A national survey of UK final year students' opinion of undergraduate oral surgery teaching

Self-Perceived Confidence of Final-Year Dental Students in Oral Surgery for Adults and Children

INTRODUCTION

Undergraduate dental training should nurture students' self-confidence to perform basic oral surgical procedures. Inadequate confidence can lead to hesitance and anxiety, which may compromise patient safety and the quality of dental care.

AIMS

This study aimed to evaluate the confidence levels of final-year dental students in performing oral surgical procedures for adults and children and to explore the factors that influence their confidence.

METHODS

A structured questionnaire was distributed electronically to dental students at the end of their final year. Descriptive statistics and Spearman's correlation (p-value ≤ 0.05) were used to analyse the data.

RESULTS

N = 503 participated. Students were very confident in giving infiltration and Inferior Alveolar Nerve Block (IANB) (73.8% N = 371, 58.8% N = 296), performing simple permanent (anterior: 56.9% N = 286, posterior: 51.1% N = 257) and primary tooth extraction (anterior: 53.7% N = 270, posterior: 51.7% N = 260). However, they were 'somewhat confident' performing third molar extraction (upper: 37% N = 186, lower: 39.6% N = 199), writing drug prescriptions (42.7% N = 210), managing postoperative swelling (37.85 N = 190) and extracting for the medically compromised patients (37.2% N = 187). Students were not confident performing root separation (32.4% N = 163), bone removal (41.6% N = 209) or raising a flap (43.3% N = 218). Half of the students indicated, 'I did not encounter or have the chance to extract certain types of teeth', as a factor that lowers their confidence (50.1% N = 252).

CONCLUSION

Students were less confident performing third molar extraction, surgical extraction procedures, writing drug prescriptions and extraction for medically compromised patients. Further clinical exposure to such procedures is expected to raise students' confidence.

Blended learning compared to traditional learning for the acquisition of competencies in oral surgery by dental students: A randomized controlled trial

OBJECTIVE

To determine whether blended learning results in better educational outcomes compared to traditional learning in the acquisition of oral surgery technical skills for 4th-year undergraduate dental students.

MATERIALS AND METHODS

Seventy-three students participated in this two-arm parallel randomized controlled trial. Only students in the blended learning group had access to the online preparation platform for oral surgery practical work (PW) on a pig's jaw and to the debriefing. Kirkpatrick's four-level model was used to assess the educational outcomes directly after (levels 1 and 2) and 6 months later, after the start of the students' clinical activity (levels 3 and 4).

RESULTS

For level 1, higher global satisfaction scores were found for students in the blended learning compared to the traditional learning group (p = .002). For level 2, blended learning resulted in an increase in knowledge score (p < .01), comparable to that observed in the traditional learning group. For level 3, students in the blended group made more progress in 6 months than those in the traditional group in terms of feeling able to assess and perform anaesthesia (p = .040) and surgical tooth extraction (p = .043). No difference in level 4 was found for the 6-month clinical surgical activity between groups, but students in the blended group felt more able to assess and perform the surgical management of a failed extraction requiring bone removal (p = .044).

CONCLUSION

Blended learning for oral surgery PW had a positive impact on three of the four Kirkpatrick levels (level 1, 3 and 4). Efforts should focus on the procedures that are perceived as the most difficult.

An evaluation of oral surgery referrals to aid development of an integrated service in South West England

Introduction The number of oral surgery referrals from primary to secondary care has increased, resulting in longer waiting times. A study suggests two-thirds of patients referred to secondary care for oral surgery could be treated by dentists with enhanced skills.Aims To help inform the development of an integrated oral surgery service in South West England by assessing the proportion of inappropriate referrals to Bristol Dental Hospital.Methods A total of 100 non-consecutive written referrals to oral surgery were analysed. Multiple variables were collected, including the complexity of the treatment requested (Level 1, 2 or 3) and patient and referrer locations.Results In total, 94 referrals were included in the analysis: 17% were Level 1 complexity, 35% Level 2, and 48% Level 3. Additionally, 17% of referrals were inappropriate. Almost half (52%) (Levels 1 and 2) could have been treated in primary care. Many referrals had missing clinical details or unacceptable-quality radiographs.Conclusion An effective integrated oral surgery managed clinical network in South West England could reduce waiting times in secondary care and potentially improve patient experience. An electronic referral management system could also improve the quality of referral information.

A Comparison of Models for Teaching Suturing and Surgical Skills to Dental Students

Learning suturing skills is an important area of the undergraduate curriculum and ideally requires realistic and anatomically accurate surgical training models to prepare students for treating patients. Little is currently understood regarding which model might be perceived by students to be the best or which might most effectively facilitate their learning. The aim of this study was to compare four teaching models: a tabletop silicon dental model, a restricted access tabletop model, a traditional phantom head mounted model, and a Thiel cadaver. Student preferences were explored for each of the models. Following lecture and video-based teaching 67 fourth-year students attended a practical suturing teaching session followed by the second session more focused on the experience of cutting and suturing mucoperiosteal flaps. Forty-six students (67%) gave online anonymous feedback on the first session. The majority (95%) felt prepared to place a simple interrupted suture on a patient, and 88% felt confident to do so. Twenty-eight students (40%) provided feedback on the second session with 82% agreeing that they were prepared to cut a mucoperiosteal flap and 48% felt confident to do this for a patient. The cadaver model was rated as the best of the four models for both suturing and mucoperiosteal flap skills. These results support its use for teaching students to suturing and surgical skills. However, despite this teaching student-rated confidence to cut and suture flaps for a patient remains poor.

