Chairside teaching and the perceptions of dental teachers in the UK

Characteristics of Good Clinical Teachers: Insights From Japanese Clinical Trainee Dental Residents

BACKGROUND

The characteristics of good clinical teachers, as considered by clinical trainee dental residents, remain uncertain not only in Japan but also globally. This study aimed to ascertain the characteristics associated with a good clinical teacher as perceived by clinical trainee dental residents in Japan; additionally, it determined how these characteristics differ from those identified in previous studies at various learning stages and in other professions, particularly among physicians.

METHODS

Employing a qualitative approach, data were gathered through semi-structured focus groups and in-depth interviews. The focus group transcripts were analysed meticulously and independently, with anonymisation and coding conducted by the three authors. Clinical trainee dental residents or dentists within a year of completing clinical training were recruited using maximum variation sampling until thematic saturation was achieved.

RESULTS

A total of 38 participants took part in eight focus group interviews and one in-depth interview. The 376 identified descriptors were categorised into 44 distinct themes. 'Provides advice at the level of resident' emerged as the most prevalent theme, followed by 'Provides feedback and formative assessment', 'Provides practical guidance', and 'Models a close dentist-patient relationship'. Using Sutkin's primary categories (teacher, physician and human characteristics), 25 of the 44 themes were classified as teacher characteristics, 10 as physician characteristics, and 9 as human characteristics. Twenty-two themes corresponded directly to Sutkin's framework, and 22 were novel contributions of this study.

CONCLUSIONS

While the identified common themes resonate with those recognised in the medical field as attributes of good clinical teachers, half of the themes were specific to the dental domain and were independently established. These findings underscore the successful elucidation of the unique attributes specific to good clinical teachers among clinical trainee dental residents.

Virtual counselling of tobacco cessation during the COVID-19 pandemic: A qualitative study on the experiences and perceptions of Malaysian dental undergraduates and their patients

INTRODUCTION

When dental institutions had to close down during the Movement Control Order (MCO) implementation due to the COVID-19 pandemic, dental students were faced with delays in completing their tobacco cessation schedule. An alternative was to allow students to conduct virtual counselling (VC) for smoking cessation for their patients to address their clinical requirements. This study aimed to explore Malaysian dental undergraduates' and patients' experiences undergoing smoking cessation counselling through virtual platforms.

MATERIALS AND METHODS

The study consisted of qualitative, semi-structured Focus Group Discussions (for students, n = 23) and in-depth interviews (for patients, n = 9); to phenomenologically describe the perceptions of participants involved in the VC. Each session was recorded with the participants' permission. The recorded session was transcribed verbatim and thematically analysed using the qualitative data analysis software, NVivo™.

RESULTS

The major themes that emerged were: (1) General opinions and experiences, (2) Content of VCs, (3) Remote access to counselling, (4) Patient-clinician relationships, (5) Technical issues, (6) Changes after VCs, and (7) Future application. Most students and patients were quite comfortable with VC as it is convenient, allowing students to be creative and avoid the hassle of transport and traffic. However, some of the students felt that it lacked the personal touch and guidance from lecturers who would normally be present during physical class.

CONCLUSION

Virtual counselling enables remote access to counselling, but it is also subjected to some limitations, especially regarding lack of clinical assessments, human touch and internet issues. Though participants were optimistic about adapting it in the future, multiple factors must be considered. Ultimately, the behavioural change will depend on the patient's motivation in making a difference.

Knowledge assessment on cleft lip and palate among recently graduated dentists: a cross-sectional study

BACKGROUND

The complex presentation, associated co-morbidities and multi-disciplinary requirements dictate the requirement for in-depth knowledge in order to effectively manage patients with cleft lip and palate (CLP). We aimed to develop a validated questionnaire for cleft lip and palate knowledge assessment and to evaluate the knowledge of cleft lip and palate among a group of recently-graduated dentists.

MATERIALS AND METHODS

A multiple-site, cross-sectional questionnaire-based study was conducted. The study population included recently graduated dentists involved in a dental internship program. A bespoke questionnaire was developed and validated, with internal consistency assessed using Cronbach's alpha and factor analysis performed. A 47-item prototype was distilled into a 15-item questionnaire. This was distributed to the participants with a response rate of 67% obtained.

