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Journal: Journal of dental education

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To date, there has been a lack of published studies examining the validity of the Health Sciences Reasoning Test (HSRT) to assess critical thinking among dental students. The aim of this study was to examine the construct validity of the HSRT using a novice-expert model consisting of first-year dental students as novices and experienced general dentists as experts. Novice cohort subjects were recruited from all 105 students in the first-year dental school class at the University of Texas Health Science Center at San Antonio during a regularly scheduled course in August 2015. A total of 83 students participated, for a 79% response rate. Thirty individuals personally recruited from the same school’s faculty and from private practitioners made up the expert cohort. The results showed that the adjusted mean overall score for the expert cohort (25.31) was significantly higher than that of the novice cohort (22.64) (p=0.04). The expert cohort achieved higher adjusted mean scores in all scales (Induction, Deduction, Analysis, Inference, and Evaluation), with the difference in the Analysis scale being significant (p=0.02). In this study, experienced general dentists achieved significantly better overall scores on the HSRT as compared to first-year dental students, suggesting the instrument was able to measure differences between novice and expert. Further efforts to validate the instrument in a dental education setting and to understand its correlation with strategies and practices aimed at developing critical thinking in dental students are warranted.

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Critical thinking and problem-solving are two of the most frequently desired goals for dental student learning, but greater understanding is needed of how students' critical thinking skills develop from the beginning to the end of the curriculum. The aim of this study was to use students' performance on critical thinking assessments at five time points from the first to the fourth years to longitudinally assess their critical thinking development across the curriculum. In 2014-16, the performance of students in two successive graduating classes at one U.S. dental school was collected from five assignments designed to, among other things, assess critical thinking. Those assignments ranged from a case study in the Cariology I course in fall of the first year to an OSCE completed before graduation. Students were divided into four quartiles from lowest- to highest-achieving based on the first (baseline) assessment, and those quartiles were tracked to determine each student’s progress over the four years. The results showed that, for both cohorts, students who ranked in the top quartile remained in the top of the class for all subsequent assessments. Also in both cohorts, the students who had the lowest scores on the initial assessment of critical thinking skills showed statistically significant improvements over time, increasing their scores by 9.4% (cohort 1, p<0.001) and 4.6% (cohort 2, p=0.003) in each consecutive assessment. These results suggest that implementing critical thinking assessments early in the curriculum can assist in predicting students' future performance on critical thinking assessments. Furthermore, a dental curriculum intentionally designed to promote critical thinking capacities can help students improve these skills over time, whatever their level at the beginning.

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Postbaccalaureate programs help predental students strengthen their basic science knowledge and improve their study skills before applying or reapplying for dental school admission. A high percentage of postbac students are admitted to and graduate from dental schools, but gaining greater understanding of how well these students perform in key areas of the first two years' curriculum would be useful for the design of those programs. The aim of this study was to evaluate postbac dental students' performance in the D1 and D2 years at one U.S. dental school compared to dental students with a four-year baccalaureate degree only. Performance assessed was the students' dental school grades in basic science courses, in all D1 and D2 didactic courses, and on preclinical simulation lab practical exams. Didactic and practical scores were gathered anonymously for the Classes of 2013-18 at the College of Dental Medicine-Arizona (CDMA) at Midwestern University, where postbac students with master’s degrees from the affiliated College of Health Sciences made up 6-19% of each class. The two cohorts chosen for comparison were students with baccalaureate degrees only and students with one-year Master of Arts degrees from the College of Health Sciences. The scores of these postbac dental students and their non-postbac peers were found to be comparable in the basic science courses. However, for all the didactic courses combined, the non-postbac cohort had significantly higher mean scores than the postbac cohort for the fall quarter 2 and winter quarter 2 in 2013-15 and all years combined. The practical scores for the two cohorts were not significantly different for any year. Overall, this study demonstrated that the MA program in the College of Health Sciences prepared the postbac students to compete on an equal level with the non-postbac students in the CDMA D1 and D2 curriculum.