Perceived confidence of dental students and new graduates in performing tooth extractions-An exploratory study

INTRODUCTION

The ability to perform uncomplicated tooth extractions is a core clinical skill in undergraduate dental education. The aim of this study was to evaluate pre-extraction assessment skills of dental students and interns and explore their self-perceived confidence in performing these tooth extractions.

MATERIALS AND METHODS

A cross-sectional survey investigated the self-perceived confidence to perform the extraction for a set of eight expert-rated cases. The participants were dental students at three different stages, that is, in Years 4 and 5 of the Bachelor of Dental Surgery (BDS) programme and interns. The participants were asked to rate the difficulty level of each of the eight tooth extraction cases. The self-perceived confidence of the participants to perform extraction of each was also explored. Finally, the participants were asked to identify the main reason for the perceived lack of confidence.

RESULTS

A total of 199 responded to the survey, yielding a response rate of 94.7%. The effect of grade of extraction (the expert rating of cases) and stage of education on difficulty ratings was assessed using a mixed three stage of education × 4-grade ANOVA, with response (Difficult = 1, Easy = 0) as the dependent variable. The results showed that there was a correlation between the stage of education and grade of extraction and affected the self-perceived confidence of the participants. Gender showed a significant impact with females categorizing significantly more cases as difficult. A three-way contingency table (counts of each confidence-level response by stage of education by expert rating of cases) suggests a statistically significant association between the three factors. Most participants identified limited clinical exposure as the main reason for their perceived lack of confidence.

CONCLUSION

The findings of this study show that a majority of the participants were able to recognize tooth extraction cases which were beyond the scope of their training stage with females reporting a lower confidence. Increased clinical exposure to a wider range of tooth extraction cases with varying levels of difficulty may contribute to improving the self-confidence of undergraduate dental students and interns.

Measuring satisfaction with dental education among dentists and dental students in Croatia: A cross-sectional study

INTRODUCTION

The study aimed to determine satisfaction level with the quality of education among dental students and dentists in Croatia based on the acquired knowledge and clinical and soft skills.

MATERIALS AND METHODS

An online cross-sectional survey was conducted among 533 dentists and dental students. The questionnaire consisted of four sections with closed-ended questions. The first section included personal and professional data, whereas the second to fourth sections assessed satisfaction with learned basic dental, professional technical or clinal and interpersonal social or soft skills on a 5-point Likert scale. The data were analysed using the Mann-Whitney U-test and linear regression analysis. The significance level was set at .05.

RESULTS

When comparing satisfaction scores between dentists and dental students in terms of basic dental knowledge and skills learned, students showed higher satisfaction scores for the categories of "Emergency Medical Situations" (p = .005) and "Ergonomic Principles of Work" (p = .004). Dentists, on the other hand, showed higher satisfaction for the categories "Selection and use of local anaesthetics and local antibiotics" (p = .005, p = .026; respectively). For the type of technical skills from the different areas of dentistry, dentists were most satisfied with "Oral Surgery" (4.26 ± 0.85), while students were most satisfied with "Oral Medicine" (4.29 ± 0.89). Finally, when comparing satisfaction scores with social skills, dentists had lower satisfaction scores in all categories studied (p ≤ .05).

CONCLUSION

Dental students showed higher overall satisfaction than dentists. The most significant satisfaction was expressed in technical skills learned, and the most considerable dissatisfaction was recorded in the unmeasurable skills category focused on "Career management".

Evaluation of Self-Perceived Confidence and Competence in Oral Surgery among Final Year Undergraduate Students in Greece

OBJECTIVES

 Oral surgery is an integral part of dentistry that deals with the diagnosis and management of pathology of the mouth and jaws that requires surgical intervention. The aim of undergraduate studies in oral surgery is, upon graduation, to be confident and competent to treat without assistance surgical cases in the spectrum of general dentistry. This study evaluates the senior Greek dental students' self-confidence and self-perceived competence to undertake cases within the scope of oral surgery. Evaluation of clinical experience gathered during training and self-perceived confidence and competence in generic oral surgery skills is included.

MATERIALS AND METHODS

 The present study was a questionnaire survey conducted during the academic year 2018-2019. The questionnaire comprised three sections. Section 1 included demographic data and four closed-ended questions concerning numerical data about procedures that they had already performed or observed, section 2 included four questions concerning their self-perceived competence to perform basic surgical techniques, and section 3 included 10 clinical case scenarios.

RESULTS

 One hundred and twenty-seven students participated in the study. Among the basic surgical skills, students were most confident with suturing, and they were least confident with bone removal. Students from the Aristotle University of Thessaloniki (AUTH) tend to show higher level of confidence compared with students from the National and Kapodistrian University of Athens (NKUA) in most questions.

CONCLUSION

 Greek graduate dental students report moderate levels of self-confidence in oral surgery. A realistic approach in increasing self-confidence and competence in oral surgery would be the focus on preclinical training in generic elementary surgical skills, in combination with increased observational sessions of oral surgery procedures or outreach training.

