Perceptions of a simulated general dental practice facility - reported experiences from past students at the Maurice Wohl General Dental Practice Centre 2001–2008

A retrospective clinical study on the survival of posterior composite restorations in a primary care dental outreach setting over 11years

OBJECTIVES

To investigate the survival in terms of time to re-intervention of composite restorations in posterior teeth among patients attending for treatment at a primary care dental outreach setting over an 11-year period and to determine whether dental, patient or operator factors influenced this.

METHODS

Electronic primary dental care data were collected on individual patients, including information on their dental treatment and socio-demographics as well as service provision, key performance indicators and student activity.

RESULTS

A total of 1086 patients had at least one posterior composite placed between 2007 and 2018. This amounted to 3194 restorations placed of which 308 had a re-intervention within the 11-year period. For all restorations, the annual failure rate at 1 year was 5.73 %, at 5 years was 16.78 % and at 10 years was 18.74 %. A logistic regression showed that when compared to the least deprived 5^th quintile, the most deprived 1^st and 2^nd quintiles were significantly less likely to have a re-intervention, being 49.2 % (p = 0.022) and 53.2 % (p = 0.031) less likely, respectively.

CONCLUSIONS

The survival rates of posterior composite restorations placed at a single outreach centre providing undergraduate dental training in the South of England, mirrors other studies. The new findings presented suggest similar re-intervention rates between dental students and dental hygiene-therapy students. This study's findings around patient deprivation and rate and time of re-intervention raises important questions related to the need for targeted dental and after care for certain groups in the population.

CLINICAL SIGNIFICANCE

Understanding the factors associated with re-intervention of restorations provided to patients has an impact on patients and dental practices. Also, as we consider widening use of skill mix in dentistry to increase access to care, parity in provision of treatments within the dental team increases opportunities for delegation of tasks.

Belongingness in undergraduate dental education

Objective To undertake a detailed educational evaluation into dental students' experience of the concept of belongingness and their development as 'safe beginners' on an outreach placement at the University of Portsmouth Dental Academy (UPDA).Method The participants were asked two questions: Did you feel belongingness at UPDA?; and When in your year rotation did you feel this? They completed the educational evaluation anonymously in their last week of attendance. The quantitative data was handled with descriptive statistics and the qualitative data was analysed for recurring themes.Results A 95% response rate was achieved. Eighty six percent of respondents strongly agreed to feeling belongingness and 56% felt it after their first two weeks. Four themes were identified: 'Interaction with the preexisting people environment' (1a. Initial welcoming and warmth 1b. Continued interest in me as an individual); 'Developing collegiality' (2a. My group of fellow students 2b. Working with the dental team as a dentist 2c. The team of everyone at UPDA); 'In the clinical environment' (3a. Being a dentist with responsibility and respect 3b. The physical environment 3c. Becoming a reflective independent practitioner); and 'Leadership'.Conclusion Belongingness in dental education should be defined as:- a deeply personal and contextually mediated experience in which a student becomes an essential and respected part of the dental educational environment where all are accepted and equally valued by each other and which allows each individual student to develop autonomy, self-reflection and self-actualisation as a clinician.

Dental students' perceptions of their experience at a residential outreach centre

INTRODUCTION

The Portsmouth Dental Academy delivers an interprofessional education to dental students on outreach placement from King's College London Dental Institute.

AIM

To establish what the dental students' attitudes to the placement are and how these correlate to the perceptions of the staff who work with them.

METHOD

Using Delphi consensus procedures, a simple, closed, two-question questionnaire was developed. The questionnaire was completed by the students and then, to triangulate the results, was subsequently applied to staff who teach and assist them on clinic.

RESULTS

To the question: Why do you think the experience that is commonly termed the 'Portsmouth experience' is so successful 'in the eyes of the students'?, the students ranked first the response: 'Students gain experience in primary dental care clinical practice under the current NHS contract - UDAs and KPIs'. To the second question: What do you think the students most enjoyed about working in Portsmouth?, the students ranked first: 'A sense of independence - being made to make their own decisions'.

CONCLUSION

The students' major perception of the 'Portsmouth experience' centres around the placement being a realistic preparation for their future practising career. This is combined with a strong sense of belonging when studying and working at the Academy.

Bespoke video vignettes - an approach to enhancing reflective learning developed by dental undergraduates and their clinical teachers

This study explores the selective use of video as a medium to support reflective processes as related to dental undergraduate learning. With the objective of developing and enhancing high-quality adult dental care, the use of compiled video materials created in an undergraduate clinical setting was investigated. Video cameras were used to capture elements of reflection-in-action and reflection-on-action typically found during everyday clinical practice. 'Gold standard' or 'textbook outcomes' are rarely, if ever, fully achieved in dental practice. Real-life clinical experiences offer challenges and opportunities for both teachers and students to engage with reflective learning processes. The materials generated allowed for an experience of individual reflective learning and the creation of a data bank or archive with potential use for the benefit of a wider student cohort. Various aspects of the students' views and comments on the process of reflection were reported and explored by means of a semi-structured focus group moderated by a linked educational advisor.

