The Graduating European Dentist: Contemporaneous Methods of Teaching, Learning and Assessment in Dental Undergraduate Education

Clinical skills examination as part of the Swedish proficiency test of dentists educated outside of the EU/EEA

INTRODUCTION

The increase in the migration of dentists educated outside the EU/EEA calls for the sharing of information and evaluation of recognition processes within countries in the EU. In 2017, the Swedish National Board of Health and Welfare implemented the Proficiency test, a recognition process for dentists who have completed an education programme outside the EU/EEA. The Proficiency test consists of a theoretical and an integrated clinical skills examination, followed by a 6-month clinical practice. The clinical skills examination is a two-part examination that includes an OSCE and an operative test on a dental manikin. This paper presents data from proficiency tests between 2018 and 2022, and explores factors related to grade fail, that is, demographics, theoretical exam scores and language comprehension.

MATERIALS AND METHODS

In a cohort study, demographics and factors associated with grade fail were explored using test results from theoretical and clinical skills examinations (n = 181) from 2018 to 2022. Pearson correlation coefficient and linear regression analysis were used for studying correlations and associations between exam results. Univariable linear and logistic regression models were used for background variable associations with clinical skills exam outcomes.

RESULTS

Higher age was a significant risk factor for failing the clinical skills examination and the OSCE. Higher scores in the theoretical exam reduced the odds of failing the OSCE but were not associated with results in the operative test or the overall results of the clinical skills examination. Regarding the OSCE there was a statistically significant difference within all professional qualifications explored between participants who passed and participants who failed the OSCE.

CONCLUSIONS

Four years of data collection reveal that age and previous theoretical exam results influence the odds of failing the clinical examination. The study results also highlight the necessity of multiple assessment formats to assess clinical and communication skills of foreign-trained dentists.

Consensus report of the second European Consensus Workshop on Education in Periodontology

BACKGROUND

The second European Consensus Workshop on Education in Periodontology was commissioned, as a result of the changes in the discipline and the advances in educational methods/technology, to update the 2009 Consensus report of the first European Federation of Periodontology (EFP) Workshop on the same topic that was jointly authored by the Association for Dental Education in Europe.

AIM

To identify and propose changes necessary in periodontal education at three levels, namely undergraduate, specialist and continuing professional development (CPD), with respect to learning outcomes, competencies and methods of learning/training and evaluation.

METHODS

Four working groups (WGs) considered education in periodontology at the undergraduate, specialist and CPD levels, and education methods. Four commissioned position papers, one per WG, summarized the relevant information. Workshop participants gathered at an in-person consensus meeting to discuss the individual reviews, and this consensus report summarizes the conclusions.

RESULTS

The learning outcomes for undergraduate and specialist education in periodontology have been updated, and a proposal for learning outcomes for CPD programmes was made. Learning/teaching/training and evaluation methods were proposed for each level of education, which included face-to-face, virtual and blended learning methods.

CONCLUSION

Developments in oral/dental medicine and in contemporary educational technologies have been translated into updated learning outcomes and learning/teaching/ training/evaluation methods relevant to education in periodontology.

O-HEALTH-EDU: A viewpoint into the current state of Oral Health Professional education in Europe: Part 1: Programme-level data

INTRODUCTION

Current legislation leaves Oral Health Professional (OHP) education open to wide interpretation and may result in significant variation in educational practice and resultant professional attributes across Europe. Data regarding the current state of OHP education across Europe is limited. The aim of Part 1 of this series is to provide programme-level data for Primary Dental Degree Programmes, Dental Hygiene and Postgraduate Education.

METHODS

A 91-item questionnaire was developed following the Delphi method. The questionnaire and the Articulate glossary of OHP education terms were developed concurrently to facilitate a common understanding of language. Piloting was performed in multiple stages and included institutions internal and external to the research group. The questionnaire was uploaded online and converted to a data hub, allowing dental schools to control their own data and update the data provided whenever they wish. All ADEE member schools (n = 144) were invited to provide data. Forty questions relating to school details, Primary Dental Degree Programmes, Dental Hygiene and Postgraduate Education were included in this part of the series.

RESULTS

Seventy-one institutions from 25 European countries provided data between June 2021 and April 2023, which represents a response rate of 49.3% of ADEE members. Programme-level data for Primary Dental Degree Programmes, Dental Hygiene and Postgraduate Education is presented including programme length, funding, languages and fees, student numbers and demographics, student admission and selection processes and permission to practice after graduation.

CONCLUSION

This series of papers, as far as the authors are aware, are the first attempts to build a comprehensive picture of the current state of OHP education in Europe. A comprehensive view of the state of OHP education in Europe is not yet available but the O-Health-Edu data hub provides a means for all education providers in Europe to contribute data to reach this goal. It is anticipated that the data hub will be updated and built upon over time to continually establish a clearer picture of the state of OHP education in Europe.

O-Health-Edu: A viewpoint into the current state of oral health professional education in Europe: Part 2: Curriculum structure, facilities, staffing and quality assurance

INTRODUCTION

Oral health professional (OHP) education is likely to vary across Europe in accordance with an EU directive that is open to broad interpretation. It is not clear how OHP curricula are structured or delivered across Europe. The objectives of Part 2 of this paper series are: (i) to provide an overview of common practices in curriculum structure, the availability of facilities, staffing (faculty) and quality assurance processes and (ii) to consider how the existing programme structures align to stakeholder guidance documents.

METHODS

A total of 27 questions from a 91-item questionnaire were used for this manuscript. The questionnaire was developed following the Delphi method to establish consensus from a group of experts. Members of the research team and colleagues from other countries in Europe completed a multi-step piloting process. An online data hub was created to allow the respondents to be data controllers and respond to the questionnaire. ADEE member schools (n = 144) were invited to provide data.

RESULTS

Totally, 71 institutions from 25 European countries provided data between June 2021 and April 2023, which represents a response rate of 49.3% of ADEE members. Data on curriculum approaches, teaching methods, integration of topics of interest, clinical education, staff-student ratios, access to facilities and new technologies, teaching staff (faculty) and quality assurance processes are presented for Primary Dental Degree Programmes.

CONCLUSION

To the best of our knowledge, this series of papers are the first attempts to provide a comprehensive overview of OHP education in Europe. Results showed that the majority of European dental programmes are engaged in providing innovative and scientifically grounded education in order to develop quality future OHPs. Nevertheless, significant variability in the delivery of clinical education across the European OHP schools was notable in this dataset. A comprehensive view of the state of OHP education in Europe is not yet available but the O-Health-Edu data hub provides a means for all education providers in Europe to contribute data to reach this goal. It is anticipated that the data hub will be updated and built upon over time to continually establish a clearer picture of the state of OHP education in Europe.