RESULTS

The overall proportion of correct responses among dental interns was moderate (73%). The best results were found in relation to CLP treatment including the effect of unfavorable surgical outcomes on speech (89.5%) and the impact of CLP on the occlusion (87.6%). The lowest rate of correct responses (26.7%) was identified in relation to the association between CLP and smoking.

CONCLUSION

A validated CLP questionnaire was developed, permitting evaluation of the knowledge of cleft lip and palate and its management among recently graduated dentists. There is limited appreciation among dental interns of the risk factors for CLP as well as post-surgical complications. Given that general dentists are often the gatekeepers for the management of patients with cleft lip and palate, it is important that the findings of this survey are used to inform the curriculum and teaching of cleft lip and palate.

3D printed versus commercial models in undergraduate conservative dentistry training

INTRODUCTION

The treatment of carious lesions is one of the most fundamental competencies in daily dental practice. However, many commercially available training models lack in reality regarding the simulation of pathologies such as carious lesions. 3D printed models could provide a more realistic simulation. This study provides an exemplary description of the fabrication of 3D printed dental models with carious lesions and assesses their educational value compared to commercially available models in conservative dentistry.

MATERIALS AND METHODS

A single-stage, controlled cohort study was conducted within the context of a curricular course. A stereolithographic model was obtained from an intraoral scan and then printed using fused deposition modelling. These models were first piloted by experts and then implemented and compared against commercial models in a conservative dentistry course. Experts and students evaluated both models using a validated questionnaire. Additionally, a cost analysis for both models was carried out.

RESULTS

Thirteen dentists and twenty-seven 5th year dental students participated in the study. The 3D printed models were rated significantly more realistic in many test areas. In particular, the different tactility and the distinction in colour was rated positively in the 3D printed models. At 28.29€ (compared to 112.36€), the 3D printed models were exceptionally cost-efficient.

CONCLUSIONS

3D printed dental models present a more realistic and cost-efficient alternative to commercial models in the undergraduate training of conservative dentistry.

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.

Dental Education during the COVID-19 Pandemic in a German Dental Hospital

Due to the SARS-CoV-2 pandemic, dental treatment performed by undergraduate students at the University of Marburg/Germany was immediately stopped in spring 2020 and stepwise reinstalled under a new hygiene concept until full recovery in winter 2020/21. Patient treatment in the student courses was evaluated based on three aspects: (1) Testing of patients with a SARS-CoV-2 Rapid Antigen (SCRA) Test applied by student assistants (SA); (2) Improved hygiene regimen, with separated treatment units, cross-ventilation, pre-operative mouth rinse and rubber dam application wherever possible; (3) Recruitment of patients: 735 patients were pre-registered for the two courses; 384 patients were treated and a total of 699 tests with the SCRA test were performed by SAs. While half of the patients treated in the course were healthy, over 40% of the patients that were pre-registered but not treated in the course revealed a disease being relevant to COVID (p < 0.001). 46 patients had concerns to visit the dental hospital due to the increase of COVID incidence levels, 14 persons refused to be tested. The presented concept was suitable to enable patient treatment in the student course during the SARS-CoV-2 pandemic.

A multicenter study of dental curricula in Asia/Pacific nations: The views and experiences of final-year dental students

OBJECTIVES

The objective of this qualitative study was to gain greater understanding of final-year dental students' views on and experience of their dental curricula in 4 universities from different Asia/Pacific countries, including New Zealand, Australia, and Hong Kong (China).

METHODS

A qualitative study approach was used, with semistructured interviews conducted with final-year students from each of the 4 universities.

RESULTS

Interviews were conducted with 60 final-year dental students, and 5 main themes were extracted from the interviews: (1) the definition of an "ideal" dental curriculum, (2) theoretical teaching, (3) transitional tools, (4) assessment, and (5) grading.

CONCLUSION

The findings provide insight into final-year students' views of dental curricula and suggestions on possible areas of reform in the dental curriculum. Further investigations are necessary to provide a curriculum that enables students to become competent, future-ready dental practitioners.

3D-printed patient individualised models vs cadaveric models in an undergraduate oral and maxillofacial surgery curriculum: Comparison of student's perceptions

BACKGROUND

Recent advances in 3D printing technology have enabled the emergence of new educational and clinical tools for medical professionals. This study provides an exemplary description of the fabrication of 3D-printed individualised patient models and assesses their educational value compared to cadaveric models in oral and maxillofacial surgery.