Video-based online learning - a fast and easy way to teach your team about the oral surgery armamentarium

Dental trainees and scrub teams are often unfamiliar with the oral surgery armamentarium. After research of the subject, no appropriate simple training resources were found. We created a simple video vital to facilitate i-training, promote effectiveness of the surgical team, and minimise patient risks. We share our QR code for our free, simple reproducible educational video and a 'test yourself' style questionnaire.

Exodontia skills acquisition: Focusing on clinical teaching and training

OBJECTIVES

The aim of the research was to evaluate the traditional exodontia block course. The objectives were to explore the experiences and views of students, clinical teachers and dental practitioners of the various elements of the course curriculum.

METHODS

The study was a qualitative, participatory action research study using descriptive analysis. The study was conducted at a Dental Faculty in South Africa. A purposive sample of students, clinical teachers and dental practitioners were invited to participate. Focus group discussions were used to collect data which was analysed by an external coder.

RESULTS

The study population consisted of 15 undergraduate dentistry students, 10 clinical teachers and seven dental practitioners. Four broad themes with sub-themes emerged from the study. The main themes identified strengths and deficiencies of the traditional course and made recommendations for its improvement. The themes identified were i) Integration of knowledge and skills, ii) Block course structure, iii) Challenges associated, and iv) Recommendations for improvement. Overall, the participants were satisfied that the course met its objectives. The results pertaining to clinical skills acquisition identified that teaching the use of elevators and luxators in the course, and standardisation of terminology among all clinical teachers as areas requiring attention. Teaching and learning strategies such as community-based learning, peer learning, case reviews, feedback and visual technology were viewed by the student, as well as clinical teacher samples, as strategies most beneficial to clinical learning.

CONCLUSIONS

The review of the curriculum for exodontia skills acquisition and development, provided several benefits. Firstly, this research served as a quality assurance indicator. It further highlighted many teaching and learning strategies that would improve clinical skills development, reduce stress and anxiety, and support student learning. To a large extent, pertinent information was obtained that served to inform the subsequent redesigning of the course. The findings of the study augment the literature currently available on the best practice for exodontia skills acquisition and development and provide baseline information for the planning and redesign of related courses.

An investigation into oral surgery referrals in Wales

Introduction With waiting list time increasing in all specialties in the aftermath of the COVID-19 pandemic, it is vital to make sure that patients are receiving treatment in an appropriate setting. Most oral surgery undertaken in secondary care could be successfully carried out in a primary care setting by specialist oral surgeons or general dental practitioners (GDPs) with a special interest in oral surgery.Aim To investigate reasons for oral surgery referrals to secondary care.Method A pilot study looking at oral surgery referrals to secondary care was completed to identify key themes for referrals. From this, a questionnaire was designed. An electronic copy of the questionnaire was distributed to all GDPs registered with Health Education and Improvement Wales (HEIW) throughout Wales.Results Five main themes for referrals, which corresponded with the pilot study findings were: contract limitations; the perception that recently trained dentists do not have the practical skills to undertake oral surgery; limited communication between the oral and maxillofacial surgery departments and GDPs; limited practice resources; and GDPs being less risk averse in undertaking oral surgery in primary care.Outcome Following the results from this research, an All-Wales oral surgery referral handbook for general dental practitioners was published, hosted by HEIW, describing oral surgery patient care pathways. Formation of the Oral Surgery Managed Clinical Networks in Wales and the All-Wales Oral Surgery Strategic Advisory Forum will help further develop robust, sustainable patient care pathways, in collaboration with the health boards.

The Impact of a 1-Year COVID-19 Extension on Undergraduate Dentistry in Dundee: Final Year Students' Perspectives of Their Training in Oral Surgery

BACKGROUND

The detrimental impact of the COVID-19 pandemic on dental education prompted the Scottish Government to fund an additional year to the dental course to ensure that the students had the necessary clinical experience. The aim of the study was to better understand the final year student perceptions of this extension on their oral surgery experience at the University of Dundee.

METHODS

This mixed methods study consisted of an anonymous online questionnaire and a focus group.

RESULTS

Forty-one students (69.3%) completed the questionnaire and ten students participated in the focus group. Thirty-six (88.8%) students agreed that the oral surgery teaching provided sufficient knowledge to undertake independent practice. All of the students felt confident to carry out an extraction, and the majority of them (n = 40, 95%) felt confident to remove a retained root, however, their confidence with surgery was lower.

CONCLUSION

The extension gave the students sufficient experience in oral surgery to gain confidence in clinical skills and an appropriate level of knowledge in preparation for the next phase of their career. Most of the students agreed that the extension was necessary and beneficial. This cohort graduated with more oral surgery experience than any of the students did in the previous 4 years from Dundee and with experience that was comparable with the students at other schools in the pre-COVID-19 era.

