Dental hygiene graduates' educational preparedness: Self-confidence ratings of the CDHA baccalaureate competencies

A comparison of simulation and traditional local anesthesia teaching methods among dental hygiene students

BACKGROUND

The COVID-19 pandemic forced dental educators to quickly modify the teaching-learning platform without testing outcomes of alternative teaching methods prior to implementation. One critical course affected was the teaching of local anesthesia (LA) that moved from practicing injections using the traditional student-to-student method to the simulation model using manikins.

PURPOSE

This study compared two LA teaching methods (student-to-student versus simulation) in two consecutive cohorts before and during the pandemic to assess differences in students' skill level and self-confidence.

METHODS

This quasi-experimental study recruited a convenience sample of dental hygiene students at the University of Minnesota during 2020 and 2021. Consent was collected prior to student-to-student injection practice and survey distribution. Data collected were clinical and summative clinical assessments to determine LA skill level, and student surveys to assess self-confidence. Analyses included descriptive statistics, linear models within and between cohorts, and inductive analysis for qualitative survey responses.

RESULTS

Fifty of 57 students (88%) completed the survey, and 54 (95%) consented access to their clinical assessments. Skill level was significantly higher for the simulation cohort compared to the student-to-student cohort on the LA summative clinical assessment (59.0 vs. 55.6, p = 0.004). No differences were found in self-confidence between cohorts. A positive association was found between students' self-confidence and skill levels for both cohorts, but only student-to-student cohort results were statistically significant (student-to-student: r = 0.44, p = 0.02; simulation: r = 0.24, p = 0.26).

CONCLUSION

Results support incorporating simulation manikin teaching methods for LA with a student-to-student partner component.

Curriculum mapping of health promotion competencies in dental and oral health training programmes in Australia

ISSUE ADDRESSED

Dental diseases are chronic conditions that place a significant burden on the population's health; however, they are mostly preventable using a range of health promotion strategies Health promotion is a core competency for all dental and oral health graduates, but little is known about what health promotion content is taught in undergraduate degrees. The aim of this study was to explore the dental and oral health content in Australian undergraduate dental and oral health degrees and map against the last two versions of the Australian Dental Council (ADC) health promotion competencies.

METHODS

All ADC-accredited dental and oral health courses delivered at Australian universities in 2019 were eligible to be included. Key words were used to locate subjects within the courses that contained health promotion content. This was analysed and ranked against the last two versions (2011 and 2016) of the ADC health promotion competencies. The competencies were then ranked using Blooms updated "six levels of thinking."

RESULTS

Seven oral health and eight dental courses were mapped. The number of health promotion subjects in courses varied substantially; the percentage of subjects that contained health promotion in oral health courses ranged from 30% to 75% and 16% to 60% for dental courses. All oral health courses were explicitly meeting the current ADC health promotion competencies, however, only half of the dental courses met the competency standards.

CONCLUSION

Curriculum mapping provided a snapshot of the health promotion content within dental and oral health degrees in Australia. Evaluations of the extent to which these courses meet the ADC competencies provide useful information for students, clinicians and policy makers. SO WHAT?: This study provides evidence that health promotion training is occurring at varying levels. However, in dentistry, not all the ADC health promotion competencies are being met. A change is needed in the ADC health promotion competencies and ethos of academics involved in the development of curriculum to include and give appropriate attention to health promotion theory, especially advocacy. This will enable future dental professionals to advocate for a range of oral health promotion activities such as water fluoridation, universal dental care and sugar-sweetened beverage taxes.

Oral health academics' conceptualisation of health promotion and perceived barriers and opportunities in dental practice: a qualitative study

BACKGROUND

Oral diseases place a significant burden on individual and population health. These diseases are largely preventable; health promotion initiatives have been shown to decrease the disease rates. However, there is limited implementation of health promotion in dentistry, this could be due to a number of factors; the ethos and philosophy of dentistry is focused on a curative, individualised approach to oral diseases, confusion around health promotion as a concept. Oral health academics are well placed to implement health promotion, training of these professionals needs to include prevention, as training influences dental practice. However, there is a little understanding about how oral health academics (dental professionals who educate dental and oral health students) view health promotion. The aim of this exploratory study is to understand how oral health academics conceptualise health promotion and perceive the barriers and possible opportunities for health promotion implementation in dental practice.

METHODS

Nominal group technique (NGT), a highly structured face-to-face meeting, was conducted with 24 oral health academics to explore how they conceptualize health promotion and the barriers and opportunities for health promotion in practice. An additional 4 questions were emailed to oral health educators after the NGT meeting to gather additional data, 6 oral health academics were involved. The data was analyzed using thematic analysis.

RESULTS

Three board themes were identified: "Knowledge, ideas and concepts of health promotion", "Challenges to health promotion", "Opportunities for health promotion practice". The oral health academics in this study discussed health promotion in a holistic way, however, health education and behaviour change were mentioned more than other aspects of health promotion. The structure of dental practice specifically the curative approach that underpins dentistry and the lack of funding, and value placed on health promotion could act as a challenge to health promotion being implemented in practice. There has been a shift towards prevention in dentistry, however the participants acknowledge there needs to be a change in the curative culture of the profession. Collaboration with other health professionals and using a common risk factor approach were the identified opportunities for health promotion practice.

CONCLUSIONS

Oral health academics have a holistic understanding of health promotion, but still focus more on behavioural approaches which is common within dentistry. For a change to occur in health promotion practice a change in the structure, curative approach and funding model of dentistry is required. Collaboration with other health professionals is an opportunity to be capitalised on. Training of future dental professionals is the perfect place to start to implement the changes and opportunities for health promotion presented in this paper.

Fourth-year dental hygiene students' educational preparedness: Self-confidence ratings of the Canadian Dental Hygienists Association baccalaureate competencies (2017-2019)

PROBLEM STATEMENT

The Canadian Competencies for Baccalaureate Dental Hygiene Programs (CCBDHP) were first published in 2015 by the Canadian Dental Hygienists Association. They reflect the first articulation of dental hygiene baccalaureate competencies in North America. However, there is little evidence to support baccalaureate graduates acquire these abilities.

OBJECTIVE

To examine the confidence levels of baccalaureate fourth-year students in their ability to demonstrate the CCBDHPs.

METHODS

This 3-year longitudinal study rated the self-confidence levels of fourth-year students as they neared graduation from the University of British Columbia from 2017 to 2019. It involved an online, anonymous survey using a 5-point scale ranging from not confident to confident. Respondents rated their self-confidence in the 110 sub-competencies articulated within the 13 competency domains of the CCBDHP.

RESULTS

Responses were received from 54 of the 70 graduating students for a cumulative 77% response rate. Respondents expressed the most confidence in the competency domains of Clinical Therapy (100%), Collaboration (100%), Disease Prevention (100%), Professionalism (100%), and Oral Health Education (90%) but expressed less confidence in Research Use (73%), Health Promotion (70%), Leadership (67%), Policy Use (20%), and Advocacy (11%).

CONCLUSION

These data suggest that curriculum revisions are needed in 5 domains but such changes may not be sufficient. Transition support may be warranted to assist graduates as they enter practice, while some competencies may be more appropriate for graduate studies. The study contributes to an international discussion about the educational preparedness of baccalaureate graduates, and the boundaries between diploma, baccalaureate and master's education.