Dental Sleep Medicine Education Amongst Accredited Orthodontic Programmes in Thailand

BACKGROUND

Dental sleep medicine education (DSME) should be emphasised in postgraduate orthodontic training; however, there appears to be no clear guideline for its implementation into the curriculum.

OBJECTIVE

The aim was to investigate the current status of DSME as well as its feasibility and implementation in postgraduate orthodontic programmes.

METHODS

A structured interview with predetermined response options was chosen as a data collection method to gather relevant information from representatives of all accredited postgraduate orthodontic programmes in Thailand. These interviews were conducted online via the Cisco Webex Meeting platform. A combination of data analysis techniques was employed to achieve a thorough comprehension of the research findings, including descriptive statistics, quantitative content analysis, thematic analysis, and alignment analysis.

RESULTS

All participating programmes reported the inclusion of DSME in their curricula. A didactic approach was adopted by all programmes. However, only 2 out of 7 programmes offered clinical sessions for their students. Several challenges in implementing DSME within orthodontic programmes were identified, including a shortage of expertise and limited patient access. The participants also suggested that knowledge and resource sharing amongst institutions could serve as a potential solution to enhance the feasibility of DSME.

CONCLUSIONS

This research highlighted the significant disparities and inadequacy of DSME within postgraduate orthodontic programmes in Thailand due to various challenges. Consequently, there is a compelling need to place greater emphasis on DSME and establish a national-level standardisation within orthodontic programmes. This effort is essential for enhancing the awareness and competency of orthodontists in the field of DSME.

[Need for dentists with post-graduate training in endodontology according to members of the Swiss Dental Association]

This questionary-based study was financed by the Swiss Society for Endodontology (SSE). At the time of this survey (2022) there were merely 20 board-certified endodontists in Switzerland, and 239 other members of the SSE, i.e. general practitioners with some form of post-graduate endodontic training or a keen interest in the field. The aim of this investigation was to evaluate the need for a higher number of trained endodontists as viewed by the general population of dentists in Switzerland. An electronic questionary in either German, French, or Italian was sent to all 4072 active members of the Swiss Dental Association (SSO). The questionnaire focused on the background of the surveyed dentists, their willingness to refer endodontic cases to a specialist or colleague with a focus on endodontics, their propensity to do so, and their perceived need for endodontists in their region. The response rate was 21%, and was similar between the different regions and cantons. Seventy-nine (9%) of the dentists participating in the survey were members of the SSE, while 16 (2%) were board-certified. Merely 7% of the participants received endodontic referrals themselves, while 81% referred cases in some instances. However, only 13% of participants referred endodontic cases always or regularly. The main reason for not referring was the belief by the surveyed dentists that they could perform the endodontic treatments themselves. Long distance to the next endodontic specialist or expert was the second most frequently given reason not to refer cases. A total of 58% of the participants believed that there were enough endodontists in Switzerland to cover the encountered clinical problems.

Flexibility and access to dental postgraduate speciality training

Increasingly, there is a clear emphasis on the need for improved access to flexible training. This reflects changing societal attitudes and expectations towards work-life balance and increasing demand for flexible working. The recently published Advancing dental care review: final report (2021) reflects these same demands within dental postgraduate training. Increasing flexible training options has the potential for far-reaching beneficial effects for dental speciality training. There are barriers to accessing speciality training for specific applicant groups and this risks potentially excluding excellent-quality candidates from pursuing speciality training. There is opportunity in utilising and developing flexible training options to support widening access to dental speciality training. Recruitment and working pattern arrangements should reflect these aspirations, ensuring that the best trainees are successful irrespective of their personal circumstances.

Safety Training in US Pediatric Dentistry Advanced Education Programs: A Survey of Program Directors

Purpose: Incorporation of patient safety and quality improvement into the educational framework of all health care trainees, including those in dentistry, is growing. The purpose of this study was to characterize the current state of patient safety training and education in US pediatric dentistry residency programs. Methods: A 19-item web-based survey was emailed to all US pediatric dentistry residency program directors in 2021. The survey collected information regarding program background, safety education, safety protocol and experience, attitudes toward safety, and potential support for safety education. Data were analyzed using descriptive statistics and Fisher's exact test. Results: Seventy-two directors (76 percent response rate) completed the survey. The majority felt safety education was somewhat (11 percent, N equals six) or extremely important (68 percent, N equals 49) for residents. Only six percent (N equals four) reported residents entered their program with an adequate understanding of safety science. Most (74 percent, N equals 53) taught safety science through both didactic seminars and clinical experience. Timeouts under general anesthesia (78 percent, N equals 56) and emergency simulations (72 percent, N equals 52) were more common modes of clinical safety training. Overall, a limited number of program directors had familiarity with many safety tools used to prevent adverse events. Program directors' experience with adverse events was not associated with opinions regarding the importance of safety education. The majority expressed interest in AAPD supporting safety education. Conclusions: Although program directors feel safety education is important, programs do not sufficiently address safety education and look for support to help integrate safety measures into education.

