Comparison of Dental Students' Self-Evaluation and Faculty Evaluation of Communication Skills During a Standardized Patient Exercise

Situational simulation teaching effectively improves dental students' non-operational clinical competency and objective structured clinical examination performance

BACKGROUND

Appropriate communication with dental patients enhances treatment outcomes and patient satisfaction. Implementing simulated patient interviews courses can improve patient-centered care and reduce conflict during clerkship training. Therefore, this study explored the relationship among student participation in a situational simulation course (SSC), academic performance, clerkship performance, and objective structured clinical examination (OSCE) performance.

METHODS

This study was conducted with a sample of fifth-year dental students undergoing clerkship training. After implementing a situational simulation course to investigate the relationship among participation in SSC, academic performance, clerkship performance, and OSCE performance, a path analysis model was developed and tested.

RESULTS

Eighty-seven fifth-year dental students were eligible for the SSC, and most (n = 70, 80.46%) volunteered to participate. The path analysis model revealed that academic performance had a direct effect on OSCE performance (β = 0.281, P = 0.003) and clerkship performance (β = 0.441, P < 0.001). In addition, SSC teaching had a direct effect on OSCE performance (β = 0.356, P < 0.001).

CONCLUSIONS

SSCs can enhance dental students' non-operational clinical competency and OSCE performance effectively. Simulated patient encounters with feedback, incorporated into the dental curricula, have led to improved communication. Based on our findings, we suggest implementing SSC teaching before the OSCE to improve communication and cognitive skills.

The pedagogical value of parallel charts for dental students in clinical education: A qualitative study

INTRODUCTION

Narrative medicine is a novel approach aimed at attending to the socio-emotional aspects of illness and care. Parallel charts represent one of the tools of narrative medicine and are brief accounts of care in which practitioners can express their feelings and emotions towards patients and treatments. They are, therefore, intended to collect practitioners' feedback in the form of "narrative" tools to encourage reflection.

MATERIALS AND METHODS

This is a single-centre observational pilot study comprising the setting up and analysis of parallel charts in two classes of 5th and 6th year students in a Paediatric Dentistry Department in France. Forty-four students completed 126 parallel charts. A qualitative, thematic, analysis was conducted and the charts were also classified according to the three types of description of illness made by Arthur Kleinman.

RESULTS

This work showed that dental students mainly compiled parallel charts from a disease-centred perspective. The qualitative analysis identified the various themes addressed by the student: relationship with patients and managing children's anxiety, student stress, relationship with the environment or with lecturers.

CONCLUSION

The qualitative analysis highlighted the usefulness of compiling parallel charts by the students to allow them to express both positive and negative feelings, and thus to adopt a self-evaluative approach regarding their practices based on emotional impact. Parallel charts may improve patient-practitioner relationship, but more extensive studies over longer periods of time need to be undertaken.

Assessment of communication and physical exam skills: A comparison of students, faculty and standardized patients

PURPOSE/OBJECTIVES

The objective of this retrospective study was twofold: it aimed to investigate dental students' communication and physical exam self-assessment skills by comparing students' self-evaluations with those completed by faculty and standardized patients (SPs). Second, it aimed to compare faculty and SPs assessment of students' communication skills.

METHODS

At the end of their first year of training, students (n = 127), participated in one SP encounter about an initial dental consultation. Students completed self-assessment before receiving feedback from faculty (n = 19) and SPs (n = 19). The data source included evaluation forms submitted by students, faculty and SPs. The Wilcoxon signed rank test was used to compare the overall scores between groups. Agreement between evaluations items were analyzed with McNemar's test (p < 0.05).

RESULTS

Overall, there were no statistically significant differences in how students and faculty graded for either communication (p = 0.6724) or physical exam (p = 0.1921) skills. However, both students and faculty provided less favorable marks than SPs for communication skills with a statistically significant difference in the overall grading between both students and SPs (p = 0.0146) and between faculty and SPs (p = 0.0045).

CONCLUSIONS

While there was disagreement between students and faculty versus SPs, they weren't meaningful differences in scores and the dissimilarities mainly consisted of ratings of explanation skills. We suggest that, when applicable, dental student's self-evaluations may represent an alternative to faculty assessments of communication and physical exam skills. Nonetheless, we recommend that SPs be included in the assessment of communication skills to provide students with comprehensive feedback that more realistically represents the natural patient-provider relationship.