METHODS

A single-stage, controlled cohort study was conducted within the context of a curricular course. A patient's CT scan was segmented into a stereolithographic model and then printed using a fused filament 3D printer. These individualised patient models were implemented and compared against cadaveric models in a curricular oral surgery hands-on course. Students evaluated both models using a validated questionnaire. Additionally, a cost analysis for both models was carried out. P-values were calculated using the Mann-Whitney U test.

RESULTS

Thirty-eight fourth-year dental students participated in the study. Overall, significant differences between the two models were found in the student assessment. Whilst the cadaveric models achieved better results in the haptic feedback of the soft tissue, the 3D-printed individualised patient models were regarded significantly more realistic with regard to the anatomical correctness, the degree of freedom of movement and the operative simulation. At 3.46 € (compared to 6.51 €), the 3D-printed patient individualised models were exceptionally cost-efficient.

CONCLUSIONS

3D-printed patient individualised models presented a realistic alternative to cadaveric models in the undergraduate training of operational skills in oral and maxillofacial surgery. Whilst the 3D-printed individualised patient models received positive feedback from students, some aspects of the model leave room for improvement.

COVID-19: The immediate response of european academic dental institutions and future implications for dental education

The COVID-19 pandemic has had an immediate and dramatic impact on dental education. The Association of Dental Education in Europe decided to carry out an investigation to assess the immediate response of European Academic Dental Institutions. An online survey was sent to both member and non-member dental schools to investigate the impact on non-clinical and clinical education, assessment and the well-being/pastoral care measures implemented. The preliminary findings and discussion are presented in this paper, for the responses collected between the 25 March and 5 April 2020. The survey at this time of publication is ongoing, and detailed results can be accessed https://adee.org/covid-19-european-dental-education%E2%80%99s-immediate-response.

Exploration of constructive feedback practices in dental education chairside teaching: A case study

BACKGROUND

Chairside teaching is one of the teaching-learning methods in clinical dental education in which direct care is provided to patients. When students have been deemed competent in carrying out procedures on a dental phantom, they need clinical experience on patients, with guidance and constructive feedback from clinical teachers. Constructive feedback is an important learning platform in helping students analyse the strong and the weak aspects of their performance in order to identify required improvements. This study aimed to explore the practice of giving constructive feedback in chairside teaching.

METHOD

A qualitative method with a case study design. Data were collected through in-depth interviews and focus group discussions (FGDs) with clinical teachers and students in clinical rotation. Data triangulation was carried out by observing the practice of giving constructive feedback in chairside teaching and document analysis from January to April 2019. Results of the in-depth interviews and FGDs were transcribed verbatim and analysed using a thematic analysis approach.

RESULT

In-depth interviews with five programme coordinators and FGDs with two groups of clinical teachers (N = 8 and N = 6) and two clinical student groups (N = 8 each). Three main themes emerged in this study: ways to provide feedback, challenges on feedback provision and challenges on feedback follow-up.

CONCLUSION

Differences in perception between clinical teachers and students were identified, influenced by students' interactions with the learning environment. Interventions are to be encouraged that involve teachers, students and institutions, and the interactions amongst the three.

Competence, competency-based education, and undergraduate dental education: a discussion paper

INTRODUCTION

The aim of undergraduate dental education is to provide competent dentists to serve societal needs and improve population oral healthcare. Competency-based education has influenced the development of dental education for decades but this term is problematic. This article explores components of competency-based undergraduate health professional education in order to help the dental profession have a better understanding of the context and purposes of undergraduate dental education.

METHODS

This is a discussion paper based on a wide reading of the literature on the education of health professionals with a specific focus on competency-based undergraduate education.

RESULTS AND DISCUSSION

Competence comprises an integration of knowledge, skills and attitudes indicating a capability to perform professional tasks safely and ethically. The process of becoming a competent practitioner is complex. Four characteristics of competency-based education are: curriculum components and content shaped by societal needs; focused on student-centred learning; learning achievement; and limited attention to time-based training and numerical targets. Alongside a competency-based approach, undergraduate dental education can be influenced by institutional features and external factors but these receive little consideration in the literature.

