What I wish I'd learned at dental school

Navigating the Path to Independent Dentist: A Qualitative Phenomenological Exploration

OBJECTIVE

The objective of this study was to explore the process of becoming an independent dentist, extending beyond the entry-level period.

MATERIALS AND METHODS

Fifteen general dental practitioners were interviewed. The recorded interviews were transcribed verbatim, and utilizing Colaizzi's descriptive phenomenological method, we sought to exclude subjectivity and derive meanings and themes from participants' experiences concerning the process of becoming independent dentists.

RESULTS

The study identified 3 phases in the process of developing as an independent dentist: (1) the foundation phase, involving dental training as a student under faculty supervision; (2) the extension phase, expanding experience as an entry-level dentist; (3) the equilibrium phase, characterized by providing stable dental care based on diverse experience and professionalism.

CONCLUSION

Becoming an independent dentist entails more than unsupervised treatment provision; it involves developing the professionalism necessary for delivering quality dental care through deliberate practice and reflection.

CLINICAL RELEVANCE

The study outlines the stages of transitioning to an independent dentist, spanning foundational training, entry-level experience, and achieving stable care provision. Emphasizing the importance of professionalism and reflection, it provides a valuable framework for enhancing dental education and on-going professional development, fostering both technical proficiency and a commitment to quality patient care.

Flipped classroom orthodontic education for undergraduate dental students: A factor analysis study

INTRODUCTION

Dental schools have a primary responsibility to devise a curriculum that enhances students' confidence and knowledge in orthodontic case analysis. This study aims to compare the confidence levels and performance of undergraduate students in orthodontic case screening, moderated by faculty in a lecture-based format against their self-analysis of the same cases 1 year later, using a case-based and flipped learning approach.

MATERIALS AND METHODS

This study involved 100 fifth-year students. The same group received predoctoral orthodontics training through an instructor-centered, didactic approach in their fifth year and a case-based, student-centered, flipped classroom approach in their sixth year. At the end of each semester, the students completed an orthodontic case analysis and a self-reflection survey.

RESULTS

This study found no significant differences in diagnostic capabilities for orthodontic findings between the two methods studied. However, the self-evaluation survey data revealed an increase in students' confidence levels. This was specifically in terms of carrying out independent orthodontic case diagnosis, effectively communicating with orthodontic specialists, and their comfort in approaching orthodontic cases following the flipped classroom approach. Despite increased confidence in case diagnosis, the results showed that final-year students are uncertain about creating initial treatment plans and referring cases at an early stage.

CONCLUSION

Despite no observed improvement in students' orthodontic diagnostic abilities after another semester of student-centered learning, their confidence in diagnosing orthodontic cases was notably enhanced.

Problem-based learning curriculum disconnect on diversity, equitable representation, and inclusion

Diversity, equity, and inclusion (DEI) mission statements continue to be adopted by academic institutions in general, and by dental schools around the globe in particular. But DEI content seems to be under-developed in dental education. The objectives of this study were two-fold: to extract information from all the PBL cases at University of British Columbia's Faculty of Dentistry curriculum in terms of the diversity, equitable representation, and inclusion of patient and provider characteristics, context, and treatment outcomes; and; to compare these findings with the composition of the British Columbia census population, dental practice contextual factors, and the evidence on treatment outcomes within patient care. Information from all the 58 PBL cases was extracted between January and March 2023, focusing on patient and provider characteristics (e.g., age, gender, ethnicity), context (e.g., type of insurance), and treatment outcomes (e.g., successful/unsuccessful). This information was compared with the available literature. From all the 58 PBL cases, 0.4% included non-straight patients, while at least 4% of BC residents self-identify as non-straight; there were no cases involving First Nations patients although they make up 6% of the British Columbia population. Less than 10% of the cases involved older adults who make up almost 20% of the population. Only Treatments involving patients without a disability were 5.74 times more likely to be successful compared to those involving patients with a disability (p<0.05). The characteristics of the patients, practice context, and treatment outcomes portrayed in the existing PBL cases seem to differ from what is known about the composition of the British Columbia population, treatment outcome success, and practice context; a curriculum disconnect seems to exist. The PBL cases should be revised to better represent the population within which most students will practice.

