Clinical competency exercises: some student perceptions

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.

Changes in the Difficulty of Endodontic Cases Treated by Undergraduate Students at a University Clinic Between 1971 and 2019

OBJECTIVE

This study aimed to assess the proportions of complicated endodontic cases treated by undergraduate dental students in a University clinic now and in the past.

MATERIAL AND METHODS

Data were obtained from the electronic records and previous publications from the Faculty of Dentistry, University of Oslo, Norway. The operators were dental undergraduate students in their final 2 years of training. Proportions of tooth types, diagnosis, and retreatments were studied.

RESULTS

The amount of endodontically treated molars increased from 18% in 1971% to 44% in 2019. The number of teeth with preoperative apical periodontitis increased from 31% to 46%, and retreatments from 9% to 15%. The changes were highly significant, with the greatest change occurring from 1984 to 2009.

CONCLUSION

Undergraduate students are exposed to more complicated teeth now than 50 years ago.

Difficulties Faced by Undergraduates While Conducting Endodontic Therapy

BACKGROUND

Dentistry is a complex field that utilizes both theoretical and practical knowledge along with a distinct coordination of the hand, brain, and eye of an individual, forming a major part of endodontic therapy. Assessing the understanding and practical knowledge of undergraduates from time to time is essential in evaluating the success of the undergraduate education system. Therefore, the purpose of this study was to evaluate the challenges that are associated with endodontic therapy and are faced by undergraduate students at College of Dentistry, Qassim University.  Methodology: Ninety-seven undergraduates who had completed their preclinical training and had done endodontic treatments were included in this questionnaire-based study. The Chi square test and Fisher's exact test have been used to determine whether or not there is a significant difference on a categorical scale between two or more groups of study parameters.

RESULTS

According to our results, de-roofing of the pulp chamber and recognizing the canal orifices are the two areas that need more consideration. The gender-wise difference in the challenges faced by the students while performing the majority of steps during endodontic treatment was found to be insignificant. However, a significant difference was noted in relation to the complete deroofing of the pulp chamber (p-value=0.04) and locating the canal orifices (p-value=0.04). Moreover, fifth year students rarely faced difficulties in performing anesthesia and rubber dam placement, whereas fourth year students faced difficulties in both procedures.

CONCLUSION

The study concludes that de-roofing the pulp chamber and identifying the orifices of canals are two areas where more attention should be given while training undergraduate dental students.

Dental Students' Perception and Self-Perceived Confidence Level in Key Dental Procedures for General Practice and the Impact of Competency Implementation on Their Confidence Level, Part I (Prosthodontics and Conservative Dentistry)

Background

Evaluating the level of dental students' competence is crucial for validating their preparedness for graduation. Confidence has a significant role in achieving competence. There are limited studies that assess the level of self-perceived confidence among final-year dental students regarding their ability to conduct key dental procedures. This study aims to assess the self-perceived confidence level of final-year dental students in performing essential dental procedures across various dental disciplines and to assess the effect of implementing competencies in the curriculum on the self-perceived confidence level of students by comparing two cohorts of final-year students in two different years 2016 (Traditional Cohort) and 2019 (Competencies Cohort).

Materials and Methods

An questionnaire was answered by two cohorts of final-year dental students: one group in 2016 before the implementation of the competency-based assessment system (group 1, n = 153), and the other in 2019 after the implementation of this system (group 2, n = 199), the same questionnaire was used for both cohorts. The results from the two groups were compared regarding the degree of self-perceived confidence in conducting key dental procedures. The data were analysed using SPSS statistics and Levene's Test for Equality of Variances and t-test for Equality of Means calculated.

