Analysis of Student Confidence Levels and Application Success Rates in Simulator Based Dental Anesthesia Education
Condition: Confidence, Self
Study type: Interventional

Summary: 
      The present study investigates confidence levels reported among intern dentists who used
      dental anesthesia simulators, before performing local anesthesia on patients as well as
      patient reports on intern dentist confidence levels to deliver anesthesia injections and
      compare them to those who did not receive dental anesthesia simulator education. Application
      success rates will also be investigated and compared.

      The study was carried out in the dental anesthesia simulator laboratory and in the faculty
      clinics of Ankara University, Faculty of Dentistry. A hundred volunteer intern dentists who
      completed the third year of the 5-year undergraduate education program and who had not
      performed local anesthesia on a patient contributed. Seventy intern dentists received
      training on dental anesthesia simulators, and made applications on patients, while 30 intern
      dentists made applications without training on the dental anesthesia simulators and served as
      control. With a prepared single questionnaire, intern dentists made self-assessment of
      preparedness and confidence, educators made assessment of application success rates and
      treated patients evaluated intern dentists' confidence levels.
    

Detailed description: 
      Ethical approval was obtained from the Ankara University Faculty of Dentistry Clinical
      Research Ethics Committee (Approval no: 14/16). The study was carried out in the dental
      anesthesia simulator laboratory and in the faculty clinics of Ankara University, Faculty of
      Dentistry within a 2-year period. During the first year of the study, the faculty did not
      have DAS availability. During this first year 30 intern dentists who had completed the third
      year of the 5-year undergraduate education program and who could not receive DAS training
      before their first anesthesia application on a patient, were recruited as a control group
      among consent to participate. During the second year of the study after DAS became available,
      70 intern dentists who had completed the third year of the 5-year undergraduate education
      program and who had not applied local anesthesia to a patient, were recruited as a study
      group among consent to participate. The study group applied their first anesthesia
      application on a patient after DAS education.

      For the study 10 conduction anesthesia models mounted on metal rods, (CAM SUG2005-UL-SP,
      Nissin Dental Products Kyoto, Japan, Figure.1), were provided. The part-task simulators had
      11 anesthetic contact sensor points (7 in the upper jaw and 4 in the lower jaw) with 32
      anatomically shaped teeth, audio signal and light signal indicators when correct position and
      angle was achieved. The models had clear pink upper and lower gingivae allowing view of
      injection, making it ideal for beginner intern dentists, while allowing a more realistic
      training experience.

      Both groups attended theoretical presentations an interactive lesson about IANB from an oral
      and maxillofacial surgery professor. Technical information about DAS were also covered for
      the study group lessons. Following lessons, both groups answered a questionnaire concerning
      preparedness. Afterwards, intern dentists in the control group carried on with patient
      application whereas the study group carried on with DAS education before continuing on
      patients.

      During DAS lessons the intern dentists applied IANB on simulators. The illumination of the
      light and sound indicator on the model as a result of injection to the pterygomandibular
      region was accepted as a successful application. The results of the first five IANB
      applications made by the intern dentists were recorded. Intern dentists who completed the DAS
      training completed a questionnaire.

      After trainings, both groups applied IANB to a patient for the first time in the clinic and
      completed another questionnaire. The intraoperative and immediate postoperative complications
      were monitored. Tingling sensation on the lip and tongue, reported by the patient, was
      accepted as criteria for profound anesthesia. After achieving anesthesia, the questionnaire,
      was answered by the patient on whom the application was performed.

      Questionnaire:

      Section 1: Expectations After Theoretical Education

        -  The theoretical training adequately prepared me for my first anesthesia application. *

        -  I feel ready for my first anesthesia application. * Section 2: Expectations After DASM
           Training

        -  The DASM training adequately prepared me for my first anesthesia application. *

        -  I feel ready for my first anesthesia application. *

        -  It was useful to work on the DASM before my first anesthesia application. * Section 3:
           IANB application

        -  Explain if complications developed during anesthesia application.

        -  I was nervous during anesthesia application. *

        -  I was sure of myself during anesthesia application. *

        -  I was confident in determining the front edge of the mandible. *

        -  I was sure of myself when determining the area to enter the dental injector. *

        -  I was sure of myself as the dental injector entered soft tissue. *

        -  I was sure of myself as the dental injector progressed through the soft tissue. *

        -  I felt that the dental injector touched the mandible. *

        -  I provided anesthesia. **

        -  I do not need surveillance in my next application. *

        -  It was/would have been useful to work on the DASM before my first anesthesia
           application. * Section 4: To be filled out by your patient

        -  The intern dentist was confident. *

        -  The intern dentist gave me confidence. *

        -  The sting of the needle was painful. *

        -  The injection of the solution was painful. *

        -  I felt tingling on my lip. **

        -  I felt tingling in my tongue. **

             -  Questions with answer key: Strongly agree, Agree, Indecisive, Disagree, Strongly
                disagree.

                  -  Questions with answer key: Strongly agree, Indecisive, Strongly disagree.
    

Intervention name(s): Dental anesthesia simulator usage
Intervention type(s): Device
Intervention description(s): Training on dental anesthesia simulator
Intervention MeSH terms: Anesthetics
Allocation: Non-Randomized
Intervention model: Parallel Assignment
Masking: Single (Participant)
Primary purpose: Other
Keywords: Dental anesthesia; Dental education; Simulators; Technology