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".

The fear of letting go and the Ivory Tower of dental educational training

ISSUE

Clinical training in dental education is complex and happens mostly within a well-controlled environment such as a university dental clinic where oral health care services are delivered; it is mostly student-centered. While such training is important, it is also possible to augment and enhance it by training predoctoral dental students outside such a clinic within off-site community-based placements using a more person-centered approach. However, there seems to exist a reluctance in recognizing and utilizing the work produced in these off-site placements holistically as an integral part of students' clinical assessment.

APPROACH

Community-based clinical experience adds value to the training of our predoctoral dental students. This perspective describes the benefits of community placements and recognizes their importance in the clinical and professional development of a future graduate. It also presents a way to assess students' performance that by-and-large mirrors that of the university dental clinic while striking a balance between student-centered education and person-centered care.

IMPACT

In this perspective, we argue that the clinical work delivered at a community placement ought to be weighted equitably with the clinical work delivered at a university clinic when assessing students' competency as a whole. Our message is to keep a balance of student-centered education and person-centered care to the benefit of all those involved.

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.

Perception of recently graduated Dutch dentists of their education

INTRODUCTION

The curriculum of the three dental schools in the Netherlands consists of a three-year bachelor's and three-year master's course. The education programmes focus inter alia on clinical dental reasoning, thinking and acting scientifically, general oral healthcare activities, and communication and (inter)professional cooperation. This study examined how recently graduated dentists, in the light of their work experience, evaluate their education in retrospect.

MATERIALS AND METHODS

All 1074 dentists who graduated between 2012 and mid-2017 were invited by e-mail to answer a web survey. Of those, 314 (29%) took part in the study.

RESULTS

The majority of dentists were positive about their knowledge of general and clinical oral healthcare fields when they graduated (70% and 68%, respectively). Fewer dentists were satisfied with their skills in terms of some specific procedures (50%) and clinical professional areas (33%). By far, the majority (85%) were satisfied with the educational skills of their teachers. The majority (70%) felt that their education fitted in well with their professional practice. Nevertheless, 60% thought a year's trainee work experience would be a good idea. The overall evaluation of dentists who have their own practices was less positive than those who do not.

CONCLUSION

Knowledge and skills relating to managing a practice were not sufficiently addressed in the programme. The introduction of a practical internship would be desirable, preferably during the education. But when they look back, the majority of recently graduated dentists in the Netherlands are generally positive about the education they received.

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.

Exploring the business skills, experiences and preparedness of UK-based private physiotherapists when establishing and developing a physiotherapy business: A hermeneutic phenomenological study

AIM

To explore the business skills, experiences and preparedness of UK-based private physiotherapists when establishing and developing a physiotherapy business.

DESIGN

A hermeneutic phenomenological approach.

PARTICIPANTS

Six UK-based private physiotherapy practice owners were recruited via purposive and snowball sampling.

METHODS

In-depth, semi-structured video interviews (n = 12) were audio-recorded and transcribed. Field notes, respondent validation and a reflexive diary were used. Data underwent line-by-line analysis, identifying codes and themes. Constant comparison of data, codes and themes occurred throughout. Peer review was utilised, and small sections of data and all emerging codes were independently reviewed.

RESULTS

Knowledge acquisition: participants acquired business knowledge from training, external help, and trial-and-error approaches. Improved physiotherapy-related business training was requested. Business skills: Business plans were generally organic or lapsed with time. Success and timing of marketing strategies varied widely. The altruistic nature of many physiotherapists creates difficulties in requesting payments for services. Clinical policies: Lone working risks appeared more weighted towards protecting staff from physical abuse rather than allegations.

CONCLUSIONS

Improved physiotherapy-related business support and guidance may be beneficial. Focusing on word-of-mouth, website marketing, and establishing support networks may benefit practice owners. Greater consideration of the potentially negative implications of lone working, particularly accusations of inappropriate sexual behaviour, is recommended.

Preparedness for practice of newly qualified dental practitioners in the Australian context: an exploratory study

BACKGROUND

The current study explored the perspectives of preparedness for dental practice from a range of relevant stakeholders (i.e., educators, employers, final-year students, graduates, practitioners, and professional associations) using an anonymous online survey in which participants described either their preparedness for practice, or the preparedness of graduates they have encountered, across six domains.

