Evidence-Based Practice Knowledge, Perceptions, and Behavior: A Multi-Institutional, Cross-Sectional Study of a Population of U.S. Dental Students

Self-Perceived Preparedness of KFU Dental Graduates to Practice Dentistry: A Cross-Sectional Study

Introduction

Assessing graduates' performance is essential to identify the strengths and weaknesses in dental education. This study examined the self-perceived preparedness of dental graduates at King Faisal University (KFU), Saudi Arabia, using the Dental Undergraduates Preparedness Assessment Scale (DU-PAS).

Materials and Methods

Using a cross-sectional design, this study assesses dental graduates' preparedness. This assessment measures various skills and attributes expected of dental graduates based on the DU-PAS. From January to April 2021, an electronic form was distributed to 102 eligible dental graduates of KFU. The response rate was 92.15%. The total preparedness score ranged from 0 to 100. The questionnaire consisted of two parts, the first investigating preparedness in clinical procedures (24 items) and the second investigating preparedness regarding cognition, communication, and professionalism skills (26 items). Data are analyzed using SPSS Descriptive analysis using frequencies and percentages.

Results

The study included 94 participants, all of them male, with a response rate of 92.4%, who graduated from the College of Dentistry KFU in Saudi Arabia. The participants' median age was 25. The mean DU-PAS score for the participants was 79.08 (SD ±12.15; range, 47.84-100). The mean score for Part A of the scale, which comprises the clinical skills, was 84.55 (SD ±13.56; range, 43.75-100). It revealed that participants felt they had no experience with the four procedures. The mean score for Part B of the scale comprising cognitive and behavioural attributes was 73.60 (SD ±16.29; range, 36.54-100). More than one-third of the participants reported limited experience in attributes related to items B30 (suspected oral cancer, 36.2%), and B33 (evaluating new dental materials, 22.3%).

Conclusion

In this study, dental graduates of KFU reported a high level of self-perceived confidence in their skills. Consequently, they will be able to integrate seamlessly into general dental practice. However, the participants' feedback reflects certain deficiencies in practising specific clinical procedures.

Dental Students’ Knowledge, Attitude, and Confidence toward Evidence-based Dentistry: A 5-year Retrospective Study

AIM

The purpose was to assess dental students' knowledge, attitude, and confidence toward evidence-based dentistry in five graduating Doctor of Dental Surgery (DDS) classes.

MATERIALS AND METHODS

All dental students (class of 2019, 2020, 2021, 2022, and 2023) enrolled in the D3 research design course were required to take a pre-Knowledge, Attitude, and Confidence in Evidence-based Dentistry (KACE) survey. On completion of the 11-week course, a post-KACE survey was distributed to compare the differences in the three domains of evidence-based dentistry (EBD). For the knowledge domain, the responses from the 10 questions were converted to either correct (1) or wrong (0) so that the compiled scores could range from 0 to 10. The attitudes and confidence domains used a five-point Likert scale. The compiled attitude score was a sum of the responses from 10 questions yielding a range from 10 to 50. For confidence, the compiled score ranged from 6 to 30.

RESULTS

The mean knowledge scores of all classes together before and after training were 2.7 and 4.4, respectively. Overall, there was a statistically significant difference between pre- and post-knowledge indicating an improvement in knowledge associated with the training (p < 0.001). The mean attitudes of all classes together before and after the training were 35.3 and 37.2, respectively. Overall, there was a statistically significant improvement in attitude (p < 0.001). The values of mean confidence of all classes together before and after the training were 15.3 and 19.5, respectively. Overall, there was a statistically significant improvement in confidence (p < 0.001).

CONCLUSIONS

A dental curriculum emphasizing Evidence-based practice (EBD) resulted in increased knowledge acquisition, improved attitude, and confidence toward EBD of dental students.

CLINICAL SIGNIFICANCE

Educational initiatives emphasizing evidence-based dentistry increase students' knowledge acquisition, improved attitude, and confidence toward EBD that may also translate to active implementation of EBD in their future practices.