Teledentistry within oral health care providers' training: A scoping review

INTRODUCTION

Despite teledentistry (TD) ubiquitous utilization, it has yet to be fully adopted by oral health care providers' educational training. This study aimed to explore TD incorporation in the training of oral health care providers.

METHODS

This review included studies on the TD content offered to oral health care providers. The JBI (Joanna Briggs Institute) methodology was used, and two reviewers screened the literature. Studies published between 1989 and 4 June 2022 were searched using "Teledentistry" and "Education" as initial keywords. The searched databases included MEDLINE, Cochrane Library, CINAHL, EPPI, Scopus, Epistemonikos, ERIC, MedEdPORTAL, ProQuest Dissertations and Theses Global, and Google Scholar. All of the relevant literature, regardless of their language, were added. The data were extracted using an extraction table and are presented in tabular and narrative summary formats.

RESULTS

A total of 2180 documents were found, and 1804 documents were screened by the title and abstract after deduplication; 59 were selected for full-text review; and 19 were eligible for data extraction. Of all studies, 63.15% were published after the COVID-19 pandemic. Practicing TD and TD reimbursement were some of the addressed topics. Didactic education and hands-on practice were the most employed training methods. Self/peer evaluations and surveys were among the employed assessment techniques.

CONCLUSION

TD education has been emphasized during the COVID-19 pandemic. There is a variation in the existing TD educational programmes, from addressing topics to assessment techniques. However, the number of educational programmes on this topic is sparse.

Domains, competences and learning outcomes for undergraduate education in periodontology

AIM

This review is intended to adapt the current conceptual framework in dental education based on four domains to propose a set of competences, learning outcomes and methods of teaching, learning and assessment for undergraduate education in periodontology.

REVIEW

Based on the current framework of competences and learning outcomes recommended by the Association for Dental Education in Europe (ADEE), undergraduate education in periodontology has been updated using the classification and clinical practice guidelines for the diagnosis and treatment of periodontal and peri-implant diseases.

CONCLUSIONS

Specific learning outcomes have been proposed within each competence area, that is in Domain I (n = 10), Domain II (n = 13), Domain III (n = 33) and Domain IV (n = 12). Teaching methods and learning activities based on the different dimensions of the cognitive process have been proposed. Additionally, 10 key learning outcomes have been proposed as exit outcomes, which implies their accomplishment within the final assessment of any graduating student.

Impact of fully online flipped classroom on academic achievement in undergraduate dental education: An experimental study

INTRODUCTION

The last two decades have seen a shift towards blended learning in education due to technological advancements. This study focuses on dental education, comparing two blended learning models -enriched virtual and fully online flipped classroom - in terms of academic achievement, aligning with the Association for Dental Education in Europe's competencies.

MATERIALS AND METHODS

The research was modelled in a quantitative design with a pre-post-test control group experimental design. The study was conducted at Ege University Faculty of Dentistry in Turkey for 4 weeks with the experimental (n = 44) and control (n = 39) groups divided into two groups by impartial assignment. To the experimental group, the theoretical part of the course was tried to be conveyed before each lesson with video lessons prepared with EdPuzzle containing reinforcement questions and a question set consisting of case questions. The practical learning objectives of the course were tried to be gained through the discussion of the previously presented case questions in the online synchronous course. As tools for collecting data, a unique academic achievement test, a course evaluation form and a semi-structured qualitative data collection form were used.

RESULTS

It was seen that the flipped classroom model had a more positive effect on students' academic achievement than the enriched virtual classroom model. The general satisfaction levels of the participants regarding these two models are also higher in favour of the flipped classroom model.

CONCLUSION

This study provides significant findings for educational institutions, policymakers and educators about the impact of fully online teaching methods on academic achievement. In this context, the flipped classroom method can be preferred both in cases where education is blocked and in dental education institutions that want to ensure digital transformation efficiently and partially remotely.

Evaluating the use of role-play simulations in teaching management of medical emergencies in the dental clinic

BACKGROUND

Practical hands-on training is necessary for clinical competence in managing medical emergencies in the dental setting. Therefore, the King Abdulaziz University Faculty of Dentistry developed a role-play simulation-based clinical module for training clinical years (Years 4, 5, and 6) dental students in medical emergency management between 2016 and 2020. This study aimed to assess the knowledge and skills of years 4, 5, and 6 dental students before and after the completion of the role-play simulation-based medical emergency training module.

METHODS

A mandatory four-hour annual training module was designed consisting of a 45-minute lecture on the medical emergency basic action plan and overview, four hands-on stations, and six role-play simulation-based medical emergency stations. A 16-item multiple choice test was used to assess the knowledge of the students before and after the training module every academic year. An objective structured clinical exam (OSCE) on a medical emergency scenario was administered to the students graduating each year. The difference between the pre- and post-module test scores and the one-time OSCE pass/fail rate were analyzed statistically using appropriate tests.

RESULTS

A total of 846 students participated in the study between 2017 and 2020: 275 once, 483 twice, 87 thrice, and one participated four times; in total, 1,506 assessments were conducted. Overall, the pre-test and post-test mean scores were 9.4 ± 3.0 and 13.5 ± 1.6, respectively. All students showed significant improvements in the post-test scores compared to the pre-test scores. Year 4 students showed the highest improvement, followed by Year 5 and Year 6. There was a statistically significant association between the pass/fail rate of the OSCE station and the number of times the module was taken.

CONCLUSIONS

The significant improvement in the scores of clinical year students in this study supports an annual mandate for all dental students to undergo simulation-based competency training in their clinical years. Teaching institutions are recommended to utilize simulation and hands-on instruction to teach medical emergency management.

Longitudinal assessment of undergraduate dental students: Building evidence for validity

PURPOSE

To investigate the content and criterion validity, and reliability of longitudinal clinical assessment of undergraduate dental student clinical competence by determining patterns of clinical performance and comparing them with validated standalone undergraduate examinations.

METHODS

Group-based trajectory models tracking students' clinical performance over time were produced from LIFTUPP© data for three dental student cohorts (2017-19; n = 235) using threshold models based on the Bayesian information criterion. Content validity was investigated using LIFTUPP© performance indicator 4 as the threshold for competence. Criterion validity was investigated using performance indicator 5 to create distinct trajectories of performance before linking and cross-tabulating trajectory group memberships with a 'top 20%' performance in the final Bachelor of Dental Surgery (BDS) examinations. Reliability was calculated using Cronbach's alpha.