Results

Group 1 showed a significantly higher means of self-perceived confidence levels than group 2 in the ability to conduct seven out of the 20 prosthodontics procedures studied: providing patients with Cobalt-Chromium (Co-Cr) removable partial dentures (RPD) (3.77 vs. 3.56), providing the patient with Acrylic RPD (3.70 vs. 3.23), treatment planning for partially edentulous patients (3.83 vs. 3.34), giving OHIs for denture patients (4.17 vs. 3.95), dealing with CD postinsertion complaints (3.97 vs. 3.76), giving postinsertion instructions for removable prostheses cases (4.12 vs. 3.82), and providing patients with immediate dentures (2.67 vs. 2.32). The same applies to 6 out of 16 conservative dentistry procedures: placing anterior composite (4.41 vs. 4.12), placing posterior composite (4.43 vs. 3.88), placing posterior amalgam (4.29 vs. 4.02), placing matrix band for Class II restorations (4.24 vs. 3.71), placing a prefabricated post (3.34 vs. 2.88), and placing fiber post (3.45 vs. 3.34). On the other hand, group 2 shows higher means of self-perceived confidence than group 1 in only two conservative dentistry procedures: onlay restorations (2.18 vs. 2.76) and inlay restorations (2.22 vs. 2.75). No significant differences in means of self-perceived confidence were found between the two groups in the remaining 21 procedures studied.

Conclusions

This study has shown that final-year dental students have high self-perceived confidence levels in doing simple dental procedures yet less confidence in more complex ones. Although, students' self-perceived confidence decreases after the introduction of a competency-based assessment system. Competency implementation and execution criteria may differ between schools which may have an impact on final outcomes. Hence, there is a need for regular evaluation of competencies being assessed to maintain a curriculum that is up to date.

Challenges Assessment in Endodontics Among Undergraduate Students

Objective To explore perceptions of undergraduate dental students regarding difficulties faced during endodontic procedures. Methods An e-questionnaire was sent to 57 fourth-year and 45 fifth-year dental students. It comprised questions regarding demographic data and difficulties faced during different steps of the endodontic treatment. The responses were recorded on a 5-point Likert scale. During dichotomization, responses where one and two were chosen were considered yes whereas responses where three, four, and five were chosen were considered no. The sample size (SS) calculated using the Qualtrics SS calculator was 89. Data were analyzed using SPSS version 20. Frequencies and percentages were calculated. A p-value of less than 0.05 was considered significant. The chi-square test was applied for comparison based on the students' academic year and genders. Results Ninety students responded with an 88.2% response rate. Most students reported not facing any difficulty in differentiating healthy pulp and periapex from conditions of pulp pathosis (78.9%) and periapical pathosis (75.6%). Most males found access opening and de-roofing of the pulp chamber (35.6%) and working length determination (31.1%) difficult. Females reported having difficulty mostly in mesial and distal shift radiograph techniques (55.6%) and access openings (51.1%). No statistical difference was found based on an academic year or gender except in the use of mesial and distal shift techniques for radiograph acquisition Conclusion Assessing difficulties encountered by students during endodontic therapy can aid in the development of teaching strategies for preclinical and clinical instruction. Mesial and distal shift techniques, access cavity preparation, and working length determination are areas requiring more focus in the training process.

Evaluating the stress of root canal treatment in patients and dentists compared to other dental treatments: A systematic review and meta-analysis

This systematic review aimed to investigate whether root canal treatment caused greater stress than other dental treatments for patients and dentists. All peer-reviewed literature published in English between January 1990 and January 2023 was included. This included randomized/non-randomized control trials, cohort studies, case-control studies, and cross-sectional studies. An electronic search used PubMed, Scopus, Medline, Cochrane Collaboration, and Embase. Hand searching supplemented the screening pool. Studies examining physiological or psychological stress measures within patients or providers of dental treatment (dentists, dental specialists, and dental students) were eligible. The study must have reported on the stress outcome for root canal treatment and at least one other dental procedure. After screening 3639 eligible records, there were 23 studies included, varying from very-low to low certainty of evidence. This review found that root canal treatment was more psychologically stressful for patients than routine restorative or cleaning procedures. However, the stress of root canal treatment relative to other dental procedures, especially extractions, was inconclusive for both dental patients and providers. Since patients regard root canal treatment as more stress-evoking than other routine dental procedures, providers should endeavour to minimise their own bias toward root canal treatment when providing adequate information for an informed treatment choice.

Assessment of the educational value of endodontic access cavity preparation YouTube video as a learning resource for students

Objective

To evaluate the educational value of YouTube as a learning tool for dental students regarding endodontic access cavity preparation.

