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Khalifah AM, Celenza A. Teaching and Assessment of Dentist-Patient Communication Skills: A Systematic Review to Identify Best-Evidence Methods. J Dent Educ 2019; 83:16-31. [PMID: 30600246 DOI: 10.21815/jde.019.003] [Citation(s) in RCA: 16] [Impact Index Per Article: 3.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/08/2018] [Accepted: 07/19/2018] [Indexed: 11/20/2022]
Abstract
Dentist-patient communication skills are important aspects of contemporary oral health care, as shared decision making with patients becomes more common. The aim of this systematic review of the literature on teaching and assessment methodologies for communication skills in dental practice was to categorize those skills most relevant to dental practice and determine the best-evidence teaching and assessment methods. The systematic review was conducted using MEDLINE, EBM-Cochrane Libraries, Embase, ERIC, BIOSIS, CAB Abstracts, and PsycINFO using the OVID search engine, together with manually searching relevant journal articles. Relevant data were extracted from all included articles, and thematic analysis, categorization, and quality review of the articles was performed. Fifty articles published between 2000 and 2016 were identified as relevant to this study. Most were comparative design studies. The largest numbers were single group studies with before and after tests and cross-sectional studies. A total of 26 communication skills were identified and grouped into four major categories: generic skills, case-specific skills, time-specific skills, and emerging skills. Review of the teaching methods described in those articles showed that educators used a combination of passive and active strategies. All the assessment measures were considered to be valid and reliable. This categorization of essential dentist-patient communication skills reported in the literature may be used to assist in curriculum design along with use of tested teaching methods and validated assessment measures. The review highlights the need for more robust study designs for research in this important aspect of dental education.
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Affiliation(s)
- Ayman M Khalifah
- Ayman M. Khalifah, MHPEd, is a dentist and Lecturer, Department of Dental Education, Taibah University College of Dentistry, Almadinah Almunawwarah, Kingdom of Saudi Arabia; and Antonio Celenza, MBBS, MClinEd, FACEM, FRCEM, is Professor of Emergency Medicine and Medical Education, School of Medicine, Faculty of Health and Medical Sciences, The University of Western Australia, Australia
| | - Antonio Celenza
- Ayman M. Khalifah, MHPEd, is a dentist and Lecturer, Department of Dental Education, Taibah University College of Dentistry, Almadinah Almunawwarah, Kingdom of Saudi Arabia; and Antonio Celenza, MBBS, MClinEd, FACEM, FRCEM, is Professor of Emergency Medicine and Medical Education, School of Medicine, Faculty of Health and Medical Sciences, The University of Western Australia, Australia.
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Rüttermann S, Kiessling C, Haak R, Gerhardt-Szep S, Härtl A. Identification of influence factors for the implementation of communication curricula in dental education. EUROPEAN JOURNAL OF DENTAL EDUCATION : OFFICIAL JOURNAL OF THE ASSOCIATION FOR DENTAL EDUCATION IN EUROPE 2018; 22:e386-e391. [PMID: 29239084 DOI: 10.1111/eje.12315] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Accepted: 11/12/2017] [Indexed: 06/07/2023]
Abstract
INTRODUCTION The aim of the study was to reveal possible obstacles or advantages for the implementation of a dental communication curriculum. It was questioned whether (i) universities with a communication curriculum in medicine realise the same development in dentistry, (ii) the existence and usage of a learning objectives catalogue is a main factor to facilitate the implementation, and (iii) it is more easy to establish with a lower number of students. MATERIAL AND METHODS Data of two recently published surveys were taken as the basis for further analysis. The quality of the curricula was evaluated by a scoring system. Correlations were calculated between the scores and possible influence factors. A t test for paired samples was accomplished to reveal differences between medical and dental curricula, and a Mann-Whitney U test to identify differences in schools with and without the usage of a learning objectives catalogue. RESULTS No significant correlation was found between the quality scores of medical and dental schools; t tests revealed significant differences between them (P = .004). Correlation between cohort size and quality of the curriculum was marginal. Mann-Whitney U test revealed significantly higher quality scores for dental schools using a learning objectives catalogue (P = .001). CONCLUSIONS The existence of a learning objectives catalogue might facilitate the implementation of communication curricula at dental schools. A missing notable curriculum in the corresponding medical school should not detain from a respective campaign in the dental curriculum. Large student numbers should also not discourage from developing a communication curriculum.