Rapid transition to distance learning due to COVID-19: Perceptions of postgraduate dental learners and instructors

The outbreak of Coronavirus disease 2019(COVID-19) necessitated an abrupt transition from on campus, face-to-face sessions to online, distance learning in higher education institutions. The purpose of this study was to investigate the perceptions of postgraduate dental learners and instructors about the transition to distance learning, including the changes to the learning and teaching and its efficaciousness. A convergent mixed methods approach to research was utilized. All the instructors and postgraduate learners in a dental college were invited to participate in an online survey. Quantitative data was analyzed using descriptive and inferential analyses on SPSS for Windows version 25.0, and for the responses to the open-ended questions, multi-staged thematic analysis was utilized. Both groups of stakeholders: learners and instructors, were satisfied with the rapid transition to distance learning due to COVID-19. Instructors were significantly more satisfied than the learners. The stakeholders adapted well to the change. The perception of the stakeholders regarding the case-based scenarios significantly influenced their level of satisfaction. As perceived by the stakeholders, the transition to distance learning entailed advantages and challenges. Going through the experience enabled the stakeholders to develop informed opinions of how best to sustain learning and teaching irrespective of how matters unfold in relation to the pandemic. In conclusion, the worldwide dental education community faced unprecedented challenges due to the onset of COVID-19. From a macro perspective, decision-makers must not miss out on the valuable opportunities, inherent in the experience, to reinforce curriculums, and maximize learning and teaching.

Social Mission Metrics: Developing a Survey to Guide Health Professions Schools

The social mission, which is focused on advancing social justice and health equity, has gained recognition as an important aspect of health professions education. However, there is currently no established method to measure a school's commitment to these activities. In this Perspective, the authors describe the development of a new tool to measure the social mission at dental, medical, and nursing schools across the United States, and they reflect on the implications of using this tool to deepen discussions around the social mission and strengthen progress toward health equity.From 2016 to 2019, the authors created and field tested the online social mission metrics survey for health professions schools to identify their level of engagement in social mission activities, track that level over time, and compare their progress with that of other schools. The survey measures a school's social mission values, programs, and activities across 6 domains and 18 activity areas. The authors also developed a scoring system based on stakeholder priorities, which they used to provide customized, confidential feedback to the schools that participated in the field tests.Going forward, the authors recommend that schools complete the survey every 3 to 5 years to track their social mission over time, and they plan to expand the survey process to additional dental, medical, and nursing schools as well as to schools in other health professions. The social mission metrics survey is meant to be a useful tool for improving the level and quality of social mission engagement at health professions schools, with the goal of improving the awareness, skills, and commitment of health professionals to health equity.

The impact of confidence on clinical dental practice

INTRODUCTION

Increasing confidence through learning has the potential to change General Dental Practitioners' (GDPs) perceptions of clinical practice. By examining how changes in confidence influence the clinical practice of two cohorts of GDPs, during and following an extended period of postgraduate training, we show the importance of confidence to GDPs and that a lack of confidence is a primary reason why GDPs attend postgraduate training courses.

METHODS

A mixed-method approach was adopted for this study. Quantitative data were collected via a series of linked questionnaires; qualitative data were collected using focus group discussions, interviews and contemporaneous field notes. Analysis was undertaken using SPSS software and a phenomenological approach, respectively.

FINDINGS

Participants indicated an increase in confidence in their ability to undertake dental procedures, which led to an increase in confidence in communication skills, and their ability to undertake complex restorative procedures. This led to greater treatment acceptance by patients resulting in better "job satisfaction."

DISCUSSION

A sense of confidence is central to personal development and ongoing study, leading to first, an improved capability to perform tasks (competence); second, confidence is a product of the relationship and trust of those people associated with the individual/professional and third, the correct level of challenge is important to confidence.

CONCLUSIONS

The issue of confidence has not been looked at in postgraduate dentistry, but it is well recognised in medical education fields.

Career pathways and professional skills of postgraduate students from a dental research-intensive programme

BACKGROUND

With current global trends in postgraduate education, graduate programmes must make evidence-based improvements to offer the best programme that aligns with student needs and prepare them for their future career prospects. The aim of this cross-sectional study was to investigate the postgraduation career pathways of MSc and PhD students who graduated within the past 15 years from the McGill University Postgraduate Dental Research Program.

MATERIALS AND METHODS

An online questionnaire, composed of 10 closed-ended format items, was used that covered domains such as student profile, career profile, postgraduate skill development, job search experience and satisfaction. Descriptive statistics and interpretative qualitative analysis were used to evaluate student feedback.

RESULTS

Sixty-six students responded to the online survey, out of which sixty-two students completed the survey (61% participation rate). The majority of the graduate students, 67% (n = 44), obtained MSc degree in Dental Sciences. Overall, our results showed that most graduates started careers in academia in their original field of study and were satisfied with their income. Most graduates reported "critical and creative thinking" to be the strongest acquired skills during their postgraduate training and identified fierce competition for their position of interest as the main challenge after graduation.

DISCUSSION AND CONCLUSION

Our results showed that graduates in dental research appeared to be overall satisfied with their careers after postgraduate research training, both in terms of scope of practice and income. However, strong competition in obtaining the position of their interest seemed to be the main obstacle after graduation.

Training and evaluation of professors of dentistry in postgraduate programmes in Brazil

INTRODUCTION

In Brazil, the undergraduate dental education still remains fragmented and dissociated from its social context, with emphasis on the individualistic and private aspects of dental health. This study aimed to analyze the training and development of university professors of dentistry in stricto sensu postgraduate programs in Brazil.

