Final year dental students' self-assessed confidence in general dentistry

Navigating the Path to Independent Dentist: A Qualitative Phenomenological Exploration

OBJECTIVE

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

MATERIALS AND METHODS

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

RESULTS

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

CONCLUSION

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

CLINICAL RELEVANCE

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

The level of confidence of dentists in identifying intact and sectioned teeth

OBJECTIVE

This study aimed to assess the confidence levels of dentists in identifying intact and sectioned human teeth and to identify the factors contributing to variations in confidence levels.

DESIGN

An anonymous Jisc e-survey showing 14 questions was sent to dentists worldwide. Apart from acquiring demographic details of the participants, ten three-dimensional (3D) tooth models were presented for tooth identification including the opinion on the level of confidence in identifying. They included seven permanent and three deciduous teeth in intact or sectioned state. The tooth models were created and manipulated using ZBrush software (Maxon Industries, Inc.) and uploaded to the Sketchfab model hosting platform. The accuracy of results was quantitatively analysed in five categories, namely: (I) tooth type, (II) region, (III) tooth classification, (IV) tooth within the same class, and (V) FDI World Dental Federation notation.

RESULTS

Most participants received education in dental anatomy at the undergraduate level. No significant differences in accuracy were seen between intact and fractured tooth models. The highest accuracy was seen in Category I (Permanent or Deciduous, 0.74) and the lowest in Category V (FDI Notation, 0.26). The perceived confidence of each participant (total of 56) was seen to have the highest accuracy when the participant opined limited confidence, although with no significant differences for each category (P>0.05). Moreover, the most common error was found in the category II region, where participants could not correctly locate the tooth on the right or left side of the mouth in six 3D tooth models.

CONCLUSION

The assessment of intact and sectioned teeth has not presented differences in accuracy. High accuracy was seen when dentists categorised permanent and deciduous teeth. The highest accuracy in results was linked to the limited confidence of dentists but factors contributing to this level of confidence are not clear in this study. More attention should be paid to the dental features that distinguish location on the right or left side of the mouth.

Impact of COVID-19 on Depression, Anxiety and Stress of Dental Students: A Systematic Review

AIM

To determine the impact of the COVID-19 pandemic on depression, anxiety and stress of dental students by way of a systematic review.

MATERIALS AND METHODS

This review was conducted following the Cochrane Handbook for Systematic Reviews. An electronic search was conducted for the period January 2020 to February 2023. Quality assessment was evaluated in accordance with the Newcastle-Ottawa Scale. Frequency distribution was calculated for stress, anxiety and depression associated with students' gender, year of study and living circumstances.

RESULTS

Twenty-three studies were eligible for inclusion in the final review. Variables contributing to stress, anxiety and depression of dental students include gender, year of study and living circumstances. Being female is the most significant factor impacting on mental health.

CONCLUSIONS

Results emphasise the need for dental institutions to develop targeted intervention programmes for more vulnerable students. Failure to act in a future pandemic event could result in ongoing psychological issues that persist following graduation, resulting in unfit dentists who may potentially affect the quality of the dental workforce.

Cultural topics with clinical implications needed in the dental curriculum to develop intercultural competence: A systematic review

OBJECTIVE

To identify cultural topics with clinical implications to be incorporated into the dentistry curriculum to develop Intercultural Competence.

METHODS

Systematic review with PRISMA criteria that exported 216 articles from the Web of Science, Scopus, and SciELO databases from 2012 to 2022, of which 40 were selected. The inclusion criteria were theoretical and empirical scientific articles, of quantitative, qualitative, or mixed methods nature, on cultural topics.

RESULTS

The data analysis allowed the organization of information into four cultural topics: Development of professional intercultural self-awareness, Individual, family, and cultural implications, Construction of intercultural therapeutic relationships, and Specific clinical aspects, each with particular contents to be developed in the dentistry curriculum. However, some clinical issues have yet to be explored in-depth, leaving research possibilities open to all disciplines in dentistry. Additionally, it is necessary to analyze the cultural bias in the discussion and conclusion of some reviewed articles, as they were conducted from an ethnocentric perspective. Thus, peer reviewers of scientific journals and researchers in these topics must have appropriate training in Intercultural Competence.

