Preparing dental students for independent practice: a scoping review of methods and trends in undergraduate clinical skills teaching in the UK and Ireland

Clinical assessment strategies for competency-based education in prosthetic dentistry

Reflective practice is viewed as a theoretical and pedagogical concept in higher education having several diverse approaches and interpretations. The most important aspect of reflective practice is that it is a necessary quality assurance aspect of higher education which should occur recurrently and at different stages of the program. It usually entails an evaluation of advanced instructions which has become the norm in an educational setting, in order to improve the learning outcomes. Reflective practice must therefore be seen as a tool which allows continuous improvement, modifications, and changes to educational approaches, which include theoretical and clinical assessment strategies. Academics in prosthetic dentistry at a research-led university reflected on their current assessment strategies used in the senior undergraduate dental program as part of a quality assurance process and its global comparability. This paper aims to share and explain the importance of reviewing assessment strategies in higher education, especially in such a clinical program using reflective practice as a framework. Different assessment strategies used over a 5-year period are explored and their different structures, expectations, and appropriateness for a clinical program are reported from the literature. The concerns were addressed in a cyclical manner within this framework, and Blooms and blueprinting implemented where appropriate. We conclude that without a validated definition and framework for regular reflective practices, and guidelines to modify the included assessment strategies, the quality assurance within a competency-based dental program may be compromised.

Effectiveness of error-based active learning compared to conventional lecture-based method among undergraduate dental students: A randomized controlled trial

INTRODUCTION

Dental education assumes an indispensable role in adequately equipping students for a successful career in dentistry. Error-based active learning, an innovative approach in dental education, is a combination of mistake-driven learning (MDL) and case-based learning (CBL) to provide a transformative learning atmosphere for students. While active learning has gained popularity in dental education, the effectiveness of error-based active learning remains unexplored. This study aims to evaluate the effectiveness of error-based active learning among final-year dental undergraduate students in comparison with the conventional lecture-based approach.

MATERIALS AND METHODS

A parallel-arm single-blind randomized controlled trial was conducted in a dental institute in India from November 2022 to December 2022. A total of 74 students were randomly allocated to two groups: Group A (n = 37) received error-based active learning and group B (n = 37) received conventional lecture-based learning approach. Atraumatic restorative treatment (ART) was chosen as the topic for the study. The knowledge of students was assessed at three intervals: baseline, post-intervention, and 4 weeks after the intervention, using a self-designed and validated questionnaire with Cronbach's alpha of 0.87 and a content validity ratio of 0.84. A standard survey questionnaire was employed to evaluate students' perceptions of the teaching methods.

RESULTS

Error-based active learning group outperformed the lecture-based group significantly in the post-intervention test (20.92 ± 1.42 vs 16.97 ± 3.06), with better knowledge retention (18.30 ± 2.02 vs 14.05 ± 4.26) and positive feedback from the students.

CONCLUSIONS

The error-based active learning approach proved superior to the conventional lecture-based method in enhancing and retaining knowledge regarding ART.

Community-Based Dental Education (CBDE): A Survey of Current Program Implementation at Australian Dental Schools

Purpose

Community-based dental education (CBDE) diverges from traditional dental school training methods by integrating dental students into primary care community settings. This immersive approach enables students to refine their clinical and hands-on skills while serving the oral health needs of underserved populations. This study aimed to identify ways in which Australian dental schools are currently implementing CBDE and compared to current evidence.

Materials and Methods

This study utilized a 24-item, self-completion survey, adapted from existing questionnaires, which was sent to the CBDE coordinators in the nine eligible dental programs in Australia between mid-January 2023 and mid-April 2023. The survey consisted of multiple-choice, binary, and open-ended questions, including information on the level of student involvement, types of external clinics used, length of rotations, student supervision and assessment, pre-rotation preparation, and post-rotation evaluation, as well as challenges faced in implementing programs.

Results

Six of the nine invited coordinators responded, resulting in a 66.7% response rate. All participants confirmed that their schools had a community-based teaching program. All six respondents reported that participation in external clinics is required for graduation. Implementation of CBDE appears to be influenced by (1) level of student involvement, (2) the types of clinics utilised, (3) allocation and length of rotation, (4) student supervision and assessment, (5) pre-rotation preparation, and (6) post-rotation evaluation. Six (n = 6) institutions reported requiring a post-rotation reflection from students and all respondents reported seeking feedback from clinical supervisors at external sites. Emerging themes from open-ended questions highlight challenges in coordinating external rosters, securing funding, supervising students at external sites, and ensuring diverse types of student exposure during external rotations.

Conclusion

This study provided insights into the implementation of CBDE in Australian dental schools. Results outlined in this research offer valuable insights for dental schools aiming to enhance their programs and improve student learning outcomes.

Evaluating the effectiveness of a novel digital evaluation technology on dental preclinical crown preparation training

OBJECTIVES

To evaluate the assessment scores of a novel digital training program versus traditional training in dental preclinical crown preparation.

METHODS

Crown preparations in two consecutive preclinical training sessions were retrospectively collected and assigned to three groups: traditional group (TG), scanning group (SG), and digital evaluation group (DG). Students in the TG (n = 20) were taught by conventional visual grading, while students in the SG (n = 25) received three-dimensional feedback from digitally scanned preparations. All the SG students continued with supplementary digital evaluation and preparations were allocated into the DG (n = 25). Comparison of total scores between groups was investigated using independent samples t-test and paired samples t-test. Mann‒Whitney U-test and Wilcoxon signed-rank test were used to statistically analyze the differences in subdividing categories. The level of significance was p < 0.05. Questionnaires on the digital evaluation procedure were answered by students in DG.

RESULTS

The results showed a significant improvement (p < 0.01) in the total scores of DG than those of TG and SG, while there were no statistically significant differences between TG and SG. Scores of surface finish and undercut improved significantly in DG compared to TG and SG. The reduction scores of DG were significantly higher than those of SG. Students' feedback indicated a positive perspective on the implementation of the novel digital evaluation technology.