CONCLUSION

Understanding competence, competency-based education, and institutional and external factors will help to improve educational quality, define roles and professional development for the dental educator, and inform further research.

Identifying and preparing the next generation of part-time clinical teachers from dental practice

Part-time general dental practitioners (GDPs) and dental care professionals (DCPs) working in practice are being increasingly utilised to deliver undergraduate clinical dental education to both dental and hygiene/therapy students. As such, there is a need for appropriate recruitment processes and ongoing staff development in the different and complex role of the clinical teacher. Recently a group of experienced dental practitioners, making a journey from GDP to part-time clinical teacher, identified common themes, experiences, challenges and realisations. These were: 'what is clinical dental education?'; 'me as a clinical teacher'; and 'specific teaching issues'. The themes highlighted the complexity of dental education and the different environment of the teaching clinic from general practice. Some of the themes identified could be a starting point for the induction process to facilitate an easier transition from experienced GDP to clinical teacher. With the current demands from both students and patients alike, the 'three way dynamic of patient, student and teacher' needs to be supported if dental schools are to attract and develop the highest quality clinical teachers. It is of critical importance to give an exceptional experience to students in their clinical education as well as to patients in terms of excellent and appropriate treatment. The challenge for deans and directors of education is to find the resources to properly fund teacher recruitment, induction and the development of part-time GDPs in order to produce the expert teachers of tomorrow.

Developmental guidelines for good chairside teaching – a consensus report from two conferences

Developmental Guidelines for Chairside Teaching are a direct outcome of 10 years of research, originally prompted by feedback from undergraduate dental students who not only thought that the teaching they received was uneven and variable in quality, but also felt strongly that they learned more with educationally trained teachers than those with little or no teacher training. Workshops embracing the views of teaching colleagues from many other Dental Schools produced a consensus view that developmental guidelines for teachers would provide a valuable resource. A conference to consider all aspects on chairside teaching and learning was convened with delegates invited from all UK Dental Schools. This was subsequently followed by a second conference to develop specific guidelines for chairside teaching and learning. The Nominal Group Technique was used in the first chairside teaching conference, and Structured Small Expert Groups were used in the second. The overall consensus from these workshops and conferences were as follows: (i) developmental guidelines for chairside teaching can act as a useful resource for teachers to improve and maintain their standard of chairside teaching, (ii) developmental guidelines can be divided into themes of organisational issues and learner and teacher qualities, and (iii) Guidelines should be 'developmental' because they encourage chairside teachers to focus on the next immediate goal to maintain and improve quality and standards. These developmental guidelines could provide a universal toolkit for improved chairside teaching which would result in a better student learning experience. Set out in this way these guidelines have currency across academic and practical skills levels, different educational systems, philosophies and country boundaries.

So how do you see our teaching? Some observations received from past and present students at the Maurice Wohl Dental Centre

This study explores student perceptions of clinical teaching delivered at the Maurice Wohl Dental Centre, King's College London Dental Institute. An on-line survey together with two paper-based questionnaires were used to invite three immediate past cohorts of final-year dental students to reflect and comment on their experiences during their year of attendance. Supporting data from current student focus group and face-to-face interviews were also included in the study. The principal findings from these triangulated methodologies were that the overwhelming majority of students felt they got on very well with their teachers. The development of a positive professional relationship with the teacher appeared to motivate students to work better. Teaching thought to be overly didactic and authoritarian would not be well received. The principal teaching style identified at the Centre was considered to be supportive and nurturing, encouraging a self-motivated and reflective approach to clinical practice.

Making the most of teaching at the chairside

This study examines the chairside as an opportunity for teaching and learning. It sets out to understand how students learn in the dental clinic so that they can better be supported in their clinical learning. The study draws on current theories of learning to establish a rationale for effective chairside teaching. Current theories highlight the active role of learners in 'constructing' their own knowledge of a field, and emphasise the importance of active learning and reflection in this process. The study is practical in nature. It weaves evidence from empirical studies of medical and dental clinical teaching, as well as 'best practice tips' from the literature, with theory to suggest a strategy for effective teaching in the clinical context. The study concludes with a caveat, warning that effective clinical teaching requires an investment in time.