A Tale of Two Teaching Methods: Students' Clinical Perspectives on Administering Dental Local Anesthetics

Undergraduate dental students' perceptions of dental pain in children - A grounded theory study

INTRODUCTION

There is an underuse of pain management strategies in dental care for children, possibly owing to perceived stress and discomfort when treating children, which has also been reported by dental students. The aim of this study was to explore how undergraduate dental students experience and understand pain related to dental treatment in children.

MATERIALS AND METHODS

Interviews were held with 21 Swedish dental students, from 3 dental schools, all in their final 2 years of education. The interviews were transcribed verbatim and analysed according to Grounded Theory.

RESULTS

A core category, seeking guidance to avoid pain, was identified and related to 6 conceptual categories. The students used different strategies to manage pain prevention in child dentistry and to become skilled dentists. They described high levels of stress, as well as having high expectations on themselves when treating children. The stress led to a surface learning approach, something the students were not fully aware of.

CONCLUSION

All children should have the right to be ensured optimal pain prevention in dental care. The basis for this is laid during undergraduate education. Thus, pain management in child dentistry is an area in need of special attention in this respect. The academic staff has an important role in supporting their students in their process to gain an identity as professional dentists. To ensure that students incorporate an understanding of the importance of pain prevention when treating children there is a need to create more integration between theory and clinical training in undergraduate education.

Evaluation of the efficacy of a simulation model used in oral and maxillofacial surgery education

BACKGROUND

The traditional teaching methods of dental education are gradually being replaced with futuristic education methods based on the usage of educational tools such as mannequin-based simulation models and virtual reality. However, the effectiveness of mannequin-based simulation models as a learning method in the field of oral surgery remains unclear. This study aims to investigate the efficacy of training on a tooth extraction model (TEM) in view of undergraduate dental students' experience and perception of their education.

METHODS

A quasi-experimental trial was implemented with two consecutive year classes, totaling 136 students at the Dentistry Faculty of Altinbas University, Turkiye. Two cohorts were created from dental students in the classes of 2023 and 2022 graduates. Cohort 1 (n = 71) received 14 h of theoretical education followed by 10 h of preclinical education on TEM. Cohort 2 (n = 65) received only 14 h of theoretical education. An anonymous questionnaire was prepared with four main sections including the preferences of learning style, participants' perceptions of the preclinical training methods, the students' competency and free text comments. Students' opinions were quantified with both 7-point Likert scales and thematic analysis. Anxiety levels were measured with the interval scale of anxiety response (ISAR). Descriptive statistics, inferential statistical and thematic analyses were conducted according to survey responses. Student characteristics were summarized and compared for two cohorts using a t-test. For all statistical analyses, the significance level was set atP ≤ 0.05.

RESULT

Cohort 1 was more comfortable with sequential motions performed with the forceps (P = 0.033) and felt more ready for their first clinical tooth extraction experience (P = 0.028). Cohort 2 showed a significantly higher preference for textbooks among supplementary materials (P = 0.04); however, they tended to exhibit lower self-confidence and higher anxiety levels, though without any statistical significance (P > 0.05).

CONCLUSION

It is clear that the students who have yet to start seeing patients benefit from increased practice with training models, which adequately reflect and represent real-life situations encountered in everyday practice.

Origami-Based Haptic Syringe for Local Anesthesia Simulator

Although medical simulators have benefited from the use of haptics and virtual reality (VR) for decades, the former has become the bottleneck in producing a low-cost, compact, and accurate training experience. This is particularly the case for the inferior alveolar nerve block (IANB) procedure in dentistry, which is one of the most difficult motor skills to acquire. As existing works are still oversimplified or overcomplicated for practical deployment, we introduce an origami-based haptic syringe interface for IANB local anesthesia training. By harnessing the versatile mechanical tunability of the Kresling origami pattern, our interface simulated the tactile experience of the plunger while injecting the anesthetic solution. We present the design, development, and characterization process, as well as a preliminary usability study. The force profile generated by the syringe interface is perceptually similar with that of the Carpule syringe. The usability study suggests that the haptic syringe significantly improves the IANB training simulation and its potential to be utilized in several other medical training/simulation applications.