A model for a geriatric teaching programme and its impact on self-rated and tested competencies of undergraduate dental students

INTRODUCTION

In the light of the growing ageing population, it is important that future dentists be taught geriatric competencies to assure good dental care and treatment addressing the special needs of older patients.

MATERIALS AND METHODS

We developed and evaluated a geriatric teaching programme amongst final year undergraduate dental students (n = 30) at the University of Bern, Switzerland. The geriatric teaching programme was based on the European undergraduate curriculum in geriatric medicine for medical students covering the following eight geriatric domains that were considered relevant to dental care: Analgesics, cognitive impairment, decision-making capacity, gait and balance disorder, hearing impairment, malnutrition, polypharmacy and vision impairment. Using a pre/post-design, we administered a structured questionnaire including standardised questions on self-rated and tested competencies. Both assessments scores were standardised to a maximum score of 100 points. Data were evaluated by comparison of pre-test and post-test mean scores.

RESULTS

The geriatric teaching programme proved to be feasible covering eight geriatric domains based on a case-based didactic approach in totally eight 45-minute lessons. Both self-rated and tested competencies of dental students increased in all eight domains in the course of the geriatric teaching programme. After the geriatric teaching programme, both mean self-rated competency scores (67.9 vs. 49.6, p < .001) and mean tested competency scores (78.7 vs. 56.7 points, p < .001) significantly improved compared to baseline.

CONCLUSIONS

Integrating a consolidated refined geriatric teaching programme is a potentially feasible and effective method for dental undergraduate students and is expected to have an impact on better dental care of older patients.

A video- and feedback-based approach to teaching communication skills in undergraduate clinical dental education: The student perspective

OBJECTIVE

Student evaluation of a communication-education programme that combined patient consultation videos with peer- or expert-based feedback.

METHODS

A self-perception questionnaire was given to undergraduate dental students who had undertaken a curricular communication training and feedback programme, in which each participant was videoed three times during a patient interview or consultation, subsequently receiving either peer (PG) or expert feedback (EG). The questionnaire used feedback programme content to evaluate student perspectives, ascertaining whether the students experienced a gain in knowledge and professional conversational skills, whether videos or feedback helped them improve more and general questions about the structure and content of the curriculum. Differences between feedback groups were analysed (Mann-Whitney U test).

RESULTS

45 participants (peer group: n = 23, expert group: n = 22) took part in the study. The peer group experienced watching their video (38%) and receiving feedback (33%) as their major beneficial aspect to improve communication skills (watching fellow student´s video: 17%, providing feedback: 12%). The expert group experienced the major effect in receiving expert feedback (73%, video watching: 27%). The students said that communication skills should be a core competency in dental education learning outcomes (PG: 4.48 ± 0.67, EG: 4.41 ± 0.67; P > 0.05) and that communication curricula should include video-based feedback (PG: 3.91 ± 0.73, EG: 4.00 ± 0.93; P > 0.05).

CONCLUSION

Watching videos and both receiving and providing peer group feedback were experienced as helpful in improving students' communication skills. These findings suggest that a longitudinal communication curriculum, which includes both video-based peer feedback and correlated self-reflection, is a promising learning approach for dental education.

Development of an Online Asynchronous Clinical Learning Resource ("Ask the Expert") in Dental Education to Promote Personalized Learning

This article describes the development and testing of an online asynchronous clinical learning resource named "Ask the Expert" to enhance clinical learning in dentistry. After the resource development, dental students from years 3 and 4 were randomly allocated to two groups (Group A-"Ask the Expert" and L-"lecturer-led"). All the students attempted a pre-test related to replacement of teeth in the anterior aesthetic zone. Group A (33 students) underwent an online case-based learning session of 60 minutes' duration without a facilitator, while Group L (27 students) concurrently underwent a case-based learning session of 60 minutes' duration with a lecturer facilitating the session. An immediate post-test was conducted followed by a retention test after one week. Student feedback was obtained. There was a significant increase in the test scores (maximum score 10) for both groups when comparing the pre-test (Group A-5.61 ± 1.34, Group L-5.22 ± 1.57) and immediate post-test scores (Group A-7.42 ± 1.34, Group L-8.04 ± 1.22; paired t-test, p < 0.001). However, no significant difference was observed in the test scores when comparing Group A to Group L for both the immediate post-test as well as the retention test (Group A-5.36 ± 1.29, Group L-5.33 ± 1.39 (independent sample t-test, p > 0.05). To conclude, adequately structured online asynchronous learning resources are comparable in their effectiveness to online synchronous learning in the undergraduate dental curriculum.