MATERIALS AND METHODS

Delphi electronic methodology was used within a qualitative-quantitative design to gather data from a panel of 58 experts. Discussions representing the analytic axis focused on: (i) the evaluative processes of higher education, in particular stricto sensu postgraduate programs, and their influence on academic activities in undergraduate dentistry courses and (ii) policies for training and developing university professors.

RESULTS

Of the experts, 30 participated in the first round, 24 in the second, and 19 in the third. They considered the training of university professors in dentistry to be highly specialized and technologically focused and indicated the review of political-pedagogic aspects of the educational sphere, as well as the social, economic, cultural, epidemiologic, and professional aspects of training and preparation prescribed by the National Curricular Guides for graduate courses in dentistry. An adequate process of evaluating the official organs and regulators of postgraduate stricto sensu programs, as well the programs themselves, should be implemented.

CONCLUSION

The experts stated that changes to the university teaching system are necessary, even in the field of dentistry. Mechanisms for evaluating areas and professors were inadequate, and the training was overly specialized and not consistent with the social reality of the country.

Human disease/clinical medical sciences for dentistry in early-years dental graduates: Transition from undergraduate study to clinical practice

INTRODUCTION

Dental bodies across Europe have published curricula aiming to guide the development of a graduating dentist who is safe and competent, and which also contain direction on what knowledge and understanding of patient's health, drugs and disease a recent graduate should have.

MATERIALS, METHODS AND AIM

A questionnaire to survey Foundation Dentists in Wales regarding their undergraduate teaching and assessment in human disease/clinical medical science for dentistry and how this translates to their knowledge, attitudes and confidence in the dental management of patients who may have chronic disease or disability.

RESULTS

A 97% response rate to the questionnaire from Foundation Dentists graduating from schools across the UK showed that the large majority felt their teaching and learning in human disease/clinical medical science for dentistry was appropriately delivered and assessed, and that they were well prepared for independent dental practice and to plan and safely manage treatments for all their patients.

DISCUSSION

This survey of newly qualified dentists representing graduates from different types of dental courses and both newer and long-established schools across the UK reports the foundation dentists felt that they are competent and safe to care for all patients, including those with complex medical histories.

CONCLUSIONS

The foundation dentists surveyed have completed dental undergraduate courses containing the appropriate education and assessment for human health and disease, such that they are prepared to manage their patient population safely, and are well placed to serve their patients as the population continues to age and the amount of medical morbidity increases.

Oncology Curricula in Postgraduate General Dentistry Programs: a Survey of Residency Program Directors

Management of patients undergoing treatment for cancer requires a multidisciplinary team including general dentistry providers; however, the relative knowledge and training of general dentists in the management of this patient population are relatively unknown. The purpose of this study was to assess the oncology curricula of postgraduate general dentistry training programs, from the perspective of the program directors, to better understand the opportunities for and/or barriers to dental care for cancer patients. A cross-sectional survey was sent to the 275 Commission on Dental Accreditation-accredited programs; 82 program directors responded (response rate, 30%). More than 50% of respondents indicated "none" or "little" curricular emphasis on cancer biology, bone marrow transplantation, immunotherapy, or prosthetics for use during head and/or neck surgery. Conversely, more than 50% of respondents indicated "moderate" or "substantial" emphasis on acute oral effects of cancer-related therapy, long-term oral effects of cancer-related therapy, antiresorptive medication pharmacology, radiotherapy techniques and biological effects, and osteonecrosis of the jaw. Residents had the most experience with radiotherapy patients and the least with bone marrow or transplantation patients. Overall, general dentistry program directors were enthusiastic to participate in the multidisciplinary team but reported challenges to including oncology curricula in residency training programs. Training for general dentistry providers in formalized postgraduate residency programs may be variable or limited-as a result, communication regarding patient management is critical. Opportunities exist to enhance the general dentistry curricula and, thereby, improve access to dental care for patients receiving treatment for cancer.

A longitudinal evaluation of the Rural Clinical Placement Program at the University of Sydney Dental School

INTRODUCTION

Australia has a lack of dental practitioners in rural and remote regions. This study evaluates the impact of a Rural Clinical Placement Program (RCPP) offered to final year students at the University of Sydney (USYD) Dental School on the graduates working locations.

MATERIALS AND METHODS

University of Sydney students who graduated between 2009 and 2013 (n = 404) were invited to complete a telephone interview. One hundred and thirty-five graduates were interviewed, 90 RCPP participants and 45 non-participants.

RESULTS

The majority of graduates interviewed were from a metropolitan background (87%), 47% were female, 77% worked full time, and 70% were employed in private practice. A higher proportion (33%) of the RCPP participants were working in rural Australia compared with 18% of the non-participants. The graduates reported that the RCPP was a high-quality program with excellent rural clinical supervisors, provided broad clinical dentistry; they met appreciative patients and enjoyed the rural lifestyle.

CONCLUSIONS

The RCPP was a valuable and positive experience with many considering it as a highlight of their dental education. A large proportion reported the program positively influenced their employment location choices, and a higher proportion of the RCPP participants were identified as working rurally, compared to the non-participants.