RESULTS

A total of 120 participants completed the survey. Participants were from several Australian states and territories; regional, rural, and urban locations; and working in the public and private sector. Students and new graduates generally felt prepared for activities in all the identified domains. Stakeholders reported consistently that the knowledge of dental profession graduates was at the required level to enter practice in Australia in a safe way. Activities involving the knowledge of clinical entrepreneurship and financial solvency were the dimensions where students and graduates felt least prepared (e.g., explaining fees, negotiating finances). In the domains involving clinical and technical competencies, students and new graduates self-assessed as less prepared around managing dental trauma and medical emergencies. On the other hand, activities around social and community orientation, and to a lesser extent professional attitudes and ethical judgements, were the dimensions where students and graduates felt the most prepared.

CONCLUSIONS

Present findings indicate that there appear to be good standards of preparedness for practice for graduate dental professionals. This exploratory study provides insights into the nature of preparedness for Australian dental professionals and provides a basis for targeting education and professional development to address areas of need.

Oral surgery wait times in NHS secondary dental care in England: a five-year review

Aims To report the oral surgery referral to treatment waiting times in hospitals in England and to identify any trends in the percentage of patients seen within 18 weeks.Materials and methods Data published by the NHS statistics team was analysed from 2016-2020.Results Pre-COVID-19, the best performing month was February 2016, with 91.5% of patients seen within 18 weeks. The worst performing month was September 2019, with 79.3% of patients seen within 18 weeks. Oral surgery was the worst performing speciality for 8% of months (4/50). Post-COVID-19, oral surgery was the worst performing speciality for 70% of months (7/10). In July 2020, the percentage of patients seen within 18 weeks of an oral surgery referral dropped to 24%.Discussion Over the last five years, there has been a steady decline in the number of patients who have been seen within 18 weeks of their oral surgery referral. There has also been an increase in oral surgery referrals to secondary care which needs to be addressed.Conclusion Improvements to undergraduate and postgraduate training, combined with enhanced commissioning of primary care services, is required.

From inputs to outputs: an analysis of the changes to learning outcomes for dental undergraduate education in the UK

Introduction/aims Preparing for practice (PfP) was thought to represent a significant shift in the expectations of dental undergraduates compared to its predecessor, The first five years (TFFY). This project aimed to explore requirement changes by comparing learning outcomes for undergraduate dentists in these two documents. Changes in curriculum requirements defining clinical, professional, or a blend of these skills were also investigated.

Methods Curriculum mapping was used to compare learning outcomes in PfP to requirements in TFFY.

Results The total number of learning outcomes increased from 101 to 149 in PfP compared to TFFY. There was a proportional reduction in outcomes describing clinical skills and an increase in the proportion of outcomes describing professional and blended skills. Three TFFY requirements did not appear in PfP and a further 23 learning outcomes in PfP were absent in TFFY.

Conclusions In the transition from TFFY to PfP, there has been an overall increase in the number of outcomes graduates must attain before they can register with the General Dental Council. There are more outcomes defining professionalism which subsequently has resulted in proportional but not actual decrease in outcomes related to clinical skills. While there is uncertainty over how schools have managed curricula to incorporate these changes and thus whether the perception of graduate preparedness can be directly attributable to these changes, it is timely to consider any changes within dental learning outcomes in the context of preparedness concerns.

Highlights developments in content and structure of learning outcomes for dentists in the revision from The first five years to Preparing for practice.

Considers how professional and clinical skills have been incorporated into curricula.

Acknowledges the importance of stakeholder involvement when revising learning outcomes so that there is a clear understanding of the skillset of the dental graduate.

Influence of dental college funding and time established on the satisfaction of dental graduates with their undergraduate experience in Saudi Arabia

OBJECTIVE

With the emergence of graduates from all government and private-funded dental colleges in Saudi Arabia (SA), it is pressing to explore the graduates' satisfaction with the dental undergraduate education and training they received. The aim of the present study was to investigate the graduates' satisfaction with their education and training according to college funding arrangements (government vs private-funded) and time since establishment (established- >15 years vs new-<15 years).