Evidence-based dentistry: Knowledge, Practice, Confidence and Attitude amongst Malaysian dental undergraduate students: A Multi-institutional study

INTRODUCTION

Evidence-based dental practice provides patient-centred, compatible and efficient interventions and forms the basis for health profession education. So far, there is a paucity of data about Malaysian undergraduate dental education and the role of evidence-based dentistry in it. The current research aimed to study the level of knowledge, attitude, practice and confidence of dental undergraduate students in Malaysia towards evidence-based dental practice.

METHODS

This cross-sectional study included final-year undergraduate dental students (N = 645) who completed a pre-tested self-administered questionnaire that analysed the domains of perceived knowledge, practice, critical appraisal and attitude towards evidence-based dentistry. We further explored the association between these domains with the type of curriculum, sex, prior research experience and EBD training.

RESULTS

A total of (n = 526) students participated (response rate of 81.55%). About 92% knew about evidence-based dentistry. Whilst 58% had undergone formal training in evidence-based dentistry, 90% of the respondents showed an overall positive attitude towards evidence-based dentistry. However, only 45% of them practised it most of the time. Schools with an integrated curriculum showed more willingness and practised evidence-based dentistry more frequently (p < 0.001). More than 50% of the participants rated their confidence in appraisal as moderate.

CONCLUSION

Our findings revealed that Malaysian dental undergraduate students who are well aware of evidence-based dentistry displayed a positive attitude towards it. The type of dental curriculum had a significant association with practice and attitude towards evidence-based dental knowledge and practice.

Senior dental students' perceptions of evidence-based dentistry

INTRODUCTION

This study aimed to assess senior dental students' knowledge and attitudes regarding evidence-based dentistry (EBD), their use of the current literature and considerations for patient preferences.

MATERIALS AND METHODS

A modified Knowledge, Attitudes, Access, and Confidence Evaluation (KACE) survey was administered to collect data from senior dental students at the University of Maryland School of Dentistry (UMSOD). The chi-squared test was used to compare the correct response rates of each question in the knowledge of scientific evidence domain. Spearman's rank correlation coefficient was conducted to examine correlations between students' knowledge of scientific evidence and their confidence in appraising the study qualities.

RESULTS

61 seniors (out of 130) answered all survey questions. Participants displayed an intermediate level of knowledge of EBD. Only 15% of participants correctly answered to the most appropriate design; the distribution of responses appeared significantly different amongst the questions in the basic knowledge section (chi-squared test, p < .0001). There was no or very weak correlation between students' knowledge of scientific evidence and their confidence in appraising study qualities (Spearman's ρ = 0-0.18). The participants highly valued the use of the current literature and patient preferences. However, their preferred sources of scientific evidence were the Internet excluding Cochrane reviews (60%) and colleagues (56%). Forty per cent of participants rarely or never used textbooks.

CONCLUSION

Whilst seniors felt confident in evaluating study qualities and implementing EBD in routine practice, their understanding of the study design was poor. Seniors' preferred sources of scientific evidence were non-peer-reviewed Internet sources and colleagues.

Knowledge, Attitude, Access and Confidence in Evidence-based practice amongst French dental undergraduates: A transcultural adaptation and psychometrics analysis of French version of the KACE questionnaire

OBJECTIVE

The aim of this study was to provide a reliable instrument to assess evidence-based practice (EBP) dimensions in French-speaking dental students. To do so, a transcultural adaptation into French of the self-administered KACE questionnaire (Knowledge, Attitude, Access and Confidence Evaluation) and the evaluation of its psychometric properties in a sample of French dental students and teachers were performed. The effects of individual and academic factors on student performance in the KACE were also investigated.

METHOD

Teachers and fourth-year students completed once the translated KACE and fifth-year students completed twice the questionnaire before and after an epidemiology course. Cronbach's alpha coefficient analysis, Kruskal-Wallis and post hoc Dunn's tests, paired samples Wilcoxon tests and a generalised linear mixed model were performed to assess the psychometric properties (reliability, internal consistency, discriminant validity and responsiveness) of the questionnaire and to identify the factors associated with KACE scores, respectively.