A comparison of simulation and traditional local anesthesia teaching methods among dental hygiene students

BACKGROUND

The COVID-19 pandemic forced dental educators to quickly modify the teaching-learning platform without testing outcomes of alternative teaching methods prior to implementation. One critical course affected was the teaching of local anesthesia (LA) that moved from practicing injections using the traditional student-to-student method to the simulation model using manikins.

PURPOSE

This study compared two LA teaching methods (student-to-student versus simulation) in two consecutive cohorts before and during the pandemic to assess differences in students' skill level and self-confidence.

METHODS

This quasi-experimental study recruited a convenience sample of dental hygiene students at the University of Minnesota during 2020 and 2021. Consent was collected prior to student-to-student injection practice and survey distribution. Data collected were clinical and summative clinical assessments to determine LA skill level, and student surveys to assess self-confidence. Analyses included descriptive statistics, linear models within and between cohorts, and inductive analysis for qualitative survey responses.

RESULTS

Fifty of 57 students (88%) completed the survey, and 54 (95%) consented access to their clinical assessments. Skill level was significantly higher for the simulation cohort compared to the student-to-student cohort on the LA summative clinical assessment (59.0 vs. 55.6, p = 0.004). No differences were found in self-confidence between cohorts. A positive association was found between students' self-confidence and skill levels for both cohorts, but only student-to-student cohort results were statistically significant (student-to-student: r = 0.44, p = 0.02; simulation: r = 0.24, p = 0.26).

CONCLUSION

Results support incorporating simulation manikin teaching methods for LA with a student-to-student partner component.

A pilot study of local anesthesia training using a mixed‐reality haptic fidelity model

PURPOSE/OBJECTIVES

One of the most difficult local anesthetic blocks to master in dentistry is the inferior alveolar nerve block (IANB). Historically, dental students have practiced local anesthesia on one another. At the University of Colorado, these practice sessions have been limited to one required laboratory session. The predictability and confidence of student IANB success have not been high in the past. Therefore, the objective of this study was to investigate the impact of a novel IANB simulator, built on a three dimensional (3D)-printed mixed-reality haptic model, for second-year dental students to practice on prior to their laboratory session.

METHODS

Thirty-nine student participants volunteered to practice with the IANB simulator. Participants were divided into two groups, Group A and Group B. Self-reported confidence and injection-specific accuracy were measured during IANB simulator practice and the laboratory session. During lab, partner numbness was assessed as a measure of IANB success. Groups A (n = 20) and B (n = 19) practiced with the simulator before and after laboratory, respectively. Injection domains were not assessed during Group B's practice with the IANB simulator.

RESULTS

Self-reported confidence increased for both groups (p < 0.001). However, for anesthetic success, Group A exhibited significantly greater success (52.6%) than Group B (17.6%) (p = 0.029).

CONCLUSION

Self-reported confidence in performing an IANB improved and higher anesthetic success was achieved for Group A. Further investigation is necessary to determine the long-term impact of using the IANB simulator in dental education.

Evaluating the effectiveness of a virtual reality simulation for preclinical local anaesthesia dental education

INTRODUCTION

Traditional manikin training has limitations that virtual reality can address. This study investigated the effectiveness of two part-task training simulation methods, a virtual reality (VR Sim) vs a plastic manikin (PM Sim), on learning outcomes for local anaesthesia skills for second-year pre-clinical dental students.

METHODS

In an experimental study, 58 second-year students were randomly assigned to one of two groups, VR Sim or PM Sim. Both groups completed the same pre-post survey. The VR Sim group practiced with a VR simulation, completed a built-in treatment test and a transfer test with a live person, and was evaluated by an expert teaching assistant (TA) with a rubric. The PM Sim group practiced with a plastic manikin and completed a treatment test on the same manikin evaluated by a TA, followed by the same transfer test with a live person and evaluated by a TA with a rubric.

RESULTS

Covering knowledge and skills in the delivery of local anaesthesia, mean final transfer test scores were statistically significantly higher for the PM Sim compared to VR Sim, F(1, 57) = 9.719, p = .003 with effect size, η2 p  = 0.148. Scores on respective treatment tests were similar to final transfer test scores for each group suggesting differences were localised to the practice methods. Pre-survey results indicated participants had low prior experience with VR technology.