Methods and findings

YouTube search was made for videos related to endodontic access cavity preparation using specific terms. After exclusions, 41 videos were chosen and assessed for tooth type, video length, days since upload, country of origin, number of views and likes, source of authorship, and viewing rate. To grade the content of videos, a usefulness score with seven elements was developed. Each element was given a score of 0 or 1. Statistical tests were run by using Kruskal-Wallis and Mann-Whitney tests (SPSS Inc, Chicago, IL, USA) at a 5% significance level. The videos received a mean of 181198.5 views with a mean duration of 686.1 seconds. The mean number of “likes” was 1047.8. Almost half of the videos covered content related to molar teeth. Most videos were provided by health care professionals with almost 50% uploaded from India. The mean usefulness score was 4.29 (range: 1–7) and the most discussed elements were description, instruments used, access cavity demonstration, and evaluation criteria. About a quarter of the videos were classified as good, while 46.3% as moderate and 29.3% as poor. Among the content usefulness categories, no difference was found in the video demographics (p>0.05) except “days since upload” (p = 0.018) in which good quality videos were found to have the highest median. Moreover, although insignificant, good videos were found to have the longest duration and lowest number of views, likes, and viewing rate. The mean usefulness score of videos released during the COVID-19 pandemic was lower than that for pre-pandemic videos (p = 0.042), and videos uploaded by academic institutions had a higher mean usefulness score than videos uploaded by health care professionals (p<0.001).

Conclusions

Information on endodontic access cavity preparation is not comprehensive in most of the reviewed YouTube videos and could be of low educational value.

How is working length determination taught? A survey to assess what is recommended in undergraduate Schools of Dentistry in Brazil

INTRODUCTION

To analyse what are the methods for working length (WLD) determination taught for undergraduate students in Brazilian Dental Schools and the perception of professors about the use of electronic WL determination in the clinical practice.

METHODS

An online questionnaire with eighteen closed questions was sent to 209 Schools of Dentistry in Brazil using the Google Forms Platform. The questionnaire was structured to analyse the perception of professors in the department of endodontics about the method of working length determination taught in undergraduate courses in Dentistry. The data collected in the questionnaires were transferred to an Excel^® spreadsheet and analysed using absolute and relative frequencies. The non-parametric Mann-Whitney test was used to compare groups.

RESULTS

Of the 209 schools contacted, 41 (19.61%) returned answers to the questionnaire. According to professors, electronic working length (WL) determination had a shorter length of time to perform it (p < .001), WL measurement accuracy (p < .001) and ease of performance (p < .001). Professors felt safer when maintaining patency when using electronic WL determination (p = .0020).

CONCLUSIONS

Both radiographic and electronic methods of WL determination are taught in Brazilian Schools of Dentistry. The electronic method was used more frequently, especially in undergraduate clinical courses.

The impact of technological endodontic resources on the training of the general dentist

INTRODUCTION

Technological resources are considered important for the practice and training in endodontics. It is not yet clear the extent of the insertion of these resources in predoctoral dental programmes and the effect of such resources to the general dentist training.

AIM

To evaluate the faculty perception regarding the insertion of technological resources, particularly rotary instruments, and the impact of such resources to the student's learning process graded at the end of predoctoral dental programmes in Brazil by the National Students Performance Exam (ENADE).

METHODS

The endodontic department faculties in all 205 programmes that participated in the 2016 ENADE received a questionnaire by email. The institution, faculty credentials, and insertion of technologies in each programme were described, and an association between these data and the ENADE score was tested.

RESULTS

149 educators (72.7%) answered the form. From this total, 73.2% of them were from private institutions and 26.8% from public ones. Educators mix manual and rotary instrumentation to treat selected patients in 47.7% of the programmes. Most educators (89.9%) consider the utilisation of technology in endodontics as positive. Whilst there was not a significant association between the use of rotary instrumentation and better performance in ENADE, there was a significant association between the performance and the supply of special instruments by the institutions.

CONCLUSION

These results show that even though most faculties consider the insertion of technologies as positive, the factor that caused a significant impact to the training of the general dentist is the general infrastructure of the institutions.

An 8-year retrospective survey of assessment in postgraduate dental training in complicated tooth extraction competency

BACKGROUND/PURPOSE

Direct observation of procedural skills (DOPS) has been increasingly used in health education in recent years. This study evaluated the effect of education and trainees' perception of assessment on the clinical skills of postgraduate dental trainees in complicated tooth extraction.