RESULTS

186 participants completed the survey. Cronbach's alpha ranged from 0.06 to 0.48 for Knowledge, 0.21 to 0.59 for Attitude, 0.42 to 0.76 for Access and 0.82 to 0.93 for Confidence. The discriminant value and sensitivity of the French KACE revealed significant differences amongst students and teachers and accurately identified the effect the training course had on the students who had completed it. Preparing for a residency programme or having received add-on modules in science improved the students' performance in the test. Being female negatively impacted the KACE Confidence score.

CONCLUSION

This version of the KACE is appropriate to assess EBP dimensions in French dental students. Academic background and gender may affect test performance.

Knowledge of evidence-based research methodology amongst orthodontic postgraduate residents in four universities: An international survey

AIM

The aim of this international survey was to assess knowledge concerning the design, conduct, critical appraisal and synthesis of clinical studies among senior orthodontic postgraduate residents.

MATERIALS AND METHODS

Senior postgraduate residents from four universities in Europe and the United States were invited to complete a custom questionnaire. The overall correct answer score and proportion of residents correctly answering each of the 10 questions within the survey were analysed with descriptive statistics, analysis-of-variance, chi-squares test and linear regression at 5%.

RESULTS

A total of 46 residents with mean age of 30.4 years scored an overall % correct score of 48.8%±13.8%, with the % of correct answers to each question ranging from 7 to 89%. The worst-answered questions pertained to correctly characterizing sensitivity and specificity (7%), number needed to treat (9%), credibility of trial synthesis in meta-analysis (35%) and publication bias (37%). The vast majority of postgraduate students could correctly identify entities that can be blinded in a randomized trial (89%), statistical power of a trial (74%) and proper methods for random allocation sequence (67%). No statistically significant differences were found among the four included universities, while residents having obtained another degree apart from dentistry scored better than others (+9.5%; 95% confidence interval: 0.6% to 18.5%; P=0.04).

CONCLUSIONS

Postgraduate residents in orthodontics possessed moderate knowledge on evidence-based methodology. Efforts should be reinforced to assimilate research methodology perspectives in the postgraduate curricula of universities, in order to further augment critical training of orthodontic specialists.

Association between predoctoral evidence-based practice training and later use of peer-reviewed journals: National dental PBRN

OBJECTIVE

We examined whether evidence-based practice (EBP) during dental school was associated with the increased use of peer-reviewed literature during subsequent clinical practice for National Dental Practice-Based Research Network (PBRN) dentists. We also sought to understand whether this association was moderated by being a dental specialist.

METHODS

We analyzed cross-sectional data from 1228 dentists participating in the PBRN. We used logistic regression to examine the association between self-reported EBP training during dental school and the use of peer-reviewed journals in clinical practice, controlling for the number of years since dental school graduation and dental practice type. We stratified the data by dental specialists and examined effect modification using the Breslow-Day test for homogeneity of the odds ratio.

RESULTS

The prevalence of peer-reviewed journal use by PBRN dentists in clinical practice was 87% (n = 1070) with no statistical evidence of effect modification by dental specialists on the EBP peer-reviewed journal use relationship (p > 0.05). After controlling for years since dental school graduation and dental practice type, dentists who self-reported EBP training during dental school had greater odds of using peer-reviewed journals in clinical practice than dentists who did not self-report EBP training during dental school (OR, 1.47; 95%CI = 1.01, 2.15).

CONCLUSION

The use of peer-reviewed published literature by PBRN dentists who had EBP predoctoral training is one important step in the EBP process by which practicing dentists can implement evidence-based findings, interventions, and policies into routine health care and public health settings. These findings add to the body of support for EBP curricula in dental education.

Aligning Information Literacy and Evidence-Based Dentistry Concepts in a Rubric to Improve Dental Education

Understanding of the alignment of key concepts in both evidence-based dentistry and information literacy could lead to greater collaboration between librarians and dental faculty. To identify these areas of partnership, a group of dental librarians from across North America created a rubric aligning information literacy concepts with competencies from dental education groups in the United States and Canada. The process included identifying relevant competencies, determining information literacy concepts for each competency, and adding learning outcomes scaled by Bloom's Taxonomy. The resulting rubric is useful for advocating librarian involvement in dental education curriculum, communication with dental faculty, and instruction planning.