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The aim of this study was to determine if there was a relationship between students' academic history and their performance in the first year of dental school, with a focus on academic load in undergraduate education. A total of 174 student records from the Rutgers School of Dental Medicine Classes of 2011 to 2018 were analyzed. These records included students at the top and bottom of each class at the end of their first term of study. Outcomes were broad measures of student success: student continued in curriculum, student withdrew/was dismissed, or student remediated at least one course. In the comparison of the top and bottom ten students across the classes, the following variables were found to be significant: Barron’s score of undergraduate institution, undergraduate science GPA, number of failures or withdrawals from science courses during undergraduate education, DAT scores, and underrepresented minority status. The results of this study are not meant to inform the admissions process, but to highlight opportunities for enhancing student services via early identification of students who may benefit from additional academic support while in dental school.

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The aim of this study was to evaluate dental students' retention of factual and procedural knowledge gained in a preclinical course in operative dentistry during a clinical dental curriculum. In 2017, all 157 seventh- to tenth-semester dental students at a dental school in Germany were asked to repeat the same written examination performed at the end of the preclinical course in the sixth semester. The examinations consisted of 30 multiple-choice questions covering factual and procedural knowledge. The percentage of correctly answered questions per exam and differences in correct answers between the original examination and the re-examination (per question) were analyzed. Students were also asked to self-rate their percentage of correctly answered questions and their knowledge in various disciplines of operative dentistry at the times of the original examination and the re-examination. After exclusions, data were analyzed for 129 students, for a participation rate of 82%. For the seventh- and tenth-semester students, the results on the original examination and the re-examination were not significantly different, while the eighth- and ninth-semester students performed significantly better on the original examination than the re-examination. In all semesters, procedural knowledge remained stable between the original examination and the re-examination, while factual knowledge decreased slightly. Their performance on the original examination was underestimated by the eighth- and ninth-semester students. All the students underestimated their performance on the re-examination. Students mostly rated their knowledge level significantly higher on the original examination than on the re-examination. Overall, this study found that factual and procedural knowledge gained in a preclinical course in operative dentistry was not increased during the clinical dental curriculum.

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One approach to enhancing quality care outcomes and patient safety is through effective implementation of clinical risk reduction strategies. Clinical risk identification at The Ohio State University College of Dentistry revealed lack of a standardized informed consenting process for patients. The purpose of this project was to develop and implement a uniform college-wide informed consenting process. An operating procedure was also developed. The resulting consenting documents used a uniform approach in which clinics could use a basic readable and processable informed consent template. The template was edited for appropriate content suitable for an electronic health record. Implementing an operating procedure along with associated contemporary uniform electronic informed consent forms was realized through efforts of a core team with informed consenting experience. The core team developed the template and the majority of all documents before editing all division-based consents. This method relied on growing expertise and momentum. Outcomes of chart audits following implementation of the new electronic informed consent forms showed a transitory increase in missing consent forms. Subsequently, the number of missing consent forms decreased to near pre-implementation levels. Patient refunds related to missing informed consent issues dropped, and patient satisfaction remained high throughout the project. Other institutions can use this project as a guide for developing their own uniform consent forms and process.

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Dental educators are challenged to bridge the theory-practice gap to enhance the educational experience and meet the diverse learning needs of students. The aim of this study was to explore dental hygiene students' perceptions of the effectiveness, appeal, and satisfaction regarding instrumentation videos as a resource to improve learning in the clinical environment. All 152 first-year students in a U.S. baccalaureate dental hygiene program at two sites in two consecutive years were invited to participate in the study. Survey questions addressed demographics, effectiveness, appeal, and satisfaction with the instrumentation videos along with open-ended questions to explore students' perceptions of the videos' value and benefits. A total of 143 students completed the survey, for a response rate of 94%. The results showed that 50% to 70% of the respondents agreed or strongly agreed with questions relating to effectiveness, appeal, and satisfaction with the videos. Most participants used the videos while practicing (83%). Students who spoke English as a second language were less likely to feel the videos were effective, found them less appealing, and were less satisfied with them (p<0.05). Participants who practiced while using the videos were more likely to report them as being effective and appealing and were more satisfied with the videos than were participants who did not practice with them (p<0.05). Thematic analysis revealed the following themes in the open comments: helpfulness of the videos in clinical practice to clarify, reinforce, and visualize skills learned. These students reported satisfaction with the instrumentation videos, suggesting these learning aids have potential value in closing the theory-practice gap in clinical dental hygiene education.