Factors Influencing Dental Hygienists' Decisions to Pursue Doctoral Degrees

Purpose: To identify the factors that have influenced dental hygienists to pursue post-graduate education opportunities, specifically dental (DDS, DMD) as compared to academic doctoral degrees, such as doctor of philosophy (PhD) or doctor of education (EdD).Methods: A convenience sample of dental hygienists with doctoral degrees were identified from multiple sources (n=140) and sent a 27-item web-based survey. Univariate logistic regression analysis was used to explore the influence of independent variables (respondents' demographic and personal characteristics, influential persons and experiences, encouraging and motivating factors) on the respondents' decision to pursue either a dental or an academic doctoral degree.Results: Of the 140 potential participants, 69 (n=69) responded (49% response rate): 17 dental degree respondents, 46 academic degree respondents. In contrast to academic degree respondents, those with dental degrees graduated from dental hygiene programs more recently (p=0.03), spent less time working as a dental hygienist (p=0.01), considered themselves mechanically inclined (p=0.03), and preferred to learn a new skill rather than read about a current research study (p=0.002). Both groups agreed that working one-on-one with people was important to career satisfaction. Dental degree respondents were more likely to have been influenced or encouraged to pursue dentistry by dentists (p=0.01) and family (p=0.004). Academic degree respondents were more likely to have had experiences with a researcher/scientist (p=0.004) or had been influenced by an educator (p=0.01). Only 40% of all respondents reported that dental hygiene instructors were instrumental in encouraging their advanced education.Conclusion: Dental hygienists possessing characteristics similar to the academic degree respondents in this study should be encouraged to pursue academic doctoral education, providing the necessary skills to advance the dental hygiene profession.

Scientific Research in Latin America: Experiences of Collaborative Projects on Craniofacial Anomalies

Scientists based in Latin America, particularly in Argentina, Brazil, Chile, and Mexico, substantially increased their rate of scientific publications during the past decades. Brazil experienced the most growth with the implementation of an efficient postgraduate system that is tripling the number of doctors every 10 years. Research on craniofacial anomalies is similarly increasing in Latin American countries. A PUBMED search using the key word “cleft” and a particular country's name showed that Brazil has published the most articles in that field during the past few years, many of which were published by research groups linked to the Hospital for Rehabilitation of Craniofacial Anomalies located in Bauru, which provides cleft and craniofacial care for more than 2500 new patients every year. Based on experiences with international collaboration, this report discusses obstacles to collaborative research and presents recommendations to enhance the possibility of creating successful partnerships among international research teams.

The learning environment in professional doctorate and postgraduate dental education: a qualitative study

INTRODUCTION

Currently, there is a lack of studies focusing on professional doctoral students' and graduates' perceptions of their learning environment, in particular, using a qualitative approach to elicit in-depth information. This article aims to contribute to the existing body of knowledge by systematically exploring, critically analysing and getting a deeper understanding of professional doctorate dental students' and graduates' insights into effective and ineffective clinical and physical learning environment characteristics.

METHODS

The study included a total of 20 participants. Participants included 16 final-year Doctor of Clinical Dentistry (DClinDent) students and four dental specialists (graduates of the DClinDent programme). Semi-structured, individual interviews were used. Participants were asked to reflect upon and describe in detail their effective and ineffective learning environment experiences. The critical incident technique was used to guide the data collection. Data were analysed using a general inductive qualitative approach.

RESULTS

Learning environment characteristics which participants associated with effective learning included the following: sufficient opportunities for comprehensive treatment planning; introduction to a number of patient treatment philosophies; a sufficient number of complex cases; clinically oriented research and assignment topics; a focus on clinical training in the programme generally; a research topic of a realistic depth and breadth, suitable for their 'specialist training' degree; and a well-resourced and updated physical infrastructure. On the other hand, most participants indicated that the absence of an adequate number of clinical cases, an overemphasis on research (as opposed to clinical practice) in the DClinDent programme and an 'outdated' physical infrastructure in the dental school clinics could hamper effective clinical learning.

CONCLUSION

These findings contribute to the meaningful advancement of the literature on learning environment strategies through the exploration of (and in-depth qualitative insights into) what facilitated effective learning by New Zealand professional doctorate candidates and graduates. These findings provide a starting point for reflection by international academic directors, educational developers, curriculum planners, programme managers and clinical teachers in respect of the further development of the learning environment. Although the findings from this study may not be directly transferable to all international contexts, they have the potential to contribute to the further development of theory in this area.

Current differences in dental education between Chinese and Western models

Dental education is the foundation of a country's development of dental science. Economic conditions and cultural backgrounds vary across countries; hence, there are some differences in dental education between Chinese and Western models, including the education programmes, licensures, curricula, teaching methods, facilities. These differences may become obstacles for mutual communication and the development of dental education. In the last 5 years, China has introduced several policies and published some standards, such as the residency programmes and Accreditation Standards for Undergraduate Dental Education Programs. These actions aim to improve the current situation of dental education and reduce the gap between Chinese and Western education models. Indeed, some changes have been made. This article provides a brief introduction of the existing differences and changes and can, thus, serve as a reference for educators.