CONCLUSIONS

These findings suggest that digital evaluation technology is useful for preclinical crown preparation training. Attention should also be paid to studying the optimal integration of digital dentistry into traditional dental curricula and its effects on students' learning curves.

Prevalence of Internet Gaming Disorder and Its Impact on Routine Activities Among Dental Students in Belagavi, India: A Cross-Sectional Study

BACKGROUND

 Internet gaming has gained popularity since the millennium, greatly expanding both the game industry and the player base. Moreover, internet gaming disorder (IGD) is a condition included in the most recent version of the Diagnostic and Statistical Manual of Mental Disorders 5 (DSM-5) for further study.

AIM

To assess the prevalence of IGD and its association with physical symptoms among dental students in Belagavi, India.

MATERIALS AND METHODS

A cross-sectional study was conducted among 385 dental students, chosen through simple random sampling. Data were gathered using a pre-validated, closed-ended questionnaire, incorporating the 9-item DSM-5 short version. The questionnaire was administered to undergraduate students during theory classes and collected after 10 minutes, while postgraduate students received it in their respective departments. To identify significant differences, Chi-square and analysis of variance (ANOVA) tests were applied, with statistical significance established at p ≤ 0.05.

RESULTS

A total of 385 responses were collected, comprising 86 males (22.3%) and 299 females (77.7%). Among the respondents, 28 (7.2%) were diagnosed with IGD, while 123 (31.8%) were identified as risky gamers. Significant differences were found between disordered, risky, and normal gamers concerning sleep-related problems (p ≤ 0.05).

CONCLUSION

The prevalence of IGD and risky gamers was 7.2% and 31.8% respectively. There was a significant association between disordered, risky, and normal gamers with daily routine activities.

Metacognition in oral health education: A pedagogy worthy of further exploration

AIM

This study aimed to investigate the perceptions of dental students and teachers about introducing metacognition pedagogy within an established clinical professional curriculum to provide primary data informing its feasibility.

METHODOLOGY AND METHOD

A qualitative study using phenomenography methodology was undertaken as part of a master's dissertation. Semi-structured interviews were conducted on 16 participants which included 9 clinical teachers and 7 dental students.

FINDINGS

Metacognition pedagogy was positively perceived by most of the participants as being beneficial to students' learning in oral health education. A few reported some negativity. All participants identified some challenges to be addressed if a metacognition pedagogy was to be implemented in the undergraduate curriculum.

CONCLUSION

According to the perceptions of most participants in the study, metacognition emerged as a potential factor in improving student learning and exam performance, and facilitating the development of critical thinking, professionalism, and clinical skills. In the context of rigorous, demanding, and challenging courses, and recognising the complexities and uncertainties inherent in health professional working environments, metacognition emerges as a valuable tool, fostering self-awareness, regulation, and adaptability. Ultimately, metacognition has the capability to shape more adept learners and clinicians, yielding benefits for students, teachers, and patients alike.

Student and clinical supervisor perceptions of community-based dental educational experiences: A scoping review

PURPOSE

This scoping review was conducted to map the breadth of experiences in community-based dental education (CBDE), as reported by students and clinical supervisors.

METHODS

This scoping review was conducted following the structured framework proposed by Arksey and O'Malley and adhering to PRISMA-SCR guidelines for scoping reviews. Applying specified eligibility criteria, a systematic search of four electronic databases (PubMed, Scopus, Embase, and Web of Science) was followed by data extraction and data synthesis of full-text articles. Research was conducted between June 2022 and September 2022.

RESULTS

Sixteen articles were identified for the final full-text review. Utilizing a narrative thematic review, the following five domains emerged: preparation for autonomous practice, understanding of primary care dentistry, understanding of health disparities and patient needs, clinical confidence, clinical diversity, and skill development, and perspectives on quality of teaching and assessment.

CONCLUSION

Community/outreach dental education effectively supplements traditional dental school-based education from the perspectives of students and community-based clinical supervisors.

Undergraduate perspectives of the awareness, diagnosis and management of patients with eating disorders

Introduction Patients with eating disorders (EDs) may present with potentially life-threatening complications due to missed and late diagnoses. Dentists can play a fundamental role in the early identification and signposting of patients with suspected EDs.Aims To investigate the awareness of final-year dental students of the aetiology, diagnosis and management of EDs.Methods An anonymous electronic questionnaire was distributed to final-year dental students at the University of Manchester. Respondents reported their knowledge, confidence and education related to the management of patients with EDs.Results Over 50% of students felt they had an above average awareness of the clinical signs and oral manifestations of EDs. The majority of students lacked confidence in discussing a suspected ED diagnosis with patients (75%) and referring them to appropriate services (71%). Additionally, 58% were not confident in planning treatment for and treating a patient with an ED. In total, 100% of students reported that they would benefit from further teaching related to the management of patients with EDs.Conclusion Participants highlighted the need for further teaching related to the diagnosis and management of patients with EDs. This study supports the development of an educational resource of undergraduate dental students.

The impact of virtual reality simulation on dental education: A systematic review of learning outcomes and student engagement

PURPOSE

Virtual reality (VR) simulations have been increasingly employed to train dental students prior to clinical practice. According to the literature, blended learning designs in the form of VR simulations can be utilized by both dental students and instructors to provide quality education. They can also save time and improve motor skills before students enter clinical stages. Therefore, this study was designed to review the importance of available VR simulators and their impact on student learning and outcomes.

METHOD

The Preferred Reporting Items for Systematic Reviews and Meta-Analysis guidelines were followed to review the literature systematically, and different databases such as PubMed, ScienceDirect, Cochrane Library, Scopus, and Google Scholar were searched (up to December 2023) for relevant articles using keywords: "virtual reality," "virtual reality simulators," "virtual reality simulation," and "dental education." The Mixed Methods Appraisal Tool was used to assess the study quality.

RESULTS

After a comprehensive literature search, 1477 research articles were identified, of which 16 were included in the present study. In terms of students' learning outcomes, engagement, and optimal approach, a significant improvement was observed compared to conventional training methods, specifically in their knowledge, performance, confidence, and psychomotor skills.