METHODS

A piloted, electronic questionnaire was emailed to all the members of the Saudi Dental Society who had graduated from government and and private dental colleges in SA (2,185 registrants).

RESULTS

The response rate was 36.4%, with 580 government-funded college graduates (72.9%) and 216 private college graduates (27.1%) having completed and returned the questionnaire. The distribution of participants between established and new colleges was 'established' 396 (49.8%) and 'new' 400 (50.2%). Levels of dissatisfaction were recorded for graduates from established and new, government-funded and private colleges. The levels of dissatisfaction were greater amongst the graduates of established and government-funded colleges.

CONCLUSION

The findings of the present study indicate concerning levels of dissatisfaction with important aspects of dental education in SA. It is suggested that there is a pressing need for more integration of basic and clinical sciences and an emphasis on hands-on training. National coordination of arrangements for dental curricula could make a major contribution to addressing the problems identified.

A nationwide survey assessing the satisfaction of dental colleges graduates with their undergraduate experience in Saudi Arabia

OBJECTIVE

To date, there are no publications on the Saudi graduates' perceived value of their dental curriculum. The aim of this nation-wide survey was to investigate graduates' satisfaction with specific disciplines of their dental education and training. The first part of this study addressed findings according to the respondents' gender and the number of years of postgraduate experience (Graduate-related factors).

METHODS

An electronic questionnaire was emailed to registrants of the Saudi Dental Society, specifically dental interns, general dentists, and specialized dentists who graduated from private and governmental dental colleges in Saudi Arabia (n = 2185).

RESULTS

The response rate was 36.4 %. The number of male respondents was (n = 352, 44.2 %), the remainder being female (n = 444, 55.8 %). The number of recent dentists (≤ 5 years since graduation) was (n = 428, 53.8 %) and experienced dentists (n = 368, 46.2 %). There were statistically significant gender variations in satisfaction levels, and among dentists with different post-graduation experiences. Although male and female dental students are taught similar curriculums and have similar graduation requirements, there were statistically significant differences in various subjects covered. Similarly, recent and experienced dentists reported statistically significant differences in satisfaction in various subjects.

CONCLUSION

This study provides graduates' perspectives on the strengths and weaknesses of their dental education in Saudi Arabia. The findings help in curriculum reform and collaborations between the dental colleges nationally. Ultimately this can lead to formulating a national dental accreditation and assessment body.

CLINICAL SIGNIFICANCE

The findings of this study provide graduates' perspective on the dental education received in Saudi Arabia. This will help stimulate discussion and collaboration within and amongst the colleges on improving their curriculum in this fast-paced, evolving field of dentistry.

What I wish I'd learned as an orthodontic trainee: an online survey of British Orthodontic Society members concerning postgraduate training experiences

Objective:

To survey the opinion of recently qualified and established orthodontists on the perceived value of their training and to identify specific areas which which were considered to be deficient, adequately covered or focussed on excessively.

Design:

Descriptive cross-sectional survey

Setting:

Online electronic questionnaire.

Participants:

Members of the British Orthodontic Society (BOS).

Methods:

An electronic questionnaire was circulated to members of the BOS focusing on dental education history, and opinions concerning orthodontic teaching generally and specific clinical and non-clinical subjects. Information was also obtained in terms of possible need for improvement, modification or removal of teaching on focused academic and clinical aspects.

Results:

A total of 217 responses were received from 1080 emailed invitations resulting in a response rate of 20.1%. Respondents were generally satisfied with their training both in relation to theoretical, academic and practical aspects. However, training was regarded as deficient by some respondents in respect of temporary anchorage devices (38%), bonded retainers (6%), experience with lingual appliances (47%), removable aligners (44%), inter-proximal reduction (24%) and adult orthodontics (16%), working with therapists (32%), and NHS contracts (47%) and commissioning (47%).

Conclusion:

The overall satisfaction of BOS members with postgraduate orthodontic training is generally high, although both recently qualified and established practitioners emphasised the need for better exposure to training in specific practical aspects and practice management within the NHS.

Perceptions of foundation dentists on minor oral surgery teaching in dental foundation training

AIMS

The aim of this service evaluation was to explore the experiences of foundation dentists (FDs) during their dental foundation year (DFT) in the field of oral surgery and surgical extractions.