CONCLUSIONS

This review provides a guide and pedagogical sequence of the cultural topics that should be incorporated into the dentistry curriculum to achieve Intercultural Competence, it also highlights a wide range of relevant aspects to consider in establishing an adequate therapeutic relationship. Explicit accreditation criteria contribute to the establishment of Intercultural Competence in the curricula; however, in countries that lack regulations, there is a moral and ethical duty to incorporate the subject so that the future professional can manage and establish inclusive healthcare.

Dental Students' Perception and Self-Perceived Confidence Level in Key Dental Procedures for General Practice and the Impact of Competency Implementation on Their Confidence Level, Part I (Prosthodontics and Conservative Dentistry)

Background

Evaluating the level of dental students' competence is crucial for validating their preparedness for graduation. Confidence has a significant role in achieving competence. There are limited studies that assess the level of self-perceived confidence among final-year dental students regarding their ability to conduct key dental procedures. This study aims to assess the self-perceived confidence level of final-year dental students in performing essential dental procedures across various dental disciplines and to assess the effect of implementing competencies in the curriculum on the self-perceived confidence level of students by comparing two cohorts of final-year students in two different years 2016 (Traditional Cohort) and 2019 (Competencies Cohort).

Materials and Methods

An questionnaire was answered by two cohorts of final-year dental students: one group in 2016 before the implementation of the competency-based assessment system (group 1, n = 153), and the other in 2019 after the implementation of this system (group 2, n = 199), the same questionnaire was used for both cohorts. The results from the two groups were compared regarding the degree of self-perceived confidence in conducting key dental procedures. The data were analysed using SPSS statistics and Levene's Test for Equality of Variances and t-test for Equality of Means calculated.

Results

Group 1 showed a significantly higher means of self-perceived confidence levels than group 2 in the ability to conduct seven out of the 20 prosthodontics procedures studied: providing patients with Cobalt-Chromium (Co-Cr) removable partial dentures (RPD) (3.77 vs. 3.56), providing the patient with Acrylic RPD (3.70 vs. 3.23), treatment planning for partially edentulous patients (3.83 vs. 3.34), giving OHIs for denture patients (4.17 vs. 3.95), dealing with CD postinsertion complaints (3.97 vs. 3.76), giving postinsertion instructions for removable prostheses cases (4.12 vs. 3.82), and providing patients with immediate dentures (2.67 vs. 2.32). The same applies to 6 out of 16 conservative dentistry procedures: placing anterior composite (4.41 vs. 4.12), placing posterior composite (4.43 vs. 3.88), placing posterior amalgam (4.29 vs. 4.02), placing matrix band for Class II restorations (4.24 vs. 3.71), placing a prefabricated post (3.34 vs. 2.88), and placing fiber post (3.45 vs. 3.34). On the other hand, group 2 shows higher means of self-perceived confidence than group 1 in only two conservative dentistry procedures: onlay restorations (2.18 vs. 2.76) and inlay restorations (2.22 vs. 2.75). No significant differences in means of self-perceived confidence were found between the two groups in the remaining 21 procedures studied.

Conclusions

This study has shown that final-year dental students have high self-perceived confidence levels in doing simple dental procedures yet less confidence in more complex ones. Although, students' self-perceived confidence decreases after the introduction of a competency-based assessment system. Competency implementation and execution criteria may differ between schools which may have an impact on final outcomes. Hence, there is a need for regular evaluation of competencies being assessed to maintain a curriculum that is up to date.

Comparing traditional and comprehensive clinical training methods in dental education: a study of students' self-confidence and clinical performance

Aim To compare students' self-confidence levels and clinical performance scores between traditional and comprehensive clinical training methods in dental schools in India.Methods A snowball sampling of undergraduate dental students who had completed their final year during 2021-2022 was undertaken. A questionnaire was designed and distributed to investigate students' self-confidence in performing 35 clinical procedures on a 5-point Likert scale. Additionally, the clinical performance score in external practical assessment during final year was assessed to correlate the self-confidence levels with traditional and comprehensive clinical training methods.Results Students reported a higher level of self-confidence trained under the comprehensive (3.41 ± 0.40) compared with the traditional method (3.07 ± 0.50) (p <0.05). Interestingly, the median clinical performance score was higher for students using the traditional method (2.88) than for those using the comprehensive method (2.44); however, no significant difference was observed (p = 0.460). The correlation between self-confidence and clinical performance scores was strongly positive (r = 0.521).Conclusion This study concluded that both traditional and comprehensive clinical training methods have strengths and weaknesses. Combining these two methods could improve clinical training in India.