RESULTS

Threshold 4 models showed all students followed a single upward trajectory in all three cohorts, showing clear progression in competence over three clinical BDS years. A threshold 5 model produced two distinct trajectories, and in each cohort a 'better performing' trajectory was identified. Students allocated to the 'better performing' trajectories scored higher on average in the final examinations for cohort 2 (29% vs 18% (BDS4); 33% vs. 15% (BDS5)) and cohort 3 (19% vs. 16% (BDS4); 21% vs. 16% (BDS5)). Reliability for the undergraduate examinations was high for all three cohorts (≥0.8815) and did not change appreciably when longitudinal assessment was included.

CONCLUSIONS

There is some evidence to support that longitudinal data have a degree of content and criterion validity for assessing the development of clinical competence in undergraduate dental students, which should increase confidence in decisions based on these data. The findings also provide a good foundation for subsequent research.

Using storytelling in undergraduate dental education: Students' experiences of emotional competence training

AIM

The aim of the study was to explore the use of storytelling as a teaching method for emotional competence interventions within undergraduate dental curriculum (dental and dental hygiene students).

MATERIALS AND METHODS

Students participated in five sessions related to emotional competence: one theoretical and four practical. During the latter, divided in small groups, students told individually two stories: a story about a clinical situation in which they had an emotional experience and a story concerning a patient's experience of the same emotion. Each session focused on a single emotion: happiness, fear, anger and shame. A questionnaire was used to collect perceptions about enjoyment, how stories were chosen, what was learned and if the sessions were stimulating in any way. A focus group was organised to collect reflections about the learning environment, process of learning and specific skill set developed during these sessions.

RESULTS

The majority of the students enjoyed listening, telling and preparing the stories. They reported to experience social support and feeling a sense of community during the sessions. The students believed that stories helped them to reflect on their clinical work and to regulate their emotional experiences more efficiently in clinical situations. Regarding the learning environment, the dental students pointed out the distinctiveness and dissimilarities between the dental and dental hygiene students, but also expressed that they had a desire to learn more about the other student group.

CONCLUSION

Storytelling used as part of an emotional competence course appears to have benefits for students' reflection about their role as dental health professionals. This teaching method was well-perceived by the students included in this study.

ARTICULATE: A European glossary of terms used in oral health professional education

INTRODUCTION

The Erasmus+O-Health-EDU project aims to gain a comprehensive view of oral health professional (OHP) education in Europe, through the development of web-based surveys and online toolkits. A glossary to facilitate a common language through which academic teams could cooperate and communicate more accurately was identified as a key need within the project. The aim of ARTICULATE was thus to create a shared language, with a European focus, for terms and concepts used in the field of OHP education.

METHODS

The methodology was developed from those published for construction of other glossaries with a circular and iterative process: the creation of content and definitions by a group of experts in OHP education, the testing of "fitness for purpose" of the content, and stakeholder consultation. All creation steps were followed by refinements based on testing results and stakeholder comments. The final glossary was then launched as an online resource including a built-in mechanism for user feedback.

RESULTS

The scope and structure of the glossary were mapped out at a workshop with 12 dental education experts from 7 European countries. A total of 328 terms were identified, of which 171 were finally included in ARTICULATE. After piloting with a close group of other colleagues, the glossary was opened for external input. Thirty European Deans or Heads of Education assessed the definition of each term as "clear" or "not clear." A total of 86 definitions were described as "clear" by all individuals. Terms deemed unclear by at least one individual were revisited and changes made to 37 of the definitions. In conjunction with the launch of the glossary, a range of stakeholder organisations were informed and asked to participate in an open global consultation by providing feedback online. Since its launch in June 2021, the ARTICULATE website (https://o-health-edu.org/articulate) has had an average of 500 visits/month. To promote community ownership, forms embedded on the ARTICULATE webpage allow users to give feedback and suggest new terms. A standing taskforce will meet regularly to consider amendments and make changes to ensure that the glossary remains a relevant and up-to-date resource over time.

CONCLUSION

ARTICULATE is a unique, evolving, online glossary of terms relating to OHP education, created as a resource for all interested OHP educators. The glossary is a key output of the O-Health-Edu project, which relies on a comprehensive vision of OHP education to address the future oral health needs of the European population.

Molar-incisor hypomineralisation: Knowledge and perception of Syrian undergraduate and postgraduate dental students

INTRODUCTION

Dentists' knowledge and expertise, especially in their early career, are primarily shaped during undergraduate studies. This cross-sectional study aimed to assess the knowledge and perception of Syrian under- and postgraduate students regarding diagnosing and managing molar-incisor hypomineralisation (MIH)-affected teeth.

MATERIALS AND METHODS

Final-year dental students (FY-students), postgraduates in paediatric dentistry (PD-postgraduates) and postgraduates in other lines of specialty (OS-postgraduates) in all Syrian dental schools were invited to participate in an established web-based survey covering the knowledge and attitudes regarding the prevalence, aetiology, diagnosis and management of MIH. Data were analysed with descriptive statistics and Fisher's exact/chi-squared tests at 5%.

RESULTS

In total, 1142 post- and undergraduate students from six public and five private dental schools in Syria participated in this study (867 FY-students, 74 PD-postgraduates and 201 OS-postgraduates). PD-postgraduates were found to present statistically significantly better knowledge regarding MIH compared with the two other groups. Only 19% of FY-students and 54% of OS-postgraduates reported themselves familiar with MIH (compared with 97% of PD-postgraduates). Similarly, 18% of FY-students and 27% of OS-postgraduates were capable of diagnosing MIH (compared with 81% of PD-postgraduates). Stainless-steel crowns and direct composite fillings were chosen as most suitable for treating MIH-affected molars from all responders.

CONCLUSIONS

FY-students and even OS-postgraduates in Syria lack knowledge and confidence when confronted with MIH. The university curricula need to include more educational materials to equip the students with the necessary tools to manage MIH clinically.

Empathy of dental students and educators in French hospitals: A cross-sectional study

Empathy is a key factor in the dentist-patient relationship. The aim of this study was to determine empathy in dental students and educators in French hospital dental services. A cross-sectional study was conducted among dental students and educators who practiced in 10 hospital dental services affiliated with the Faculty of Dentistry of the University of Lorraine in France. A questionnaire was self-administered online using the Jefferson Scale of Physician Empathy (JSPE). The study included 209 participants comprising 50 students in fourth year, 66 students in fifth year, 48 students in sixth year, and 45 educators. Participants were 63.6% females, aged 27 ± 8 years. The mean empathy score was 109.40 ± 11.65. The sub-scores of the three dimensions were 57.02 ± 6.64 for Perspective Taking, 42.56 ± 6.22 for Compassionate Care, and 9.78 ± 2.61 for Walking in the Patient's Shoes. Females showed significant higher empathy scores than males (111.36 vs. 105.84). The empathy score was correlated with age and insignificantly decreased during clinical training (from 110.06 in fourth year to 106.63 in sixth year). French dental students and educators showed high levels of empathy.

