Development and implementation of communication skills in dentistry: an example from South Africa

Design of a communication skills course in dentistry: Applying active-learning strategies to improve educational outcomes

PURPOSE/OBJECTIVE

Effective communication, between patient and dentist, is a core clinical skill that commands dedicated pedagogy similar to that of developing scientific knowledge and psychomotor skills. This study aimed to describe active-learning strategies in a dental communication skills course, which sits within a broader foundation dental course and evaluate students' educational outcomes.

METHODS

This is a two-phase retrospective, mono-centred study, completed in 2019 at an Australian dental school. Phase I, a case report, describes the Communication Skills for Oral Health (CSOH) course design and its active-learning strategies. Phase II analysed data from the course using Kirkpatrick's evaluation model to objectively measure the impact of the course and provide feedback to education designer. Students' perception (Level 1) was evaluated with an institutional, validated online survey. Descriptive and statistical analysis, included paired tests and Spearman's correlation analyses, used to investigate learning effect (Level 2) and student behaviour change (Level 3). To assess the impact of the CSOH course design (Level 4) the student grades from the course were analysed.

RESULTS

The CSOH course encompasses three major topics: Essentials of Communication Skills, Professional-Patient Relationship and Managing Difficult Situations. Each topic included didactic content complimented with a variety of active-learning strategies to teach and assess students. Positive outcomes were recorded across all Kirkpatrick levels.

CONCLUSIONS

This study suggests an efficient communication skills course design, which may assist in the development of communication skills courses in other dental education institutions.

Teaching and Assessment of Dentist-Patient Communication Skills: A Systematic Review to Identify Best-Evidence Methods

Dentist-patient communication skills are important aspects of contemporary oral health care, as shared decision making with patients becomes more common. The aim of this systematic review of the literature on teaching and assessment methodologies for communication skills in dental practice was to categorize those skills most relevant to dental practice and determine the best-evidence teaching and assessment methods. The systematic review was conducted using MEDLINE, EBM-Cochrane Libraries, Embase, ERIC, BIOSIS, CAB Abstracts, and PsycINFO using the OVID search engine, together with manually searching relevant journal articles. Relevant data were extracted from all included articles, and thematic analysis, categorization, and quality review of the articles was performed. Fifty articles published between 2000 and 2016 were identified as relevant to this study. Most were comparative design studies. The largest numbers were single group studies with before and after tests and cross-sectional studies. A total of 26 communication skills were identified and grouped into four major categories: generic skills, case-specific skills, time-specific skills, and emerging skills. Review of the teaching methods described in those articles showed that educators used a combination of passive and active strategies. All the assessment measures were considered to be valid and reliable. This categorization of essential dentist-patient communication skills reported in the literature may be used to assist in curriculum design along with use of tested teaching methods and validated assessment measures. The review highlights the need for more robust study designs for research in this important aspect of dental education.

Reliability of rubrics in the assessment of orthodontic oral presentation

Aims

The aim of this study was to evaluate the reliability of using rubrics in dental education, specifically for undergraduate students’ assessment in orthodontic oral presentation.

Methods

A rubric-based case presentation assessment form was introduced to three contributing instructors. In each instructor’s group, the course director, along with the assigned instructor, assessed 8 randomly selected fourth year male dental students utilizing the same assessment form (total of 24 students). The two final scorings made by the assigned instructor and the course director were then gathered for each student. The data of this prospective comparative study then was analyzed using paired t-test to look for any significant differences in the scoring of the course director and each instructor in each group.

Results

No significant statistical differences were detected in grading variables between the instructors and the course director. Furthermore, the data showed no significant correlations between the students’ final course grade, and their case presentation grades scored by instructors’/course director.

Conclusion

Despite the elaborate nature of the routine orthodontic case presentation, the use of rubrics was found to be a promising reliable assessment element.

Students' perceptions of vertical and horizontal integration in a discipline-based dental school

INTRODUCTION

Integration is a key concern in discipline-based undergraduate dental curricula. Therefore, this study compared feedback on integration from students who participated in different instructional designs in a Comprehensive Patient Care course.

METHODS

The study was conducted at the University of Pretoria (2009-2011). Third-year cohorts (Cohorts A, B and C) participated in pre-clinical case-based learning, whilst fourth-year cohorts (Cohorts D and E) received didactic teaching in Comprehensive Patient Care. Cohorts A, D and E practised clinical Comprehensive Patient Care in a discipline-based clinic. Cohort B conducted their Comprehensive Patient Care patient examinations in a dedicated facility supervised by dedicated faculty responsible to teach integration. Students had to indicate on visual analogue scales whether the way they were taught at the school helped them to integrate knowledge from the same (horizontal integration) and preceding (vertical integration) year of study. The end-points of the scales were defined as 'definitely' and 'not at all'. Analysis of variance (ANOVA) was employed to measure the differences between cohorts according to the year of study.