Effect on undergraduate student self-confidence in using 3D printed primary molars for root canal treatment simulation training

PURPOSE

The main purpose of this study was to assess the effect of a root canal treatment (RCT) practical simulation-based session using 3D printed primary molars on the self-confidence of fourth-year undergraduate dental students. Our study was also designed to explore student experiences with both manual and rotary RCT procedures and to investigate the association between the self-confidence in undertaking an RCT and the quality of the RCT.

METHODS

Student global self-confidence in undertaking an RCT on a healthy, cooperative child aged 4-5 years was evaluated 2 h before, 1 month after, and 11 months after the simulation training session. Once each instrumental procedure had been completed, the students were also asked to score the level of confidence (specific self-confidence) they felt regarding the use of RP and MP. After each training session, the quality of the RCT was radiographically evaluated by two trained, independent investigators.

RESULTS

Overall, student global self-confidence in undertaking an RCT increased significantly immediately after the practical session and remained stable for the ensuing eleven months. The students declared a clear preference for RP and were more self-confident in undertaking an RCT after RP than after MP. The proportion of RCTs considered of good quality was the same for the manual (31.5%) and rotary (30.3%) procedures.

CONCLUSIONS

Simulation training is a good way to train dental students who are confident in undertaking RCTs. However, confidence is not directly related to competence. Teachers should be encouraged to develop a comprehensive simulation training program, including feedback, debriefing, and repetitions.

Competencies of dental public health for undergraduate students and their self-perceived achievements: The case of Iran

PURPOSE

The aim of this study was to develop Dental Public Health (DPH) competencies and to assess the self-perceived achievements of undergraduate students in regard to these competencies.

MATERIALS AND METHODS

In the first phase, by using the mixed method of the RAND-UCLA model, a list of the proposed competencies was developed and validated based on three-round expert consensus using both rating and group discussing method. In the second phase, 120 senior (final-year) dental students were asked to determine their achievements based on the finalised list of competency statements on a 0-10 numerical scale. Descriptive statistical analysis was then performed using SPSS (version 22) to determine the mean score of the items and domains. Some background factors were also tested for any relationship.

RESULT

After three rounds of implementing the RAND-UCLA method, 31 statements in 10 domains were developed and validated. The mean total score of the self-reported competency was 176.87 ± 52.4 amongst the recruited dental students with a range of 37 to 304. The highest mean ± sd score (7.7 ± 1.8) was found for the preventive oral health services field, whilst the lowest one (4.5 ± 2.3) was reported for understanding the components and functions of the health system. The average self-reported scores of professional ethics and professionalism, evidence-based practice and oral health determinants were also acceptable amongst them.

CONCLUSION

The finalised competencies gained the consensus level of agreement and appropriateness by representatives of all DPH experts in the country. However, according to the dental students' self-reports, they had moderate competencies in most cases. Therefore, content and applied methods of training and evaluation may need to be revised to support students' development. Also, the complementary evaluation method at real work setting is highly suggested.

Preclinical 3D-printed laboratory simulation of deep caries and the exposed pulp reduced student anxiety and stress, while increasing confidence and knowledge in vital pulp treatment

Aim

To evaluate the impact of a preclinical laboratory session using 3D printed teeth on dental student stress, anxiety, confidence and knowledge when treating deep caries and pulp exposure.

Methodology

This was a two‐centre controlled study, with randomized distribution of students into two groups: a vital pulp treatment (VPT) lecture‐only (control) group and a VPT‐lecture combined with a VPT‐laboratory (experimental) group. In both universities, preclinical students with endodontic or operative dentistry laboratory sessions could participate. All students were invited to the lecture. Two weeks later (timepoint‐T1), both groups completed validated and bespoke questionnaires and scales to evaluate their stress (Stress‐VAS), anxiety (STAI Trait [T] and State [S]), self‐confidence and knowledge. Thereafter, only the experimental group attended the hands‐on laboratory session demonstrating the techniques of selective caries removal and partial pulpotomy on a commercial 3D‐printed tooth. Two weeks later (timepoint‐T2), the participants from both groups repopulated the same questionnaires and VAS. The control group had the laboratory session after the completion of the study. The statistical analysis was performed with Statistica® (significance p = .05). The homogeneity between the two samples was checked by Khi² and Student tests. Stress‐VAS, STAI‐S, confidence and knowledge scores were compared within each group, and between the two groups, at T1 and T2, with a repeated measures anova test (+/−Tukey post‐hoc test).