MATERIALS AND METHODS

This study was conducted as a retrospective survey among postgraduate dental trainees learning complicated tooth extraction in Taipei and Linkou Chang Gung Memorial Hospital from 2012 to 2019. Practical skills were assessed using DOPS by trainees and faculty members. Each clinical case included a complicated extraction of a permanent tooth.

RESULTS

A total of 69 participants (26 men and 43 women, average age = 26.49 years, range = 24-34 years) were included in this study. Within the survey cohort, faculty assessments scored significantly higher than did trainees' self-assessments in each complicated tooth extraction procedure, with no difference between both sexes. The higher-performing trainees tended to underrate their performance much more than did the lower-performing trainees. More than 40% of the trainees evaluated themselves as having "poor capability" in some invasive surgical procedures, even though their actual performance was not lower than that of those who evaluated themselves as having adequate or good capability.

CONCLUSION

Self-assessment skills should be developed with more practice and experience. We hope that these findings can guide the planning of faculty development programs for clinical instructors, particularly the new cohort of faculty who will succeed the rapidly retiring boomer generation in the next 10 years.

Perception of a modular 3D print model in undergraduate endodontic education

AIM

To evaluate a modular 3D print training dental model with embedded human teeth and electronic working length determination for undergraduate endodontic education.

METHODOLOGY

Cone-beam volume tomography data of a human skull were transferred into stereolithographic (STL) data, and a customizable modular 3D print model with individually removable sextants and teeth was generated for the use in commercially available phantom heads. Each of sixty-eight students performed a complete root canal treatment on an extracted human tooth. Working lengths were determined with electronic apex locators (EAL) and verified radiographically. Subsequently, an evaluation was carried out with regard to the difficulty of the working steps access cavity preparation, working length determination, root canal preparation/irrigation and canal filling, and these steps were compared to commonly used benchtop models. Additionally, the agreement of electronic and radiographic working length determination was assessed and analysed statistically with the chi-square test.

RESULTS

A total of 68 teeth (20 incisors, 26 premolars and 22 molars) with 127 root canals were treated. In total, 87% of the students considered the modular 3D print model considerably more demanding than the conventional benchtop model. Overall, 96% felt better prepared for the clinical situation, 92% felt markedly reduced stress levels during endodontic practice in the subsequent clinical courses, and 93% of the students suggested the model should be used in future preclinical endodontic training. The preradiographic use of EAL resulted in 85% of the cases having radiographically acceptable working length determination within 0-2 mm from the radiographic apex. Readings more than 2 mm from the apex or beyond were significantly more common in molars than in premolars and incisors (P < 0.05).

CONCLUSIONS

The vast majority of students rated the modular 3D print training model positively despite it being more demanding. They also recommended its use in preclinical teaching and training. The model allowed a more realistic simulation of the clinical situation with a simultaneous use of EALs and led to reduced stress levels in endodontic treatment in the subsequent clinical courses.

Validity and reliability of a self-assessment scale for Dental and Oral Health student's perception of transferable skills in Australia

BACKGROUND

The Australian Dental Council's (ADC) competency framework requires graduating dental practitioners to be competent in a number of transferable skills, which includes: being scientifically versed, technically skilled and capable of safe independent work and teamwork, whilst adhering to high ethical standards (Australian Dental Council. Professional Competencies of the Newly Qualified Dentist. Melbourne, Australia: ADC; 2016). Part of the role of dental educators is to ensure graduating students acquire requisite transferable skills, in line with regulatory requirements (Chuenjitwongsa et al. Eur J Dent Educ. 2018;22:1). In order to achieve this, it is imperative to assess students' own understanding or perception of transferable skill requirement upon graduation. The objective of this study was to develop a valid and reliable scale for this assessment.

METHOD

A cohort of students drawn across three different dental programmes: undergraduate dentistry (years 1-3); post-graduate dentistry (years 4-5); and Bachelor of Dental Technology/Prosthesis, participated in this study. A self-assessment questionnaire containing relevant open- and closed-ended questions was administered. The questionnaire assessed students' perception of transferable skills for their future career and attitude towards learning and developing transferable skills.

