Undergraduates' self-reported clinical experience, confidence and perspectives of hospital and outreach paediatric dentistry: a three-year multi-centre evaluation

Evaluation of confidence levels of undergraduate dental students in various stages of root canal treatment

INTRODUCTION

The objective of this study is to assess the confidence levels of 4th- and 5th-year dental students in relation to root canal treatment (RCT). Additionally, the study aims to examine how these levels fluctuate in response to various procedures, tooth types, and gender.

METHODS

This cross-sectional, survey-based study was conducted with 4th- and 5th-year dental students. The students were requested to evaluate their confidence levels in relation to a number of endodontic procedures, including anesthesia administration, rubber dam placement, canal preparation, irrigation, filling, retreatment and the management of complications. The survey results were analysed using the Mann-Whitney U test and the Friedman test in order to evaluate the existence of any differences in confidence levels as a function of procedure, tooth type and gender.

RESULTS

The findings indicated that 4th-year students demonstrated higher levels of confidence in most procedures. The lowest levels of confidence were observed in the management of complications, including perforations, broken instruments, and the extrusion of irrigants apically. Male students reported significantly higher levels of confidence than female students across all procedures and tooth types.

CONCLUSION

The findings of this study indicate that there are significant variations in the confidence levels of dental students during RCT procedures, depending on the specific procedure, tooth type, and gender. The findings of this study demonstrate that dental students' confidence levels during RCT procedures vary significantly depending on the type of procedure, tooth type, and gender. Deficits in confidence were particularly evident in challenging procedures, such as the management of complications.

Student and clinical supervisor perceptions of community-based dental educational experiences: A scoping review

PURPOSE

This scoping review was conducted to map the breadth of experiences in community-based dental education (CBDE), as reported by students and clinical supervisors.

METHODS

This scoping review was conducted following the structured framework proposed by Arksey and O'Malley and adhering to PRISMA-SCR guidelines for scoping reviews. Applying specified eligibility criteria, a systematic search of four electronic databases (PubMed, Scopus, Embase, and Web of Science) was followed by data extraction and data synthesis of full-text articles. Research was conducted between June 2022 and September 2022.

RESULTS

Sixteen articles were identified for the final full-text review. Utilizing a narrative thematic review, the following five domains emerged: preparation for autonomous practice, understanding of primary care dentistry, understanding of health disparities and patient needs, clinical confidence, clinical diversity, and skill development, and perspectives on quality of teaching and assessment.

CONCLUSION

Community/outreach dental education effectively supplements traditional dental school-based education from the perspectives of students and community-based clinical supervisors.

Dental students' clinical and academic experience during placement in a UK tertiary care children's hospital

INTRODUCTION

There are well-recognized difficulties across UK dental schools in recruiting paediatric patients who are willing to attend, have manageable dental disease, and do not require the behaviour management skills of an experienced dentist. This presents a concern for the skill development of the future workforce. At the School of Dentistry in Liverpool, the challenge to enable students to develop these core skills is supported by attendance at a tertiary care children's hospital. The present study investigates whether attendance of final-year dental students at a children's hospital affects perceptions of their surgical experience, self-reported preparation for working independently as a dentist, and understanding of specialist care.

MATERIALS AND METHODS

A self-administered online survey was distributed to final-year dental students (2020-2021). Quantitative and qualitative data were gathered using mixed item formats for descriptive analysis. Questions addressed themes including experience of primary tooth exodontia, understanding of general anaesthetic dental care and multidisciplinary patient management.

RESULTS

The response rate was 90% (n = 66). Attendance was beneficial to student learning and experience; responders reported increased surgical experience, self-confidence and understanding of multidisciplinary care. Students developed insight into future career pathways.

CONCLUSION

The present study supports the use of external clinic rotations, known as outreach placements, for dental student training. The findings support existing literature demonstrating the value of outreach placements in providing an experience not available in dental school environments. Dental students' perceptions of their surgical experience, knowledge of specialist care, and preparedness for independent practice may be enhanced by attendance to outreach placements.