Results

The groups comprised 54 students each, with no statistical difference between the groups regarding demographic, academic data and STAI‐T score. The two groups had no significant difference of Stress‐VAS, STAI‐S, confidence and knowledge scores at T1 while they presented a significant difference in stress, anxiety and confidence scores at T2, but with no significant difference in knowledge score. However, knowledge score, as other parameters, improved significantly between T1 and T2 in the experimental group.

Conclusions

The addition of a laboratory session using 3D‐printed teeth that simulated deep caries and pulp exposure management, significantly reduced the stress and anxiety of students and increased their confidence. Within the limitations of this study, the benefit of introducing new technology in increasing student confidence and reducing stress offers opportunity for educational improvement in the VPT and cariology areas.

Combining virtual reality and 3D-printed models to simulate patient-specific dental operative procedures-A study exploring student perceptions

INTRODUCTION

Students face a number of challenges in translating the skills acquired in pre-clinical simulation environments to the delivery of real patient care. These are particularly emphasised for complex operative procedures such as tooth preparations for indirect restorations. This paper reports student perceptions of a novel approach designed to improving student confidence when undertaking operative procedures on patients for the first time, by providing patient-specific simulation using virtual reality (VR) and 3D-printed models of the student's real clinical case.

MATERIALS AND METHODS

Students practised on patient-specific models, in the presence of a clinical tutor, firstly using VR simulation then with 3D-printed models in a clinical skills laboratory. The students then carried out the operative procedure on their patients, on the third occasion of practice. After providing the treatment for their patients, students attended a semi-structured interview to discuss their experiences. The qualitative data were analysed using two forms of inductive analysis.

RESULTS

Students most frequently cited: the value of the educator, increased confidence and efficiency during the clinical procedure, improved patient confidence and the complementary benefits of the two simulation modalities. Thematic analysis of participants' responses uncovered five key themes: The value of virtual reality dental simulators The value of clinical skills laboratory simulation with 3D-printed models The value of educator engagement The impact on the clinical procedure and the patient The VR and clinical skills laboratory balance CONCLUSION: This paper reports the early findings of an intervention that improves dental student confidence through the use of patient-specific VR exercises and 3D-printed models. These provided an incremental learning experience for an operative clinical procedure, prior to treatment of the live patient. Early results suggest this is a positive experience for the students, providing a valuable contribution to their confidence and preparedness.

Students at Saarland University dental school-A survey on their background and curriculum perception

INTRODUCTION

With the aim of optimising dental education without overburdening students, new legislation restructuring the undergraduate dental curriculum in German is under way. The goal of this study was to survey the current situation of dental students at one specific university with respect to their socio-economic background, admission to dental school, curriculum perception and work-life balance.

MATERIALS AND METHODS

An online questionnaire was presented to all undergraduate students enrolled at Saarland University who had at least completed the first preclinical practical course in dentistry.

RESULTS

A response rate of 85% was reached with two-thirds of the student body being females. The profession of 40% of students' parents either was physicians or dentist. Students reported a slight reduction in time spent for leisure activities during their studies, however, with sports activities hardly being affected. With respect to a proper work-life balance, almost 50% of respondents considered their clinical workload as being too high. Students did not express a clear opinion regarding curriculum structure, whilst the content mostly satisfied their expectations (59%). The majority (71%) of students considered their preclinical training as being demanding whilst less than 3% fully agreed that preclinical training provided an optimal background for patient treatment. The learning modules in the first clinical semester were considered as being adequate by 56% of students. Examinations during courses were seen as properly reflecting the students' knowledge by 79% of students.

DISCUSSION

The status quo of German dental students is characterised by a high workload affecting the students' work-life balance and by a transition between preclinical and clinical education which only about half the student body perceives as being adequate. Patient-based examinations obviously are not considered as being problematic.