An Educational Evaluation of Thiel Cadavers as a Model for Teaching Suturing Skills to Dental Students during the COVID-19 Pandemic

Suturing is an essential skill in dentistry and not one easily acquired. The COVID-19 pandemic prompted a change to the use of Thiel cadavers and online resources with the aim of improving skill acquisition using the best model available. This study investigated the utility of the Thiel cadaver for teaching suturing skills and the potential impact of the lockdown. Fifty-seven year 4 students attended a teaching session. Student views on this teaching were explored via a questionnaire survey and qualitative data collected from a focus group. Data were analysed using an inductive approach. The response rate was 53% (30 students) for the questionnaire with 9 students participating in the focus group. Independent feedback was provided by two members of the teaching staff. Online video resources were very well received by the students with 97% agreeing that it was useful preparation. Ninety percent (90%) thought that the cadaveric model was suitable for this teaching and realistic. Positive emergent themes from the focus group centred on the use of the cadaveric model and the positive and relaxed teaching and learning environment. Staff perceived this model as superior to previously used models. There were no reported negative pandemic impacts and the cadaver model was well received.

Mind the 'GAPP': a pre-graduation assessment of preparedness for practice amid a pandemic

Introduction 'Preparedness for practice' refers to a multifaceted concept, encompassing not only clinical skills, but also broader, non-clinical skills, such as communication and professionalism. Previous graduates have reported feeling less prepared for complex procedures, such as molar endodontics and surgical extractions. Dental students typically utilise their final year to refine their clinical skills, however, the COVID-19 pandemic has meant that newly qualified dentists will have had around six months where they have not performed clinical dentistry before beginning dental foundation training (DFT).

Aims This study aimed to explore final year students' self-reported preparedness for practice, identify areas of relative weakness that may influence future training needs and to highlight any perceived impact of the pandemic on final year experience and potential impact on DFT.

Materials and methods The current Graduate Assessment of Preparedness for Practice (GAPP) questionnaire was adapted for our specific research aims and piloted and the PreGAPP questionnaire distributed via the social media channels of dental school student societies. Analysis was carried out using IBM Statistical Package for the Social Sciences software using descriptive statistics and the Mann-Whitney U test for two unrelated variables.

Results Responses were received from final year students across all 16 UK dental schools. Students reported increased preparedness across domains in which they had the most experience; for example, providing preventative advice and administering local anaesthesia. Male students reported feeling significantly more prepared than female students, mature students significantly more than younger students, and students on four-year courses significantly more than traditional five-year courses. The COVID-19 pandemic was expected to have a major-to-severe impact on undergraduate experience and future DFT prospects.

Conclusion Dental graduates in the COVID-19 era may have significantly different training needs to those before them. Complex clinical procedures remain the areas where students feel they are least prepared for practice. The importance of a clinical passport to highlight current experience level to trainers, alongside the creation of a personal development plan at the beginning of DFT, will ensure that targeted and personalised training can be implemented where required.

Illustrates the perceived effect of the COVID-19 pandemic on final year students' preparedness for practice and the impact it may have on dental foundation training through quantitative and qualitative methods.

Highlights and explores the differences in the perceptions of preparedness for practice of final year students across sex, age and course length.

Explores various aspects of clinical supervision and assessment and reinforces the importance of appropriate student-staff ratios to ensure clinical learning is effective.

The impact of wrong-site surgery on dental undergraduate teaching: a survey of UK dental schools

INTRODUCTION

Patient safety within dental education is paramount. Wrong-site surgery (WSS) tooth extraction is not uncommon and is a significant never event (NE) in dentistry. This study aimed to explore dental schools' undergraduate experience of NEs, safety interventions implemented and the impact on student experience.

METHODS

All 16 UK dental schools were surveyed via email.

RESULTS

The response rate was 100%. A modified World Health Organization (WHO) checklist was used within institutions (94%) including pre-operative briefings and recording teeth on whiteboards (81%, respectively). Students were directly supervised performing extractions (63%) utilising a 1:4 staff: student ratio. WSS by students was reported in 69% of schools, with student experience being impacted by an increased patient safety focus.

DISCUSSION

This study demonstrated an increased utilisation of an adapted WHO checklist. Modification of practices to ensure patient safety was demonstrated at all schools, irrespective of student WSS occurrences. Institutions experiencing student NEs commonly implemented WHO checklists and recording teeth for extraction on whiteboards. Other strategies included direct staff supervision and pre-operative briefings.

CONCLUSION

UK dental schools have increased the emphasis on patient safety by the implementation of national healthcare models, for example WHO checklists and pre-operative briefings. These strategies both aim to improve communication and teamwork. Increased levels of staff supervision foster greater quality of teaching; however, this has resulted in reduced student clinical experience. A proposed minimum standard for undergraduate surgery is suggested to ensure safe and competent dental practitioners of the future.

Three-dimensional printed model of impacted third molar for surgical extraction training

OBJECTIVES

Extraction of impacted mandibular third molars is one of the most common surgical procedures performed at dental clinics; however effective training models for teaching oral surgery to dental students are limited. This study aimed to use three-dimension (3D) printing technology to develop an effective training model for impacted third molar extraction.

METHODS

The data for the 3D model were digitally processed using high-resolution computed tomography, and two common, but different patterns of impacted third molars were simulated using computer-aided design. Thereafter, the model was printed using the 3D-printing technology, and the efficiency of the 3D-printed model and an animal model (pig mandible) were compared using a five-point Likert scale by 35 oral surgeons in the oral surgery department and 208 students of stomatology in the internship stage.