Leadership and work community - views of graduating dental students

PURPOSE

This study aims to explore what kind of perceptions dental students at graduation stage have on leadership and work communities, and themselves as leaders and work community members after completing a leadership course tailored for them.

DESIGN/METHODOLOGY/APPROACH

The research material comprised reflective essays written by fifth-year dental students who had participated in a leadership course. The essays were analyzed using qualitative content analysis.

FINDINGS

Most students reported that they had not considered seeking a leadership position before the course, but their views of leadership had grown more positive as a result of completing the course. Students perceived interpersonal communication competence as the most important factor for leaders, the whole work community and for themselves. They assessed that their biggest strengths were found in this area. The biggest challenges in adapting to a work community concerned the students' professional identities, which were still taking shape at the time of graduation.

ORIGINALITY/VALUE

The need for leaders in health-care professions is growing due to ongoing reforms, multidisciplinary teamwork, the development of new technologies and patient demands. Therefore, undergraduate leadership education is needed to ensure that students have knowledge of leadership. Graduating dental students' perceptions concerning leadership and work communities have not been widely explored. Students' perceptions of leadership were positive after the course and helped students to realize their own potential in this area.

Implementation of game-based training in oral rehabilitation of edentulous patients in an undergraduate dental course

BACKGROUND

Coronavirus disease-19 dramatically changed the learning conditions of dental students, with restricted access to training sessions and clinical practice. The "Playdent" project proposed the integration of serious games (SGs) in the third-year curriculum, based on tailor-made scenarios questioning the first dental visit of edentulous patients, and examined whether training with the games would advance students' learning outcomes.

MATERIALS AND METHODS

Test scores of 89 students, allocated either to a "test" group that accessed SGs during a 4-week test period in addition to conventional lectures or to a "control" group that benefited solely from conventional lectures, were measured before and immediately after the test period. The subsequent satisfaction of students was assessed in the "test" group.

RESULTS

Scores obtained after the 4-week period significantly increased within the "test" group (11.1% ± 24.9%, p = 0.04, degree of freedom [df] = 30) while they did not change within the "control" group (p = 0.21, df = 57). Qualitative feedback expressed by students who played SGs during the 4-week period demonstrated that 71% of them rated the SGs as satisfactory and 91% of them judged the consistency of SGs content with lectures to be satisfactory.

CONCLUSION

Game-based learning showed a positive impact on the learning outcomes of third-year students. Qualitative assessments provide insights into the pertinence of SGs offered in addition to traditional lectures of third-year complete denture courses. SGs may consolidate skills in oral rehabilitation acquired through traditional passive learning formats proposed in preclinical courses.

Adaptation to Virtual Assessment during the COVID-19 Pandemic: Clinical Case Presentation Examination

BACKGROUND

Case presentation assessment is common in both medicine and dentistry and is known under various names depending on the country and institution. It relates mainly to aspects of diagnosis and treatment planning and is considered highly authentic and useful. The COVID-19 pandemic necessitated the movement of this assessment from face-to-face to online. The aim of this investigation was to explore the students' impressions of the two different examination modalities. With this information, a decision on future diets of this examination can be made to accommodate the students' perspectives.

METHODS

Quantitative and qualitative data were gathered using an online, self-administered survey.

RESULTS

The students were split 50/50 regarding which assessment modality they preferred. Overall, they considered the online examination to be fair, and the majority agreed that the online format allowed them to display their knowledge as well as face-to-face.

CONCLUSIONS

The delivery of case presentation examination is possible online. An online case presentation is a fair, useful, and authentic assessment that is appropriate to the needs of the faculty and students. Satisfaction with the two possible methods of conducting this assessment suggests it would be reasonable to conduct this examination online in the future.

Progress and challenges in the harmonisation of European undergraduate dental education: A systematic literature review with narrative synthesis

INTRODUCTION

Harmonising education to support workforce mobility has been a policy objective for the European Union. However, alignment across varied national contexts presents challenges in dental education.

METHODS

A systematic literature review with narrative synthesis. Searches of the electronic databases Embase [Ovid]; MEDLINE [Ovid]; Scopus; CINAHL; AMED and PsycINFO were conducted for relevant material published between 2000 and 2019 on undergraduate curricula, quality standards and learning outcomes in dentistry.

RESULTS

Seventy-six papers met the inclusion criteria. Fifty-three papers were commentaries or editorials, twenty-one were research studies, and two were literature reviews on specific dental subfields. Eighteen of the research studies reported surveys. The literature contains extensive proposals for undergraduate curricula or learning outcomes, either broadly or for subfields of dentistry. Included papers demonstrated the importance of EU policy and educator-led initiatives as drivers for harmonisation. There is limited evidence on the extent to which proposed pan-European curricula or learning outcomes have been implemented. The nature and extent of dental students' clinical experience with patients is an area of variance across European Union member states. Arrangements for the quality assurance of dental education differ between countries.

DISCUSSION

Harmonisation of European dental education has engaged educators, as seen in the publication of proposed curricula and learning outcomes. However, differences remain in key areas such as clinical experience with patients, which has serious implications if graduate dentists migrate to countries where different expectations exist. Mutual recognition of professional qualifications between countries relies on education which meets certain standards, but institutional autonomy makes drawing national comparisons problematic.

Are we passing the acceptable? Standard setting of theoretical proficiency tests for foreign-trained dentists

INTRODUCTION

Dentists educated outside the EU, EEA and Switzerland have the option to undergo proficiency testing to practice dentistry in Sweden. A standardised evidence-based procedure for proficiency tests is crucial. This paper explores if the standard setting of the theoretical examination in the Swedish proficiency test for foreign dentists is fit to differentiate candidates who meet the acceptable standard for licensure from those who do not, by analysis of inter-rater reliability and credibility of Angoff panels and the test's ability to differentiate candidates regarding learning outcomes and dental disciplines.

MATERIALS AND METHODS

In a cohort study design, test results were collected from seven examinations during 2018-2019 (n = 316), combined with Angoff judgements and demographic data from The National Board of Health and Welfare. Intraclass correlation, Pearson correlation and linear regression were calculated.

RESULTS

All exams demonstrated substantial judge inter-rater reliability using the Angoff procedure (0.65-0.82). Item difficulty predicted by the expert panels showed significant positive correlations with the item difficulty by candidate results (0.69-0.77). Candidates who did not meet the requirements for pass mark in the theoretical test revealed a significantly reduced performance overall in professional qualifications (i.e., learning outcomes) and reduced performance within dental disciplines.

