Evaluation of an ethical method aimed at improving hygiene rules compliance in dental practice

Speaking up behavior and cognitive bias in hand hygiene: Competences of German-speaking medical students

Introduction

Infection prevention and speaking up on errors are core qualities of health care providers. Heuristic effects (e.g. overconfidence) may impair behavior in daily routine, while speaking up can be inhibited by hierarchical barriers and medical team factors. Aim of this investigation was to determine, how medical students experience these difficulties for hand hygiene in daily routine.

Methods

On the base of prior investigations we developed a questionnaire with 5-point Likert ordinal scaled items and free text entries. This was tested for validity and reliability (Cronbach’s Alpha 0.89). Accredited German, Swiss and Austrian universities were contacted and medical students asked to participated in the anonymous online survey. Quantitative statistics used parametric and non-parametric tests and effect size calculations according to Lakens. Qualitative data was coded according to Janesick.

Results

1042 undergraduates of 12 universities participated. All rated their capabilities in hand hygiene and feedback reception higher than those of fellow students, nurses and physicians (p<0.001). Half of the participants rating themselves to be best educated, realized that faulty hand hygiene can be of lethal effect. Findings were independent from age, sex, academic course and university. Speaking-up in case of omitted hand hygiene was rated to be done seldomly and most rare on persons of higher hierarchic levels. Qualitative results of 164 entries showed four main themes: 1) Education methods in hand hygiene are insufficient, 2) Hierarchy barriers impair constructive work place culture 3) Hygiene and feedback are linked to medical ethics and 4) There is no consequence for breaking hygiene rules.

Discussion

Although partially limited by the selection bias, this study confirms the overconfidence-effects demonstrated in post-graduates in other settings and different professions. The independence from study progress suggests, that the effect occurs before start of the academic course with need for educational intervention at the very beginning. Qualitative data showed that used methods are insufficient and contradictory work place behavior in hospitals are frustrating. Even 20 years after “To err is human”, work place culture still is far away from the desirable.

Dental and physical therapy faculty collaborate in assessing and educating dental students on musculoskeletal disorders

INTRODUCTION

Research shows 54% to 93% of practicing dentists suffer from musculoskeletal disorders (MSDs), with many developing afflictions early in their careers. Studies also show that dental students are developing MSDs early in their professional education.

OBJECTIVE

The research goal was to quantify the prevalence, anatomical location and initial onset of MSDs among first-year dental students. The study also assessed the students' self-reported opinion as to whether there were enough educational touchpoints to improve their ergonomics in daily activities.

METHODS

At the conclusion of a 9-month preclinical restorative course, that included 2 lectures on MSDs, ergonomics, and postural cueing sessions, a dental and physical therapy faculty member administered a survey to 143 first-year dental students. This survey included questions about the history and presentation of the students' MSD symptoms and their opinion on the relative value of the educational interventions.

RESULTS

There was a 96.5% response rate to the survey with 87.8% of students reporting mild to moderate pain. The cervical spine (41.7%) and hands (42.4%) were the most common areas afflicted. 55.4% reported pain commencing 1 month after starting in the simulation clinic. Over 60.9% of students "agreed" or "somewhat agreed" that the 2 sessions of hands-on ergonomic educational interventions resulted in improved biomechanics and students requested additional educational resources.

CONCLUSION

Dental students are developing MSDs as soon as 1 month after commencing dental school. Dental education should include ongoing ergonomic training throughout the curriculum to help students prevent MSDs.

Final year dental students' perception and practice of professionalism and ethical attitude in ten Sudanese dental schools: A cross-sectional survey

Introduction:

Professionalism and ethics are essential components of all dental schools. Therefore, this study aimed to assess the level of professionalism among Sudanese undergraduate dental students.

Materials and Methods:

This descriptive cross-sectional study was conducted among 307 students in the final year undergraduate Dental Surgery Bachelor program with 155 public and 152 private university students. We collected data through a self-administrated, semistructured questionnaire.

Results:

Although most of the students enrolled in dental schools due to their performance at higher school (P value 0.00), this has no significant effect on their attendance and academic performance afterward (P value 0.25). The perception of the students toward ethics teaching was generally positive in both public (77.34%) and private schools (78.77%). Ethics was represented in the curriculum of both private (51.7%) and public (48.3%) dental schools as perceived by their students. 95.43% and 94.00% of public and private students, respectively, would always or sometimes work in teams, and 98.02% and 94.04% of public and private students, respectively, would always or sometimes respect patients' preference (P value 0.01). A total of 95.33% of the dental students would consult or refer patients with unexpected situations. Only 26% of all students would treat infectious diseases themselves.

Conclusion:

About three-quarters of Sudanese dental students showed a satisfactory level of perception toward the importance of teaching dental ethics and professionalism. It was reflected in an excellent attitude for teamwork and respecting patients' choices. The demand for teaching professionalism course in every dental school will increase gradually, and family physicians with interest in medical education may play a pivotal role in teaching professionalism to dental students.

Evaluation of the mechanical cleaning efficacy of dental handpieces

BACKGROUND

Dental handpieces undergo a decontamination process before reutilization. Thorough cleaning is a prerequisite to effective sterilization, to guarantee safety and prevent cross-infections.

AIM

To assess the cleaning efficacy offered by devices dedicated to dental handpieces.

METHODS

PIDTests©, which are patented tubes made of transparent material and designed to replace handpieces in cleaning devices, were artificially stained by Soil Test© (Browne/STERIS). Three cycles were performed with PIDTests© connected to every handpiece adapter in the four different machines tested: X-Cid 2© (Micro-Mega) with a total of nine PIDTests©; iCare+© (NSK) with nine PIDTests©; DAC Universal© (W&H) with 18 PIDTests©; and BioDA 80© (VR2M) with 24 PIDTests©. A visual evaluation and a biuret reaction test were performed.

FINDINGS

In three of the tested cleaning devices (X-Cid2©, iCare+© and DAC Universal©), all of the PIDTests© showed Soil Test© residues, on the internal and external surfaces indicating cleaning was ineffective. Only the BioDA 80© showed no residual stains on all the PIDTests© and negative biuret reaction test results, making the cleaning effective.

CONCLUSIONS

Manufacturers should optimize the cleaning device parameters, based on the Sinner circle (grouping compensatory parameters which influence the effectiveness of a cleaning process, such as pressure, temperature, time, detergent concentration), to improve cleaning efficacy and enable dental surgeons to ensure the safety. Although PIDTests© are the only tool to provide visual indications on the cleaning efficacy of washer-disinfectors dedicated to handpieces, manufacturers should continue with the development of improved and validated tools to assess cleaning efficacy.