Self-assessment of ergonomics amongst dental students utilising photography: RCT

Evaluation of a workplace assessment method designed to improve self-assessment in operative dentistry: a quasi-experiment

BACKGROUND

Dental education has placed continued emphasis on self-regulated learning (SRL) and its subprocess, self-assessment. This study set out to evaluate the effectiveness of a novel workplace assessment method in developing trainees' self-assessment of operative procedures.

METHODS

A Direct Observation of Procedural Skills (DOPS) form was modified for the use and measurement of self-assessment. Participants were trained on how to conduct self-assessment using the designed assessment form and its grading rubric. Feedback and feedforward sessions were given to address self-assessment and performance issues. A P-value less than 0.10 was considered significant and the confidence level was set at 90%.

RESULTS

Thirty-two Year 5 dental students with an age mean of 22.45 (SD = 0.8) completed five self DOPS encounters during the clinical operative dentistry module in 2022. The aggregated total deviation (absolute difference) between self-assessment and teacher assessment decreased consistently in the five assessment encounters with a significant mean difference and a medium effect size (P = 0.064, partial Eta squared = 0.069). Participants' self-assessment accuracy differed from one skill to another and their ability to identify areas of improvement as perceived by teachers improved significantly (P = 0.011, partial Eta squared = 0.099). Participants' attitudes towards the assessment method were positive.

CONCLUSIONS

The findings suggest that the self DOPS method was effective in developing participants' ability to self-assess. Future research should explore the effectiveness of this assessment method in a wider range of clinical procedures.

Feedback for the prevention and rehabilitation of work-related musculoskeletal disorders: A systematic review

BACKGROUND

Work-related musculoskeletal disorders (WRMSDs) remain a challenge despite research aimed at improving their prevention and treatment. Extrinsic feedback has been suggested for the prevention and rehabilitation of WRMSDs to improve sensorimotor control, and ultimately to reduce pain and disability. However, there are few systematic reviews on the effectiveness of extrinsic feedback for WRMSDs.

OBJECTIVE

To perform a systematic review investigating the effect of extrinsic feedback for the prevention and rehabilitation of WRMSDs.

METHODS

Five databases (CINAHL, Embase, Ergonomics Abstract, PsycInfo, PubMed) were searched. Studies of various designs assessing the effects of extrinsic feedback during work tasks on three outcomes (function, symptoms, sensorimotor control) in the context of prevention and rehabilitation of WRMSDs were included.

RESULTS

Forty-nine studies were included, for a total sample of 3387 participants (including 925 injured) who performed work-related tasks in the workplace (27 studies) or in controlled environments (22 studies). The use of extrinsic feedback was shown to be effective in controlled environments for short-term prevention of functional limitations and sensorimotor alterations (very limited to moderate evidence) and for improving, in injured participants, function, symptoms and sensorimotor control (moderate evidence). In the workplace, it was shown to be effective for short-term prevention of functional limitations (limited evidence). There was conflicting evidence regarding its effect for WRMSD rehabilitation in the workplace.

CONCLUSION

Extrinsic feedback is an interesting complementary tool for the prevention and rehabilitation of WRMSDs in controlled environments. More evidence is needed regarding its effect for the prevention and rehabilitation of WRMSDs in the workplace.

Prevention of work-related musculoskeletal disorders among dental professionals: A scoping review

BACKGROUND: Musculoskeletal disorders (MSDs) are highly prevalent among dental professionals. Studies examining the prevention of dental work-related MSDs have been completed globally. OBJECTIVE: To identify and evaluate the available evidence regarding MSD prevention in dental practice, and to identify knowledge gaps. METHODS: An electronic search was conducted across multiple scientific databases. Identified articles were assessed according to inclusion/exclusion criteria. Systematic reviews, interventions and published expert opinion were included. RESULTS: Five systematic reviews, 27 intervention studies and 21 expert opinion articles were included. There was overall consensus that use of ergonomic equipment is beneficial in MSD prevention. Knowledge gaps identified included: a lack of systematic reviews on the role of exercise and therapy in MSD prevention; a lack of high-quality intervention studies; a lack of research in general outside of ergonomic equipment use. Expert opinion articles have been published despite a lack of dental-specific research. CONCLUSIONS: Whilst more robust research is required, current evidence supports the use of optical enhancement, saddle chairs, and wide-diameter silicone-handled instruments in MSD prevention. Knowledge gaps were identified relating to the use of exercise, therapy, and education in the prevention of dental work-related MSDs. Further research is required, specifically high-quality intervention studies.