Impact of COVID-19 pandemic on dental education: online experience and practice expectations among dental students at the University of Jordan

BACKGROUND

The quarantine associated with the COVID-19 pandemic forced dental schools to suspend their clinical training and to shift to distant learning methods. The aim of this study is to investigate the impact of quarantine on the self-perceived preparedness of dental graduates and to explore the efficacy of online education from students' perspectives.

METHODS

The questionnaire distributed to dental students comprised of two main sections. The first part covered the online education experience, and the second part measured the level of self-perceived preparedness for a range of cognitive, communication and professional skills.

RESULTS

The survey yielded a response rate of 72%. The majority of students (77%) agreed that they missed educational experiences as a result of the lockdown. More than half of them felt less motivated to follow-up with distant e-learning and believed that online assessment is not a good method for evaluation. A high percentage of the students (66%) thought that online group discussions had a positive value while 67% preferred online lectures compared to theatre lectures. Majority of students particularly 5th year (78.7%) (p < 0.001) stated that the quarantine increased their collaboration with their colleagues. According to 87% of students, the experience most negatively affected was their clinical training. In general, students showed satisfactory self-perceived preparedness related to a range of attributes and professional skills.

CONCLUSIONS

The data showed that students partially appreciated the online system, whereas they did not consider it a substitute for face to face clinical practice. The overall self-perceived preparedness level was promising; however students had reservations regarding independent practice following graduation.

Self-perceived preparedness of undergraduate dental students in dental public universities in Malaysia: A national study

AIMS

To evaluate the self-perceived preparedness of final-year dental undergraduate students in dental public universities in Malaysia.

METHODS

Final-year dental undergraduate students from six dental public universities in Malaysia were invited to participate in an online study using a validated Dental Undergraduates Preparedness Assessment Scale DU-PAS.

RESULTS

In total, about 245 students responded to the online questionnaire yielding a response rate of 83.05%. The age range of the respondents was 23-29 years with a mean age of 24.36 (SD 0.797). The total score obtained by the respondents was ranged from 48 to 100 with a mean score of 79.56 (SD 13.495). Weaknesses were reported in several clinical skills, cognitive and behavioural attributes.

CONCLUSIONS

The preparedness of undergraduate students at six dental institutions in Malaysia was comparable to students from developed countries. The dental undergraduate preparedness assessment scale is a useful tool, and dental institutions may be used for self-assessment as well as to obtain feedback from the supervisors.

Brazilian dentists' perception of dentin hypersensitivity management

The aim of this study was to investigate how Brazilian dentists perceive and manage dentin hypersensitivity (DH) in their clinical routine. A 13-item questionnaire-based survey was developed and sent electronically to a convenience sample of dentists. The questionnaire assessed the personal and dental practice characteristics of the sample, the occurrence of DH in their daily clinical practice, and management strategies. The data were analyzed descriptively and together with the chi-square test (a = 0.05). A total of 353 responses were obtained from September 2017 to March 2018. Of all the respondents, 62% were females, 49.9% reported fewer than five years of dental practice, and 70.5% were self-identified as private practitioners. Most of the dentists reported an estimated frequency (30-60%) of patients with DH in their practice. The most frequently cited (91.79%) trigger of DH was air blast and/or scratching with a probe. The first-choice strategy to manage DH was a dentin desensitizer (48.16%). The number of years in clinical practice did not influence DH relapse frequency (p = 0.76) significantly, or consider DH treatment as a problem (p = 0.22). The present findings indicate that, regardless of clinical experience, dentists in Brazil still consider DH management a challenge in their daily dental practice. In addition, the results suggest that guidelines should be developed to disseminate the available knowledge regarding this condition in ways that may influence decision-making processes among practitioners.