HPV Vaccination and the Role of the Pediatric Dentist: Survey of Graduate Program Directors

PURPOSE

This study's purpose was to evaluate what is currently being taught in graduate pediatric dental programs regarding the human papillomavirus (HPV), the HPV vaccine, and risk factors associated with oropharyngeal cancer (OPC).

METHODS

A 42-question survey was administered via paper-and-pen survey instrument to attendees at the 2016 American Academy of Pediatric Dentistry (AAPD) annual meeting for graduate and associate program directors. The survey included questions evaluating attitudes/beliefs toward the HPV vaccine and current training in graduate pediatric dentistry programs and aimed to define whether the directors believe that the discussion of HPV vaccination and associated risk factors was within the scope of practice for pediatric dentists.

RESULTS

Sixty-four of 71 attendees completed the survey; 77 percent of respondents believe they should be discussing the HPV vaccine with patients/parents. Increased age of respondent was correlated with the idea of discussion of sexual health and its link to OPC being within the scope of practice of pediatric dentistry (r equals 0.35, P=.005).

CONCLUSIONS

A majority (77 percent) of graduate and associate program directors believe they should be discussing the human papillomavirus vaccine with patients and parents; however, only 25 percent of respondents currently include information about HPV and the vaccine in their curricula.

Faculty Development for Metro New York City Postdoctoral Dental Program Directors: Delphi Assessment and Program Response

Faculty development for dental academicians is essential to cultivate a continuous faculty workforce, retain existing faculty members, enhance their teaching skill sets, and remain responsive to changing program requirements and curricular reforms. To maximize the utility of dental faculty development, it is important to systematically assess and address faculty members' perceived training needs. The aims of this study were to determine priority topics among one group of postdoctoral program directors and to translate those topics into faculty development programs as part of Columbia University's Health Resources and Services Administration (HRSA)-sponsored faculty training program for primary care educators. The study was conducted in 2013-16. A Delphi consensus technique was implemented with three sequential surveys of 26 New York City metropolitan area general, pediatric, and public health dentistry residency program directors. On the first survey, the five respondents (19% response rate) identified 31 topics. On the second survey, 17 respondents (response rate 65%) rated the 15 most important topics. In the third and final round, 19 respondents (73% response rate) ranked teaching research methods and teaching literature reviews as the topics of greatest interest. Overall, the responses highlighted needs for faculty development on teaching research methods, motivating trainees, trainee evaluation, and clinical care assessment. Based on these results, a series of six Faculty Forums was developed and implemented for dental educators in the metropolitan area, starting with the topic of teaching research methods. The process flow used for assessing training needs and developing and evaluating training can be applied to a variety of populations of educators.

Perceived learned skills and professional development of graduates from a master in dental public health programme

INTRODUCTION

Assessing the impact of a training programme is important for quality assurance and further development. It also can helps with accountability and marketing purposes. This study evaluated the impact of King's College London (KCL) Master of Science programme in Dental Public Health in terms of graduates' perceived learned skills and professional development.

METHODS

An online questionnaire was sent to individuals who completed successfully the KCL Master of Science programme in Dental Public Health and had a valid email address. Participants provided information on demographic characteristics, perceived learned skills (intellectual, practical and generic) and professional development (type of organisation, position in the organisation and functions performed at work before and after the programme). Learned skills' scores were compared by demographic factors in multiple linear regression models, and the distribution of responses on career development was compared using nonparametric tests for paired groups.

RESULTS

Although all scores on learned skills were on the favourable side of the Likert scale, graduates reported higher scores for practical skills, followed by intellectual and generic skills. No differences in scores were found by sex, age, nationality or time since graduation. In terms of career development, there were significantly higher proportions of graduates working in higher education institutions and taking leadership/managerial roles in organisations as well as greater number and variety of functions at work after than before the programme.

CONCLUSION

This online survey shows that the programme has had a positive impact on graduates in terms of perceived learned skills and professional development.

Assessment of Diagnosed Temporomandibular Disorders and Orofacial Pain Conditions by Predoctoral Dental Students: A Pilot Study

Temporomandibular disorders and orofacial pain (TMD/OFP) conditions are challenging to diagnose for predoctoral dental students due to the multifactorial etiology, complexity, and controversial issues surrounding these conditions. The aim of this study was to determine if patients in the clinic of one U.S. dental school reported existing signs and symptoms of TMD/OFP, whether the dental students diagnosed the condition based on the reported signs and symptoms, and if the condition was then treated. The study was based on a retrospective analysis of electronic health record data over a three-year period. The results showed that, during the study period, 21,352 patients were treated by student providers. Of those patients, 5.33% reported signs or symptoms associated with TMD/OFP; 5.99% received a TMD/OFP diagnosis; and 0.26% received at least one form of TMD/OFP treatment that had either a diagnosis or signs/symptoms of TMD/OFP. In addition, a small percentage (0.24%) of patients with no documented diagnosis received some sort of TMD/OFP-related treatment. A randomly selected sample of 90 patient charts found that no diagnoses of TMD/OFP were recorded in any of them. The results suggested that students had only marginally diagnosed the problems. Training for students including comprehensive didactic courses and clinical experiences to gain knowledge, context, and skill may be required to ensure they reach the required level of competence and prepare them to face the diagnostic challenges of TMD/OFP after graduation.