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Affiliation(s)
- S Rüttermann
- Department of Operative Dentistry, Center for Dentistry and Oral Medicine (Carolinum), Goethe University Frankfurt, Frankfurt, Germany
| | - C Kiessling
- Department of Assessment, Medizinische Hochschule Brandenburg Theodor Fontane, Neuruppin, Germany
| | - R Haak
- Department of Cariology, Endodontology and Periodontology, University of Leipzig, Leipzig, Germany
| | - S Gerhardt-Szep
- Department of Operative Dentistry, Center for Dentistry and Oral Medicine (Carolinum), Goethe University Frankfurt, Frankfurt, Germany
| | - A Härtl
- Institut für Didaktik und Ausbildungsforschung in der Medizin, Klinikum der Universität München, München, Germany
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Coelho C, Pooler J, Lloyd H. Using patients as educators for communication skills: Exploring dental students' and patients' views. EUROPEAN JOURNAL OF DENTAL EDUCATION : OFFICIAL JOURNAL OF THE ASSOCIATION FOR DENTAL EDUCATION IN EUROPE 2018; 22:e291-e299. [PMID: 28714531 DOI: 10.1111/eje.12282] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Accepted: 06/13/2017] [Indexed: 06/07/2023]
Abstract
TITLE A qualitative study to explore the issues for patients and students when giving feedback on the communication of dental students. OBJECTIVES The Department of Health and National Institute for Health Research are committed to involving patients in improving clinical education, research and service delivery. Yet, there is a limited body of evidence on the perceptions of patients when asked to be involved in this way, and specifically when asked to provide feedback on the communication skills of dental students. This study seeks to address this gap and heighten the understanding of the issues faced by patients when asked to be involved in clinical education. METHODS Data were collected using focus groups with dental students (n=10) and patients (n=8) being treated by these students. Both groups were asked about their thoughts, feelings and beliefs about patients being asked to provide feedback on the communication skills of dental students. Data analysis involved inductive thematic analysis of transcribed audio recordings. RESULTS Four themes emerged from the data: "legitimacy," "co-educators," "maintaining the equilibrium of the patient-student relationship" and the "timing of patient feedback." Support for involving patients in giving feedback on students' communication skills was established, with patients considering they were best placed to comment on the communication skills of dental students. Patients and students do not want to provide feedback alone and want support to assist them, especially if feedback was negative. Issues of anonymity, confidentiality and ownership of the feedback process were worrisome, and the positioning of patient feedback in the programme was seen as critical. CONCLUSIONS Patients and students are willing to engage in patient feedback on students' communication skills, and with support and training, the concerns around this are not insurmountable and the benefits could potentially profit both groups. These findings have resonance with other healthcare educators when using patients as educators in the development of communication skills.
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Affiliation(s)
- C Coelho
- Clinical Dental Education, Peninsula Dental School, University of Plymouth, Plymouth, UK
| | - J Pooler
- Plymouth University Peninsula Schools of Medicine & Dentistry, Plymouth, UK
| | - H Lloyd
- Clinical Psychology, Peninsula Dental School, University of Plymouth, Plymouth, UK
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Rüttermann S, Sobotta A, Hahn P, Kiessling C, Härtl A. Teaching and assessment of communication skills in undergraduate dental education - a survey in German-speaking countries. EUROPEAN JOURNAL OF DENTAL EDUCATION : OFFICIAL JOURNAL OF THE ASSOCIATION FOR DENTAL EDUCATION IN EUROPE 2017; 21:151-158. [PMID: 26960532 DOI: 10.1111/eje.12194] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Accepted: 02/07/2016] [Indexed: 06/05/2023]
Abstract
INTRODUCTION Teaching communication is perceived to be of importance in dental education. Several reports have been published worldwide in the educational literature describing modifications of the dental curriculum by implementing the teaching of communication skills. Surveys which evaluate the current state of training and assessment of communication skills in dental education in different countries exist already in some countries, but little information is available about German-speaking countries. MATERIAL AND METHODS In a cross-sectional study with the aim of a census, all 36 dental schools in Germany (30), Austria (3), and Switzerland (3) were surveyed. RESULTS The present survey revealed that at 26 of the 34 dental schools (76%), communication skills training has been implemented. Training of communication skills mainly takes place between the 6th and the 9th semester. Ten schools were able to implement a partly longitudinal curriculum, while the other sites only offer stand-alone courses. Of the 34 dental schools, six assess communication skills in a summative way. Three of those schools also use formative assessments for their students. Another seven sites only use formative assessment. From the various formats of assessment, OSCE is mentioned most frequently. CONCLUSION The necessity to train and assess communication skills has reached German-speaking dental schools. The present survey allows an overview of the training and assessment of communication skills in undergraduate dental education in German-speaking Europe.