Undergraduate dental students' perception of paediatric dental teaching in an urban and rural Australian dental school

BACKGROUND

Confidence in performing paediatric dental treatment is important as it ensures better oral health outcomes in the patient's adulthood.

AIM

To investigate the confidence and attitudes of final year dentistry students, attending an urban and rural dental programme, towards their paediatric dentistry training.

DESIGN

A questionnaire was distributed to final year dentistry students at the urban-based university, The University of Queensland, and at the rural-based university, La Trobe University. The questionnaire collected information using 5-point Likert scale and short-answer questions, which explored the theoretical, observational, preclinical and clinical aspects of students' paediatric dentistry training. Jamovi and GraphPad Prism were used for data analysis and the creation of graphs.

RESULTS

The questionnaire was completed by 32 rural students and 47 urban students, with a response rate of 79%. Rural students were found to be less confident with the theory on restorative procedures than urban students. Observations of a dentist performing treatment on child were completed by a significantly larger proportion of urban students (70.2%) than rural students (46.9%). Students from both universities reported to have developed the least confidence in the preclinical training of pulp therapies and expressed the need for additional preclinical sessions for more training. At both universities, students indicated they were the least confident in the clinical practice of pulp therapies and management of traumatic dental injuries. Urban students were found to be more confident than their rural counterparts in the clinical practice of examination, treatment planning and preventative procedures, as well as in restorative procedures.

CONCLUSIONS

Both urban and rural students were found to have the least confidence in preclinical and clinical skills related to pulp therapies. Restorative dentistry was an area in which urban students were significantly more confident than rural students in both the theoretical and the clinical aspects.

Comparison of self-perceived competence of recent dental graduates from the Universities of Otago and Dalhousie

INTRODUCTION

This study investigates and compares the self-perceived competencies of recent dental graduates from the University of Otago (UoO) (Dunedin, New Zealand) and Dalhousie University (DU) (Nova Scotia, Canada).

MATERIALS AND METHODS

A validated survey was emailed to recent graduates from the UoO (December 2019) and DU (May 2020). Chi-squared statistical analysis examined the differences between groups.

RESULTS

The response rate was 73% from the UoO class and 75% from the DU class. Out of 59 competencies, 11 items showed a significant difference. Orthodontics and the surgical aspects of dentistry were the main areas where significant differences have been observed between the two cohorts. Out of the four items in orthodontics, a significantly higher proportion of DU graduates felt more competent than graduates from UoO in three items ("performing orthodontic treatment planning," "performing space maintenance/regaining" and "performing orthodontic full-arch alignment"; p < .001). Similarly, graduates from DU felt significantly more competent in three of the eight items in the oral and maxillofacial surgery domain ("managing complications of oral surgery," "performing soft-tissue biopsies" and "managing trauma to the dentofacial complex"; p < .001), all requiring surgical training and skills.

CONCLUSION

Of the differences identified, graduates from DU reported higher levels of self-perceived competence compared with their UoO counterparts, especially in the orthodontics and oral and maxillofacial surgery domains. This could be because DU students have more practice in these specialties during their training. The results suggest that increased exposure for UoO students in these areas may be beneficial to their self-perceived competence.

Dental students' experience of conscious sedation: A qualitative review of student reflections

INTRODUCTION

The UK General Dental Council (GDC) requires dental graduates to competently identify, manage and refer patients with dental pain and anxiety. This study aimed to explore sedation training experience quantitatively and qualitatively through individual reflective logs.

MATERIALS & METHODS

A single-centred mixed-methods evaluation of teaching, within a UK university conscious sedation department. Fourth-year dental students undertook lectures and supervised clinical sessions following the undergraduate curriculum. Patient attendance patterns, individual experience and group experience were analysed descriptively. Reflective log sheets were analysed by Thematic Framework Analysis.