Survey of Current Clinical and Curriculum Practices of Postgraduate Pediatric Dentistry Programs in Nonintravenous Conscious Sedation in the United States

PURPOSE

The purposes of this study were to: (1) describe the sedation protocols of postgraduate pediatric dentistry programs (PPDPs) in the U.S.; (2) evaluate how consistent they were with current American Academy of Pediatric Dentistry sedation guidelines and Commission on Dental Accreditation (CODA) sedation curriculum requirements; (3) identify barriers to and tools for implementing these guidelines; and (4) determine the independent association between PPDPs' adherence to guidelines and the program setting.

METHODS

In February 2015, a 40-item questionnaire was e-mailed to all postgraduate pediatric dentistry program directors (PPDPDs) of CODA-accredited programs in the U.S. (n equals 74). Data were analyzed using descriptive statistics and Kruskal-Wallis and pairwise Nemenyi tests.

RESULTS

Fifty-two PPDPDs responded (70 percent). Since the 2013 change in CODA sedation requirements, only a limited number of PPDPs (36 percent) were found to be noncompliant with CODA standards. PPDPDs trained at hospital-based programs were found to direct programs that were more compliant with CODA sedation standards (P<.05). A major perceived barrier to increasing the number of sedation cases was the lack of a patient pool (37 percent).

CONCLUSIONS

Further efforts should be made by teaching institutions for programs to be compliant with American Academy of Pediatric Dentistry and Commission on Dental Accreditation sedation standards.

The Effect of Awareness of American Board of Orthodontics Criteria on Treatment Outcomes in a Postgraduate Dental Clinic

The aims of this study were to evaluate the posttreatment outcomes in a postgraduate orthodontic clinic following a course on American Board of Orthodontics Cast and Radiograph Evaluation (ABO-CRE); to compare the outcomes of postgraduate students who took the course before and after finishing treatment of their cases; and to assess if the need for orthodontic treatment as determined by the Index of Orthodontic Treatment Need (IOTN) at the beginning of treatment affected students' final scores. A course on ABO-CRE was given to second- (group A), third- (group B), and fourth- (group C) year postgraduate students at Yeditepe University, Istanbul, Turkey, in 2012. Pre- and posttreatment plaster models of 253 cases (group A) were treated by students in 2011-12. An additional 251 (group B, 2012-13) and 341 (group C, 2013-14) cases were evaluated in the first and second years after the course, respectively. The models were graded retrospectively using the ABO-CRE and IOTN. The results showed that the total mean scores on the posttreatment plaster models were significantly higher in the pre-course group than the first- and second-year post-course group (p<0.05 and p<0.01, respectively). The borderline cases (grade 3) received a lower score on the ABO-CRE than the cases with need (grade 4) (p<0.01) and severe need (grade 5) (p<0.01) for orthodontic treatment. Increasing awareness by giving information about the ABO-CRE significantly improved the posttreatment success of these postgraduate students. After the course, treatment outcomes in the following year were better than two years later, suggesting it may be useful to teach the course annually to refresh students' knowledge.

Self-Perceptions of Value, Barriers, and Motivations for Graduate Education Among Dental Hygienists

Increasing the knowledge base of its practitioners through formal education is vital to advancing the dental hygiene profession, ensuring practitioners' readiness for participation in future health care workforce models, and preparing future dental hygiene educators. The aim of this study was to discover the value of, barriers to, and motivations for graduate education among dental hygienists as a first step toward establishing ways to stimulate enrollment and facilitate program change. A qualitative pilot study design was used, with focus groups used for data collection. Four virtual focus groups were conducted on a video conferencing platform with dental hygienists (N=15) of varying educational levels residing in nine states. Focus group results were examined for emerging themes. The majority of participants placed a high value on graduate education as it related to expanding employment options and satisfying personal goals, but perceived it to have little value regarding advancement in clinical practice. Top barriers to education were reported to be time management, finances, and degree program options. Motivational themes for pursuing education included increased career options, benefits, and salary; personal satisfaction; potential to advance the profession; and financial support. The participants agreed that increased education can lead to more varied career opportunities and advance the profession, but their responses suggested limited motivation to pursue graduate studies. Determining ways to increase the value, reduce barriers, and enhance motivation for a graduate degree should be a priority of academic institutions and professional organizations involved in dental hygiene to ensure a workforce that is qualified for future health care initiatives and prepared to become educators.

Dental, Dental Hygiene, and Graduate Students' and Faculty Perspectives on Dental Hygienists' Professional Role and the Potential Contribution of a Peer Teaching Program