METHODS

A phenomenological approach was taken aiming to explore the FDs' experiences through a qualitative design. All FDs in the region deemed eligible for the evaluation were invited to attend a semi-structured interview or answer a qualitative questionnaire when attending for their exit interview at the completion of DFT. The interviews were then transcribed and thematic analysis was undertaken.

RESULTS

79 FDs took part in the evaluation, representing 86% of trainees eligible for inclusion. Findings showed that not all FDs had the opportunity to undertake surgical extractions independently during the year. Data was analysed and 4 main themes generated when evaluating FDs' experiences; specific learning encounters, influence of the educational supervisor, supportive learning environment and ready for independent practice.

CONCLUSIONS

This evaluation shows that there are a number of factors associated with FDs' experience during DFT, and not all FDs are leaving the training with a positive experience, with a query as to whether they are fulfilling the aims of training to become an "independent practitioner." It poses questions about what can be done to improve future training and what exactly does DFT need to achieve in terms of experience in surgical extractions.

Why UK dental education should take a greater interest in the behavioural and social sciences

Recent moves by public health academics and social scientists for increased recognition of the behavioural and social sciences (BeSS) in medical education in the UK have put the role and place of the BeSS in dental education back on the curricular agenda. Behavioural and social sciences have been a component of the UK dental curriculum since 1990 but, to our knowledge, have only been reviewed once, in 1999. The aim of this article is to reignite a discussion about the role and place of BeSS in dental education in the UK. It reiterates the benefits of BeSS to dental education and dentistry in general, while remaining cognisant of the implicit and explicit barriers that can conspire to side-line their contribution to dental education. This paper concludes by making renewed calls for more integration of BeSS into the dental undergraduate curriculum as well as sectoral recognition for its contribution to the advancement of dental education and the professional development of dentists.

A cross-sectional study of dentists about the need for a practice management course in undergraduate dental program

Objective

To evaluate dentists' opinions about the need for a practice management course in the undergraduate dental program.

Materials and Methods

This cross-sectional study was conducted in 2017 on practicing dentists in Lahore, Pakistan. A self-administered pilot-tested questionnaire was distributed among 588 dentists using a convenience sampling method to obtain their responses about the need for a practice management course. Descriptive statistics and bivariate and multivariate logistic regression analyses were performed.

Results

About 83.8% of 588 dentists completed the questionnaires. There were 36.7% of males and 63.3% of females (mean age 26.22 ± 4.8 years). The principles of patient management (94.1%), time management skills (90.3%), and teamwork (89.2%) were the most commonly agreed topics of the practice management course. The least agreed topics included office design (59.2%), health-care systems (60.9%), and inventory systems (69%). Most participants (74.4%) thought that a practice management course is required to successfully manage a dental practice, and 63% recommended to include the course in the dental curriculum. Multivariate logistic regression showed that dentists working in private clinic (odds ratio (OR): 3.35, P = 0.001), dentists with graduation within ≤ past 5 years (OR: 3.64, P = 0.001), and dentists who attended a practice management course (OR: 3.12, P = 0.001) were more likely to agree to the need of a practice management course to successfully run a dental office.

Conclusion

Most dentists believed that a practice management course is required for a successful dental practice. The development and implementation of such a course should be based on the feedback from dentists to ensure evidence-based approaches.

Leadership in dental education

Dental school education continues to evolve at a significant pace. The challenge for those in leadership positions in dental education is to deliver a curriculum which is contemporary, evidence-based, and at the same time meeting the expectations of regulators and the established dental workforce - the latter being professional colleagues, including employers of future graduates. An important change in recent years is the acceptance that dental education itself is no longer a 'start-stop process', beginning at entry to dental school and concluding at graduation. Rather, dental education should be viewed as a continuous and life-long continuum. Perhaps one of the greatest attributes we can develop in our students is the desire and ability to seek to update, refresh and develop their knowledge and skills in the ever-advancing world of dental practice.

Endodontists' Intravenous Sedation-related Attitudes and Professional Behavior: A National Survey

INTRODUCTION

Research shows that a high percentage of endodontic patients are interested in receiving intravenous (IV) sedation. The objectives of this study were to assess endodontists' IV sedation-related education, attitudes, and professional behavior and to explore whether providing versus not offering IV sedation procedures was associated with IV-related education and attitudes and whether background characteristics and education were related with IV sedation attitudes and behavior.