RESULTS

The 3D-printed model consisted of three parts: a non-replaceable part (i.e., the body of the mandible and the teeth from the left first molar to the right first molar) and two replaceable parts (i.e., the part of the ascending ramus of the mandible, as well as the second and third molars). It was covered with a layer of rubber-like material to simulate the gingiva. For the comparison between the 3D-printed and animal models, a total of 205 questionnaires were collected. Both oral surgeons and students agreed that the 3D-printed model was better than the animal model in terms of total value and the anatomy of the bone and teeth, simulating the surgical procedure (p < 0.05), while the two models achieved similar results for haptic feedback of the soft tissue (p > 0.05).

CONCLUSIONS

The 3D-printed model is realistic and effective for learning impacted third molar extraction and received positive feedback from students and oral surgeons. This model can significantly improve the pre-clinical skill training of dental students.

An investigation into the oral surgery curriculum and undergraduate experience in a sample of DFT's in the UK

AIM

There is conflicting evidence concerning the ability of recent graduates to meet the standards required in exodontia to be independent practitioners. In particular, there is a lack of confidence in surgical extractions. This study evaluated Foundation Trainee's confidence levels in their oral surgery experience and the teaching of oral surgery in UK dental schools.

MATERIALS AND METHODS

Two separate studies were carried out, and the first was a survey to all foundation trainees in the Yorkshire and Humber Deanary in 2019 which analysed their oral surgery experience and confidence levels. The second study surveyed all Dental Schools in the UK with regard to their contact hours, assessment methods, instruments taught and number of extractions in oral surgery for their undergraduate programmes.

RESULTS

There was a response rate of 52% for the foundation trainees which showed that they were confident in performing non-surgical extractions but lacked confidence with surgical extractions. There was a positive correlation between the amount of undergraduate experience and confidence levels in exodontia. The second survey which had a response rate of 71% showed variations in the numbers of hours taught for oral surgery, instruments taught and assessment methods, with the structured clinical operative test used more commonly. On average, 41 non-surgical extractions were performed by students before graduation and two surgical extractions.

CONCLUSION

There is a need to identify how oral surgery teaching can be improved in UK dental schools to ensure that foundation trainees are more confident and competent in both surgical and non-surgical exodontia. In addition, teaching and assessment methods need to be developed to reflect such requirements.

Self-confidence in oral and maxillofacial surgery: a cross-sectional study of undergraduate dental students at Kuwait University

BACKGROUND

To evaluate the self-confidence of undergraduate dental students in relation to oral and maxillofacial surgery (OMFS) to assess the teaching curriculum at Kuwait University using a validated questionnaire originally developed by the Association of British Academic Oral Maxillofacial Surgeons (ABAOMS).

METHODS

A cross-sectional survey of sixth year (n = 20) and seventh year (n = 19) dentistry students was conducted by Kuwait University Faculty of Dentistry between the 1st and 15th of May 2020. The ABAOMS questionnaire is composed of 17 questions assessing various areas of the undergraduate OMFS curriculum. The response options to the questionnaire utilised a Likert scale. Independent sample t-tests were performed to assess the difference in responses between the 2 year groups. Spearman's rho correlations were calculated to measure the strength of association between confidence in all aspects of surgical and forceps exodontia.

RESULTS

A total of 39 questionnaires were completed by the students. The majority of students expressed feelings of confidence that they have enough knowledge to undertake independent practice (61%). General aspects of the questionnaire were answered favourably except for surgical extraction of teeth, in which both classes reported a lower level of self-confidence.

CONCLUSIONS

The ABAOMS survey revealed the students' self-confidence in undertaking independent practice and preforming basic oral surgery procedures. Students felt comfortable with exodontia using forceps and elevators, root removal, managing acute pericoronitis, managing haemorrhage from a socket, assessing impacted teeth, and recognising the clinical features of potentially malignant and malignant lesions of the oral cavity. They reported a lower level of confidence in performing surgical procedures.

Preparing dental students for independent practice: a scoping review of methods and trends in undergraduate clinical skills teaching in the UK and Ireland

Introduction The governing bodies for dentistry in the UK and Ireland require dentists, at graduation, to possess the knowledge, skills and attributes which enable them to practise safely, without supervision. The means by which dental schools achieve this may differ and may undergo modification in response to changes in the expectations of governing bodies and challenges within the teaching environment. It is therefore important to identify which of these approaches works well and to disseminate good practice described in the literature.Objectives To use a scoping review to identify from the published literature the methods used to teach clinical dental skills, including innovations, motivations for changes, and factors affecting the delivery and quality of teaching.Method Scoping review methodology was used to select and analyse 57 articles published between 2008 and 2018.Results Innovations in didactic teaching were facilitated by advances in IT and development of virtual learning environments, which promoted independent, self-directed learning. Pre-clinical practical teaching took place in clinical techniques laboratories utilising mannequin heads, with a minority of dental schools using virtual reality simulators in addition. Clinical experience was gained mainly in multi-disciplinary clinics and offsite outreach teaching centres. Insufficient numbers of suitable patients, increasing student numbers and a fall in teaching staff contributed to a reported reduction in clinical experience of certain treatments.Conclusions Contemporary clinical dental skills teaching produces new graduates who possess excellent theoretical knowledge, are prepared and confident in basic clinical skills, but are lacking in experience of complex treatments which may result in a reduced preparedness for independent practice.