CONCLUSIONS

The results indicate that a modified Angoff method is a feasible, simple, and defensible method for setting the pass mark for the theoretical examinations. The standard setting appears to differentiate candidates who do not meet the requirements of the professional qualifications of the dental degree. Adjustments could be undertaken to further discriminate for competence within single dental disciplines.

Design of a communication skills course in dentistry: Applying active-learning strategies to improve educational outcomes

PURPOSE/OBJECTIVE

Effective communication, between patient and dentist, is a core clinical skill that commands dedicated pedagogy similar to that of developing scientific knowledge and psychomotor skills. This study aimed to describe active-learning strategies in a dental communication skills course, which sits within a broader foundation dental course and evaluate students' educational outcomes.

METHODS

This is a two-phase retrospective, mono-centred study, completed in 2019 at an Australian dental school. Phase I, a case report, describes the Communication Skills for Oral Health (CSOH) course design and its active-learning strategies. Phase II analysed data from the course using Kirkpatrick's evaluation model to objectively measure the impact of the course and provide feedback to education designer. Students' perception (Level 1) was evaluated with an institutional, validated online survey. Descriptive and statistical analysis, included paired tests and Spearman's correlation analyses, used to investigate learning effect (Level 2) and student behaviour change (Level 3). To assess the impact of the CSOH course design (Level 4) the student grades from the course were analysed.

RESULTS

The CSOH course encompasses three major topics: Essentials of Communication Skills, Professional-Patient Relationship and Managing Difficult Situations. Each topic included didactic content complimented with a variety of active-learning strategies to teach and assess students. Positive outcomes were recorded across all Kirkpatrick levels.

CONCLUSIONS

This study suggests an efficient communication skills course design, which may assist in the development of communication skills courses in other dental education institutions.

Digital teaching tools in sports medicine: A randomized control trial comparing the effectiveness of virtual seminar and virtual fishbowl teaching method in medical students

Background

Since the COVID-19 pandemic, the demand for online courses has increased enormously. Therefore, finding new methods to improve medical education is imperative.

Objective

The aim of this study was to compare the self-reports of the individual student-centered virtual teaching techniques (seminar versus fishbowl) in a group of medical students.

Methods

During the second semester of 2020, students in the clinical phase of the study (n = 144) participated in the optional subject of Sports Medicine. The students were divided into 2 groups. One group (n = 72) received the knowledge transfer in the form of a virtual seminar, the other group (n = 72) in the form of a virtual fishbowl.

Results

Virtual seminar and virtual fishbowl students gave insights into these teaching techniques. Most of the students from the virtual fishbowl group believed that the virtual fishbowl format allowed them to be more actively involved in learning. The mean quiz scores were statistically higher for students in the virtual fishbowl group than students in the virtual seminar group (p < 0. 001).

Conclusion

This study concluded that virtual seminars and virtual fishbowl formats could be served as structured learning and teaching formats. At the same time, the virtual fishbowl format can promote an active exchange of knowledge from students’ perspectives.

Cone Beam Computed Tomography (CBCT) Technology and Learning Outcomes in Dental Anatomy Education: E-Learning Approach

E-learning is an educational method that improves knowledge innovation by sharing relevant images for advanced learning, especially in a pandemic state. Furthermore, cone-beam computed tomography (CBCT) is a method that gathers medical or dental diagnostic images. This study aimed to analyze the effectiveness of dental anatomy education through a CBCT technology tool, through teachers' and students' perspectives, adjusted according to the disruptions caused by the Covid-19 pandemic. A cohort study and longitudinal exploratory analysis were performed. Forty undergraduate first-year dental students, from the University of Coimbra in Portugal, were selected as per the inclusion and exclusion criteria. Two different teaching methods were applied during an identical time-period: face-to-face lectures complemented by physical models (T1 cohort) and webinar lectures complemented by CBCT images (T2 cohort). Learning outcomes were then studied according to theoretical and spatial orientation contexts. A self-reported survey that focused on students' satisfaction, stress, and support was studied. Both teaching methods were analyzed with paired sample student's t-test and Pearson Correlation Confidence intervals 95% with P < 0.05. Furthermore, exploratory factor analysis (EFA) was used for self-reported satisfaction survey validity and reliability analysis. The learning outcomes between T1 and T2 cohorts were statistically significant, (P < 0.001) corresponding to differences with a large effect degree (r > 0.60). Students' satisfaction, as measured on a six-point Likert scale, was positively influenced by the webinar lectures supplemented with CBCT images (T2 cohort) in a learning context (4.95 ± 0.5) and future applications (5.92 ± 0.27). In conclusion, the webinar approach with CBCT images was more effective and better learning method for teaching dental anatomy.

Dental Students and Faculty Perceptions of Teaching Methods: Traditional Classes, Online Virtual Classes, and Recorded Lectures

Background:

Rapid advancement in technology has provided alternatives to traditional classroom teaching. Such instructional methods have gained increasing importance during the COVID-19 pandemic when physical classroom attendance was not possible. The study evaluated faculty’s and students’ perceptions concerning the online virtual classes and recorded lectures as compared to traditional classes delivered at the College of Dentistry, King Saud bin Abdulaziz University for Health Sciences.

Materials and Methods:

Surveys were developed and distributed to 34 faculty members and 186 students. Perceptions about virtual classes, recorded lectures, physical attendance, the effectiveness of different teaching methods, and overall experience were evaluated. Descriptive statistics were presented using frequencies and percentages. The Chi-square test compared the students’ and the faculty members’ responses. The level of significance was set at α =0.05.

Results:

Thirty-one faculty members and 149 dental students participated, and the overall response rates were 91.2% and 80.1%, respectively. While there was a general agreement on the usefulness of making recorded lectures available, a statistically significant difference (p<0.001) was found between students’ and faculty members’ views on making classroom-lecture attendance optional (67.1% of students and 12.9% of the faculty agreed/strongly agreed). Statistically significant differences (p<0.001) were found between the students and faculty members concerning the effectiveness of recorded lectures and attending online virtual classes as an alternative to classroom attendance.

Conclusion:

Overall, students were more accepting of technology than faculty members as a substitute for traditional classroom teaching. For a more efficient and satisfactory learning experience, both teaching methods should be considered in a blended-learning module.