RESULTS

Seventy-two students participated. Of 153 booked patients, 79 (51.6%) attended of which 74 (48.4%) were treated by undergraduates. The mean performed inhalation sedation and intravenous sedation cases per student were 1 and 0.8, respectively. Three students (4%) assisted only. Group experience varied. Three themes arose from reflections: consolidation of theory and learning; confidence through experience; and responding to challenges.

DISCUSSION

Whilst experience quotas were not met, GDC requirements for increasing students' knowledge and confidence within CS were met. Practical experience enhanced learning. "Hands-on" experience was most valuable for self-reported confidence but learning by proxy also aided development. Students recognised challenges, but not the implications for themselves or their career. Strategies to reduce barriers to experience require research.

CONCLUSION

Whilst variable, all students were provided learning opportunities. Physical experience gave the greatest confidence. Opportunities afforded by the undergraduate curriculum allowed students to learn and develop through consolidation of theory, response to challenges and ultimately the gaining of confidence.

Understanding the building blocks of the paediatric dentistry curriculum for undergraduate students in an Australian University

Purpose

To investigate the attitude of final-year dental students towards their paediatric dentistry training and their confidence in treating child patients.

Methods

A 55-item questionnaire was distributed online and physically to the final-year BDSc (Hons) students at The University of  Queensland (Australia). The questionnaire consisted of four parts including theoretical knowledge, clinical observational experience, preclinical training and clinical training in paediatric dentistry. Self-reported confidence was recorded using five-point Likert scale questions ranging from ‘not confident at all’ to ‘completely confident’, which were allocated the numbers 1–5, respectively. Jamovi and GraphPad Prism were used for data analysis and creation of graphs.

Results

A total of 47 students completed the questionnaire giving a response rate of 77%. Approximately two-thirds of participants had previous experience working with children and 70% had observed a practitioner providing paediatric dental treatment. The students reported the lowest level of clinical confidence for pulp therapy (M = 2.32; SD = 1.08). The clinical confidence in dental trauma management was also reported to be low (M = 2.50; SD = 1.15). The clinical administration of local anaesthetic (LA) had the highest level of confidence (M = 3.95; SD = 1.03). The students reported that they were highly confident in the theoretical knowledge of behaviour guidance techniques (M = 3.64; SD = 0.97) and preclinical training involving examination, treatment planning and preventative procedures (M = 4.33, SD = 0.67).

Conclusion

This study showed that students reported low levels of confidence in pulp therapies and trauma management in children as compared to other aspects of paediatric dentistry. Students indicated the need for more preclinical and clinical training sessions, as well as more opportunities to perform a wider variety of treatments on paediatric patients.

Supplementary Information

The online version contains supplementary material available at 10.1007/s40368-021-00688-1.

Are they ready? Awareness and preparedness of the emerging workforce for Dental Check by One

Background Dental Check by One (DCby1) is a British Society of Paediatric Dentistry campaign, which aims to increase dental attendance of young children. As the future workforce, dental students have a key role in ensuring its long-term success.Aims To establish final-year dental students' awareness of DCby1. To evaluate their preparedness for providing dental care for young children and to identify perceived barriers to doing so at the time of graduation as they prepare to enter the workforce.Materials and methods An anonymous, online survey was administered to graduating final-year dental students in 2018, 2019 and 2020. Quantitative data were gathered using mixed item formats and Likert scales. Qualitative data were also gathered using free-text questions, allowing evaluation of the opinions of responders.Results The response rate was 83% (n = 63) in 2018, 91% (n = 62) in 2019 and 73% (n = 57) in 2020. Eight percent (n = 5) of responders were aware of DCby1 in 2018, improving to 67% (n = 38) in 2020. Each year, 98% to 100% of responders felt prepared to provide preventive care for young children. Fewer than 60% felt prepared to provide breastfeeding and weaning advice to parents. Responders felt unprepared to examine the dentition of a preschool child. Undergraduate curricula and social media were identified as preferable sources of public health campaign information for students.Conclusion Awareness and preparedness for DCby1 appears to be improving. Ninety-five percent of all responders across three years of study felt prepared to examine a child aged under one year and this is encouraging for the long-term success of DCby1. Targeted curriculum reform including both didactic teaching and online learning platforms appears to have been pivotal to improving undergraduate awareness and preparedness. Social media may offer opportunities for engaging with undergraduate learners.