Evaluating the Current State of Ergonomics Education Offered to Students in US Medical Students

BACKGROUND

The high rate of work-related musculoskeletal disorders (WMSD) among surgeons is well-documented and found to factor into medical students' interest in surgical specialties. Ergonomic techniques can reduce musculoskeletal pain in surgeons. Access to ergonomics education in residency is minimal and the ergonomics education offered in medical school has not been characterized.

METHODS

An anonymous, online survey was distributed to 210 administrators in medical education and curriculum at all accredited US allopathic medical schools. They were asked about their knowledge of ergonomics, assessment of potential benefits of ergonomics education to their students, and the ergonomics education offered at their institution.

RESULTS

A total of 71 surveys were completed (33.8% response rate). 82% of schools reported familiarity with the study of ergonomics and 81% thought it would be beneficial to the future careers of their students to receive ergonomics education. Respondents estimated 43% of surgeons experience WMSDs and those that did not think ergonomics education would be beneficial to their students' future careers had a statistically significantly lower estimate of WMSD burden amongst practicing surgeons. Only one respondent reported that students at their institution receive greater than three hours of ergonomics education, while 98% reported their students will receive less than three hours. Considering this, 81% of respondents reported that students do have access to other resources that encourage ergonomic practices, such as gym access, yoga classes, and surgical simulation labs.

DISCUSSION

Medical schools should increase access to ergonomics education and integrate it into their curriculum as early as possible.

Analysis and prevention of ergonomic risk factors among dental students

INTRODUCTION

Dentistry is a high-risk profession for the development of work-related disorders. Dental students are also exposed to several risk factors. The goal of the study was to determine and localise musculoskeletal pain during dental work, afterwards to measure electromyography signals from the muscles groups mostly affected by the musculoskeletal pain. Study was done in order to provide possible suggestions for the most effective preventive measures of MS pain among dental students.

MATERIALS AND METHODS

In order to solve the objectives, the research was realised in two segments. In the first part of the study, specially designed questionnaires were used to determine the frequency of musculoskeletal pain, risk factors and preventive measures among students. The second part of the study included electromyography analyses of muscular activity of students during dental work. Inclinometers also were set up in the purpose of monitoring inclination of the spine.

RESULTS

Results of the questionnaire study indicated that pain during work was frequent, 81.8% of all the subjects reported pain during work. The recorded muscle activity of the neck muscles indicated a high ergonomic risk, while the muscle activity of the shoulders and back muscles indicated a medium risk. Work with a back flexion of 20 degrees and more indicates that students are at risk.

CONCLUSION

Dental students used to work in unnatural working position. High ergonomic risk occurred in neck muscles. Students should be aware of the potential risks during work and to learn how to prevent it. Regular physical activity is strongly suggested to the students in order to avoid ergonomic problems.

Effectiveness of CAD/CAM technology: A self-assessment tool for preclinical waxing exercise

INTRODUCTION

This study assessed the utility of CAD/CAM technology as a self-assessment tool for preclinical waxing compared to traditional student self-assessment to evaluate preclinical work.

MATERIAL AND METHODS

Thirty-seven students completed the wax-up of the maxillary left central incisor with the goal of recreating original anatomy and completed a traditional self-assessment. The original, unreduced cast and waxings were scanned with an intraoral scanner (E4D, Planmeca). Using CAD/CAM software (Compare, Planmeca), each waxing was superimposed over the original. Tolerance (250 µm) was set to illustrate under- and over-contoured areas, enabling visualisation of the waxing compared to original in three dimensions. Students then completed another self-assessment and an exit survey.

RESULTS

Twenty-four per cent of self-assessment responses changed after using Compare Software. 20% changed from satisfactory to unsatisfactory. Four per cent changed from unsatisfactory to satisfactory. Greatest change in response occurred in the Incisal Edge (49%) rubric category. Interproximal Contact Area (3%) demonstrated least change in response. Seventy per cent strongly agreed that Compare Software enabled more effective assessment of Lingual Contour. Eight per cent strongly disagreed that Compare Software enabled more effective assessment of finishing.

DISCUSSION

CAD/CAM software can improve student's critical self-assessment. Different rubric categories demonstrated differing rates of response change, indicating more critical of certain aspects of the waxing. Majority strongly agreed that the software enabled more effective self-assessment.

CONCLUSION

CAD/CAM technology enhances student's learning in dental wax-up through improving self-assessment. This technology may improve teacher-student communication, reduce one-on-one teaching time and allow higher student-teacher ratio.