Assessing dental students' professional satisfaction with operative dentistry teaching and curriculum: A study in Saudi Arabia

ABSTRACT

Evaluating students' professional training satisfaction with operative dentistry teaching and curriculum can help identify their educational needs and improve the quality of the education imparted. This study aimed to assess the professional training satisfaction of senior undergraduate dental students in Saudi Arabia from the operative dentistry course teaching and its curriculum at different levels and among genders.A total of 193 (109 male, 56.48%; and 84 female, 43.52%) students participated in the survey. The respondents were at the 10th, 11th, and 12th levels of the Operative Dentistry course in a ratio of 34.2%, 32.1%, and 33.7%, respectively. Data were collected from survey items (18 questions) covering 6 areas: learning objectives, course materials, content relevance, instructor knowledge, instructor delivery and style, and facility and environment. Descriptive and analytical tests were performed using SPSS Software 19, with the significance level set at 0.05.A high level of satisfaction was seen among level 10 (68.18%), 11 (79.03%), and 12 (86.15%) students. A significant statistical difference was observed among level 10 students with a low level of satisfaction and a high level of satisfaction (P = .045). The percentage of satisfaction increased with the level. A high level of satisfaction was seen among male (78.90%) and female (76.19%) students, with a total satisfaction level of 77.72%.Continuous evaluation and assessment of teaching and curriculum can be a tool to improve the quality of education imparted, especially in clinical courses such as operative dentistry. This helps to prepare students for their professional life as healthcare providers. The role of teaching skills related to amalgam must be re-evaluated. It is recommended to include student representation and participation in course development committees, as they are the final recipients of the educational process.

Defining dental operative skills curricula: An ADEE consensus paper

This paper reports on the recent activity of the pan-European consensus of the ADEE Special Interest Group for Pre-Clinical Operative Skills. Following the previous recommendations from the group, and in order to support teachers and to harmonise the delivery of skills training across Europe, a more formal curriculum relating to pre-clinical operative skills needs to be created. This paper reports European consensus surrounding the categorisation (level of importance, and difficulty) of basic operative dental clinical skills within the undergraduate curriculum and provides recommendations relating to session structure and timing of curricular elements for basic operative dental clinical skills teaching.

An analysis of an educational method to improve the shade-matching ability of dental students

STATEMENT OF PROBLEM

The predoctoral dental curriculum includes didactic lectures, demonstrations, and training on shade-matching techniques and protocols. However, a significant percentage of esthetic failures are still observed clinically. An assessment is required to determine whether reevaluation and modification of this training protocol would help future dental practitioners better perceive and communicate the dental shade.

PURPOSE

The purpose of this study was to evaluate dental students' knowledge of and skill in shade selection and effective prescription writing before and after educational training with 3 different shade guides.

MATERIAL AND METHODS

Thirty predoctoral dental students (interns) who had completed their academic program and were undergoing clinical training were selected. After excluding color vision deficiency, the study participants were first asked to evaluate the shade of the right maxillary central incisor of 5 patient participants by using 3 different shade guides (Vitapan Classical, Vitapan 3D-MASTER, Chromascop) under standardized conditions. They were then asked to write an esthetic prescription, communicating the shade to a dental laboratory technician. A dental faculty member evaluated the baseline control shade for each participant, and a standardized prescription format was written. This was used as a reference by a dental laboratory technician to score the intern's prescription as clear, unclear, poor, or illegible. After the assessment, focused small group learning with lectures, clinical demonstrations, and case-based discussion was provided to the interns on shade assessment over 10 to 15 days. All the interns were reassessed for their visual shade perception and prescription writing after a month's interval. The mean percentage agreement, mean percentage shade match, and mean color difference between the shade selected and the control shade for each of the 5 participants, with all 3 shade guides, were evaluated along with the prescription scoring before and after the educational training. Statistical comparison of before and after values were made by using the paired-sample z-test for percentage agreement versus disagreement among the interns for the shade selected, paired t test for mean percentage agreement, mean percentage shade match, and mean color difference. The repeated measure ANOVA test was used for the prescription scorings (α=.05).

RESULTS

A significant difference in prescription scoring (P<.001) was observed. A significant difference in the percentage shade match (P<.01) for all 3 shade guides and mean percentage agreement for Chromascop and Vita 3D-MASTER (P<.05) were observed. A nonsignificant mean color difference between the shade selected by the intern and the baseline shade was observed.

CONCLUSIONS

A significant difference in prescription scoring was observed after training, along with a higher percentage shade match and percentage agreement. This indicated a need to reconsider the educational training provided for dental shade assessment and communication and to implement better protocols in the dental curriculum.

Dry Skulls and Cone Beam Computed Tomography (CBCT) for Teaching Orofacial Bone Anatomy to Undergraduate Dental Students

Learning bone anatomy of the skull is a complex topic involving three-dimensional information. The impact of the use of human dry skulls and cone beam computed tomography (CBCT) imaging was investigated in the teaching of undergraduate dental students. Sixty-four first-year students in the University of Hong Kong were randomly divided into eight groups. Four teaching methods were tested: (1) CBCT followed by standard lecture, (2) CBCT followed by lecture with skulls, (3) standard lecture followed by CBCT, and (4) lecture with skulls followed by CBCT. After each, students were given a multiple-choice questionnaire to assess their objective learning outcome (20 questions) and a questionnaire for their subjective satisfaction (10 statements). Surveys were assessed with Cronbach's alpha, Kendall's tau-b, and principal components analysis. Data were analyzed with Student's t-test and a one-way ANOVA (significance α = 0.05). Standard lecture followed by CBCT showed the highest learning outcome score (81.6% ± 14.1%), but no significant difference was present among four teaching methods. Cone beam computed tomography followed by lecture with skulls scored the highest overall subjective satisfaction (4.9 ± 0.8 out of 6), but no significant difference was present among teaching methods. Nevertheless, students' perception of learning was positively influenced by the use of skulls (P = 0.018). The timing of administration of the CBCT did not affect students' subjective satisfaction or objective learning outcome. Students perceived to learn more by using skulls, but their objective learning outcomes were not significantly affected. A discrepancy seems to exist between students' perception of learning and their effective performance.

Adaptation, psychometric properties, and implementation of the Mini-CEX in dental clerkship

BACKGROUND

Workplace-based assessment is a key component of dental-student clerkships, allowing students to demonstrate clinical proficiency.

PURPOSE

This study adapts the Mini-Clinical Evaluation Exercise (Mini-CEX) to a dentistry-program clerkship, analyzing the results and examining the psychometric properties of Mini-CEX.

METHODS

First, Delphi panel methodology was used to ensure content validity. Mini-CEX was then piloted in the dental-clerkship program, with each student assessed by at least 2 supervisors and a peer student. Subsequently, psychometric properties, acceptability, and observation time were analyzed.

RESULTS

The study was conducted between July and November 2019. Overall, 140 Mini-CEX evaluation exercises were carried out on 30 students by 84 supervisors and 56 peers. The adapted instrument was found to be unidimensional, obtaining an acceptable internal consistency (α = 0.74). As the assessor type changed, there were differences in observation time; the medians (Q1-Q3) were 10 minutes (5-15) for supervisors and 30 minutes (20-45) for peer students (P < 0.001). This difference was also observed in assessor perceptions (P < 0.001), with supervisors scoring a median of 6 (6-6.75) and peer students scoring a median of 7 (6-7). No differences were found between supervisor and peer scores.