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.

How is paediatric dentistry taught? A survey to evaluate undergraduate dental teaching in dental schools in the United Kingdom

INTRODUCTION

The quality assurance of undergraduate dental education in the UK is regulated by the General Dental Council who describe the competencies expected of the newly qualified dentist or "safe beginner." Whilst the literature has explored the level of undergraduate training in a number of dental specialties within the UK, there is a paucity of information on the UK curriculum for undergraduate paediatric dental teaching.

AIMS

This study aimed to assess the undergraduate teaching of paediatric dentistry within dental schools in the UK.

METHODS

An anonymous questionnaire was distributed to all 16 UK dental schools via email.

RESULTS

Twelve questionnaires were completed, giving a response rate of 75%. First exposure to both academic teaching and clinical teaching in paediatric dentistry ranged from years 1-4. Whilst there were broad similarities between units with regard to core components of the curricula, there were notable differences including the teaching of regenerative endodontics (75%) and the use of the titanium trauma splint (58%). Silver diamine fluoride was only used clinically in one unit (8%), and non-vital pulpotomy was taught by two units (16%). There was also considerable heterogeneity in assessment methods between universities.

CONCLUSION

The undergraduate paediatric dental curriculum is broadly similar between UK dental schools. However, there are discrepancies in assessment methods and the teaching of new advances.

3D Technology Development and Dental Education: What Topics Are Best Suited for 3D Learning Resources?

The aim of this study is to identify topics (knowledge and skills) from the dental curricula that would benefit from having a 3D learning resource using an exploratory sequential design method. The first phase targeted stakeholders from a Scottish dental school. Seven focus groups and three interviews disclosed 97 suitable topics for 3D technology development. These results were used to construct a survey that was sent to final year dental students, newly dental graduates and academics from three Scottish universities. The survey asked participants to rank each item based on the perceived benefit that a 3D learning resource would have for dental education. Results revealed that detailed anatomy of the temporomandibular joint, dental anaesthesiology, dental clinical skills techniques, dental occlusion and mandibular functioning were top priorities. Gender differences only appeared in relation to ‘Extraction techniques: movements and force’ (p < 0.05), this topic was considered to be more beneficial by females than by males. No statistical difference was found when comparing results of graduates with undergraduates. These results serve as a starting point when developing a new 3D technology tool for dental education, considering users demands and perceived needs has the potential to benefit dental students and dental education directly.

Assessing the Quality of Life of Dental Students by using the WHOQOL-BREF Scale

Background/Aim: The study aimed to evaluate the quality of life (QOL) of dental students in a private dental school with the use of the WHOQOLBREF scale.

Material and Methods: The Turkish version of the WHOQOLBREF questionnaire was used to assess the QOL of dental students in their first (n=73), second (n=58), third (n=55), fourth (n=47) and fifth (n=48) years with a mean age of 22,15 ± 1,89 between January and February 2019. The items were organized in four domains (physical and psychological health, social relations and the environment) with most response options on a five-point Likert-type scale. Descriptive statistics were computed and the P-value of <0,05 was set as statistically significant.

Results: The sample was composed of 281 students, corresponding to an overall response rate of 90,6%. The overall QOL was rated good by the responding students. The difference between male and female respondents’ answers was not statistically significant. Mean scores were lowest for the psychological domain and were highest for the physical health domain. The psychological domain of the first-year participants was significantly better than that of fourth-year participants. Furthermore, the overall quality of life was highest for first-year students’ compared to all years.

Conclusions: Although the overall QOL for students in the present study was generally acceptable, the psychological domain was the lowest in dental students. A positive relationship was observed between students’ satisfaction with health and their QOL. Dental schools should focus on reorganizing the curriculum and provide support for dental students, especially for those in their fourth-year.

The perception of the educational environment in multinational students from a dental medicine faculty in Romania

INTRODUCTION

Dental education comes with important challenges for the faculties as well as for the students. Its evolving nature leads to the constant adoption of new practices and techniques. Thus, the learning environment is in continuous development. This study aimed to describe a sample of senior undergraduate student's perceptions of their learning environment.

METHODS

Students (both Romanian and international) enrolled in the 6th year at the Faculty of Dental Medicine from a Romanian University completed the Dundee Ready Education Environment Measure (DREEM). The scale measures students' perceptions of the education environment using five domains: Learning, Teaching, Academic self-perception, Atmosphere and Social self-perception. Data were analysed using descriptive statistics, non-parametric and univariate statistics for group comparison.

RESULTS

Participants (N = 259, Romanian = 111, International = 148) had a good perception of their learning environment, with a total DREEM score of 117.82 out of 200. Still, they had a lower score in the areas of Academic and Social self-perception. The international students had more negative perceptions of the learning environment compared to the Romanian ones. The French-speaking students had the lowest scores on most of the areas.

CONCLUSIONS

Although the perception of medical dentistry education is generally good, international students are not as satisfied with the learning environment. The students' experiences could be improved by providing them with more social support. Also, it is important to address the needs of international students in order to create a more satisfying environment for them.