CONCLUSION

The findings suggest that VR simulators enhance the overall learning abilities of dental students and should be regarded as an integral component of the current curriculum. However, it is important to recognize that VR simulators cannot fully substitute traditional training methods; rather, they can effectively complement them.

Preclinical motor chunking and fine motor skill learning in fixed prosthodontics: Contribution of 3D printing and satisfaction of dental students

INTRODUCTION

In fixed prosthodontics, simulators are essential to students for a progressive transition from preclinical to clinical condition. With the 3D printing technology, we developed resin bars allowing students to better visualise by motor chunking technique. Main objectives of this work were to describe this teaching methodology used in preclinic among different promotions of second, third and fourth dental years and to evaluate students' feedback.

MATERIALS AND METHODS

Two hundred seventy resin strips were digitally designed and printed in resin. All participants from second, third and fourth had to fulfil a User Experience Questionnaire (UEQ) after the preclinical work. The scales of this questionnaire covered the complete impression of the user experience. Both classical aspects of usability (efficiency, insight and reliability) and aspects of user experience (originality, stimulation) were measured.

RESULTS

For the second dental years, 'Attractiveness', 'Stimulation' and 'Novelty' were considered 'Excellent'. For the third dental year, novelty average was considered as 'Excellent'. For the fourth dental year, 'novelty' was considered as 'Good'.

DISCUSSION

The resin plates used in this study are original and stimulating for the students, especially for the second-year dental students who found the exercises useful for their learning. This method can also be used by creating scenarios close to the clinical situations encountered in dentistry departments (more dilapidated teeth, preparation of inlays, post and core, etc.). This 3D printed simulation model is not intended to replace the Frasaco® models but is a complement to the learning process.

Knowledge, Attitudes, and Practices of Dental Students from Romania Regarding Self-Perceived Risk and Prevention of Infectious Diseases

University education is a leading source of information for dental practitioners. Particular emphasis should be given to determining the extent to which students acquire positive knowledge, attitudes, and practices (KAP) and positive metacompetences beyond the scope of each studied dental discipline. We performed a cross-sectional questionnaire-based study among dentistry students from Romania to assess self-perceived risk of infectious diseases and their KAP on topics related to infectious disease prevention. The surveyed students presented good knowledge regarding personal protective equipment (PPE), and their PPE practices significantly correlated with the perceived usefulness of PPE. Only 45.1% correctly recognized all vaccine-preventable diseases (VPDs), but knowledge regarding VPDs significantly improved with increasing year of study (τb = 0.298, p = 0.001), confirming a positive education effect. Awareness regarding the need for screening for bloodborne viruses is poor; the majority of students had never performed a test for hepatitis C virus infection (HCV) (59.4%) or for human immunodeficiency virus (HIV) infection (60.4%). Furthermore, most respondents incorrectly considered themselves at high or very high risk of acquiring BBV, and perceived risk was inversely correlated with willingness to treat patients with hepatitis B virus (HBV) infection (τb = -0.214, p = 0.018), HCV infection (τb = -0.234, p = 0.013), or HIV infection (τb = -0.242, p = 0.006). This led to 3.0% of respondents stating that they would hypothetically deny dental treatment to a patient with HBV infection, 5.0% for HCV infection, and 10.9% for HIV infection, the proportion being significantly higher for HIV (z = -2.2, p = 0.026). In conclusion, better knowledge is needed among dental students regarding their own vaccination history, screening for bloodborne viruses, accurate estimates for their risk of acquiring bloodborne viruses during routine dental practice, and the existence of post-exposure measures following occupational exposure. Improving student knowledge and awareness could translate into a higher willingness to treat patients with chronic viral infections and into a safer and more inclusive dental practice. We propose an adaptation to the university curriculum to cover these key areas for targeted focus to empower future dental practitioners and to facilitate the improvement of across-discipline metacompetences for infection prevention and control.

Preparing students for primary dental care in the Republic of Ireland

There are two dental schools in the Republic of Ireland, graduating approximately 90 new dentists annually following successful completion of a five-year undergraduate course. Currently, once these graduates have been awarded their degree, they have no legal requirement to complete post-graduation training, foundation training or continuing professional development. While the vast majority will do this voluntarily, it sets a high bar for dental educators to prepare these students to practice independently in primary dental care. As in other jurisdictions, there can often be a disconnect between the ethos taught to students for delivering primary dental care in dental schools and remuneration systems once graduates enter the workforce. Changing demographics will need to be reflected in our undergraduate curricula with explicit teaching in the area of gerodontology.

Effectiveness of virtual reality interactive simulation practice in prosthodontic education: A systematic review and meta-analysis

INTRODUCTION

Virtual reality-based interactive simulation (VRIS) provides a safe and controlled environment for dental students and professionals to develop skills and knowledge. This study aimed to investigate the effectiveness of using the VRIS for prosthodontic practice and to explore the trends, application areas, and users' attitudes towards VRIS.

MATERIALS AND METHODS

This review followed the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) guidelines for searching studies published until 21 March 2023 that reported quantitative or qualitative learning outcomes related to the use of VRIS for dental prosthodontic practice and clinical training. The quality of the included studies was assessed using the Medical Education Research Study Quality Instrument (MERSQI) and Newcastle-Ottawa Scale-Education (NOS-E) tools. A random-effects meta-analysis was conducted to compare the intervention group (utilizing VRIS) and the control group (employing conventional prosthodontic training methods) based on performance skill scores and task completion time, with a significance level set at <.05.

RESULTS

The meta-analysis revealed that the utilization of VRIS generally improves students' performance scores (SMD = 1.04; 95% CI, -0.35 to 2.44; I2  > 50%; p = .13) and reduces task completion time (SMD = -0.03; 95% CI, 1.39-7.72; I2  > 50%; p = .93). Notably, using VRIS significantly enhanced the performance scores in implant surgery practice (SMD = 0.26; 95% CI, 0.09-0.42; p < .05). Additionally, the VRIS method significantly reduced task completion time in the cavity restorative preparation task (SMD = -1.19; 95% CI, -1.85 to -0.53; p < .05).