CONCLUSION

The adapted version of Mini-CEX can objectively assess the clinical performance of dental students, achieving validity and reliability values similar to those obtained in the original instrument.

3D Technology Development and Dental Education: What Topics Are Best Suited for 3D Learning Resources?

The aim of this study is to identify topics (knowledge and skills) from the dental curricula that would benefit from having a 3D learning resource using an exploratory sequential design method. The first phase targeted stakeholders from a Scottish dental school. Seven focus groups and three interviews disclosed 97 suitable topics for 3D technology development. These results were used to construct a survey that was sent to final year dental students, newly dental graduates and academics from three Scottish universities. The survey asked participants to rank each item based on the perceived benefit that a 3D learning resource would have for dental education. Results revealed that detailed anatomy of the temporomandibular joint, dental anaesthesiology, dental clinical skills techniques, dental occlusion and mandibular functioning were top priorities. Gender differences only appeared in relation to ‘Extraction techniques: movements and force’ (p < 0.05), this topic was considered to be more beneficial by females than by males. No statistical difference was found when comparing results of graduates with undergraduates. These results serve as a starting point when developing a new 3D technology tool for dental education, considering users demands and perceived needs has the potential to benefit dental students and dental education directly.

Effectiveness of technology-enhanced learning to improve periodontics educational outcomes: A systematic review

OBJECTIVES

Technology-enhanced learning (TEL) has been suggested as a suitable learner-centered pedagogical approach in dental education. However, the results of TEL effectiveness in periodontics education are controversial. Therefore, this systematic review aimed to evaluate the effectiveness of TEL to improve educational outcomes in the periodontics field compared to traditional learning methods.

METHODS

The search comprised randomized controlled trials (RCTs) and crossover studies that were related to periodontics education from the following databases: MedLine, PsycINFO, Eric, Scopus, EMBASE, and Web of Science. Two authors independently performed study selection, data extraction, and assessed risk of bias. Kirkpatrick's 4-level evaluation model was used to evaluate educational outcomes.

RESULTS

From 1642 studies, after applying inclusion criteria, 7 studies remained for analysis. On level 1 (Reaction), undergraduate dental students reported positive attitudes related to TEL. On level 2 (Learning), 3 studies found that TEL improved knowledge gain compared to traditional learning methods. Three other studies did not show any difference between TEL and conventional learning methods, and one found that traditional learning methods presented superior results. On level 3 (Behavior), 1 study found that TEL application improved students' performance. On level 4 (Results), 5 studies suggested that the implementation of TEL would improve educational outcomes in periodontics education if combined with traditional learning methods.

CONCLUSION

The findings showed that the exclusive use of TEL does not significantly improve periodontics educational outcomes when compared to traditional learning methods. However, the combination of TEL and traditional learning methods can be the key to enhancing periodontics education.

Graduating dentists' perceptions about their professional competence in Finland and Lithuania

AIMS

Efforts to harmonise dental education in Europe have been put into action by the Association for Dental Education in Europe (ADEE). The aim of the study was to explore graduating dentists' perceptions about their professional readiness for clinical work in Finland and Lithuania.

MATERIALS AND METHODS

The survey targeted fifth-year dental students at the University of Oulu and the University of Turku in Finland, and at the Lithuanian University of Health Sciences, Kaunas, Lithuania (Lithuanian and international students) in 2016-2017. The competences were evaluated in the questionnaire in 21 dental procedures based on ADEE competences by options: "I'd manage well," "I'd need more training" or "It would not quite succeed." The option "I'd manage well" was chosen in the analyses.

RESULTS

Students felt that they were most competent in producing and maintaining accurate patient records (91.9%), implementing sterilisation and hygiene in dental practice (91.3%) and working with other members of dental team and health profession (90.0%). The largest differences between Finnish and Lithuanian students were in designing and adjusting occlusal splints (87.0% vs. 14.3%) and in undertaking subgingival scaling (95.7% vs. 57.1%). The biggest differences between Lithuanian and international students were in identifying (and treating) abnormal and anxiety-related patient (73.1% vs. 25.5%) and implementing tobacco cessation (65.3% vs. 31.9%).

CONCLUSIONS

The graduating dental students in Finland and Lithuania manage well in most of the clinical procedures based on the ADEE competences. The students were most confident when dealing with tasks that are common in dental practice.

Effect of constant versus variable small-group facilitators on students' basic science knowledge in an enquiry-based dental curriculum

INTRODUCTION

The role of small-group facilitators is of pivotal importance for the success of curricula based on active learning. Disorganised tutorial processes and superficial study of the problem have been identified as main hindering factors for students' learning. The aim of this study was to evaluate the influence of consistency of facilitation on students' performance in knowledge-based basic science assessments in a hybrid, enquiry-based (EBL) undergraduate dental curriculum.

MATERIALS AND METHODS

This was a retrospective study of 519 first- and second-year undergraduate dental students, enrolled at Peninsula Dental School between 2013 and 2018. Twice in each academic year, students sat a 60-item single-best-answer, multiple-choice examination. Percentage and Z-scores were compared between students whose EBL groups had the same facilitator throughout the academic year, and those whose EBL group was facilitated by different members of staff. All EBL facilitators were dentally qualified but with different levels of expertise in basic dental sciences, prior EBL facilitation, involvement in the curriculum design and university affiliation.

RESULTS

No statistically significant difference was observed in the percentage or Z-scores of students whose EBL sessions were supported by consistent or variable facilitators in any of the 18 MCQ tests. Z-scores of first-year students were more variable than for second-year students. In addition, pairwise comparisons revealed no statistically significant differences in students' Z-scores between any of the permanent facilitators' groups.

CONCLUSIONS

The results of our study may influence the design and delivery of enquiry-based curricula as well as human resources management by shifting the focus from maintaining facilitator consistency to ensuring comparable training and approaches across facilitators.

Comparison of the quality assurance system of dental professionals in Japan, the EU and the ASEAN

In recent years, the society requires a flexible response of the dental society to deal with changes in disease structure in the super-aging society in Japan. Regarding quality of dental care, we need to ensure quality of clinical environment, dental professionals and the system. As globalization expands, the health care professionals move to another country to work. In the European Union(EU), the quality assurance system for the graduated European dentist through the activities in undergraduate education has been established and a similar approach is ongoing in the region of the Association of South-East Asian Nations. After the registration, the continuing professional development (CPD) system takes a role on quality assurance for dentist. The DentCPD was an approach to create a standard for CPD in the EU. Regarding the quality assurance system in Japanese dentistry, there were systematic approaches, establishing the model core curriculum in dental education, the common achievement test. Besides them, the quality assurance system for dentist has not been established except the voluntary life-long learning program of the Japan Dental Association. Predicting changes of the society to have quality control for dental professionals, we should prepare the system like the CPD system which matches level of the global standard.