The changing role of dental hygienists deserves dental and dental hygiene educators' attention. The first aim of this survey study was to assess University of Michigan dental, dental hygiene, and graduate students' and faculty members' perceptions of dental hygienists' roles; their attitudes and behaviors related to clinical interactions between dental and dental hygiene students; and perceived benefits of engaging dental hygiene students as peer teachers for dental students. The second aim was to assess whether one group of dental students' experiences with dental hygiene student peer teaching affected their perceptions of the dental hygiene profession. Survey respondents were 57 dental hygiene students in all three years of the program (response rate 60% to 100%); 476 dental students in all four years (response rate 56% to 100%); 28 dental and dental hygiene graduate students (response rate 28%); and 67 dental and dental hygiene faculty members (response rate 56%). Compared to the other groups, dental students reported the lowest average number of services dental hygienists can provide (p≤0.001) and the lowest average number of patient groups for which dental hygienists can provide periodontal care (p<0.001). Dental students also had the least positive attitudes about clinical interactions between dental hygiene and dental students (p<0.001) and perceived the fewest benefits of dental hygiene student peer teaching (p<0.001) before experiencing peer teaching. After experiencing dental hygiene student peer teaching, the dental students' perceptions of dental hygienists' roles, attitudes about clinical interactions with dental hygienists, and perceived benefits of dental hygiene student peer teachers improved and were more positive than the responses of their peers with no peer teaching experiences. These results suggest that dental hygiene student peer teaching may improve dental students' perceptions of dental hygienists' roles and attitudes about intraprofessional care.

Identifying Multilevel Barriers to Tobacco Intervention in Postdoctoral Dental Education

The aims of this mixed-methods study were to assess tobacco treatment behaviors among residents and faculty in dental specialty postdoctoral programs and to explore factors in training and practice related to tobacco treatment education. Surveys and focus groups were conducted with a convenience sample of participants at three postdoctoral residency programs in New York City. Surveys assessed tobacco cessation training and behaviors. Focus groups explored barriers to implementing tobacco cessation treatment in educational settings. Data were collected between May and December 2013. Among the 160 faculty and residents identified as potentially eligible for the study, 60 were invited by program directors to participate, and 50 subsequently completed the survey and participated in a focus group (response rate of 31.3%). Survey results indicated high levels of asking patients about tobacco use and advising patients to quit. In contrast, specific tobacco cessation assistance and follow-up care occurred less frequently. There were statistically significant differences in tobacco cessation intervention across the specialties surveyed, but not between residents and faculty. Focus group comments were grouped into three broad areas: clinician factors, organizational support, and structural and contextual factors. Focus group results indicated that participants experienced significant organizational and structural barriers to learning about and providing tobacco treatment. Participants from each specialty indicated that multi-level barriers impeded their provision of evidence-based tobacco cessation interventions in postdoctoral educational settings. They suggested that didactic education should be reinforced by organizational- and systems-level changes to facilitate comprehensive tobacco education and effective cessation treatment in future dental practice.

Using discussion groups as a strategy for postgraduate implant dentistry students to reflect

INTRODUCTION

More than undergraduates, postgraduate students have the day-to-day clinical experience to reflect upon. Nevertheless, reflection in postgraduate dental education is less well studied. Hence, the purpose was to investigate the attitude towards reflection and the content of reflections in postgraduate implant dentistry education in the UK and Belgium.

MATERIALS AND METHODS

To investigate the attitude towards reflection, a questionnaire was administered to the 10 postgraduates at UCL Eastman Dental Institute (EDI) and 6 postgraduates at Ghent University (UGent). Additionally, students were invited to attend two reflective sessions (60-90 minutes). The sessions' audio recordings were transcribed and analysed using a thematic approach.

RESULTS

In total, 16 postgraduate implant dentistry students participated. Although the majority reported prior experience with reflection, there was variation in the provided definitions of reflection. EDI students agreed with reflection being beneficial for professional development/clinical reasoning and were positive about discussing clinical experiences in groups, but were divided about individual/group reflections. Their UGent counterparts were more indecisive (=neutral), but were positive about discussing clinical experiences. Thematic analysis identified recurring themes as individual learning process, learning and clinical experiences, attitude towards implant dentistry and course programme. EDI postgraduates' reflections focussed on specific clinical situations, while UGent postgraduates' reflections described general considerations.

CONCLUSION

Although students/professionals often report to reflect, it is not clear whether/how they actually reflect, due to the all-purpose word reflection has become. A strategy, using group discussions along with supervision/guidance in how to reflect, demonstrated to expand clinical reasoning into reflections about postgraduate students' clinical actions and professional growth.

Clinical accuracy outcomes of splinted and nonsplinted implant impression methods in dental residency settings

OBJECTIVE

The splint technique of implant-supported restorations is a popular impression method; however, in-vivo studies showing the advantage of this method are scarce. The objective was to compare radiographic fit of the metal frameworks fabricated according to splinted or nonsplinted impression techniques. The null hypothesis was that splinting techniques would result in more accurate impressions.

METHOD AND MATERIALS

A retrospective analysis was performed on 71 patients who had undergone multi-implant-supported rehabilitation in the years of 2012 to 2013. The treatment was carried out by three senior dentists or by residents in the department of Oral Rehabilitation at the Hebrew University Hadassah Medical Center. Each senior and the residents under his guidance treated patients consistently by only one different impression method: (1) no splint; (2) splinted transfers with pattern resin over dental floss scaffold; (3) splinting of transfers to impression tray with pattern resin. Orthoradial radiographs were used to determine if the metal framework fit the implant abutments.

RESULTS

In total, 81 impressions and 285 implants were included in the study; 56 impressions were done by seniors and 25 by residents. There was no difference in success between the three methods when done by seniors (P = .76). The fixation to tray method was found to be significantly unsuccessful in the hands of residents (P = .01).