Simulation Design, Findings, and Call to Action for Managing Difficult Patient Encounters

Objective. To implement and evaluate a laboratory simulation for teaching difficult patient encounter skills to pharmacy students to improve their self-assessed communication abilities and skills in the affective domain.Methods. Twelve simulation scenarios that represented difficult patient encounters in a variety of practice settings were developed. All students completed a self-assessment of their ability to communicate during difficult patient encounters before and after the simulations, and wrote a guided reflection afterward. The impact of the simulation was evaluated using quantitative and qualitative methodology. Three student cohorts were analyzed to determine whether significant change occurred in students' self-perceived communication abilities. Thematic analysis of the qualitative reflection responses was performed.Results. Over three years, three student cohorts of third-year professional students participated in the simulations (n=236). Students self-rated their ability to communicate on a 0-100 scale. Mean self-rating of ability prior to the simulation was 57.7 (SD=15.9) and after was 79.2 (SD=15.2). This mean difference of 21.5 points equates to an approximate 20% increase in self-rated ability. Variability in self-ratings between the cohorts was not significant. Qualitative analysis revealed that the simulation identified for student areas needing further development which in turn promoted self-awareness. Students expressed that learning in the safe, formative environment provided by the simulation contributed to their professional growth and was relevant to their future practice of pharmacy.Conclusion. This simulation fills a gap in skills-based education, addresses the affective domain of the Accreditation Council for Pharmacy Education (ACPE) Standards, transfers easily to schools and colleges of pharmacy. This supports a call to action for pharmacy educators to provide purposeful opportunities for students to practice communicating with patients during difficult encounters.

Student Potential for Self-assessment in a Clinical Dentistry Practical Training Course on Communication Skills

This study aimed to investigate student potential for self-assessment in a clinical dentistry practical training course focused on communication skills. Participants were 124 fourth-year students (70 males, 54 females; all Japanese) in 2017 and 2018 at the Nippon Dental University, School of Life Dentistry at Niigata. Participating students belonged to different cohorts in 2017 and 2018. Participants were asked to complete a self-evaluation sheet at the end of each unit of the course. Their self-evaluation scores and the faculty evaluation scores for each student for Units 1-1, 1-2, and 1-3 were statistically analyzed. The results showed that females tended to rate themselves significantly higher than males. Furthermore, there were significant differences in evaluation scores between students and faculty for nine of 11 evaluation items for male students and 10 of 11 items for female students in Unit 1-3. Faculty expectations increased from Unit 1-1 to Unit 1-3, although students were satisfied with their performance and had a sense of achievement. However, students' actual performance was below faculty expectations, suggesting faculty evaluations were stricter than students' self-evaluation. Self-assessment may enhance students' ability for self-directed learning and may also inform how faculty can effectively educate dental students. Dental educators should support students to increase their levels of self-efficacy, which will enhance their self-evaluation skills.

U.S. Re-Licensure Opioid/Pain Management Continuing Education Requirements in Dentistry, Dental Hygiene, and Medicine

Drug-induced deaths have been accelerating over the last two decades. The aim of this study was to determine if states with high opioid-induced deaths and overall drug-induced deaths were more likely to have continuing education (CE) requirements related to opioid use/pain management than states with fewer opioid-induced deaths. Almost 200 state dental and medical law boards' websites were examined for CE requirements, license renewal periods, and CE requirements for opioid use/pain management in December 2018 and January 2019. Drug-induced death data were obtained from the Centers for Disease Control and Prevention online database. States were categorized into quartiles of opioid-induced deaths per 100,000 population. A similar categorization was created for all drug-induced deaths. The results showed that states in the second, third, and fourth quartiles of opioid-induced deaths were more likely to have dental boards requiring opioid use/pain management CE than states in the first quartile in dentistry. This pattern was not the case with the medical boards' requirements. Dentists and physicians in states with higher all drug-induced deaths per 100,000 population were as likely to be required to attend opioid use/pain management CE as dentists and physicians in states with lower opioid-induced deaths. Although many licensing boards require opioid use/pain management CE in relation to their opioid-induced death rates, there is a need for policies to increase education in substance use disorders to reduce the number of drug-induced deaths.