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Affiliation(s)
- S Rüttermann
- Department of Operative Dentistry, Center for Dentistry and Oral Medicine (Carolinum), Goethe University Frankfurt, Frankfurt, Germany
| | - A Sobotta
- Klinikum der Universität München, Institut für Didaktik und Ausbildungsforschung in der Medizin, München, Germany
| | - P Hahn
- Department of Operative Dentistry and Periodontology, University Medical Center Freiburg, Medical School and Hospital, Freiburg, Germany
| | - C Kiessling
- Department of Assessment, Medizinische Hochschule Brandenburg Theodor Fontane, Neuruppin, Germany
| | - A Härtl
- Klinikum der Universität München, Institut für Didaktik und Ausbildungsforschung in der Medizin, München, Germany
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Leme PAT, Pereira AC, Meneghim MDC, Mialhe FL. Undergraduate dental students' perspectives about experiences in primary care for their education in the field of health. CIENCIA & SAUDE COLETIVA 2015; 20:1255-65. [PMID: 25923636 DOI: 10.1590/1413-81232015204.00812014] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/10/2014] [Accepted: 09/02/2014] [Indexed: 11/22/2022] Open
Abstract
Supervised training periods in primary care have been used as spaces for teaching and extension in the area of health, making it feasible to include undergraduates in concrete teaching-learning scenarios. The aim of this study was to analyze the perceptions of dental students about the importance of supervised training periods in Family Health Units to their professional education. The sample consisted of 185 students who answered the question: What is your opinion about the importance of this training period in SUS to your professional education? Comment on this experience and its positive and negative aspects The responses were analyzed by the quali-quantitative Collective Subject Discourse (CSD) technique. The students appreciated learning through practice in the service; contact with professionals from other areas; opportunity for technical-operative improvement and demonstrated sensitivity in the face of social reality, although they appeared to be concerned about being absent from the faculty, arguing that they were being prejudiced as regards their intramural clinical productivity, exhaustively demanded of them. It was concluded that students placed value on the extramural experience, however, it was perceived that there was still a predominant influence of focus on intramural clinical training.
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Affiliation(s)
| | - Antônio Carlos Pereira
- Faculdade de Odontologia de Piracicaba, Universidade Estadual de Campinas, Piracicaba, SP, Brasil,
| | | | - Fábio Luiz Mialhe
- Faculdade de Odontologia de Piracicaba, Universidade Estadual de Campinas, Piracicaba, SP, Brasil,
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Orsini CA, Jerez OM. Establishing a Good Dentist-Patient Relationship: Skills Defined from the Dental Faculty Perspective. J Dent Educ 2014. [DOI: 10.1002/j.0022-0337.2014.78.10.tb05814.x] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/30/2022]
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Bassir SH, Sadr-Eshkevari P, Amirikhorheh S, Karimbux NY. Problem-Based Learning in Dental Education: A Systematic Review of the Literature. J Dent Educ 2014. [DOI: 10.1002/j.0022-0337.2014.78.1.tb05661.x] [Citation(s) in RCA: 47] [Impact Index Per Article: 4.7] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/08/2022]
Affiliation(s)
- Seyed Hossein Bassir
- Division of Periodontology, Department of Oral Medicine, Infection, and Immunity; Harvard School of Dental Medicines
| | | | - Shaden Amirikhorheh
- Dental Research Center; School of Dentistry, Guilan University of Medical Sciences; Rasht Iran