CONCLUSION

Because the splint methods were not found to be more accurate, splinting the transfers might be an unnecessary step. Splinting of transfers to the impression tray is not recommended for inexperienced dentists.

Knowledge, Attitudes, and Practices of Pediatric Dentists Regarding Speech Evaluation of Patients: Implications for Dental Education

The aim of this cross-sectional study was to determine pediatric dentists' attitudes about speech evaluation in the dental setting and assess their knowledge of speech development and pathology. In October 2013, members of the American Academy of Pediatric Dentistry were invited to participate in an electronic questionnaire. Categories of questions were demographics, attitudes and confidence in speech pathology, and theoretical and practical knowledge of speech development and speech pathology. Theoretical knowledge was assessed using questions about phonetics and speech milestones. Practical knowledge was determined with three 30-second interview-style video clips. A total of 539 responses were received for a response rate of 10.4%. The majority of respondents reported feeling that speech evaluation should be part of the pediatric dental visit (72.8%) and felt confident in their ability to detect speech issues (73.2%). However, they did poorly on the theoretical knowledge questions (41.9%) as well as the practical knowledge questions (8.5%). There was a statistically significant difference in theoretical score between gender and type of occupation (p<0.05). This difference was not observed when examining practical knowledge. This study suggests that although pediatric dentists are in an ideal position to aid in the detection of speech issues, they currently have insufficient training and knowledge to do so.

Development and Application of a New Learning Object for Teaching Operative Dentistry Using Augmented Reality

Learning objects (LOs) associated with augmented reality have been used as attractive new technologic tools in the educational process. However, the acceptance of new LOs must be verified with the purpose of using these innovations in the learning process in general. The aim of this study was to develop a new LO and investigate the acceptance of gold onlay in teaching preparation design at a dental school in Brazil. Questionnaires were designed to assess, first, the users' computational ability and knowledge of computers (Q1) and, second, the users' acceptance of the new LO (Q2). For both questionnaires, the internal consistency index was calculated to determine whether the questions were measuring the same construct. The reliability of Q2 was measured with a retest procedure. The LO was tested by dental students (n=28), professors and postgraduate students in dentistry and prosthetics (n=30), and dentists participating in a continuing education or remedial course in dentistry and/or prosthetics (n=19). Analyses of internal consistency (Kappa coefficient and Cronbach's alpha) demonstrated a high degree of confidence in the questionnaires. Tests for simple linear regressions were conducted between the response variable (Q2) and the following explanative variables: the Q1 score, age, gender, and group. The results showed wide acceptance regardless of the subjects' computational ability (p=0.99; R2=0), gender (p=0.27; R2=1.6%), age (p=0.27; R2=0.1%), or group (p=0.53; R2=1.9%). The methodology used enabled the development of an LO with a high index of acceptance for all groups.

Educators' and Applicants' Views of the Postdoctoral Pediatric Dentistry Admission Process: A Qualitative Study

The postdoctoral application and matching process in dental education is a high-stakes and resource-intensive process for all involved. While programs seek the most qualified candidates, applicants strive to be competitive to increase their likelihood of being accepted to a desirable program. There are limited data regarding either subjective or objective factors underlying the complex interplay between programs and applicants. This qualitative study sought to provide insight into the stakeholders' experiences and views on the matching process. Telephone and in-person interviews were conducted with ten pediatric dentistry program directors and ten recent applicants to pediatric dentistry programs in the United States in 2013-14. Participants were selected to represent the geographic (five districts of the American Academy of Pediatric Dentistry) and institutional (hospital- or university-based) diversity of pediatric dentistry programs. Interviews were recorded and transcribed verbatim. Veracity and need for more information were the themes most often articulated by both groups. The program directors most valued teachability and self-motivation as desirable applicant characteristics. The applicants relied primarily on subjective sources to gather information about programs and prioritized location and financial factors as pivotal for their rankings. Both groups appreciated the uniformity of the current application process and highlighted several weaknesses and areas for improvement. These results shed light on the postdoctoral matching process in pediatric dentistry via a qualitative description of stakeholders' experiences and viewpoints. These insights can serve as a basis for improving and refining the matching process.

An Outcomes Study of 40 Years of Graduates of a General Practice Dental Residency

Assessing program quality and outcomes is essential to improve postgraduate dental education. This study's aims were to document career direction and practice patterns of graduates of the Brigham and Women's Hospital (BWH) General Practice Residency (GPR), to compare BWH GPR outcomes to those of other American GPRs, and to identify characteristics of the BWH GPR program that trainees valued. This was a retrospective cohort study with a sample comprised of BWH GPR graduates between 1973 and 2013. Outcomes examined included pursuit of specialty training and positions on academic or hospital staff. Data sources were a survey of BWH GPR graduates and published national surveys. Of the 190 BWH graduates (95% of total) who were located and contacted, 133 (70% response rate) completed the survey. Compared to national survey data, BWH GPR graduates were significantly more likely to be specialists, full-time hospital staff, or full-time or part-time dental school faculty. Most BWH graduates (96.2%) ranked the program as outstanding or good. Faculty characteristics were considered by BWH graduates to be the most important factors in judging program quality. Since faculty characteristics were the most important factors in residents' judgment of program quality, GPR programs should recruit, maintain, and develop a quality faculty in order to attract students.