CONCLUSION

Engaging in practice with VRIS has the potential to enhance learning proficiency in prosthodontic education. The advantages associated with VRIS encompass the provision of immediate feedback, decreased task completion time, heightened confidence and motivation, accelerated skill acquisition, improved performance scores, and increased learning engagement.

Measuring satisfaction with dental education among dentists and dental students in Croatia: A cross-sectional study

INTRODUCTION

The study aimed to determine satisfaction level with the quality of education among dental students and dentists in Croatia based on the acquired knowledge and clinical and soft skills.

MATERIALS AND METHODS

An online cross-sectional survey was conducted among 533 dentists and dental students. The questionnaire consisted of four sections with closed-ended questions. The first section included personal and professional data, whereas the second to fourth sections assessed satisfaction with learned basic dental, professional technical or clinal and interpersonal social or soft skills on a 5-point Likert scale. The data were analysed using the Mann-Whitney U-test and linear regression analysis. The significance level was set at .05.

RESULTS

When comparing satisfaction scores between dentists and dental students in terms of basic dental knowledge and skills learned, students showed higher satisfaction scores for the categories of "Emergency Medical Situations" (p = .005) and "Ergonomic Principles of Work" (p = .004). Dentists, on the other hand, showed higher satisfaction for the categories "Selection and use of local anaesthetics and local antibiotics" (p = .005, p = .026; respectively). For the type of technical skills from the different areas of dentistry, dentists were most satisfied with "Oral Surgery" (4.26 ± 0.85), while students were most satisfied with "Oral Medicine" (4.29 ± 0.89). Finally, when comparing satisfaction scores with social skills, dentists had lower satisfaction scores in all categories studied (p ≤ .05).

CONCLUSION

Dental students showed higher overall satisfaction than dentists. The most significant satisfaction was expressed in technical skills learned, and the most considerable dissatisfaction was recorded in the unmeasurable skills category focused on "Career management".

Evaluating Study Approach of Dental Students in Palestine using a Study Process Questionnaire: A Cross-Sectional Study

Background

Learning approach strategies are an important factor to obtain knowledge in any professional course. Surface approach learning and deep approach learning are two main types of learning strategies.

Aim

The aim of present study was to evaluate the study approach strategies of dental students in Palestine.

Materials and Methods

The present study follows a cross-sectional study design, which includes 250 students from first year to fifth year at Al Quds University. The present study evaluated the study approach using a questionnaire called R-SPQ-2F that was filled by all the students using Google forms. The assessment scores from the curriculum assessment examination were also compared with the scores of the R-SPQ-2F questionnaire. SPSS software was used to analyze data.

Results

The results of the ANOVA show that the students in the fifth years had significantly higher mean scores of deep learning approaches than other years (P < 0.001). The students having curriculum assessment scores above 80% showed significantly more deep learning strategies than surface learning strategies (P < 0.05).

Conclusion

Deep learning approach can provide better academic outcome. Newer teaching strategies that enhance the deep learning approach should be encouraged in the dental curriculum.

Assessment of Dental Student Satisfaction after Internships in Collaborative Dental Practices in Saxony-A Retrospective Questionnaire Analysis

The goal for dental students of a university-based program should be to learn about practice procedures in a dental office as part of their studies in order to gain insight into day-to-day activities, such as organizational management, patient communication, and problem-solving strategies. All dental students from the Faculty of Medicine at the University of Dresden in Germany, who completed a one-week internship in an external dental office in the last year before taking the final exam, were invited to participate in the survey (total n = 182 in years 2017-2019 and 2022). After completing the internship, the students were asked to anonymously rate the distinctive competencies they had acquired during their dental studies in terms of clinical and social communication skills. The results of the survey showed a good practicability of the acquired dental knowledge and a general satisfaction of students during their internships. No significant influence of the COVID-19 outbreak and the resulting special regulations in dental practices during the pandemic on student satisfaction was found. Students were more satisfied with their completed internships in smaller cities. Therefore, a stronger inclusion of practices outside the big cities should be considered in the current implementation of the new Dental Licensure Act in Germany.

Exploring the declared and the formal and informal taught curricula at a UK dental school through the lens of pulp management

Introduction This paper explores the declared and formal and informal taught endodontic curriculum within an undergraduate dental programme in the UK as part of a wider study, which also investigates the learned curriculum. Management of the dental pulp was chosen due to the availability of clear internationally recognised guidelines.Method The declared curriculum was identified through existing course guides and seminar and practical session plans. The formal taught curriculum was identified by cataloguing all lectures, practical teaching sessions, seminars and handouts available to dental students. Questionnaires using clinical vignettes were used to explore the informal taught curriculum.Results Valid responses to the questionnaire were received from 25/40 (62.5%) clinical supervisors. Disparities between national guidelines and the declared and taught curriculum were primarily due to broad learning objectives and disparate information from lectures and supervising clinicians. Although the majority of formal teaching aligned with national guidelines, the main deviation occurred within the informal taught curriculum.Conclusion This study highlights disparities between current evidence-based guidelines and the declared and taught curriculum in relation to pulp management in a UK dental school. Recommendations are that all policies, procedures and protocols are updated and aligned to a contemporaneous evidence base annually, plus engagement with clinical lecturers, to enable more standardised teaching.

Undergraduate Students' Experience of Dental Education Programs across Saudi Arabia: An Exploratory Study

Background

Students' satisfaction surveys are valuable tools for assessing and improving the quality of education being imparted. Limited data are available from Saudi Arabia regarding students experience at halfway through an undergraduate dental program.

Objective

To determine students' perception of their halfway experience on various attributes of the quality of dental education programs in public dental schools across Saudi Arabia.

Methods

This exploratory study included all students from four major public universities who had completed their third year of undergraduate dental education during the academic year 2022-23. A previously validated, self-administered, 23-item Students Experience Survey was modified and used to collect data regarding the following five factors: course characteristics, infrastructure and facilities, learning resources, instructor characteristics, and program efficacy.