A city-wide survey of dental students' opinions on undergraduate oral surgery teaching

PURPOSE

This study aimed to carry out a city-wide survey to evaluate undergraduate students' opinions on their oral surgery training by measuring their self-confidence.

MATERIALS AND METHODS

A cross-sectional survey of 383 3rd year, 412 4th year and 363 5th year undergraduate dental students from six dental schools in Istanbul with a mean age of 22.73 ± 1.55 was conducted towards the end of the academic year. A web link to the questionnaire was sent to the contact person at the participating dental schools. The questionnaires were anonymously evaluated. Descriptive statistics were calculated, and Chi-square tests were performed to examine the data. A P-value of <.05 was considered to be statistically significant.

RESULTS

In total, 1158 responses were returned, representing 67% of the overall students in the 2018-2019 academic year. The male respondents were significantly more self-confident than females in the general aspects of surgical skills. More than half of the respondents (53%) felt confident in oral surgery knowledge to undertake independent practice. Although 5th year respondents felt more confident in the general aspect of the questionnaire, their ability of differentiation of odontogenic and non-odontogenic pain was lower than their counterparts. The majority (86%) of the participants disagreed that the only knowledge required for oral surgery was that of tooth and jaw anatomy.

CONCLUSION

This survey revealed perceived confidence in tooth and retained root extraction. The male respondents were found to be more self-confident. There is a need for improvement in surgical skills, recognition of malignancies and differentiation of the origin of the pain.

The Anatomical Society's Core Anatomy Syllabus for Dental Undergraduates

The Anatomical Society has developed a series of learning outcomes in consultation with dentists, dental educators and anatomists delivering anatomical content to undergraduate dental students. A modified Delphi methodology was adopted to select experts within the field that would recommend core anatomical content in undergraduate dental programmes throughout the UK. Utilising the extensive learning outcomes from two UK Dental Schools, and neuroanatomy learning outcomes that remained outside the Anatomical Society's Core Gross Anatomy Syllabus for Medical Students, a modified Delphi technique was utilised to develop dental anatomical learning outcomes relevant to dental graduates. The Delphi panel consisted of 62 individuals (n = 62) from a wide pool of educators associated with the majority of undergraduate dental schools in the UK, representing a broad spectrum of UK Higher Education Institutions. The output from this study was 147 anatomical learning outcomes deemed to be applicable to all dental undergraduate programmes in the UK. The new recommended core anatomy syllabus for dental undergraduates, grouped into body regions, offers a comprehensive anatomical framework with which to scaffold clinical practice. The syllabus, presented as a set of learning outcomes, may be used in a variety of pedagogic situations, including where anatomy teaching exists within an integrated dental curriculum (both horizontally in the basic sciences part of the curriculum and vertically within the clinical years).

Students' perspectives on undergraduate oral surgery education

PURPOSE

This study evaluated students' perceptions of their self-confidence regarding aspects of their undergraduate oral and maxillofacial surgical training. It further aimed to develop a reliable Turkish version of the questionnaire originally developed by the Association of British Academic Oral Maxillofacial Surgeons (ABAOMS) Education Committee.

METHODS

A cross-sectional survey of 40 fourth-year and 47 fifth-year dentistry students of Yeditepe University Faculty of Dentistry in Turkey with a mean age of 23.30 ± 1.50 was conducted in January and February 2018. The ABAOMS questionnaire was adapted to the Turkish language and culture. The items were organized in five domains (general information, self-confidence in oral surgery, role of outreach, anatomy knowledge in relation to oral surgery, and career aspirations) with most response options on a five-point Likert-type scale. Reliability was assessed through an internal consistency analysis and a test-retest approach. Descriptive statistics, independent samples t-tests, and Chi-squared for contingency tests were used to examine the data.

RESULTS

Cronbach's alpha coefficient on the questionnaire was 0.89. The responses reflected general agreement among the respondents. Females were significantly more self-confident than males. Although the fifth-year respondents were more self-confident than the fourth-year respondents on items regarding anatomy knowledge, fourth-year respondents were more self confident in forceps extractions. Other than that no major differences in self-confidence were found between the two groups.

CONCLUSION

Though self-confidence was high regarding extraction of teeth and retained roots, the participants of this study lacked self-confidence in performing surgical extractions and its related procedures, recognition of malignancies, and ability to differentiate between pain of odontogenic or non-odontogenic origin. Female students were relatively more self-confident. Teaching should focus on practical applications that support students' sense of self-confidence in their abilities. The Turkish version of the questionnaire was a reliable instrument.

Tier 2: A Warm welcome or a Cold Reality?

Since the introduction of the 2006 NHS dental contract, various waiting list initiatives and the subsequent release of NHS commissioning guidance for dental services, there has been a remarkable and rapid shift towards the provision of intermediate services within the profession. the complexity surrounding those non-specialist providers working within these services has lead to much confusion and the further development of competencies required to work within these settings. this paper focuses on explaining and exploring the topics that arise from an area that has attracted much discussion and debate.

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.