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Ratzmann A, Wiesmann U, Proff P, Kordaß B, Gedrange T. Student evaluation of problem-based learning in a dental orthodontic curriculum--a pilot study. GMS ZEITSCHRIFT FUR MEDIZINISCHE AUSBILDUNG 2013; 30:Doc34. [PMID: 24062814 PMCID: PMC3778530 DOI: 10.3205/zma000877] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Key Words] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 11/09/2012] [Revised: 03/07/2013] [Accepted: 04/07/2013] [Indexed: 11/30/2022]
Abstract
OBJECTIVE The present questionnaire survey investigated student reception of problem-based learning (PBL) in the orthodontic curriculum with regard to acceptance, sense of purpose and motivation, knowledge and understanding, as well as tutorial support. METHODS Over a period of two terms, we compared two different didactic methods (PBL and short presentations) by randomizing the participants of a course on orthodontic diagnostics into two different groups, who inversed methods after the first term. RESULTS The two student groups did not show any significant differences with regard to assessments or examination performance. Therefore, acceptance of the PBL concept seems to be mainly associated with the motivation of individuals to use this method. The higher the motivation, the more positive is the attitude towards the PBL concept. Students seem to work more constructively and efficiently with PBL if they can judge the concept meaningful for themselves. CONCLUSION In consideration of the relevant literature and the present results, PBL can be principally integrated into the dental curriculum as a method of learning. However, student motivation is vital to learning success.
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Affiliation(s)
- Anja Ratzmann
- University Medicine Greifswald, Outpatient Department of Orthodontics, Greifswald, Germany
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Ratzmann A, Wiesmann U, Kordaß B. Integration of an Objective Structured Clinical Examination (OSCE) into the dental preliminary exams. GMS ZEITSCHRIFT FUR MEDIZINISCHE AUSBILDUNG 2012; 29:Doc09. [PMID: 22403594 PMCID: PMC3296098 DOI: 10.3205/zma000779] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Key Words] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 05/31/2011] [Revised: 09/01/2011] [Accepted: 10/07/2011] [Indexed: 11/30/2022]
Abstract
Introduction: In the pre-clinical phase of the study of dentistry at the University of Greifswald, the course “Early Patient Contact (EPC)” is conducted within the framework of Community Medicine/Dentistry. The course is based on three pillars: the patient visiting program, special problem-oriented seminars, and communication training for doctors. The essential goal consists of providing students with real patient contact right at the beginning of their study of dentistry, thus making the study of dentistry patient-based very early on. Students are trained in taking comprehensive anamneses and recording clinical findings. Methods: Within the framework of the dental preliminary exams, the course is evaluated using an OSCE on a standardized patient. Furthermore, the added value of an additional training unit (conducting anamnesis and clinical examination) in preparation for the OSCE was evaluated. The exam results of a group without training (control group) were compared with those of a group with training (intervention group). Results: The intervention group performed significantly better than the control on the following items: the total number of points achieved on the OSCE early patient contact, and in the most important points of the anamnesis and clinical examination. In addition, the intervention group tended to score higher in terms of the item “oral health status”. Conclusion: The present study showed a positive effect of an additional training unit on students’ performance in the OSCE. Taking the limitations of the study and the results of a literature review into account, we recommend conducting such training as preparation for the OSCE.
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Affiliation(s)
- Anja Ratzmann
- University Medicine Greifswald, Community Dentistry ZZMK, Greifswald, Germany.