Results

The questionnaire was administered to 296 students, of which 252 (85.1%) responded. Overall, 84% of the students had a positive experience regarding the quality of the dental education programs. Females reported significantly higher positive experiences than males (mean score: 4.36 vs. 4.21, respectively; P = 0.042). Course characteristics (P = 0.041), instructors' characteristics (P = 0.002), and program efficacy (P = 0.009) were significant predictors of students' overall experience.

Conclusion

This study found that the majority of students had a positive halfway experience with the quality of dental education programs offered in Saudi Arabia. The significant predictors of satisfaction identified in this study can be useful for policymakers to further improve satisfaction levels.

An evaluation of the relationship between clinical requirements and tests of competence in a competency-based curriculum in dentistry

BACKGROUND

The development of competencies in dentistry is a complicated process that calls for the development of not just cognitive and psychomotor abilities but also behaviors and attitudes that change as technical proficiency increases and meaningful patient encounters occur. This study examined the relationship between the number of clinical requirements completed by dental students and subsequent performance on tests of competence. The null hypothesis stated there would be no significant linear relationship different from zero between absolute clinical requirements and grades attained in various tests of clinical competence.

METHODS

Retrospective assessment data for 81 students were used in this analysis. Data included the amounts of clinical requirements completed for operative dentistry, endodontics, periodontics, and fixed prosthodontics together with data on the respective performance in tests of competence. Correlation was ascertained between grades for tests of competence and the corresponding clinical requirements using a non-parametric Spearman's Rho test at an alpha level of 0.05.

RESULTS

Fixed prosthodontics and posterior endodontics were the least common procedures completed by dental students. Statistically significant weak correlations were found between the amounts of clinical requirements performed for posterior endodontic(p = 0.005) and operative procedures (p = 0.006) and associated performance in tests of competence. A moderate correlation was found between the number of fixed prosthodontic procedures completed and associated performance in tests of competence. This latter correlation, however, was not statistically significant (p = 0.654). A significant weak correlation was found between requirements completed for periodontics and the associated test of competence (p = 0.04). A highly statistically significant moderate correlation was found between clinical requirements for anterior endodontics and the associated performance in the tests of competence (p < 0.001).

CONCLUSION

The null hypothesis was rejected since a positive correlation was found between the absolute clinical requirements completed and grades in tests of competence. However, only a weak to moderate degree of correlation was found between the completion of clinical requirements and performance in tests of competence for common clinical procedures that new dental graduates should be able to perform.

Entrustable professional activities in undergraduate dental education: A practical model for development and validation

OBJECTIVE

Entrustable professional activities (EPAs) are tasks that a person who is qualified or is in the process to be credentialed are allowed to engage. There are several levels of entrustment based on degrees of supervision assigned to each EPA. This paper aims to describe the process and outcome of creating EPAs; validate EPAs relevant to undergraduate dental training.

METHODS

A draft set of EPA statements was developed based on the consensus of an expert panel. These were then mapped to the nationally determined minimum experience thresholds (clinical and procedural experiences/competencies) and aligned to task-based instructional strategy. The EPAs were validated to improve the relevance by using a criterion-based rubric.

RESULTS

An end-to-end process workflow led to the development of an EPA-based educational framework to bridge the gaps in the curriculum. The process identified a total of 41 EPAs and out of which, 10 EPAs were notated as core EPAs and will be subjected to structured workplace-based assessment complying to the national standards. The validation exercise rated core EPAs with an overall score matching close to the cut-off of 4.07 (Equal rubric).

CONCLUSION

The end-to-end process workflow provided the opportunity to elaborate a structured process for the development of EPAs for undergraduate dental education. As validation is a continuous process, feedback from implementation will inform the next steps.

Teaching of composite restoration repair in Brazilian dental schools

OBJECTIVES

The aim was to investigate aspects of the teaching of restoration repair as a minimally invasive alternative to replacing defective direct composite restorations in undergraduate curricula teaching programs in Brazilian dental schools.

METHODS

A 14-item validated survey questionnaire was mailed to directors/coordinators of operative/restorative dentistry teachers of Brazilian Dental Schools. Data were collected on demographic characteristics of the teachers and institutions, together with questions on the teaching of the repair of defective resin-based composite restorations as part of the school curriculum; the rationale behind the teaching; the nature of the teaching (preclinical and/or clinical); how techniques were taught, indications for repair, operative techniques, materials used, patient acceptability and expected longevity of completed repairs.

RESULTS

Two hundred and twenty-two (94%) directors/ coordinators of dental curricula in Brazil were contacted. One hundred and thirty-one directors/coordinators (59%) replied, providing the e-mail address from the teacher responsible for the operative/restorative dentistry program in their school. Of these, 104 responded to the questionnaire (79% response rate). Ninety-three (89%) of the participating schools reported teaching composite repairs as an alternative to replacing restorations. Of the theoretical content, 43% was taught at preclinical and clinical levels, whereas most practical experience (53%) was acquired at clinical levels. Eighty-eight schools (95%) reported tooth substance preservation being the main reason for teaching repair techniques. All schools that taught repairs reported high patient acceptability.

CONCLUSIONS

The teaching of composite restoration repair as an alternative to restoration replacement is established in undergraduate programs in most of the Brazilian dental schools surveyed.

CLINICAL SIGNIFICANCE

The reasons for teaching restoration repair in Brazil were found to be quite unanimous among teachers, especially regarding the preservation of tooth structure. Variations were found in the clinical indications for repair, suggesting the need for further investigations. Monitoring repaired restorations should be encouraged and could contribute to future studies.

