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Journal: Journal of dental education

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Motor learning up to reaching proficiency can be registered and displayed as a learning curve. Understanding the nature of the motor learning curves will allow proper planning of teaching. The aim of this study was to measure the rate of motor learning of novice dental students in preparing dental cavities. A total of 66 first-year students (21 males and 45 females) at a dental school in Israel participated in this 12-week study. In the first and last weeks, the students prepared 12 cavities in 45 minutes in a composite material plate, using a dental high-speed burr. In the ten weeks between tests, manual performance was measured by drilling two cavities, limited to 3.5 minutes per cavity. The results showed that improvement was significant (p<0.05) at two-week intervals in all cases except for the sixth and seventh weeks, when a significant increase was observed only after three weeks. The performance of the lowest performing students (those with grades in the lowest third of the class) remained low throughout the entire course. Further subdivision of the class into two groups showed that the upper half reached the minimum required performance in week 9, whereas the lower half achieved it only three weeks later. The authors concluded that the 12-week study was not sufficiently long for the learning curve to reach a plateau. Dental students present a variety of motor learning curves and different rates of proficiency acquisition, so understanding the nature of these curves, and the differences among students, may be useful in lesson planning to support the process of motor learning.

Concepts: Measurement, Education, Learning, Knowledge, Dental caries, Learning curve, Reach, Curves

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The aim of this study was to investigate dental students' long-term retention of clinical communication skills learned in a second-year standardized patient simulation at one U.S. dental school. Retention was measured by students' performance with an actual patient during their fourth year. The high-fidelity simulation exercise focused on clinical communication skills took place during the spring term of the students' second year. The effect of the simulation was measured by comparing the fourth-year clinical performance of two groups: those who had participated in the simulation (intervention group; Class of 2016) and those who had not (no intervention/control group; Class of 2015). In the no intervention group, all 47 students participated; in the intervention group, 58 of 59 students participated. Both instructor assessments and students' self-assessments were used to evaluate the effectiveness of key patient interaction principles as well as comprehensive presentation of multiple treatment options. The results showed that students in the intervention group more frequently included cost during their treatment option presentation than did students in the no intervention group. The instructor ratings showed that the intervention group included all key treatment option components except duration more frequently than did the no intervention group. However, the simulation experience did not result in significantly more effective student-patient clinical communication on any of the items measured. This study presents limited evidence of the effectiveness of a standardized patient simulation to improve dental students' long-term clinical communication skills with respect to thorough presentation of treatment options to a patient.

Concepts: Clinical trial, Effect, Effectiveness, Simulation, Learning, Communication, Education in Scotland, The Instructor

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Dental and dental hygiene clinical faculty members often do not provide consistent instruction, especially since most procedures involve clinical judgment. Although instructional variations frequently translate into variations in student performance, the effect of inconsistent instruction is unknown, especially related to ergonomics. The aim of this study was to determine whether photography-assisted calibration training would improve interrater reliability among dental hygiene faculty members in ergonomics evaluation. The photography-assisted ergonomics calibration program incorporated features to improve accessibility and optimize the quality of the training. The study used a two-group repeated measures design with a convenience sample of 11 dental hygiene faculty members (eight full-time and three part-time) during the autumn 2016 term at one U.S. dental school. At weeks one and seven, all participants evaluated imaged postures of five dental students using a modified-dental operator posture assessment instrument. During weeks three and five, training group participants completed calibration training using independent and group review of imaged postures. All pre-training and post-training evaluations were evaluated for interrater reliability. Two-way random effects intraclass coefficient (ICC) values were calculated to measure the effects of the training on interrater reliability. The average measure of ICC of the training group improved from 0.694 with a 95% confidence interval (CI) of 0.001 to 0.965 (F(4,8)=3.465, p>0.05) to 0.766 with a 95% CI of 0.098 to 0.972 (F(4,8)=7.913, p<0.01). The average measure of ICC of the control group improved from 0.821 with a 95% CI of 0.480 to 0.978 (F(4,28)=7.702, p<0.01) to 0.846 with a 95% CI of 0.542 to 0.981 (F(4,28)=8.561, p<0.01). These results showed that the photography-assisted calibration training with the opportunity to reconcile different opinions resulted in improved agreement among these faculty members.