Outreach clinical dental education: the Portsmouth experience - a 4-year follow-up study

BACKGROUND

The Portsmouth Dental Academy (UPDA) was opened in September 2010 and was a development from the highly successful School of Professionals Complementary to Dentistry (2004-2010). The aim of the Academy was to provide integrated team education for all dental professionals in a primary care setting. The dental students are on outreach from King's College London, and the dental care professional students are registered at the University of Portsmouth.

OBJECTIVES

To evaluate the dental students response to the residential outreach educational experience at the UPDA.

METHODS

A 49-item questionnaire divided into nine domains that provided both qualitative data and quantitative data were administered at the end of the longitudinal 10-week placement, to four successive cohorts of students in 2010-2014.

RESULTS

A 95% return rate was achieved. Students valued highly the quality of the clinical teaching. Through their experience, they felt they understood fully the role of the dentist in care planning in primary care and felt well prepared for dental foundation training. This educational success is unpinned with successful maintenance factors including a well-organised induction period and giving the students a sense of belongingness, empowerment and autonomy for their personal development as new graduates.

CONCLUSION

Within the limitations of the questionnaire study over the 4-year period, the students were very positive about all the aspects of this residential outreach education at the UPDA but particularly valued the immersion in clinical dentistry and the bridging from dental school to their dental foundation training.

Use of simulators in operative dental education: experience in southern Nigeria

BACKGROUND

Though the use of simulators in operative dentistry is not new, the teaching and learning practices that take place during clinical sessions in skills laboratories are rarely reported. This study was designed to determine the current practices relating to teaching and learning of dental clinical skills in southern Nigeria.

METHODS

A cross-sectional study was conducted among the final year dental students in southern Nigeria using anonymous structured questionnaire as instrument for data collection. The questionnaire items included statements relating to existing teaching and learning practices. A five-point Likert scale response option was provided and descriptive summary statistics was computed.

RESULTS

There were 56 (34.8%) females and 105 (65.2%) males. Most of the students (41.0%) agreed that the theoretical concept behind clinical skills is taught prior to clinical sessions and most agreed that the objectives of each clinical session are stated and that the procedures are usually demonstrated. Most of the respondents (39.8%) agreed that feedback was sometimes embarrassing and given at the end of clinical sessions (76.6%). Equipment breakdown was a major challenge to learning.

CONCLUSION

Dental education in the skills labs within the region appeared standard. However, feedback should be continuous and constructive. Equipment breakdown was the major constraint to learning.

So how do you see our teaching? Some observations received from past and present students at the Maurice Wohl Dental Centre

This study explores student perceptions of clinical teaching delivered at the Maurice Wohl Dental Centre, King's College London Dental Institute. An on-line survey together with two paper-based questionnaires were used to invite three immediate past cohorts of final-year dental students to reflect and comment on their experiences during their year of attendance. Supporting data from current student focus group and face-to-face interviews were also included in the study. The principal findings from these triangulated methodologies were that the overwhelming majority of students felt they got on very well with their teachers. The development of a positive professional relationship with the teacher appeared to motivate students to work better. Teaching thought to be overly didactic and authoritarian would not be well received. The principal teaching style identified at the Centre was considered to be supportive and nurturing, encouraging a self-motivated and reflective approach to clinical practice.

Evaluation of a community-based clinical teaching programme by current and former student dental therapists and dental hygienists: a pilot investigation

AIM

There has been considerable expansion in the involvement of community-based clinical teaching programmes (sometimes termed 'outreach teaching') in UK and other international dental schools. While there has been much interest in the role of this educational methodology in the professional and educational development of student dentists, there has been little, if no, consideration of this form of teaching in relation to dental care professional (DCP) students. The aim of this pilot investigation was to report the feedback and evaluation of current and former student dental therapists and dental hygienists on their experience on the St David's community-based clinical teaching programme at Cardiff.

METHODS

In Autumn 2009, a questionnaire was distributed by hand to the current second year student dental therapist and dental hygiene class at Cardiff (n = 18) and by post to the dental therapist and dental hygiene classes of 2004 (n = 16) and 2007 (n = 17). The questionnaire included both 'open' and 'closed' questions.

RESULTS

Thirty responses were returned (response rate = 59%; 2004 (n = 5, 31%), 2007 (n = 9, 53%), current class (n = 16, 89%)). Seventy percent of respondents (n = 21) reported that they found the community-based clinical teaching programme to be a pleasant working environment and close to subsequent independent practice. Seventy-seven percent (n = 23) reported that their confidence performing nonsurgical periodontal treatment had increased while at the programme. One respondent commented that the programme was '...an invaluable and insightful introduction to what it would be like working in practice. Without being given the experience, it would have been a big shock to the system when I started working in practice...'

CONCLUSION

This pilot investigation has revealed that current and former dental therapist and dental hygiene students are enthusiastic in their support for the inclusion of community-based clinical teaching programmes in their educational and professional development. Most former and current dental therapist and dental hygiene students noted the positive effects of this form of training on their subsequent clinical careers.