Cross sectional study on the competence and confidence of dental students and graduates in the management of medically compromised patients and acute medical emergencies

A rapidly aging population means many people have multiple health issues leading to an increased risk of acute medical emergencies. The objective of this study was to evaluate how essential experiential learning is in developing dental graduates' ability to manage medically compromised patients. Three hundred and twenty-seven students and graduates were invited to participate in an online survey to rate their confidence in managing medically compromised patients and acute medical emergencies using a 5-point Likert scale. Competence of knowledge was evaluated using 30 multiple choice questions (MCQs) across six domains. The respondents were also asked whether a theory-only training adequately prepared them to manage medically compromised patients, or whether it must be supplemented with clinical training. Two-hundred and sixty-four responses were collected from 75 undergraduates (UG), 96 junior dental officers (JDO) and 93 senior dental officers (SDO). The UG reported that they infrequently managed medically compromised patients, whereas both the JDO and SDO reported having frequent encounters with these patients. The mean confidence scale in the management of medically compromised patients were 2.62, 3.50 and 3.69 (out of 5), respectively. In contrast, their confidence scale in the management of acute medical emergencies was 2.05, 2.33 and 2.50 (out of 5), respectively. The MCQ scores were 25.51, 26.44 and 26.86 out of 30, respectively. The outcomes of the JDO and SDO were significantly better than the UG (t-tests, p<0.05). All three groups responded that a theory-only training in dental school did not adequately prepare them to manage medically compromised patients. Both the JDO and SDO felt that their clinical work experience better prepared them to manage these patients. Experiential learning from "real-life" clinical experience is an essential component in developing graduates' confidence and competence in the management of medically compromised patients. A dental curriculum with theory-only training in this aspect is inadequate.

An exploration of the impact of working in pairs on the dental clinical learning environment: Students' views

INTRODUCTION

The aims of this study were to explore the undergraduate dental clinical students' experiences and perspectives of paired working in the clinical learning environment.

MATERIALS AND METHODS

An interpretivist methodological approach with a socio-cultural lens was used. A stratified purposeful sampling strategy was chosen. Students digitally recorded three audio-diaries using Gibbs' cycle to guide reflection on collaborating clinically with a peer. 1:1 semi-structured interviews were held using a topic guide. Inductive thematic data analysis was undertaken.

RESULTS

Eight participants were recruited. Main themes related to individual characteristics (motivation, professionalism, knowledge and experience) and relational features (feeling safe, attaching value, positive working relationships) that contributed to effective collaborative partnerships. The social setting is important for learning in the dental clinical environment. Benchmarking is used by students to motivate and reassure. Students learnt from their peers, particularly when they felt safe and supported and had developed good relationships. A lesser quality learning experience was highlighted in the assistant role.

CONCLUSION

Paired working for clinical training was viewed mostly positively. Working with a variety of peers was beneficial and enabled development of interpersonal skills and professionalism. More effective collaborative learning partnerships were described when students felt they belonged and had affective support. Disadvantages of paired working were noted as reduced hands-on experience, particularly for senior students and when working in the assistant role. Ground rules and setting learning goals to change the mind-set about the assistant role were recommended. Emotional and practical support of students is needed in the clinical setting.

Dental students' self-reported confidence level in restorative crown and bridge procedures: A UK quantitative study

INTRODUCTION

Graduating confident students who can flourish and develop in their future career is an important outcome of dental education. The aim of the study was to gain an insight into students' self-reported level of confidence in restorative crown and bridge procedures, highlighting in which stage of the process students have the highest and lowest confidence, depending on the level of supervision required.

MATERIALS AND METHODS

Fourth and final year students (n = 85) were invited to complete a 71-item closed questionnaire specific to self-reported confidence based on the level of supervision required in stages of crown and bridge procedures. Clinical activity for each student from their portfolio system was collected. Non-parametric tests, specifically the Mann-Whitney U-test was used to analyse the continuous non-normal data.

RESULTS

A response rate of 65% was obtained. Final year students were more confident in crown and bridge procedures than fourth year students. Fourth year students were more confident in bridges, whilst final year students were more confident with crowns. Majority of students expressed "average confidence requiring minimal supervision" in crown and bridge procedures. An association between clinical activity, confidence and year of study was noted. Gender was not strongly associated with confidence. Stages in crown and bridge procedures were noted where students lacked confidence.

CONCLUSION

The study highlighted areas in which students were most and least confident in crown and bridge procedures. A positive relationship between clinical activity in crown and bridge procedures and student self-confidence has been noted for both years, though slightly higher in the bridge procedure for fourth year students. We attribute this to the fact that fourth year students had recently completed their bridge competency assessment. Upon graduating, final year students still require supervision and reported average confidence in certain aspects of crown and bridge procedures, namely occlusal, bevel and axial reduction.

Confidence-level of foundation dentists in the North West of England in the placement of preformed metal crowns using the Hall technique

INTRODUCTION

The Hall technique is a biological caries management approach commonly used within the field of paediatric dentistry. The technique involves the placement of a preformed metal crown (PMC) without local anaesthetic, caries removal or tooth preparation. Despite being widely taught across dental schools in the United Kingdom, evidence from the literature suggests that PMCs are seldom used in general dental practice, even by newly qualified dentists. This study aimed to evaluate the experience and self-reported confidence of Foundation Dentists (FDs) in the North West of England in the placement of preformed metal crowns using the Hall technique.

MATERIALS AND METHODS

An anonymous questionnaire was distributed to 117 Foundation Dentists in the North West of England.

RESULTS

Forty-six questionnaires were returned, giving a response rate of 39%. The results revealed that 80.4% of FDs felt "somewhat," "quite" or "extremely" confident with the Hall technique at the point of graduation. This increased to 85.3% upon completion of Dental Foundation Training.

CONCLUSION

Foundation Dentists' self-reported confidence in the Hall technique was reasonably high both at the point of qualification and upon completing Dental Foundation Training. Nevertheless, many of the Foundation Dentists felt that they would benefit from further postgraduate training on the technique.

