Are the evaluation criteria used in preclinical endodontic training courses relevant? A preliminary study

Evaluation of a broken instrument removal training course for general dentistry residents

INTRODUCTION

To help general dentistry residents better manage the intracanal broken instrument situation, we introduced a hands-on training course into the endodontic curriculum of a general dentistry residency programme.

MATERIALS AND METHODS

Thirty general dentistry residents and 30 residents with endodontic specialty training background in a general hospital served as the experimental group and reference group, respectively. The experimental group underwent a training course including a 30-min lecture and two hands-on sessions (2 h each). After the course, residents from both groups were asked to perform the instrument removal procedure on simulated root canals. Success rate, procedure time and canal volume change were compared between groups. Questionnaire results were also analysed.

RESULTS

All residents successfully managed to remove the broken instruments in the test. Procedure time was significantly longer for general dentistry residents (15.8 ± 5.7 min vs 13.7 ± 4.5 min, Mann-Whitney U test, p = .038). Canal volume change was significantly greater for general dentistry residents (8.53 ± 3.82 μl vs 5.94 ± 2.73 μl, independent-samples t-test, p = .004). In the questionnaires, trainees gave overall positive ratings for the course. The marginal homogeneity test on before and after scores of the questionnaire items showed the training helped the trainees to reduce the stress level associated with instrument breakage (p < .001). It also motivated the trainees to remove the broken instrument in some straightforward cases (p < .001).

CONCLUSION

The broken instrument removal training course could help the general dentistry residents better manage the intracanal broken instrument situation.

Rubric vs. numeric rating scale: agreement among evaluators on endodontic treatments performed by dental students

BACKGROUND

Students´ assessment should be carried out in an effective and objective manner, which reduces the possibility of different evaluators giving different scores, thus influencing the qualification obtained and the consistency of education. The aim of the present study was to determine the agreement among four evaluators and compare the overall scores awarded when assessing portfolios of endodontic preclinical treatments performed by dental students by using an analytic rubric and a numeric rating scale.

METHODS

A random sample of 42 portfolios performed by fourth-year dental students at preclinical endodontic practices were blindly assessed by four evaluators using two different evaluation methods: an analytic rubric specifically designed and a numeric rating scale. Six categories were analyzed: radiographic assessment, access preparation, shaping procedure, obturation, content of the portfolio, and presentation of the portfolio. The maximum global score was 10 points. The overall scores obtained with both methods from each evaluator were compared by Student's t, while agreement among evaluators was measured by Intraclass correlation coefficients (ICC). The influence of the difficulty of the endodontic treatment on the evaluators´ scores was analyzed by one-way ANOVA. Statistical tests were performed at a pre-set alpha of 0.05 using Stata 16.

RESULTS

Difficulty of canal treatment did not influence the scores of evaluators, irrespective of the evaluation method used. When the analytic rubric was used, inter-evaluator agreement was substantial for radiographic assessment, access preparation, shaping procedure, obturation, and overall scores. Inter-evaluator agreement ranged from moderate to fair with the numeric rating scale. Mean higher overall scores were achieved when numeric rating scale was used. Presentation and content of the portfolio showed slight and fair agreement, respectively, among evaluators, regardless the evaluation method applied.

CONCLUSIONS

Assessment guided by an analytic rubric allowed evaluators to reach higher levels of agreement than those obtained when using a numeric rating scale. However, the rubric negatively affected overall scores.

Influence of Preclinical Training on Root Canal Treatment Technical Quality and Confidence Level of Undergraduate Dental Students

Objectives

The aim of this study was to investigate the influence of exposure to additional preclinical endodontic training on undergraduate students' technical quality of root canal treatment and overall confidence levels in endodontics.

Methods

Technical quality of root canal treatment performed clinically by fifth-year undergraduate students was evaluated and divided into two groups: Group 1, teeth treated by students who had attended both a preclinical endodontic block course and an elective preclinical course. Group 2: teeth treated by students who had not attended the elective preclinical course. All students were also invited to participate in a survey to rate their undergraduate endodontic training and confidence levels performing endodontic treatment. Statistical analysis of data was performed using Person chi-square test, Fisher Freeman Halton exact test, and t-test. A p-value <0.05 was considered statistically significant.

Results

There was no significant difference between the two groups in overall obturation quality (p=0.619). However, more teeth treated by attendees were of adequate obturation length (p=0.015) and lacked procedural errors (p=0.004). Significantly more elective course attendees rated their undergraduate endodontic training as adequate (p=0.002), but there was no significant difference in the level of confidence between the attendees and the non-attendees.

Conclusion

Within the limitations of this study, additional preclinical training showed minimal effect on overall quality of root canal treatment performed clinically by undergraduate students and did not enhance their confidence levels; however, it was associated with more satisfaction with their undergraduate endodontic education.