RESULT

In total, we successfully assessed 388 of the 391 students sampled (99.2% response rate), their mean age was 24.3 years (SD ± 5.7), and 53.3% were females, whilst 46.7% were males. Overall, exploratory factor analysis (EFA) extracted five factors for students' perception of current skill level, and four factors for future skill requirements. The factor structures were confirmed using confirmatory factor analysis (CFA), and the structure had a good model fit and high levels of reliability, with respect to individual dimension and content validity.

CONCLUSIONS

The structure derived from the transferable skill survey administered to a cohort of dental students suggests that the transferable skill survey can be utilised as a valid and reliable screening tool to test students' perception of transferable skill requirements.

Self-reported confidence and anxiety over endodontic procedures in undergraduate students-Quantitative and qualitative study

PURPOSE

The current literature shows a growing interest to assess the feelings and perceptions of students associated with the performance of elective endodontic procedures. This study aimed to evaluate the students' anxiety and self-perceptions related to performing such treatments.

METHODS

Forty-five students participated in the research (G1 = 22 beginners students; G2 = 23 senior students). Demographic data, STAI-State and Numerical Rating Scale (NRS) for pre-operative anxiety were completed before the appointment with patient. The STAI-Trait; NRS for post-operative anxiety; previous experiences in endodontics; and level of confidence in each stage of endodontic treatments were collected after appointment. Focal groups for qualitative data collection were performed on separate occasion.

RESULTS

Both groups showed higher scores in STAI-State than for STAI-Trait scale. G1 showed higher levels of anxiety in the pre-operative, compared with post-operative moment in the NRS scale. G2 reported feeling more confidence to insert intracanal medication and to restore teeth between appointments than G1. In both focus groups, participants reported insecurity in performing endodontic procedures due to difficulty in visualisation and to anatomic complexities. G1 reported that all the confidence they had was based in pre-clinical experience, and G2 mentioned concern about the end of graduation.

CONCLUSION

The participants' anxiety diminishes as they gain more experience in performing endodontic procedures. However, as they approach the end of the course anxiety levels increase. Greater availability of elective courses in endodontics could be a valuable alternative to provide students with more exposure to and experience with these procedures.

The confidence of undergraduate dental students in Saudi Arabia in performing endodontic treatment

Objective:

This study examined the endodontic experience, perceptions of endodontic practice, and self-rated confidence of dental students enrolled in Taibah University, Saudi Arabia.

Materials and Methods:

A questionnaire was distributed to 41 undergraduate dental students registered in endodontic courses in the 2015 academic year. The questionnaire evaluated their confidence performing nonsurgical root canal treatment. The level of confidence was classified using a 5-point scale as “very confident,” “confident,” “neutral,” “not very confident,” or “not at all confident.” The data were analyzed using SPSS version 20.0 (SPSS, Chicago, IL, USA).

Results:

The participation rate was 93%. The maxillary incisor was the most common first tooth treated. The students were relatively confident, but their confidence levels were lower regarding endodontic radiology, evaluation of root canal obturation, and determining the correct recall period for the patient.

Conclusion:

The confidence of undergraduates in endodontics must be enhanced to increase their clinical competence when performing root canal treatment.

Experiences during the execution of emergency endodontic treatment and levels of anxiety in dental students

PURPOSE

This study aims to evaluate the experience of dental students and assess their anxiety levels when performing emergency endodontic treatments.

METHODS

Undergraduate students completed the STAI-Trait/State and a questionnaire to assess their confidence level to perform each step of an emergency endodontic procedure. They also answered a numerical scale (NRS) for anxiety before and after emergency care. Ten randomly selected students from the same sample further participated in a focus group aimed at obtaining qualitative data on their perception of endodontic treatments' conduction and the learning process necessary to perform them.

RESULTS

A total of 23 students joined the study. The majority of the participants reported feeling "confident" when performing local anaesthesia (57.6%), rubber dam placement (57.6%) and coronal sealing (72.7%). However, a small number reported feeling "little confident" to perform access cavity (15.2%) or pulpotomy/pulpectomy (24.2%). Students who scored above the 3rd quartile of STAI-Trait/State were classified as "highly anxious," and comprised 26.1% of the sample. The values of NRS scale were higher in the preoperative when compared with the post-operative assessment. All students classified as "highly anxious" reported low confidence in performing "access cavity" and "pulpotomy/pulpectomy."