Evaluation of an Experiential and Self-Learning Approach to Teaching Evidence-Based Decision Making to Dental Students

The aim of this study was to evaluate the impact on predoctoral dental students of an experiential and self-learning pedagogical approach to evidence-based decision making. Dental students at one U.S. dental school in 2014 and 2015 participated in an evidence-based decision making course that consisted of minimal lecturing, learning through assigned readings and open-book online quizzes, and individual assignments to reach an evidence-based decision on a clinically relevant question. Before and after the course, each cohort completed a validated survey assessing students' knowledge, attitudes, access of evidence, and confidence related to evidence-based practice. In 2014, of 43 students enrolled in the course, all 43 (100%) completed the pre-course survey, and 33 (77%) completed the post-course survey. In 2015, of 35 students enrolled in the course, all 35 (100%) completed the pre-course survey, and 34 (97%) completed the post-course survey. Of those, the identifier codes for 23 students in 2014 and 25 students in 2015 matched for the pre-course and post-course surveys, allowing direct comparisons. Both cohorts of students showed a significant increase in knowledge regarding critical appraisal of the literature from the pre-course survey results to after the course (p<0.001). Students' reported frequency of accessing evidence from various sources also significantly increased from before to after the course for both cohorts (p<0.01). Students' confidence in evaluating various aspects of a published research report also increased significantly from before to after the course for both cohorts (p<0.001). However, no consistent change was found in students' attitudes about evidence-based practice. In this study, an experiential and self-learning approach to teaching evidence-based decision making in the classroom appeared to be successful in improving students' knowledge, use of evidence, and confidence in critical appraisal skills, though it did not have a consistent impact on their attitudes about evidence-based practice.

Prevalence of Journal Clubs: A Survey of Clinical Pastoral Education Residencies in the United States

Journal clubs are an established and effective method of promoting research literacy and evidence-based practice in the medical field. However, their use in clinical pastoral education (CPE) residencies is relatively new and largely unstudied. In 2016 we surveyed 201 ACPE certified educators of CPE residency programs throughout the United States. Eighty-eight certified educators participated in this first-of-its-kind study. Our aim was to determine the prevalence and structure of existing CPE journal clubs and establish baseline data to determine the effectiveness of future programs for increasing research literacy. Seventy-three percent of respondents indicated they did not have a journal club. Journal clubs that do exist tend to meet at least monthly and last one to two hours. Chaplains, certified educators, or chaplain residents lead the majority of journal clubs. Seventy percent of respondents whose programs had journal clubs indicated they were interested to learn more about journal clubs. Journal clubs do not appear to be common in CPE residencies and chaplains may feel unprepared to lead them. CPE journal clubs would likely be strengthened by collaboration with other disciplines and from additional training for CPE certified educators. We offer suggestions to this end as well as areas for further research.

Self-perceived preparedness of final year dental students in a developing country-A multi-institution study

AIMS

To evaluate the self-perceived preparedness to practice of final year dental undergraduate students in three dental institutions.

METHODS

Dental undergraduate students in their final year from three dental institutions in Pakistan were invited to participate in an online study to assess self-perceived preparedness using a validated preparedness assessment scale.

RESULTS

In total, 134 students responded to the questionnaire yielding a response rate of 72%. Students felt adequately prepared to carry out several clinical procedures including clinical assessment, fillings, tooth extractions and communication skills. However, perceived preparedness was low in the students' ability to undertake intraoral radiographs, treatment planning, crowns, multirooted endodontics, research skills, referral for suspected oral cancer and raising concerns regarding inappropriate behaviour of colleagues.

CONCLUSIONS

This is the first study which investigates the self-perceived preparedness of final year undergraduate dental students in Pakistan. The results show that the self-perceived preparedness of final year students was satisfactory for a range of clinical and affective skills. However, several areas of weaknesses were identified which underscore the need for additional training and consolidation.

Preparedness of undergraduate dental students in the United Kingdom: a national study

Aims To evaluate the self-perceived preparedness of final year dental undergraduate students in the United Kingdom.Methods Dental undergraduate students in their final year were invited by email through the Dental Schools Council (DSC) to provide their responses to an online preparedness assessment scale. The data analysis was carried out using the RUMM2030 software which is specifically designed for Rasch analysis, a measurement model based on item response theory.Results Students felt adequately prepared to carry out simple clinical procedures and communication skills. However, low scores were reported on ability to assess orthodontic treatment needs, treatment planning, crowns, endodontics, research skills, referral for suspected oral cancer and raising concerns regarding inappropriate behaviour of colleagues.Conclusions The scale used in this study explored the self-perceived preparedness on a range of cognitive, clinical and behavioural attributes. The data show that the students felt prepared for the majority of the attributes expected from dentists. However, a number of areas were identified where students may benefit from further training and consolidation.