The Effect of Extra Educational Elements on the Confidence of Undergraduate Dental Students Learning to Administer Local Anaesthesia

Local anaesthesia is taught early in the practical part of dental programs. However, dental students express uncertainty and concern before their practical training in local anaesthesia. The aim of this study was to evaluate how extra educational elements in the teaching of local anaesthesia affect students’ confidence using local anaesthesia. The students were divided into three groups (A, B and C). Group A received the same education that was used the previous year (i.e., four hours of theoretical lectures followed by four hours of practical exercises performed on a fellow student). Group B did their practical training on fellow students in groups of three, with each student taking turns performing, receiving and observing the procedure. Group C received training using an anatomically correct model before their practical training on a fellow student. After each training step, the students completed a questionnaire about their confidence administering local anaesthesia. The students experienced a significant increase in confidence after each educational step. Combining theory and practical instruction, including the use of anatomically correct models and peer instruction, improved students’ confidence in administering local anaesthesia. The greatest increase in confidence was in the students placed in groups of three where each student performed, received and observed the procedure.

Evaluation of the Most Stressful Dental Treatment Procedures of Conservative Dentistry among Polish Dental Students

BACKGROUND

Dental schools are considered to be a very stressful environment; the stress levels of dental students are higher than those of the general population. The aim of this study was to assess the level of stress among dental students while performing specific dental procedures.

METHODS

A survey was conducted among 257 participants. We used an original questionnaire, which consisted of 14 questions assigned to three categories: I-Diagnosis, II-Caries Treatment, and III-Endodontic Treatment. Each participant marked their perceived level of stress during the performed dental treatment procedures. The scale included values of 0-6, where 0 indicates no stress, while 6 indicates high stress.

RESULTS

Third- (p=0.006) and fourth-year (p=0.009) women were characterized by a higher level of perceived stress during dental procedures related to caries treatment. Caries treatment procedures were the most stressful for 18.3% of third-year students, 4.3% of fourth-year students, and 3.2% of fifth-year students. Furthermore, 63.4% of third-year students, 47.3% of fourth-year students, and 17.2% of fifth-year students indicated that they felt a high level of stress when performing endodontic procedures.

CONCLUSION

Third- and fourth-year female students are characterized by a higher level of stress during caries and endodontic treatment procedures. The most stressful treatments for participants were endodontic treatment procedures.

Frightened of the pulp? A qualitative analysis of undergraduate student confidence and stress during the management of deep caries and the exposed pulp

AIM

To evaluate sources of student confidence and stress during the management of deep carious lesions and the exposed pulp during undergraduate clinics. Further aims were to identify barriers and facilitators, which could result in educational or practical improvements in the delivery of teaching and provision of treatment in this area.

METHODOLOGY

A exploratory qualitative study design was used, based on recorded focus group interviews, guided by 12 predetermined questions. The discussions were transcribed verbatim and analysed by inductive qualitative content analysis. Common categories were identified to aid understanding. Forty undergraduate dental students from 4th and 5th years in Dublin Dental University Hospital participated in the study.

RESULTS

Student stress and confidence were multifactorial and broadly linked to specific domains: clinical procedure, academic education, clinical training, evaluation/grading, organization and equipment, vital pulp biomaterial and the patient. Most students expressed a preference for one-stage selective carious removal to soft dentine rather than potential pulp exposure in deep carious lesions, noting that although it helped to decrease their immediate stress, it also caused longer-term concern by leaving caries close to the pulp. Nevertheless, their confidence was affected by limited clinical experience of carrying out selective removal procedures in deep caries. A recurrent finding was students citing high levels of stress after pulp exposure. Feelings including anger, fear, embarrassment and denial were associated with pulp exposure during deep caries management. Generally, the students felt able to manage pulp capping procedures, but were less certain about partial pulpotomy, suggesting that although they are aware of its advantages, they were unsure about the appropriate volume of pulp tissue to remove. To reduce stress, students suggested that laboratory teaching should employ new 3-D printed solutions and clinics should establish clear consensus amongst supervising teachers about the best way to manage the exposed pulp.

CONCLUSIONS

Students lacked confidence as they neared the pulp and prefer selective caries removal techniques, which reduce the likelihood of pulp exposure. Students identified stressors and suggested improvements in several domains that would improve confidence. These ameliorations could lead to enhancements in student ability to perform these conservative techniques, and improve the provision of treatment in this area.