Evaluating the Quality of Multiple Choice Question in Paediatric Dentistry Postgraduate Examinations

Objectives

This study aimed to evaluate the quality of multiple choice question (MCQ) items in two postgraduate paediatric dentistry (PD) examinations by determining item writing flaws (IWFs), difficulty index (DI) and cognitive level.

Methods

This study was conducted at Mohamed Bin Rashid University of Medicine and Health Sciences, Dubai, UAE. Virtual platform-based summative versions of the general paediatric medicine (GPM) and prevention of oral diseases (POD) examinations administered during the second semester of the 2017–2018 academic year were used. Two PD faculty members independently reviewed each question to assess IWFs, DI and cognitive level.

Results

A total of 185 single best answer MCQs with 4–5 options were analysed. Most of the questions (81%) required information recall, with the remainder (19%) requiring higher levels of thinking and data explanation. The most common errors among IWFs were the use of “except” or “not” in the lead-in, tricky or unfocussed stems and opportunities for students to use convergence strategies. There were more IWFs in the GPM than the POD examination, but this was not statistically significant (P = 0.105). The MCQs in the GPM and POD examination were considered easy since the mean DIs (89.1% ± 8.9% and 76.5% ± 7.9%, respectively) were more than 70%.

Conclusion

Training is an essential element of adequate MCQ writing. A general comprehensive review of all programme’s MCQs is needed to emphasise the importance of avoiding IWFs. A faculty development programme is recommended to improve question-writing skills in order to align examinations with programme learning outcomes and enhance the ability to measure student competency through questions requiring higher level thinking.

Step-by-step teaching method improves the learner achievement in dental skill training

INTRODUCTION

This study aimed to assess and compare the outcomes of all-in-one and step-by-step teaching methods in dental skill training.

METHODS

Forty first-year dental residents were recruited into this study, which was a prospective, double-blind and randomised controlled trial. The learners were randomly allocated to either the all-in-one group (control group, n = 20) or the step-by-step group (experimental group, n = 20). They performed crown preparation on a plastic tooth under different training course structures. For the all-in-one group, the course comprised three parts: the teacher's lecture and demonstration and the learner's practice. Every part was carried out independently in turn. For the step-by-step group, the course was divided into six parts according to the procedures of crown preparation: incisal preparation, facial preparation, interproximal preparation, lingual preparation, marginal preparation, and finishing and polishing. Every part, consisting of the teacher's lecture and demonstration and the learner's practice, was carried out step-by-step. Thereafter, the training outcome was evaluated by the learners, two experts and a digital system.

RESULTS

For the outcomes of the all-in-one group and the step-by-step group, the learners' assessments were 6.15 ± 1.98 and 8.10 ± 1.41, the experts' assessments were 7.00 ± 1.75 and 8.40 ± 1.10, and the digital assessments were 6.43 ± 1.20 and 7.62 ± 0.51, respectively. In terms of each evaluation index, there was significant difference between the two groups (P < 0.05). Higher quality of crown preparation was attained in the step-by-step group.

CONCLUSION

The step-by-step teaching method can improve the learner's achievement in dental skill training.

Student experiences of two small group learning-teaching formats: Seminar and fishbowl

INTRODUCTION

As teaching strategies, the seminar and fishbowl approaches promote active learning and shift the focus from the teacher to the learner. The aim of this study was to compare the self-reported perceptions of each student-centred teaching technique amongst a group of dental students as well as resultant quiz scores after each teaching technique.

MATERIAL AND METHODS

During the first semester of 2017, all year-3 (N = 88) Semiology and year-5 (N = 71) Oral Surgery students participated in weekly seminars in which teams of students from both cohorts were given an actual clinical case to study; a diagnosis and treatment plan would be rendered, and an oral case presentation would be presented to the rest of the class. In the second semester, the same students tried to solve similar clinical cases using the fishbowl training format. A course coordinator provided final feedback, and the session culminated with a quiz. Students were invited to provide quantitative and qualitative perceptions whilst quiz scores obtained during seminar and fishbowl teaching formats were compared.

RESULTS AND DISCUSSION

A total of 97 (61%) seminar and 92 (58%) fishbowl students provided insights regarding these teaching techniques. Both cohorts believed the fishbowl format allowed them to be actively involved. However, only year-3 students gave the fishbowl format a significantly higher score than the seminar format, considering it an attractive format that allowed them to learn. In contrast, year-5 students believed the seminars met their expectations better than the fishbowl format. Interesting clinical cases as well as the final round of feedback were qualitative themes reported by both cohorts. The mean seminar and fishbowl quiz scores were statistically significant different for year-3 students (P < 0.0001), but not for year-5 students (P = 0.09).

CONCLUSIONS

These findings suggest that a more structured small-group learning-teaching format can be implemented for younger students whilst at the same time allowing more flexible organisation for senior students.

Appropriateness in Dentistry: A Survey Discovers Improper Procedures in Oral Medicine and Surgery

OBJECTIVES

The aim of this study was to assess appropriateness of diagnostic exams, treatments, and procedures among Italian dental practitioners.

MATERIALS AND METHODS

A questionnaire with multiple responses on topics of dentistry and oral medicine was administered to a sample of 198 Italian dental practitioners. Information on characteristics of the respondents was also collected. Descriptive statistics and multiple correspondence analysis (MCA) were applied. Data were analyzed using R software (version 3.3.2).

RESULTS

The survey respondents included Doctors of Medicine (MD) (54/198 = 27%) with or without specialty in dentistry (33% versus 67%), Doctors of Dental Surgery (DDS) (144/198 = 73%), DDS with specialty in orthodontics (7%), and DDS with specialty in oral surgery (4%). Mandatory procedures in dental and oral medicine education and training include (a) prescription of antibiotics before/after oral surgery procedures; (b) prevention strategies for oral cancer, and (c) prescription of dental X-ray examinations (41%, 52%, and 48%, resp.).

CONCLUSION

On examining the results of the survey, it is evident that information and implementation of the above mentioned procedures are crucially needed. Our results confirm the necessity to reduce inappropriate practices in dentistry, implementing formation and information, leading to correct prescriptions, and optimizing patients' oral health. This coincides with the Italian Slow Medicine program entitled "Fare di più non significa fare meglio-Choosing Wisely Italy," which has also motivated this study.