoping review and stakeholder consultation followed established methodological guidelines. Four databases and two grey literature sources were searched. Two researchers independently selected articles using predefined inclusion criteria. Pertinent information was inputted into an iteratively developed extraction table. NVivo 12 was used to organise the extracted data into themes. Key findings were confirmed through stakeholder consultation.

RESULTS

Sixty-eight articles were included in the scoping review. Five key themes emerged: (1) Curricular targets; (2) Intervention components; (3) Dentist and patient factors; (4) The role of interdisciplinary care; and (5) Post-graduation insights on knowledge-seeking patterns. Stakeholder consultations involved 19 participants from Southwestern Ontario and generally confirmed our findings.

CONCLUSIONS

Inconsistent reporting of multiple intervention dimensions constrains our ability to strengthen this knowledge. Future interventions and their reporting could be improved by adopting "willingness to treat" as an overarching, multi-faceted concept which encompasses knowledge on ageing, attitudes towards older patients, perceived competence and empathy. Stakeholder interviews complemented these findings.

Situational simulation teaching effectively improves dental students' non-operational clinical competency and objective structured clinical examination performance

BACKGROUND

Appropriate communication with dental patients enhances treatment outcomes and patient satisfaction. Implementing simulated patient interviews courses can improve patient-centered care and reduce conflict during clerkship training. Therefore, this study explored the relationship among student participation in a situational simulation course (SSC), academic performance, clerkship performance, and objective structured clinical examination (OSCE) performance.

METHODS

This study was conducted with a sample of fifth-year dental students undergoing clerkship training. After implementing a situational simulation course to investigate the relationship among participation in SSC, academic performance, clerkship performance, and OSCE performance, a path analysis model was developed and tested.

RESULTS

Eighty-seven fifth-year dental students were eligible for the SSC, and most (n = 70, 80.46%) volunteered to participate. The path analysis model revealed that academic performance had a direct effect on OSCE performance (β = 0.281, P = 0.003) and clerkship performance (β = 0.441, P < 0.001). In addition, SSC teaching had a direct effect on OSCE performance (β = 0.356, P < 0.001).

CONCLUSIONS

SSCs can enhance dental students' non-operational clinical competency and OSCE performance effectively. Simulated patient encounters with feedback, incorporated into the dental curricula, have led to improved communication. Based on our findings, we suggest implementing SSC teaching before the OSCE to improve communication and cognitive skills.

Bridging the gap between self-assessment and faculty assessment of clinical performance in restorative dentistry: A prospective pilot study

Purpose/Objectives

The current study was undertaken to investigate whether self‐assessment of clinical skills of undergraduate dental students could be bridged with faculty assessment by deliberate training over an extended period. A secondary aim was to explore students' perception of self‐assessment and its effect on their learning and motivation.

Material and Methods

A prospective pilot study was conducted at the Department of Restorative Dentistry at Damascus University. Sixteen students participated in the study, ranging in age between 22 and 23 years. A modified Direct Observation of Procedural Skills form with a grading rubric was used to register and guide students' self‐assessment; both were pretested on four students before the study. In total, four clinical encounters were completed by each student. Students were trained on how to conduct proper self‐assessment before and after each clinical encounter. A postcourse questionnaire was used to investigate students' perception of self‐assessment.

Results

Bias in self‐assessment decreased consistently after each encounter, and the difference in bias between the first (bias = 0.77) and the last encounter (bias = 0.21) was significant with a medium effect size (p = .022, d = 0.64). The percentage of disconfirming performance dimensions decreased from 39.7% to 26.9%. Students' ability to exactly pinpoint strengths improved consistently and significantly. However, their ability to pinpoint areas of improvement was volatile and showed no significant difference. Bland–Altman graph plots showed higher levels of agreement between self‐assessment and faculty assessment. Moreover, students' perception of self‐assessment was very positive overall.

Conclusions

These findings suggest the possibility that the gap between self‐assessment and faculty assessment could be bridged through deliberate training. Future longitudinal research using a larger sample size is still required to further explore whether self‐assessment can be actively bridged with faculty assessment by deliberate training.

Assessment of communication and physical exam skills: A comparison of students, faculty and standardized patients

PURPOSE/OBJECTIVES

The objective of this retrospective study was twofold: it aimed to investigate dental students' communication and physical exam self-assessment skills by comparing students' self-evaluations with those completed by faculty and standardized patients (SPs). Second, it aimed to compare faculty and SPs assessment of students' communication skills.

METHODS

At the end of their first year of training, students (n = 127), participated in one SP encounter about an initial dental consultation. Students completed self-assessment before receiving feedback from faculty (n = 19) and SPs (n = 19). The data source included evaluation forms submitted by students, faculty and SPs. The Wilcoxon signed rank test was used to compare the overall scores between groups. Agreement between evaluations items were analyzed with McNemar's test (p < 0.05).

RESULTS

Overall, there were no statistically significant differences in how students and faculty graded for either communication (p = 0.6724) or physical exam (p = 0.1921) skills. However, both students and faculty provided less favorable marks than SPs for communication skills with a statistically significant difference in the overall grading between both students and SPs (p = 0.0146) and between faculty and SPs (p = 0.0045).

CONCLUSIONS

While there was disagreement between students and faculty versus SPs, they weren't meaningful differences in scores and the dissimilarities mainly consisted of ratings of explanation skills. We suggest that, when applicable, dental student's self-evaluations may represent an alternative to faculty assessments of communication and physical exam skills. Nonetheless, we recommend that SPs be included in the assessment of communication skills to provide students with comprehensive feedback that more realistically represents the natural patient-provider relationship.

Impact of an Interprofessional Health Student Education Program on Older Adult Participants

Training health professional students to work with older adults will improve future workforce capacity to meet growing needs. Additionally, older adults may benefit from health education and interactions with health professional students. We analyzed survey responses from older adults who had participated in an interprofessional health student education program regarding their experiences. Qualitative data were summed and averaged, and quantitative survey data were analyzed with Fisher’s Exact Test. At least 60% of participants reported receiving information for health needs or making changes to physical activity, dental care, or diet. The most significant differences in lifestyle modifications were noted among racial and ethnic minorities and among speakers of different primary languages. 64% of the qualitative responses reflected positive affirmation of the program. Our data suggest that interactions with health students are meaningful experiences for older adults, are associated with healthy habit changes, and reflect demographic differences in response to health education.