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Eberhard L, Hassel A, Bäumer A, Becker F, Beck-Mubotter J, Bömicke W, Corcodel N, Cosgarea R, Eiffler C, Giannakopoulos NN, Kraus T, Mahabadi J, Rues S, Schmitter M, Wolff D, Wege KC. Analysis of quality and feasibility of an objective structured clinical examination (OSCE) in preclinical dental education. EUROPEAN JOURNAL OF DENTAL EDUCATION : OFFICIAL JOURNAL OF THE ASSOCIATION FOR DENTAL EDUCATION IN EUROPE 2011; 15:172-8. [PMID: 21762322 DOI: 10.1111/j.1600-0579.2010.00653.x] [Citation(s) in RCA: 21] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 05/20/2023]
Abstract
INTRODUCTION An objective structured clinical examination (OSCE) has been implemented in preclinical dentistry. It was taken at an early stage (propaedeutics course). The objectives of this study were to evaluate the reliability, validity, and feasibility of the examination, and the effect of circuit number on OSCE score. METHODS The OSCE was designed by an expert committee on the basis of pre-reviewed blueprints and checklists. Eleven stations formed an interdisciplinary circuit. Six groups of students (n = 62) passed sequentially round the same circuit. Statistical analysis was performed by using SPSS. Reliability was determined by measurement of internal consistency (Cronbach's α, Guttman's λ(2) ), standard error of measurement (SEM) (comprising generalisability index α, dependability index ϕ and pass 150;fail reliability p(c) ), consistency coefficient κ, item 150;scale correlation (Pearson correlation), and, because the unidimensionality of the stations could not be assumed, factor analysis including varimax rotation. Convergent validity (Pearson correlation, t-test), and predictive validity for future preclinical courses and the final preclinical examination were assessed by analysis of variance (ANOVA). The effect of the circuit number on score improvement was calculated, including a correction for the general competence of the students (ANOVA). Cost was calculated on the basis of the time invested. RESULTS Fifty-three out of sixty-two students passed the OSCE (mean score: 67%, SD 7.7, range, 47-81). Scores for each station correlated significantly with total scores (r = 0.35-0.54, P < 0.01). For internal consistency, α = 0.75 (relative SEM 3.8) and λ(2) = 0.766. The dependability index was ϕ = 0.694 (absolute SEM 4.4), p(c) = 0.89 and κ = 0.61. Factor analysis yielded two components: dental-materials-oriented stations and all other stations (explained variance 43%). Scores correlated significantly with success in passing practical tests (i.e. performing dental procedures under examination conditions) (known group validity, P < 0.01) and with scores for subsequent courses and the final preclinical examination (Physikum) (predictive validity, P < 0.001). Later groups performed 4% better on average (CI 95%: 1.2-6.8%; P < 0.01). The cost was 181 Euro per student. CONCLUSIONS The OSCE is reliable and valid in the context of preclinical dentistry. The cost is substantial. The problem of improvement of students' results with ascending circuit number has to be addressed.
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Affiliation(s)
- L Eberhard
- Department of Prosthodontics, University of Heidelberg, Heidelberg, Germany.
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Atchison KA, Thind A, Carreon DC, Nakazono TT, Gutierrez JJ, Afifi AA, Andersen RM. Comparison of Extramural Clinical Rotation Days: Did the Pipeline Program Make a Difference? J Dent Educ 2011. [DOI: 10.1002/j.0022-0337.2011.75.1.tb05022.x] [Citation(s) in RCA: 9] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/07/2022]
Affiliation(s)
| | - Amardeep Thind
- Schulich School of Medicine; University of Western Ontario
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Carey JA, Madill A, Manogue M. Communications skills in dental education: a systematic research review. EUROPEAN JOURNAL OF DENTAL EDUCATION : OFFICIAL JOURNAL OF THE ASSOCIATION FOR DENTAL EDUCATION IN EUROPE 2010; 14:69-78. [PMID: 20522105 DOI: 10.1111/j.1600-0579.2009.00586.x] [Citation(s) in RCA: 89] [Impact Index Per Article: 6.4] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 05/29/2023]
Abstract
Communication is an essential element of the relationship between patient and dentist. Dental schools are required to ensure that undergraduates are adequately trained in communication skills yet little evidence exists to suggest what constitutes appropriate training and how competency can be assessed. This review aimed to explore the scope and quality of evidence relating to communication skills training for dental students. Eleven papers fitted the inclusion criteria. The review found extensive use amongst studies of didactic learning and clinical role-play using simulated patients. Reported assessment methods focus mainly on observer evaluation of student interactions at consultation. Patient involvement in training appears to be minimal. This review recommends that several areas of methodology be addressed in future studies, the scope of research extended to include intra-operative communication, and that the role of real patients in the development of communication skills be active rather than passive.
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Affiliation(s)
- J A Carey
- Leeds Dental Institute, University of Leeds, Clarendon Way, Leeds, UK.
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