Modular Digital and 3D-Printed Dental Models with Applicability in Dental Education

Background and Objectives: The ever more complex modern dental education requires permanent adaptation to expanding medical knowledge and new advancements in digital technologies as well as intensification of interdisciplinary collaboration. Our study presents a newly developed computerized method allowing virtual case simulation on modular digital dental models and 3D-printing of the obtained digital models; additionally, undergraduate dental students' opinion on the advanced method is investigated in this paper. Materials and Methods: Based on the digitalization of didactic dental models, the proposed method generates modular digital dental models that can be easily converted into different types of partial edentulism scenarios, thus allowing the development of a digital library. Three-dimensionally printed simulated dental models can subsequently be manufactured based on the previously obtained digital models. The opinion of a group of undergraduate dental students (n = 205) on the proposed method was assessed via a questionnaire, administered as a Google form, sent via email. Results: The modular digital models allow students to perform repeated virtual simulations of any possible partial edentulism cases, to project 3D virtual treatment plans and to observe the subtle differences between diverse teeth preparations; the resulting 3D-printed models could be used in students' practical training. The proposed method received positive feedback from the undergraduate students. Conclusions: The advanced method is adequate for dental students' training, enabling the gradual design of modular digital dental models with partial edentulism, from simple to complex cases, and the hands-on training on corresponding 3D-printed dental models.

Fostering globally competent dental students through virtual team-working, problem-solving and person-centred multi-disciplinary care planning

Background/purpose

: Development and acquisition of communication, logical thinking, team-building, critical appraisal, critical thinking and person-centred multi-disciplinary care planning must be considered as skill sets and global core competencies for a dental professional. Therefore, an international online study course to foster undergraduate dental students' skill sets in these areas was established and this study aimed to report the perceptions of participants.

Materials and methods

An international online course consisting of three levels pertaining to the school year was delivered to dental undergraduates of Japan and Thailand from September to December in 2021. An online questionnaire survey was conducted to obtain feedback from the participants and assess the implementation of the course.

Results

In total, 64 responses were obtained from students who participated in all the assigned online sessions and completed the questionnaire (a response rate of 88%). More than 95% of students from each level felt that the programme increased their motivation to study clinical dentistry, and was beneficial for their future and made them appreciate the importance of participating in international exchange. The ratio of favourable respondents was more than 90% with a 95% confidence interval.

Conclusion

Fostering globally competent dental students is important and the acquisition of necessary skill sets could be enhanced through international virtual team-working, problem-solving and person-centred multi-disciplinary care planning activities. These are beneficial for undergraduate dental student training so that they graduate with a broader global perspective and an appreciation of the importance of delivering person-centred culturally sensitive dental care.

Evaluation of Record Keeping in Exodontia Department of Punjab Dental Hospital, Lahore: A Clinical Audit

INTRODUCTION

An audit was conducted in the exodontia department of Punjab Dental Hospital, Lahore, to assess the quality of records being kept by the undergraduate students in their third and final year, who form a major chunk of the workforce in the hospital, working in the mentioned department. The main objective behind this exercise was to improve the standards of record keeping and bring them in line with the standards practiced around the world, ultimately resulting in better patient care.

METHODOLOGY

This audit was undertaken while keeping in view all the necessary steps of a successful clinical audit. Initially, 150 records were randomly obtained from undergraduates of both third and fourth years and evaluated against a modified CRABEL score, which grades the records on a scale of 100. The results of this part of the audit were shared with the batches that were doing their clinical rotation in exodontia at the time of this audit, and a teaching session was conducted on better record-keeping standards. Following this, a repetition of the previous audit was undertaken to complete the audit cycle.  Results: The most commonly omitted component in the records in the initial audit was the patient complaint closely, followed by proper medical history and supervisor signatures. In the following, 'reaudit' compliance was seen to be improved, and all the components of record-keeping less commonly being omitted except medical history and date.

CONCLUSION

A more comprehensive patient record keeping is possible with proper intervention and inculcation of record-keeping awareness in the undergraduate course, especially in the clinical years.

Endodontic Clinical Diagnostic Skills amongst Undergraduate Dental Students: Cross-Sectional Study

The purpose of the study was to evaluate the clinical endodontic diagnostic skills amongst undergraduate dental students at pre-clinical and clinical levels at Cardiff University School of Dentistry. An online questionnaire containing eight questions about endodontic diagnosis and hypothetical clinical scenarios was sent to all year 3rd, 4th, and 5th-year undergraduate dental students who were divided into G1, G2, and G3 groups. The data were analysed descriptively and reported in percentages. Around 121 students out of 226 responded to the questionnaire with a response rate of 53.5%. The overall correct response from G1 (3rd year) was 31.6% to 65.8%, G2 (4th year) was 73% to 93%, and G3 (5th year) was 73.2% to 92.7%. The study concludes that the 4th and 5th-year undergraduate dental students’ responses to the hypothetical clinical scenarios were higher than the 3rd-year students. However, regarding questions about the endodontic diagnosis, the percentages of correct answers were similar among all the 3rd, 4th, and 5th-year students. Therefore, further studies assessing endodontic diagnostic skills amongst the same cohort of students during their progression in the undergraduate course are recommended.

Mind the 'GAPP': a pre-graduation assessment of preparedness for practice amid a pandemic

Introduction 'Preparedness for practice' refers to a multifaceted concept, encompassing not only clinical skills, but also broader, non-clinical skills, such as communication and professionalism. Previous graduates have reported feeling less prepared for complex procedures, such as molar endodontics and surgical extractions. Dental students typically utilise their final year to refine their clinical skills, however, the COVID-19 pandemic has meant that newly qualified dentists will have had around six months where they have not performed clinical dentistry before beginning dental foundation training (DFT).

Aims This study aimed to explore final year students' self-reported preparedness for practice, identify areas of relative weakness that may influence future training needs and to highlight any perceived impact of the pandemic on final year experience and potential impact on DFT.

Materials and methods The current Graduate Assessment of Preparedness for Practice (GAPP) questionnaire was adapted for our specific research aims and piloted and the PreGAPP questionnaire distributed via the social media channels of dental school student societies. Analysis was carried out using IBM Statistical Package for the Social Sciences software using descriptive statistics and the Mann-Whitney U test for two unrelated variables.