CONCLUSION

Whilst outcomes showed higher results for plastic manikin tutor training over the VR training method, they are complementary. As students practice more with the technology and the VR simulation they may improve further. Likewise, as the technology for haptics with VR improves beyond hand controllers so may the experience and learning of this skill for students.

Cross-Sectional Study on the Comparative Assessment of Mandibular Anesthesia (Inferior Alveolar Nerve Blockage) Manual Skills Shaping among Dentists on Plastic and Biomaterial Models

Background: Providing regional anesthesia skills shaping remains relevant nowadays. A number of studies show that dentists have difficulties with these working independently. The study aim is the comparative analysis of the results of mandibular anesthesia (IANB) manual-skills shaping among dentists on plastic models and cadavers. Methods: In total, 999 participants were training in the skills of mandibular anesthesia from 2017 to 2021. The participants were divided in a random way into two groups: 700 participants were trained on plastic models, and 299 were trained on the cadaver material. After a lecture on the clinical and anatomical guidelines for IANB, a demonstration of the technique was provided, with subsequent testing of the injection technique. Satisfaction with the aspects of the training was assessed using the Likert scale. Results: the analysis of average values showed that participants from the group in which the manual skills were practiced on cadavers were more satisfied with the main aspects of the training, according to the sum of the main criteria of the modified scale. Conclusions: The important advantages of cadaver educational technology are that the sensations of tissue resistance are identical to natural ones, the individuality of each object, and the possibility of the visual study of the anesthesia technique, by dissection of the needle course and the location of the anesthetic depot.

Analysis of Confidence Levels and Application Success Rates in Simulator-Based Dental Anesthesia Education Among Undergraduate Dental Students

PURPOSE

We investigated the confidence levels of undergraduate dental students who used dental anesthesia simulators and patient reports of undergraduate dental students' confidence levels in delivering anesthesia injections, in comparison with undergraduate dental students who did not use dental anesthesia simulators. We also investigated application success rates.

MATERIALS AND METHODS

The study was carried out in the dental anesthesia simulator laboratory and in the faculty clinics of the Faculty of Dentistry of Ankara University. One-hundred volunteer undergraduate dental students who had completed the third year of the 5-year undergraduate education program and who had not performed local anesthesia on a patient participated in the study. Seventy and 30 undergraduate dental students did and did not receive training on dental anesthesia simulators, respectively, before performing procedures on patients. Using a questionnaire, undergraduate dental students conducted a self-assessment of preparedness and confidence, educators assessed the application success rates, and patients evaluated the undergraduate dental students' confidence levels.

RESULTS

Patients reported that the undergraduate dental students trained using the simulators were more confident. The self-reported confidence and success rates in providing anesthesia did not differ significantly as per the use of dental anesthesia simulators.

CONCLUSIONS

Although use of simulators did not enhance self-reported confidence, patients reported that undergraduate dental students who used the simulators were more confident and reassuring. Use of simulators did not increase the undergraduate dental students' self-reported confidence or preparedness. However, we recommend using such simulators to overcome the ethical and moral issues associated with other teaching methods.

Pedagogical development in local anaesthetic training in paediatric dentistry using virtual reality simulator

PURPOSE

With the advancements in technology, dental pedagogy has also evolved, and new learning technologies have emerged. Virtual reality (VR) as an education tool in dentistry is underutilised. VR as an adjunct in local anaesthesia (LA) teaching in paediatric dentistry has not been investigated. The study aimed to investigate dental student's perception of dental LA VR simulation on a paediatric patient and to determine whether this can improve students learning experience.

METHODS

Seventy-one students participated in a self-administered questionnaire before and after the use of dental LA VR simulator. Descriptive analysis was performed to determine the perceptions of experience gained through VR. The data were tabulated, graphed, and analysed using SPSS and GraphPad Prism software.

RESULTS

The study noted that 89.9% of participants perceived that it would improve their LA skills. After using dental LA VR, 83.1% of participants experienced more engaged in the learning activity, and 55.0% of participants agreed/strongly agreed that it improved their understanding of anatomical landmarks. Around 56.4% of participants agreed/strongly agreed that it added value compared with traditional LA teaching methods.

CONCLUSION

It can be concluded that the use of VR simulation can enhance students engagement and learning experience in paediatric dentistry settings and can be used as an additional means of LA training.