Concepts: Improve, Measurement, Crossover study, Interval finite element, Repeated measures design, Analysis of variance, Dental hygienist, Consistency

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Due to postural demands, dental professionals are at high risk for developing work-related musculoskeletal disorders (WMSDs). Dental clinicians' lack of ergonomic awareness may impede the clinical application of recommendations to improve their posture. The aim of this study was to determine whether feedback involving photography and self-assessment would improve dental hygiene students' ergonomic scores and accuracy of their ergonomic self-assessments. The study involved a randomized control design and used a convenience sample of all 32 junior-year dental hygiene students enrolled in the autumn 2016 term in The Ohio State University baccalaureate dental hygiene program. Sixteen students were randomly assigned to each of two groups (control and training). At weeks one and four, all participants were photographed and completed ergonomic self-evaluations using the Modified-Dental Operator Posture Assessment Instrument (M-DOPAI). During weeks two and three, participants in the training group were photographed again and used those photographs to complete ergonomic self-assessments. All participants' pre-training and post-training photographs were given ergonomic scores by three raters. Students' self-assessments in the control group and faculty evaluations of the training group showed significant improvement in scores over time (F(1,60)=4.25, p<0.05). In addition, the accuracy of self-assessment significantly improved for students in the training group (F(1,30)=8.29, p<0.01). In this study, dental hygiene students' self-assessments using photographs resulted in improvements in their ergonomic scores and increased accuracy of their ergonomic self-assessments. Any improvement in ergonomic score or awareness can help reduce the risks for WMSDs, especially among dental clinicians.

Concepts: Better, Improve, Evaluation, Photography, Systems psychology, Camera, Photograph, Ergonomics

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Interprofessional and intraprofessional education (when students from two or more professions or within the same profession, respectively, learn about, from, and/or with each other) is crucial for effective interdisciplinary collaboration. The aims of this study were to assess the effectiveness of a clinical intraprofessional education program for dental and dental hygiene students, based on students' expectations and satisfaction with the program and patients' satisfaction with the team-based care. The pilot program was developed at the University of Tennessee Health Science Center College of Dentistry, where dental hygiene students were paired randomly with dental students scheduled for prophylaxis, scaling and root planing, or periodontal maintenance. Surveys with questions about the students' expectations and satisfaction were distributed to 89 senior dental students and 27 senior dental hygiene students before and after team-based procedures. Another survey was distributed to 17 patients asking about their satisfaction with the team-based care. All 27 dental hygiene students (100% response rate), 51 dental students (57.3% response rate), and all 17 patients (100% response rate) participated in the surveys. The results showed that both the dental and dental hygiene students had high expectations and were overall satisfied with the intraprofessional education. The students' expectations and perceived educational gap (difference between expectations and satisfaction) differed for the dental and dental hygiene students (p<0.001). The male dental students were also more satisfied than the female dental students (p<0.01). Overall, the program met or exceeded the students' expectations, and the patients were overwhelmingly satisfied with the team-based care. These results suggest that this intraprofessional practice model provided an effective educational experience for both dental and dental hygiene students and patients. The differences between the dental hygiene and dental students' expectations will help in the design of more effective training that promotes intraprofessional and interprofessional teamwork.

Concepts: Education, Physician, Educational psychology, Periodontitis, Periodontal disease

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Students in many fields have been found to learn more the more they are engaged in both the academic and social aspects of the learning experience. The aims of this study were to determine the level of dental hygiene students' engagement in their educational programs and in student chapters of the American Dental Hygienists' Association (ADHA) and to assess the relationship of that engagement to students' success as measured by cumulative GPA. All 12,000 dental hygiene students (6,000 in the first year and 6,000 in the second year of two-year programs) enrolled in the 334 accredited U.S. dental hygiene programs were invited to participate in the survey. The ADHA electronically distributed the survey on behalf of the researcher to the students in February 2015. The response rate was 22% (N=2,649); the respondents had a survey completion rate of 94%. Three positive predictors were found to influence student success. The higher the responding students rated the quality of interactions with their faculty members and with their program directors, the higher was their mean GPA. In addition, holding a higher education degree was found to be a significant predictor of academic success. This study’s results provide dental hygiene educators with a better understanding of how dental hygiene student engagement relates to academic achievement and may encourage faculty members to improve their strategies for delivering instruction. Future research should review enhanced student engagement practices as they relate to student success.

Concepts: Education, Educational psychology, University, Higher education, Dental hygienist, Hygiene, Oral hygiene, American Dental Hygienists' Association

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The aim of this study was to determine the number and size of postdoctoral teaching programs in geriatric dentistry in U.S. dental schools and other health professions educational institutions and those programs with Health Resources and Services Administration (HRSA) funding. In 2015, all 67 U.S. dental schools were contacted via email with a questionnaire to ask if they had a postdoctoral program in geriatric dentistry; if they did, they were asked to report the length and size of the program. Directors of all 16 HRSA-funded geriatric fellowships were also invited to participate in the survey. Fifty-six of the 67 (83.6%) dental schools and 15 of the 16 (93.8%) HRSA-funded programs completed the questionnaire. Postdoctoral geriatric dentistry programs were reported in 12 dental schools and six medical institutions, although only six programs were currently accepting fellows. The length of the programs was 12-36 months. The maximum number of residents in any program was ten. The oldest program was in Minnesota; it began in 1981. The newest program was beginning in 2017 at Boston University as a revised version of its previous HRSA-funded program. The loss of HRSA funding has had a major negative impact on the number of training programs. Future research is needed to determine how the loss of HRSA-funded programs has affected the availability of educators in geriatric dentistry for dental schools and the services provided to the geriatric community.