RESULTS

Third-year case-based learning cohorts rated the horizontal integration close to 80/100 and vertical integration ranging from 64 to 71/100. In year four, Cohort B rated vertical and horizontal integration 9-15% higher (ANOVA, P < 0.05) than Cohorts A and D. In year five, Cohort A rated vertical and horizontal integration 11-18% higher (ANOVA, P < 0.05) than Cohorts D and E.

CONCLUSION

Pre-clinical case-based learning and Comprehensive Patient Care supervised by dedicated faculty were associated with more favourable perceptions about integration in the discipline-based undergraduate dental curriculum.

Determining Recommendations for Improvement of Communication Skills Training in Dental Education: A Scoping Review

Professional communication skills have a significant impact on dental patient satisfaction and health outcomes. Communication skills training has been shown to improve the communication skills of dental students. Therefore, strengthening communication skills training in dental education shows promise for improving dental patient satisfaction and outcomes. The aim of this study was to facilitate the development of dental communication skills training through a scoping review with compilation of a list of considerations, design of an example curriculum, and consideration of barriers and facilitators to adoption of such training. A search to identify studies of communication skills training interventions and programs was conducted. Search queries were run in three databases using both text strings and controlled terms (MeSH), yielding 1,833 unique articles. Of these, 35 were full-text reviewed, and 17 were included in the final synthesis. Considerations presented in the articles were compiled into 15 considerations. These considerations were grouped into four themes: the value of communication skills training, the role of instructors, the importance of accounting for diversity, and the structure of communication skills training. An example curriculum reflective of these considerations is presented, and consideration of potential barriers and facilitators to implementation are discussed. Application and evaluation of these considerations are recommended in order to support and inform future communication skills training development.

Developing students' clinical reasoning skills: correlates of perceived relevance of two teaching and learning approaches

INTRODUCTION

'Relevance' is a key concept in adult learning. Hence, this study sought to examine students' perceptions of relevance of the teaching and learning in relation to different instructional designs employed in a Comprehensive Patient Care (CPC) course that aims to develop integrated clinical reasoning skills.

METHODS

Third to fifth year students (2009-2011) were asked to anonymously rate the relevance of the instructional design (RELID) they participated in by means of visual analogue scales at the School of Dentistry, University of Pretoria. They were also asked to rate their perceptions of the alignment between teaching and learning and outcomes (ATLO), assessments' contribution to learning (ACL), course organisation (CO) and teacher competence (TC). RELID served as the outcome measure in stepwise linear regression analyses. ATLO, ACL, CO, TC and the instructional design (case-based learning (CBL = 1) and the combination of discipline-based and lecture-based teaching in CPC (DB-LBT = 0)) served as the co-variables for each of the years of study.

RESULTS

The analyses showed positive correlations between RELID and ATLO and between RELID and ACL for all the years of study. RELID was associated with TC in year three and four and CO was associated with RELID in year four and five. CBL outperformed DB-LBT in terms of perceived relevance of the teaching and learning.

CONCLUSION

The results suggest that students' perceptions of the relevance of the instructional design may be enhanced when outcomes, teaching, learning and assessment are constructively aligned during the development of clinical reasoning skills.

The importance of teaching communication in dental education. A survey amongst dentists, students and patients

The aim of our study was to evaluate the subjective importance of teaching communication in the dental curriculum by conducting a survey amongst dentists, students and patients. Three questionnaires about communication-related issues were developed in which different questions could be rated on a five-point Likert scale. These questions included the subjective importance of the dental team's friendliness, an elaborated consultation, modern office equipment or the dentist's technical skills. Seven hundred and twenty-nine questionnaires were completed [233 by dentists (32%), 310 by students (43%) and 185 by patients (25%)]. Eighty-seven percentage of the dentists, 84% of the students and 84% of the patients supported an integration of communicational issues in dental education; 94.7% of the dentists and 77.2% of the patients attached vital importance to the dentist-patient relationship regarding the therapeutic outcomes. Dentists with prior communicational training experience would spend significantly (P<0.001) more money for further courses. The results show the publicly perceived importance of integrating aspects of communication in dental education.