CONCLUSION

Both quantitative and qualitative analysis showed different anxiety levels in dental students. It can possibly contribute to a reduction in confidence prior to emergency endodontic procedures. The current findings suggest it might be important to rearrange activities in order to allow for more practical classes in Endodontics.

Undergraduate dentistry students' perception of difficulties regarding endodontic treatment

The present study aimed to identify students' perceptions of endodontic treatment at a Brazilian university through a survey, which analysed student profiles and their difficulties in 2016. One hundred and two students who had experienced endodontic, laboratory or clinical procedures answered a survey based on their experiences, regarding their perceptions, experience and self-confidence levels. Results demonstrated that there was no significant difficulty among students regarding anaesthesia, rubber dam use, chamber access, working length determination, instrumentation, root filling and temporary restoration procedures during endodontic treatment. However, problems were observed regarding radiographic examination (mainly in separating root canals) and the choice of intracanal medication. The present study also raised a question regarding dental education: how can endodontic education be improved by addressing students' perceived difficulties? Evaluating the major student difficulties during root canal therapy can help the improvement of teaching strategies during preclinical and clinical teaching.

Student perceptions of exodontia competency assessment in a UK dental school

INTRODUCTION

Modern medical and dental training has migrated from assessing only the quantity of procedures performed to a combined assessment of both competency and quantity. This study explores student perceptions of competency assessment in exodontia at a UK dental school.

MATERIALS AND METHODS

Anonymous questionnaires were distributed to dental students in years three, four and five at the School of Dentistry, Cardiff University (n=149). Responses consisted of dichotomous tick boxes and 5-point Likert scales, with thematic analysis of free-text responses. Discrete variables were analysed using simple descriptive statistics. Recurring themes were identified from the responses.

RESULTS

A total of 129 questionnaires were returned (response rate 87%). Feedback from students indicated that they felt well prepared to undertake the competency assessment, agreeing that year three is the most appropriate year to assess competency (69%; n=86). In 50% of cases (n=65), the clinical supervisor was not present for the duration of the assessment. The undergraduate student body would like further teaching in the use of elevators (89%; n=114).

CONCLUSION

The competency assessment was deemed fit for purpose by the undergraduate student body. Further developments in the areas of clinical supervision and teaching on the use of elevators were considered and recommendations made to the School of Dentistry, Cardiff University. The current oral surgery course incorporates some of the recommendations.

Dental students' perceptions about the endodontic treatments performed using NiTi rotary instruments and hand stainless steel files

This study evaluated the perceptions of Brazilian undergraduate dental students about the endodontic treatments performed using NiTi rotary instruments and hand stainless steel. Data were collected using a questionnaire administered to undergraduate dental students enrolled in endodontic disciplines. The students were divided into 3 groups: G1, students who had treated straight canals with SS hand instruments; G2, students who had treated curved canals with SS hand instruments; and G3, students who had treated both straight and curved canals with NiTi rotary instruments. The number of endodontic treatments performed, types of treated teeth, students' learning, time spent, encountered difficulties, quality of endodontic treatment and characteristics of the employed technique were analyzed. There was a 91.3% rate of return for the questionnaires. Mandibular molars were the most frequently treated teeth, followed by maxillary incisors. The Kruskal-Wallis test showed no differences in learning (p=0.528) or in the characteristics of the technique employed (p=0.560) among the three groups. G3 students performed a greater number of endodontic treatments (p<0.001) in a smaller time (p<0.001) than did G1 and G2 students. Difficulties were reported primarily by students in G2 and G3 compared with G1 (p=0.048). The quality of endodontic treatments differed only between G1 and G2 (p=0.045). The use of NiTi rotary instruments should be included in undergraduate dental curriculum, contributing to the increase of patients assisted and consequently to improve the clinical experience of the students.

The retention of suturing skills in dental undergraduates

BACKGROUND

The ability to place sutures is an essential skill in dentistry. In our institution, the introduction of a video teaching aid and a checklist-based assessment has improved the standardisation of teaching as well as the transparency and objectivity of the assessment of suture skills. The aim of this study was to determine whether this skill once acquired is retained in the short term.