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The aim of this pilot study was to measure and compare dental hygiene students' level of text anxiety and performance when being tested on an objective structured clinical examination (OSCE) using camera supervision versus direct examiner observation. This randomized, controlled trial, conducted in October 2016, assessed students' anxiety levels and performance using the Zung Self-Rating Anxiety Scale and performance on an OSCE. All 32 first-year students in one U.S. dental hygiene program were invited to participate, and all 32 participated for a 100% response rate. Participants were randomly assigned to the direct observation (N=16) and camera-supervised (N=16) groups. The comparison of pre-OSCE anxiety levels and performance scores evaluated with direct observation (36.4 and 20.4) versus camera-supervised (37.5 and 20.9) found no statistically significant difference between the two groups (p=0.496, p=0.403). The difference in post-OSCE anxiety levels between the direct observation and camera-supervised groups (33.8 and 37.8) approached significance (p=0.051). This study found that student anxiety levels were similar between the two groups except for the post-OSCE direct observation anxiety levels, which were lower. No significant difference was found between the two groups' performance scores. Due to similar performance scores and anxiety levels for the direct examiner and camera-supervised methods, the camera-supervised OSCE warrants further exploration as an alternative approach to direct observation for evaluation of students' performance.

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Emotional intelligence (EI) has been increasingly associated with the success of health care professionals, including dental professionals. Mental health, physical health, and life satisfaction all have been linked to having a high EI. The aim of this study was to determine any associations between EI scores and academic and clinical performance in a cohort of undergraduate dental hygiene students. All 63 first- and second-year dental hygiene students enrolled at The Ohio State University in the spring term 2017 were invited to participate in this quantitative cross-sectional study. The survey consisted of demographic questions and 30 emotional quotient self-assessment checklist questions divided into six EI subsets. The EI subset scores were then correlated with students' academic and clinical grades. A total of 45 students completed the questionnaire, for a response rate of 71.4%. Most of the participants scored between 16 and 19 for each EI domain, meaning they had a moderate EI level. A significant regression equation of EI subset scores and clinical GPA was found (F(3,41)=7.474, p<0.001), with an R2 of 0.354. Simple linear regression was calculated to predict clinical performance based on EI, and a significant regression equation was found (F(3,41)=6.727, p<0.001), with an R2 of 0.330. The EI subsets of self-control, motivation, and self-confidence were found to be predictors of overall academic performance. The EI subsets of social competence, empathy, and motivation were found to be predictors of clinical performance. These results suggest that more attention to the development of emotional intelligence may lead to improved academic and clinical performance among undergraduate dental hygiene students.

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There is growing interest in developing more efficient, patient-centered, and cost-effective models of dental care delivery using teams of professionals. The aims of this small pilot study were to assess the number of patient visits, type and number of procedures performed, and clinic revenues generated by an intraprofessional team of dental, dental hygiene, and dental therapy students and to determine the students' and patients' perceptions of this model of care. Sixteen senior students from three student cohorts (dental, dental hygiene, and dental therapy) at the University of Minnesota piloted a team-based dental delivery model from January to April 2015. The group was named the Team Care Clinic (TCC), and the team for each clinical session consisted of one dental student, three dental hygiene students, and one dental therapy student. Data were collected from the school’s database to determine the number of patient visits, type and number of procedures performed, and clinic revenue generated by the TCC. Focus groups were used to assess student perceptions of the experience, and patient satisfaction surveys were administered to assess the patients' experience. The TCC students were given twice as many patients as non-TCC students, and they managed them effectively. Working as a team, the TCC student providers completed twice as many procedures per patient encounter as non-TCC students. Patients and students said their experiences in the TCC were positive, and students expressed a preference for team-based care delivery. The results of the study suggest the team-based dental care delivery model is promising. Team-based care delivery may allow providers to accomplish more during a patient appointment and increase provider satisfaction.