The undergraduate preparation of dentists: Confidence levels of final year dental students at the School of Dentistry in Cardiff

Objective To investigate the self-reported confidence and preparedness of final year undergraduate students in undertaking a range of clinical procedures.Methods A questionnaire was distributed to final year dental students at Cardiff University, six months prior to graduation. Respondents rated their confidence in undertaking 39 clinical procedures using a 5-point scale (1 = can undertake on own with confidence, 5 = unable to undertake). Students also responded yes/no to experiencing four difficulties and to three statements about general preparedness.Results 71% (N = 51) responded of which 55% (N = 28) were female. Over half reported being 'anxious that the supervisor was not helping enough' (57%) and 'relying heavily on supervisor for help' (53%). Eighty percent 'felt unprepared for the clinical work presented' and gender differences were most notable here (male: 65% N = 33; females: 93% N = 47). Mean confidence scores were calculated for each clinical procedure (1 = lowest; 5 = highest). Confidence was highest in performing 'simple scale' and 'fissure sealant' (mean-score = 5). Lowest scores were reported for 'surgical extractions involving a flap (mean-score = 2.28)', 'simple surgical procedures' (mean-score = 2.58) and the 'design/fit/adjustment of orthodontic appliances' (mean-score = 2.88).Conclusions As expected complex procedures that were least practised scored the lowest in overall mean confidence. Gender differences were noted in self-reported confidence for carrying out treatment unsupervised and feeling unprepared for clinical work.

A national follow-up survey of UK graduates opinion of undergraduate oral surgery teaching

INTRODUCTION

A national follow-up survey was undertaken to determine whether dental graduates from 2009 perceived that their undergraduate oral surgery education had equipped them for general dental practice 4 years after graduating.

MATERIALS AND METHODS

Graduates from the same 13 United Kingdom dental schools who had taken part in the original survey were invited to take part in this follow-up online survey. Their contact details were identified via the general dental council register, social media and alumni groups.

RESULTS

In total, 161 responded (2009b) which represents 16% of the graduates of the original survey in 2009a. A similar percentage of these respondents perceived that the teaching in oral surgery had given them sufficient knowledge to undertake independent practice (83% and 79% in 2009a and 2009b, respectively). Most respondents (99% in both years) reported confidence in undertaking simple forceps exodontia. Confidence in surgical exodontia was poor in both surveys, but one area that appeared improved in the follow-up related to the sectioning of teeth (84% in 2009b compared with 49% in 2009a). Areas of weakness identified in 2009 were reported to be improved in the follow-up.

CONCLUSION

This follow-up survey supports the findings of the original survey. Future longitudinal studies would allow institutions to identify possible weaknesses in their curriculum and to track the career development of their graduates and facilitate robust data collection.

Tooth extraction education at dental schools across Europe

Objectives/Aims:

To explore students’ opinion about theoretical and clinical training in tooth extraction at different European dental schools.

Materials and Methods:

An online questionnaire, containing 36 dichotomous, multiple choice and Likert scale rating questions, was distributed among students of 56 different dental schools. After excluding schools where <20 students responded, 656 questionnaires from 23 dental schools remained for statistical analysis.

Results:

Dental schools showed a wide variation in the initial practical teaching of tooth extraction, from years 2 to 6. Several schools used a preclinical training model, and most students considered this useful. Some students considered their knowledge about forceps and elevators insufficient (6–60%), as well as their preparation for complications (5–60%). Students usually had received education in forceps and elevator techniques. Inclusion of (non)surgical removal of retained roots and surgical removal of third molars showed a wide variety between dental schools. Less than half of the students reported education in surgical removal of impacted teeth. Students from four of the 23 dental schools felt insufficiently prepared in tooth extraction (Likert scale ⩽3).

Conclusion:

There is a wide variation among European dental schools in teaching programs of tooth extraction and the rating of these programs by students.

Management of impacted wisdom teeth: teaching of undergraduate students in UK dental schools

INTRODUCTION

Wisdom tooth removal is one of the most common oral surgical procedures performed across the world. The aim of this study was to gauge the teaching and training of impacted wisdom teeth in undergraduate dental programmes across the UK. The objectives were to identify consistencies and variations in theoretical instructions and clinical training as well as approaches to management of impacted wisdom teeth.

METHODS

This was a cross-sectional survey utilising an online questionnaire. A purposefully designed pro forma with open- as well as closed-ended questions was used. The questionnaire was hosted online on the school's blackboard academic suite (Emily). Prior to conducting the study, approval was gained from the Research and Ethics Committee, and all the ethical principles pertaining to data protection were strictly followed. E-mail invitations were sent to oral surgery leads in all dental schools in the UK. The participants were provided with an information sheet, and an informed consent was obtained. The participants were invited by e-mail to complete the questionnaire online voluntarily.

RESULTS

A total of 16 dental schools offering an undergraduate course in dentistry in the UK, 13 responded positively. (response rate = 81.25%). In majority of dental schools, this subject is taught in the 4th and 5th years. A pre-clinical competency on phantom heads is a requirement in six schools, whilst only one school requires the students to pass a clinical competency. The clinical exposure of students to wisdom tooth surgery is quite variable. Although the dental schools are fairly consistent in their teaching with regard to the indications for surgical intervention, diagnostic/treatment modalities as well as the post-operative care, interesting variations were also observed.

CONCLUSIONS

This study, perhaps the first of its kind, provides useful insights into management of impacted wisdom teeth, as taught in the undergraduate dental programmes across the UK.