MATERIALS AND METHODS

The same cohort of 67 fourth-year students performed the same assessment at two different time points 2 months apart. The first was a formative assessment and the second was a summative assessment. Feedback was collected on both occasions.

RESULTS

On the first sitting of the assessment, 93% of the students were successful compared with 79% on the second occasion. Student feedback was similar on both occasions with 77% and 75% reporting that they thought it was an easy exam. On the first occasion, 27% thought that it was a stressful examination compared with 43% on the second occasion, which may have affected their performance.

CONCLUSIONS

These findings suggest that regular reinforcement is required to avoid deterioration of suturing skills even in the short term. This might involve exposing the students to surgery earlier in the course and introducing regular formative assessments which the students appear to associate with less stress.

Developing a primary dental care outreach (PDCO) course--part 1: practical issues and evaluation of clinical activity

BACKGROUND

The primary dental care outreach (PDCO) course in Newcastle, UK commenced in September 2004 with dental undergraduates attending outreach clinics on a fortnightly rotation over a 2 year continuous placement.

OBJECTIVES

To evaluate the PDCO with respect to practical issues and clinical activity.

METHODS

Clinical activity data were collected using data sheets and Access software together with data on patient attendances and Structured Clinical Operative Tests (SCOTs). Comparative clinical data were collected from the same group of students in Child Dental Health (CDH) in the School of Dental Sciences.

RESULTS

In 2004/2005, 1683 clinical procedures were undertaken in PDCO and 1362 in CDH. Of the treatment undertaken in PDCO, 37.1% was examination and treatment planning, 17.1% basic intracoronal restorations and 13.1% fissure sealing, the activity representative of day to day in general practice. Completion rates for the five piloted SCOTs in cross infection control, writing a prescription, writing a referral letter, taking a valid consent and taking a radiograph ranged from 74% to 97% in 2004/2006. The practical issues and challenges of delivering a new clinical course broadly related to induction of new PDCO staff, support of staff, establishing effective communication, timetabling logistics, delivery of clinical teaching and quality assurance.

CONCLUSION

Once the practical issues and challenges of setting up a new clinical course have been overcome PDCO has a valuable role to play in preparing undergraduates for their future practising careers.

Oral surgery undergraduate teaching and experience in the United Kingdom: a national survey

The aim of this work was to determine the structure, mode of delivery, mode of assessment and staffing of the oral surgery undergraduate curriculum within UK dental schools. A questionnaire was distributed by e-mail in January 2006 to each of the 15 dental schools with undergraduate dental degree programmes in Ireland and the UK. Those providing feedback then met to clarify any areas as required. Thirteen completed questionnaires were returned. There were a total of 55 academics involved in the teaching of oral surgery at these 13 institutions. Over the three clinical years the mean number of clinical sessions was 51. The mean staff student ratio for supervision of forceps exodontia was 1:5. On average 51 teeth were extracted by each student in the clinical years. The mean staff student ratio for surgical extractions was 1:2. The mean number of surgical extractions for each student was 6. All schools formatively assessed competency in forceps exodontia and 9 of 13 assessed surgical extractions. Summative assessment of exodontia was done in six schools and surgical extractions in 4 of 13 schools. All 13 schools deliver teaching programmes designed to meet the requirements of the frameworks governing the central curriculum. There were, however, variations between individual schools in the content and delivery of the oral surgery clinical teaching programmes. There were dramatic variations in the numbers of academic staff involved and some institutions relied on their NHS colleagues to deliver the clinical teaching.

UK national curriculum for undergraduate oral surgery subgroup for teaching of the Association of British Academic Oral and Maxillofacial Surgeons

This article describes a curriculum in oral surgery for undergraduate dental education in the United Kingdom prepared by the Education Subgroup of The British Academic Oral and Maxillofacial Surgeons. This group is made up of representatives from each of the 13 UK Dental Schools, one Irish Dental School and one Post-graduate Institute. The document represents a group consensus of an undergraduate UK oral surgery curriculum that is founded on the frameworks outlined by the General Dental Council, the Quality Assurance Agency for Higher Education and the Association for Dental Education in Europe. Our curriculum document is more prescriptive than the information available in the aforementioned documents. It is based on UK undergraduate oral surgery experience and thus attempts to set achievable core competencies and, in a few areas, challenges the available curriculum and related documentation.