METHODS

Data were collected with an anonymous Web-based survey from 616 members of the American Association of Endodontists (response rate = 29%).

RESULTS

Only 10% of respondents agreed/strongly agreed that they had adequate training in IV sedation. However, 48% agreed/strongly agreed that there was a need for IV sedation in their practice. Although 69% did not offer IV sedation, 26% had another professional provide it, and 4% provided it themselves. These 3 groups of providers differed in the mean quality of their IV sedation-related education (scale from 1-5 with 5 = best education: 1.50 vs 1.62/2.37, P < .001) and the positivity of their attitudes toward IV sedation (2.90 vs 3.50/4.21, P < .001). Although the quality of IV sedation education was not correlated with the graduation year, the more recently respondents had graduated, the more positive they were toward providing education about IV sedation (r = .16, P < .001).

CONCLUSIONS

Most endodontists did not evaluate their IV sedation-related graduate education positively. However, nearly half acknowledged the need for IV sedation in endodontics. The more recently they graduated, the more they agreed that IV sedation-related graduate education was needed but also that staff training and maintenance of equipment would be a problem.

In their own words: investigating the preparedness of final year dental students in the UK for independent general dental practice

Introduction

There is relatively little data on the preparedness of UK dental graduates for independent general dental practice. Two recent studies have indicated that graduates appear well prepared, but although quantifying the level of preparedness, they provide limited understanding of the underlying factors contributing to preparedness. This study aims to more deeply understand the contributing factors leading to assertions of graduate preparedness using focus groups of final year dental students, and semi-structured interviews of senior faculty members.

Materials and methods

Three UK dental schools were visited in order to conduct both study elements. Focus groups and semi-structured interviews were audio recorded and fully transcribed. Thematic analysis of the transcripts resulted in the production of a thematic matrix.

Results

The major categories of the thematic matrix were classified as extrinsic; including the role of educators and features of the course, and intrinsic; relating to fear of the unknown, the development of adult learning abilities and less easily identifiable attributes in the development of competence, which became known as 'bricks and mortar'.

Discussion

Students felt that the most important factor affecting their preparation was clinical exposure. Outreach placements were felt to be particularly useful, the simulation of general dental practice being highly valued by final year students. The interaction with educators was also felt to be a key influence on preparedness, with the involvement of general practitioners in dental school teaching felt to be helpful, perhaps giving students an extended exposure to general practice.

Conclusion

It is hoped that the rich data derived from this study may allow an invaluable insight into factors contributing to preparedness of new dental graduates, which may then be considered in the light of any proposed changes in the curricula or syllabi.

Getting to the Root of Fine Motor Skill Performance in Dentistry: Brain Activity During Dental Tasks in a Virtual Reality Haptic Simulation

Background

There is little evidence considering the relationship between movement-specific reinvestment (a dimension of personality which refers to the propensity for individuals to consciously monitor and control their movements) and working memory during motor skill performance. Functional near-infrared spectroscopy (fNIRS) measuring oxyhemoglobin demands in the frontal cortex during performance of virtual reality (VR) psychomotor tasks can be used to examine this research gap.

Objective

The aim of this study was to determine the potential relationship between the propensity to reinvest and blood flow to the dorsolateral prefrontal cortices of the brain. A secondary aim was to determine the propensity to reinvest and performance during 2 dental tasks carried out using haptic VR simulators.

Methods

We used fNIRS to assess oxygen demands in 24 undergraduate dental students during 2 dental tasks (clinical, nonclinical) on a VR haptic simulator. We used the Movement-Specific Reinvestment Scale questionnaire to assess the students’ propensity to reinvest.

Results

Students with a high propensity for movement-specific reinvestment displayed significantly greater oxyhemoglobin demands in an area associated with working memory during the nonclinical task (Spearman correlation, r_s=.49, P=.03).

Conclusions

This small-scale study suggests that neurophysiological differences are evident between high and low reinvesters during a dental VR task in terms of oxyhemoglobin demands in an area associated with working memory.