[Effects of loupes and microscope on the prosthodontist's posture from ergonomic aspects]

OBJECTIVE

To assess the effects of loupes and microscope on the posture of prosthodontists when preparing the laminate veneer, and to assess the clinical value of loupes and microscope from the ergonomic aspects.

METHODS

Twenty young prosthodontists from Department of Prosthodontics, Peking University School and Hospital of Stomatology were recruited into this study, which was a prospective, single blind, self-control trials. The research hypothesis was concealed and the participants were deceived about the precise purpose of the study to counterbalance the lack of direct blinding. The prosthodontists prepared laminate veneers of open window type in the artificial dental model, under routine visual field (control group), 2.5× headwear loupes (loupes group), and 8× operating microscope (microscopic group) by turning. The participants were photographed from profile view and front view. Thereafter, the subjective assessment was performed by themselves using the visual analogue score (VAS). The expert assessment was performed by two professors using modified-dental operator posture assessment instrument on the basis of photographs of the profile view and front view.

RESULTS

The subjective assessment scores for the control group, loupes group and microscopic group were 4.55±1.96, 7.90±1.12, and 9.00±0.92, respectively. There was significant difference between the three groups' subjective scores (P < 0.05). The expert assessment scores for the control group, loupes group and microscopic group were 16.38±1.52, 15.15±1.30, and 13.60±0.88, respectively. There was significant difference between the three groups' expert assessment scores (P < 0.05). Specifically, the three groups' expert assessment scores were significantly different (P < 0.05) in trunk position (front to back) (1.33±0.41, 1.03±0.11, 1.00±0.00), head and neck position (front to back) (2.75±0.38, 2.13±0.36, 1.23±0.38), elbows level (1.38±0.43, 1.40±0.45, 1.13±0.22), and shoulders level (1.43±0.41, 1.23±0.34, 1.13±0.28). Thereinto, the microscopic group was better than loupes group in head and neck position (front to back) and elbows level (P < 0.05).

CONCLUSION

Loupes and microscope improve the posture of the prosthodontist when preparing the laminate veneer, in which the microscope is better than loupes. Therefore, the magnification devices have clinical value from the ergonomic aspects.

Dental and physical therapy faculty collaborate in assessing and educating dental students on musculoskeletal disorders

INTRODUCTION

Research shows 54% to 93% of practicing dentists suffer from musculoskeletal disorders (MSDs), with many developing afflictions early in their careers. Studies also show that dental students are developing MSDs early in their professional education.

OBJECTIVE

The research goal was to quantify the prevalence, anatomical location and initial onset of MSDs among first-year dental students. The study also assessed the students' self-reported opinion as to whether there were enough educational touchpoints to improve their ergonomics in daily activities.

METHODS

At the conclusion of a 9-month preclinical restorative course, that included 2 lectures on MSDs, ergonomics, and postural cueing sessions, a dental and physical therapy faculty member administered a survey to 143 first-year dental students. This survey included questions about the history and presentation of the students' MSD symptoms and their opinion on the relative value of the educational interventions.

RESULTS

There was a 96.5% response rate to the survey with 87.8% of students reporting mild to moderate pain. The cervical spine (41.7%) and hands (42.4%) were the most common areas afflicted. 55.4% reported pain commencing 1 month after starting in the simulation clinic. Over 60.9% of students "agreed" or "somewhat agreed" that the 2 sessions of hands-on ergonomic educational interventions resulted in improved biomechanics and students requested additional educational resources.

CONCLUSION

Dental students are developing MSDs as soon as 1 month after commencing dental school. Dental education should include ongoing ergonomic training throughout the curriculum to help students prevent MSDs.

Standardized photometric assessment method: A novel approach for the analysis of dental ergonomic posture

Background:

Identification and documentation of the proper and improper dental ergonomic postures have gained its importance in the recent years due to the increased prevalence of work-related musculoskeletal disorders (WMSDs) among dentists and dental students who do not practice proper ergonomic procedure.

Aim:

The aim of the present study is to analysis ergonomic posture among dental students while performing supragingival scaling (SGS) procedure, using the standardized photometric assessment method (SPAM).

Materials and Methods:

A total number of 90 students from the third year (III year) to final year (IV year) and internship (Intern) (30 each) were included in the study. All the 90 students were asked to perform SGS procedure and were photographed and analyzed using the current technique. Eight dental ergonomic postures were analyzed in this study and grouped according to the classification system developed for scoring dental ergonomic postures by Garbin et al., in 2011. Analysis of variance test with Bonferroni correction was used to statistically analyze the collected data.

Results:

The mean index value for III year, IV year and Intern were 2.00, 2.03, and 2.13, respectively, which was not statistically significant (P = 0.709).