Dental students' experience and perceived confidence level in different restorative procedures

PURPOSE

Graduating confident students who are able to flourish and develop in their future careers is an importance outcome of the dental education. This study aims to evaluate self-perceived level of confidence of fifth-year dental students in different restorative-related tasks and the relationship between their clinical training and its corresponding confidence.

METHODS

Fifth-year graduate dental students (n = 202) were asked to fill a questionnaire that rated their level of confidence in different clinical restorative dentistry tasks. Additionally, they were asked about the number of times they performed tasks prior to attempting the equivalent competency and in which sub-specialty they felt the most confident.

RESULTS

Completed responses were received from 120 students giving a response rate of 59%. Students felt the most prepared and confident in direct restorations and simple endodontic treatment, and they seemed less confident in indirect restorations and complex endodontic treatment. Regarding the steps of indirect restorations, students expressed least confidence in crown preparation compared to impression making and try-in procedures (P < .05). Students rated their confidence highest in operative dentistry, followed by endodontics and lastly fixed prosthodontics.

CONCLUSION

The results highlight the areas in which students exhibit the least confidence. Enhancement of student clinical skills and directed exposure is necessary to raise the level of perceived confidence which will reflect positively on their current and future professional performance.

Final year dental students' self-assessed confidence in general dentistry

BACKGROUND

Self-assessment is an important introspective skill that dental professionals will utilise throughout their professional career. Its value lies in its ability to help individuals identify areas of strengths and weakness, and subsequently seek further development of professional skills where needed. The aim of this study was to investigate the correlation between self-assessed confidence and the assessment grade of final year dental students based on the professional attributes and competencies of newly qualified dentists outlined by the Australian Dental Council (ADC).

METHODS

Ethical approval was obtained prior to distribution of a questionnaire with 45 statements to final year dental students. The survey was created based on the learning outcomes of the ADC guidelines in the domains of "scientific and clinical knowledge" and "patient care." Participants indicated their level of self-assessed confidence by marking "X" on a visual analogue scale (VAS) from zero ("No Confidence") to 10 cm ("Very Confident"). The assessment grade was based on OSCE, viva voce, case report and written paper.

RESULTS

A total of 58 (71.6%) dental students participated in the survey. The reported self-assessed confidence over two domains were under "patient care": clinical information gathering 8.92 ± 1.07 cm (range =3.94-10.0 cm: n = 58; 100%), clinical diagnosis and management planning 8.26 ± 1.34 cm (range =0.50-9.95 cm: n = 55; 94.8%), clinical treatment and evaluation, 6.07 ± 1.69 cm (range =0-10.00 cm: n = 55; 94.8%), and "scientific and clinical knowledge": 6.98 ± 1.58 cm (range =0-10.00 cm: n = 58; 100.0%). Within these categories, high confidence was reported for routine dental care (caries management and preventive care) whilst lower confidence was reported for the management of oral medicine and pathologies, dental emergencies, trauma, paediatric dentistry and prosthodontics. Correlation between the assessment grade and the overall score of self-assessed confidence is low positive (r = .225) and not statistically significant (n = 46; P = .132, Spearman'sρ).

CONCLUSIONS

The final year dental students appear to have good overall self-assessed confidence in core areas of general dentistry. However, confidence seems to be over-estimated when compared with summative assessment.

Community Health Centre-Based Outreach Clinic for undergraduate dental education: Experience in Helsinki over 8 years

INTRODUCTION

The University Dental Clinic of the City of Helsinki (UDC) developed a Community Health Centre-Based Outreach Clinic, with emphasis on paediatric dentistry. This study aimed to summarise the experiences and explore the student perspectives of the health centre-based outreach teaching clinic.