Results Responses were received from final year students across all 16 UK dental schools. Students reported increased preparedness across domains in which they had the most experience; for example, providing preventative advice and administering local anaesthesia. Male students reported feeling significantly more prepared than female students, mature students significantly more than younger students, and students on four-year courses significantly more than traditional five-year courses. The COVID-19 pandemic was expected to have a major-to-severe impact on undergraduate experience and future DFT prospects.

Conclusion Dental graduates in the COVID-19 era may have significantly different training needs to those before them. Complex clinical procedures remain the areas where students feel they are least prepared for practice. The importance of a clinical passport to highlight current experience level to trainers, alongside the creation of a personal development plan at the beginning of DFT, will ensure that targeted and personalised training can be implemented where required.

Illustrates the perceived effect of the COVID-19 pandemic on final year students' preparedness for practice and the impact it may have on dental foundation training through quantitative and qualitative methods.

Highlights and explores the differences in the perceptions of preparedness for practice of final year students across sex, age and course length.

Explores various aspects of clinical supervision and assessment and reinforces the importance of appropriate student-staff ratios to ensure clinical learning is effective.

Augmented Reality and Virtual Reality in Dentistry: Highlights from the Current Research

Many modern advancements have taken place in dentistry that have exponentially impacted the progress and practice of dentistry. Augmented reality (AR) and virtual reality (VR) are becoming the trend in the practice of modern dentistry because of their impact on changing the patient’s experience. The use of AR and VR has been beneficial in different fields of science, but their use in dentistry is yet to be thoroughly explored, and conventional ways of dentistry are still practiced at large. Over the past few years, dental treatment has been significantly reshaped by technological advancements. In dentistry, the use of AR and VR systems has not become widespread, but their different uses should be explored. Therefore, the aim of this review was to provide an update on the contemporary knowledge, to report on the ongoing progress of AR and VR in various fields of dental medicine and education, and to identify the further research required to achieve their translation into clinical practice. A literature search was performed in PubMed, Scopus, Web of Science, and Google Scholar for articles in peer-reviewed English-language journals published in the last 10 years up to 31 March 2021, with the help of specific keywords related to AR and VR in various dental fields. Of the total of 101 articles found in the literature search, 68 abstracts were considered suitable and further evaluated, and consequently, 33 full-texts were identified. Finally, a total of 13 full-texts were excluded from further analysis, resulting in 20 articles for final inclusion. The overall number of studies included in this review was low; thus, at this point in time, scientifically-proven recommendations could not be stated. AR and VR have been found to be beneficial tools for clinical practice and for enhancing the learning experiences of students during their pre-clinical education and training sessions. Clinicians can use VR technology to show their patients the expected outcomes before the undergo dental procedures. Additionally, AR and VR can be implemented to overcome dental phobia, which is commonly experienced by pediatric patients. Future studies should focus on forming technological standards with high-quality data and developing scientifically-proven AR/VR gadgets for dental practice.

Proficiency Based Progression (PBP) training- the future model for dental operative skills training?: A systematic review and meta-analysis of existing literature

OBJECTIVE

To evaluate the effectiveness of Proficiency-Based Progression (PBP) operative training using validated performance metrics, by comparing this to standard, conventional training methods.

DATA

This systematic review was conducted in accordance with the guidelines of the Transparent Reporting of Systematic Reviews and Meta-Analyses (PRISMA). Study quality was assessed using the MERSQI tool and the Cochrane Risk of Bias tool. Results were pooled using biased corrected standardized mean difference and ratio-of-means (ROM). Summary effects were evaluated using a series of fixed and random effects models. The primary outcome was the number of procedural errors performed comparing PBP and non-PBP-based training pathways. In quantitative synthesis testing for procedural errors, a pooled meta-analysis on 87 trainees was conducted using random-effects models. In a ROM analysis, PBP was estimated to reduce the mean rate of errors by 62%, when compared to standard training (ROM 0.38, 95% CI: 0.25; 0.58; p < 0.001) Sources: The electronic databases of PubMed, Embase, Web of Science, MEDLINE and Cochrane library's CENTRAL were searched from inception to 8/11/2021. Filters activated were Randomized Controlled trials, clinical trial.

STUDY SELECTION

13 studies were included for review with 11 included in the quantitative synthesis from 174 potentially relevant publications identified by the search strategy. Main inclusion criteria were studies comparing standard surgical/operative training with proficiency-based simulation training using validated metrics based on expert performance.

CONCLUSIONS

Our meta-analysis found that PBP training improved trainees' performances, by decreasing procedural errors. There is sufficient evidence to explore PBP training for use in dental skills training. PBP training was estimated to reduce the mean rate of operative errors by 62%, when compared to standard training. Given that there is a direct correlation between operative skill and patient outcomes, these data suggest that there is sufficient evidence to explore PBP training for use in dental skills training.

A Hands-On Exercise on Caries Diagnostics among Dental Students-A Qualitative Study

According to current care practices, the aim is to prevent the onset of caries lesions and to stop the progression of incipient lesions. A visual lesion assessment system, International Caries Detection and Assessment System (ICDAS), has been developed to promote reliability and repeatability of assessment of different stage caries lesions. The aims of this study were to evaluate the experiences of a hands-on exercise with authentic teeth as an adjunct to lecturing among third-year dental students and to evaluate the learning process during the hands-on exercise measured by qualitative (inductive content) analysis of the given feedback. In 2018, 51 third-year dental students at the University of Oulu, Finland, participated in a hands-on exercise on caries detection, where they assessed the depth and activity of lesions in extracted teeth using the ICDAS classification. After the lecture, students evaluated the exercise, giving feedback according to five given topics, three of which were analyzed using inductive content analysis. The exercise was considered useful and necessary but, overall, also challenging. The diverse activities and materials, as well as observational methods, promoted learning. The classification of lesions, the diagnostic methods, and the fact that there was not enough time to adopt things during the exercise were found to be challenging. For developing the exercise, the students suggested that more time should be scheduled for it and there should be more individual teaching. This qualitative study showed that, despite the challenge in caries diagnostics, dental students perceive the hands-on exercise as both a communal and individual learning experience.