Conclusions:

Analysis of the dental students using the current method showed that most of them come under inadequate and regular category which puts them in a high risk for developing WMSDs. The SPAM to analyze the dental ergonomic posture was simple and effective and should be further explored in the future studies for its pros and cons.

Longitudinal effects of utilising photography on the accuracy of ergonomic self-assessments amongst dental hygiene students

PURPOSE

The purpose of this study was to determine the longitudinal effects of feedback involving photography and self-assessment on the accuracy of ergonomic self-assessments and ergonomic scores amongst dental hygiene students.

MATERIALS AND METHODS

The study involved an experimental design. Data collection took place over 4 months, divided into weeks 1-4 and after 3 months. At weeks 1 through 4 and 3 months, all participants completed ergonomic self-evaluations, using a Modified-Dental Operator Posture Assessment Instrument. At week 1, week 4 and 3 months, all participants were photographed, and in weeks 2 and 3, only participants in the training group were photographed and used those photographs to complete ergonomic self-assessments. All participants' photographs were evaluated by three faculty raters.

RESULTS

A mixed-design ANOVA of Kappa coefficient values between student and rater scores measured the effects of the feedback with photography on the accuracy of student self-assessments. A main effect for group was not found to be significant (F(1,30) = 2.90, P = .101). A mixed-design ANOVA measured the effects of the feedback with photography on the ergonomic scores. No significant main effects were found (F(1,120) = 1.55, P = .216).

CONCLUSION

Although self-assessment utilising photographs resulted in initial improvements in the accuracy of ergonomic self-assessments and ergonomic scores after 4 weeks, both ergonomic accuracy and scores significantly decreased after 3 months. Improvement in ergonomic accuracy and scores may be sustained by the continual facilitated use of photographs and self-assessment by dental and dental hygiene educators.

Improving the Awareness of Musculoskeletal Disorder Risks Among Dental Educators

Prolonged and static postures among dental workforce personnel may lead to work-related musculoskeletal disorders (WMSDs). The aim of this study was to determine whether feedback involving photography and self-assessment would improve dental educators' postures and accuracy of ergonomic self-assessment. This study used a randomized control design. The Modified-Dental Operator Posture Assessment Instrument (M-DOPAI) was used for all ergonomic evaluations over a four-week period at one U.S. dental school. At week 1, all 30 participating dental educators were photographed and completed an M-DOPAI without viewing the photographs. In weeks 2 and 3, the educators in the control group (N=15) completed an M-DOPAI without any additional photographs. The educators in the training group (N=15) had additional photographs taken and used the photographs to complete an ergonomic self-assessment with the principal investigator. From week 1 to week 4, the ergonomics training utilizing photography resulted in improvements in the dental educators' ergonomic scores but not the accuracy of their ergonomic self-assessments. All participants strongly agreed it was important for both dental students and dentists to understand proper ergonomics, properly apply proper ergonomics, and have accurate ergonomic self-assessment skills in clinical practice. Although these dental educators valued ergonomic principles, they lacked training in applying these principles with dental students. Without additional training in ergonomics and self-assessment, the development of these skills in dental students will be affected.

Ergonomics in Dermatologic Surgery: Lessons Learned Across Related Specialties and Opportunities for Improvement

BACKGROUND

As the practice of dermatology becomes increasingly procedurally based, there is a concordant rise in musculoskeletal injury (MSI) risk. Dermatologic surgeons are most susceptible and, although the majority suffer from MSI, few have received any formal ergonomics training. This stems from a lack of awareness of this troubling trend and a paucity of research and education on the ergonomics of dermatologic surgery.

OBJECTIVE

To highlight pertinent ergonomics principles and strategies from other specialties that could be translated into dermatology, and to synthesize general recommendations aimed at reducing MSI among dermatologic surgeons.

MATERIALS AND METHODS

A comprehensive search of the PubMed and Cochrane Reviews databases from 1975 to 2019 was conducted, using a combination of ergonomics-related search terms, generating 6 publications from the dermatology literature and 58 from the fields of dentistry, medicine, and select surgical subspecialties.

RESULTS

This multidisciplinary approach yielded multiple interventions that could be applied directly (i.e., adequate lighting, adjustable operating tables, and surgical seat heights) or indirectly pending further investigation into their feasibility (i.e., video displays of the surgical field to allow neutral head and neck postures).

CONCLUSION

Although much can be learned from decades of prior ergonomics research from other specialties, considerations that are unique to dermatology remain and must be addressed with specialty-specific research.