Concepts: Education, Program, The Loss, School, Dentistry, Teacher, Program management, Revised Version

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The aim of this randomized controlled trial was to analyze inexperienced dental students' perceptions of the difficulty and applicability of digital and conventional implant impressions and their preferences including performance. Fifty undergraduate dental students at a dental school in Switzerland were randomly divided into two groups (2×25). Group A first took digital impressions in a standardized phantom model and then conventional impressions, while the procedures were reversed for Group B. Participants were asked to complete a VAS questionnaire (0-100) on the level of difficulty and applicability (user/patient-friendliness) of both techniques. They were asked which technique they preferred and perceived to be more efficient. A quotient of “effective scan time per software-recorded time” (TRIOS) was calculated as an objective quality indicator for intraoral optical scanning (IOS). The majority of students perceived IOS as easier than the conventional technique. Most (72%) preferred the digital approach using IOS to take the implant impression to the conventional method (12%) or had no preference (12%). Although total work was similar for males and females, the TRIOS quotient indicated that male students tended to use their time more efficiently. In this study, dental students with no clinical experience were very capable of acquiring digital tools, indicating that digital impression techniques can be included early in the dental curriculum to help them catch up with ongoing development in computer-assisted technologies used in oral rehabilitation.

Concepts: Male, Female, Randomized controlled trial, Sex, Preference, Utility, Binary relation

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The aim of this study was to use electronic health care records (EHRs) to examine retrospectively the incidence of and attributes associated with dental implant failures necessitating implant removal in a large cohort of patients treated in the student clinics of a U.S. dental school over three and a half years. EHRs were searched for all patients who received dental implants between July 1, 2011, and December 31, 2014. Characteristics of patients and implants that were actively removed due to irrevocable failure of any etiology (“failure cohort”) during this period were compared to those of all other patients who received dental implants during the same time frame (“reference cohort”). Differences in the frequency distribution of various characteristics between the failure and reference cohorts were compared. Of a total 6,129 implants placed in 2,127 patients during the study period, 179 implants (2.9%) in 120 patients (5.6%) were removed. In the multivariate analysis, presence of a removable (OR=2.86) or fixed temporary prosthesis (OR=3.71) was statistically significantly associated with increased risk for implant failure. In contrast, antibiotic coverage (pre- and post-surgery OR=0.16; post-surgery only OR=0.38) and implants of certain manufacturers were associated with lower risk of implant failure. In this sizeable cohort of patients receiving care in dental student clinics, the review of EHRs facilitated identification of multiple variables associated with implant failure resulting in removal; however, these findings do not suggest causative relationships. The adopted analytical approach can enhance quality assurance measures and may contribute to the identification of true risk factors for dental implant failure.

Concepts: Implants, Prosthetics, Dental implant, Electronic health record, Dentistry, Osseointegration

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Digital textbooks are being used to reduce production and storage costs of printed copies, enhance usage, and include search capabilities, but the use of digital texts is not universally accepted. In 2001, the New York University College of Dentistry introduced a digital reference library, the VitalBook. Beginning in 2005, the college annually surveyed senior students and, from 2012, also surveyed alumni on their opinions and extent of use of the VitalBook. The aim of this study was to evaluate 12 years of students' perspectives and three years of alumni perspectives on the value of the VitalBook to their dental educational experience. Students were asked how frequently they used the VitalBook, if it was a good investment, if they would use it after graduation, and if they would recommend it to others. Alumni were asked the last three questions. This study reports the results from 4,105 students over 12 years (average response rate 95.3%) and 184 alumni over three years (average response rate 17.4%). The results indicated that students used the VitalBook on average 24% of their study time, but they were split regarding the other questions. The majority opinion in 2005 was negative on all questions. These opinions shifted to become more favorable to a peak in 2010, but declined since then to a more negative overall view of the VitalBook. A split opinion among students continued through 2016, with fewer recommending it although more considered it a good investment with plans to use it after graduation. Alumni mirrored their responses as students. These results suggest that, as more flexible and dynamic digitized reference systems emerge, the use of student-paid traditional digitized textbooks may become an even less favored choice.

Concepts: Question, Dentistry, Interrogative word, Opinion