METHODS

The study data were from the years 2010 to 2016. The dental procedures carried out by the third- to fifth-year dental students were based on electronic health record of patients. The students' self-perceived benefits and free-text comments on the outreach training were collected as part of a yearly questionnaire survey.

RESULTS

A vast majority of the paediatric dental procedures that are required for competencies of dental students were performed in the outreach clinic. The most common procedures were fillings with local anaesthesia followed by preventive procedures. The majority of the students were very motivated to participate in the outreach training and reported that it was a useful educational approach to broaden their understanding of oral diseases and clinical experience.

CONCLUSION

The outreach clinic gives dental students a chance to gain valuable clinical experience through the number and diversity of the dental procedures they carry out. They gain confidence and get an opportunity to get acquainted with the primary healthcare system and social determinants of oral diseases. Outreach appears to provide complementary clinical experiences that fulfil learning outcomes. Learning objectives should be taken into account when planning the outreach programme in order to offer meaningful and motivating education.

Dental Students' Perceived Clinical Competence in Prosthodontics: Comparison of Traditional and Problem-Based Learning Methodologies

The aim of this study was to compare the perceived competence for treating prosthodontic patients of two samples of fourth-year dental students: those educated using traditional methodologies and those educated using problem-based learning (PBL). Two cohorts of fourth-year dental students at a dental school in Spain were surveyed: the traditional methods cohort (n=46) was comprised of all students in academic years 2012 and 2013, and the PBL cohort (n=57) was comprised of all students in academic years 2014 and 2015. Students in both cohorts reported the number of prosthodontic treatments they carried out per year and their perceived level of competence in performing such treatments. The results showed that the average number of treatments performed was similar for the two cohorts, except the number of metal-based removable partial dentures was significantly higher for students in the traditional (0.8±1.0) than the PBL (0.4±0.6) cohort. The level of perceived competence to treat complete denture patients for the combined cohorts was significantly higher (7.3±1.1) than that for partial acrylic dentures (6.7±1.5) and combined dentures (5.7±1.3). Students' clinical competence in prosthodontics mainly depended on number of treatments performed as the operator as well as the assistant. Students in the traditional methods cohort considered themselves to be significantly more competent at treating patients for removable partial and fixed prostheses (7.8±1.1 and 7.6±1.1, respectively) than did students in the PBL cohort (6.4±1.5 and 6.6±1.5, respectively). Overall, however, the study found that practical experiences were more important than the teaching method used to achieve students' perceived competence.

Undergraduate experience and self-assessed confidence in paediatric dentistry at the University of Jordan Dental School

INTRODUCTION

The aims of the study were to audit the number and types of clinical procedures completed by the undergraduate dental students in the paediatric dentistry course at the University of Jordan Dental School and to present data on self-reported confidence in a variety of aspects of paediatric dentistry.

MATERIALS AND METHODS

A retrospective audit of clinical logbooks for the entire class of 120 dental students in their fifth clinical year was performed. Key clinical procedures performed in the paediatric clinics were recorded including treatment performed on both primary and permanent teeth. Students were requested to complete an anonymous questionnaire to assess confidence related to six activities using a visual analogue scale (VAS).

RESULTS

All students performed restorations in primary teeth with the majority providing approximal restorations (91%), pit and fissure restorations (89%) followed by stainless steel crowns (81%). In addition, all students performed a pulpotomy for a primary tooth, extraction of a primary tooth and fissure sealants. Only a quarter of the students treated a traumatised incisor. Students considered themselves most confident (VAS ≥ 7) in performing operative dentistry, examination, diagnosis and treatment planning and providing preventive therapy. They were least confident in the management of dento-alveolar trauma (VAS = 3.8).

CONCLUSION

Students at the University of Jordan Dental School were found to have good experience of clinical paediatric operative dentistry with the majority performing pulp therapy, preformed crowns and extractions. Deficiencies have been reported in student exposure to dental trauma, and these are being addressed.