Teaching Cell Biology to Dental Students with a Project-Based Learning Approach

Although the discipline of cell biology (CB) is part of the curricula of predoctoral dental schools, students often fail to recognize its practical relevance. The aim of this study was to assess the effectiveness of a practical-theoretical project-based course in closing the gaps among CB, scientific research, and dentistry for dental students. A project-based learning course was developed with nine sequential lessons to evaluate 108 undergraduate dental students enrolled in CB classes of a Brazilian school of dentistry during 2013-16. To highlight the relevance of in vitro studies in the preclinical evaluation of dental materials at the cellular level, the students were challenged to complete the process of drafting a protocol and performing a cytocompatibility assay for a bone substitute used in dentistry. Class activities included small group discussions, scientific database search and article presentations, protocol development, lab experimentation, and writing of a final scientific report. A control group of 31 students attended only one laboratory class on the same theme, and the final reports were compared between the two groups. The results showed that the project-based learning students had superior outcomes in acknowledging the relevance of in vitro methods during biocompatibility testing. Moreover, they produced scientifically sound reports with more content on methodological issues, the relationship with dentistry, and the scientific literature than the control group (p<0.05). The project-based learning students also recognized a higher relevance of scientific research and CB to dental practice. These results suggest that a project-based approach can help contextualize scientific research in dental curricula.

Designing an Effective, Small-Scope Practice-based Study

OBJECTIVE

Present a methodology to promote good practices in designing small-scale, practice-based studies.

STUDY DESIGN

We propose the following methods to assist clinicians and other practice-based researchers in designing and conducting good quality, small-scale studies in a clinical setting.

METHODS

Research projects applied to a limited, practice-based study may require modification to increase the consistency of patient research.

RESULTS

Although common requests to collaborative methodologists mirror methods for experimental design, clinic-based studies may face different limitations. Each participant enrolled consumes resources, including time, and personnel. If practice-based studies have a different goal, to learn about the health outcomes of patients in a medical practice with limited intent for generalization, should the same methods be used?

CONCLUSIONS

When limitations are clearly stated and the findings are described within the study context, these limitations may not be so severe to discourage the research. We propose a systematic method to conduct practice-based research intended for small-scale study use. Relying heavily on existing research from similar areas, the incorporation of data from the practice, and the a priori defined timelines and resources, we set forth some guiding principles to assist clinic-based investigators. Individualized focus and small-scale studies are growing in use and acceptance especially given the focus on personalized health.

Assessment of oral health attitudes and behavior among students of Kuwait University Health Sciences Center

AIM

The aims of this study were to assess attitudes and behavior of oral health maintenance among students in four faculties (Medicine, Dentistry, Pharmacy, and Allied Health) and to compare oral health attitudes and behavior of all students at Kuwait University Health Sciences Center (KUHSC) based on their academic level.

MATERIALS AND METHODS

Students enrolled in the Faculties of Dentistry, Medicine, Pharmacy, and Allied Health at KUHSC were evaluated regarding their oral health attitudes and behavior by an e-mail invitation with a link to the Hiroshima University Dental Behavior Inventory survey that was sent to all 1802 students with Kuwait University Health Sciences Center e-mail addresses. The data were analyzed for frequency distributions, and differences among the groups were assessed using the Mann-Whitney U test, Chi-square test, and Kruskal-Wallis test. P values less than 0.05 were considered to be statistically significant (P < 0.05).

RESULTS

The results of this study indicated that dental students achieved better oral health attitudes and behavior than that of their nondental professional fellow students (P < 0.05). Students in advanced academic levels and female students demonstrated better oral health attitudes and behavior.

CONCLUSION

Dental students and students who were in advanced levels of their training along with female students demonstrated better oral health practices and perceptions than students in lower academic levels and male students, respectively. Additional studies for investigating the effectiveness and identifying areas requiring modification within the dental curriculum at KUHSC may be warranted.