bluuebunny/crossref_metadata_2025 huggingface dataset:
Improving a Dental School's Clinic Operations Using Lean Process Improvement
Authors: Robinson Fonda G. , Cunningham Larry L. , Turner Sharon P. , Lindroth John , Ray Deborah , Khan Talib , Yates Audrey
Published: June 2020

The term “lean production,” also known as “Lean,” describes a process of operations management pioneered at the Toyota Motor Company that contributed significantly to the success of the company. Although developed by Toyota, the Lean process has been implemented at many other organizations, including those in health care, and should be considered by dental schools in evaluating their clinical operations. Lean combines engineering principles with operations management and improvement tools to optimize business and operating processes. One of the core concepts is relentless elimination of waste (non‐value‐added components of a process). Another key concept is utilization of individuals closest to the actual work to analyze and improve the process. When the medical center of the University of Kentucky adopted the Lean process for improving clinical operations, members of the College of Dentistry trained in the process applied the techniques to improve inefficient operations at the Walk‐In Dental Clinic. The purpose of this project was to reduce patients’ average in‐the‐door‐to‐out‐the‐door time from over four hours to three hours within 90 days. Achievement of this goal was realized by streamlining patient flow and strategically relocating key phases of the process. This initiative resulted in patient benefits such as shortening average in‐the‐door‐to‐out‐the‐door time by over an hour, improving satisfaction by 21%, and reducing negative comments by 24%, as well as providing opportunity to implement the electronic health record, improving teamwork, and enhancing educational experiences for students. These benefits were achieved while maintaining high‐quality patient care with zero adverse outcomes during and two years following the process improvement project.
Predicting Rural Practice and Service to Indigent Patients: Survey of Dental Students Before and After Rural Community Rotations
Authors: Shannon C. Ken , Price Shelia S. , Jackson Jodie
Published: June 2020

Community‐based clinical rotations in rural areas expose dental students to diverse patient populations, practice models, and career opportunities as well as rural culture. The aims of this study at West Virginia University were to determine the best predictors of rural practice, assess the predictive validity of students’ intention to practice in a rural area before and after their rural rotations, and evaluate the relationship between students’ intention to practice in a rural area and intention to provide care for indigent patients. Online survey data were submitted pre‐ and post‐rural clinical rotation by 432 of 489 dental students over the study period 2001–12, yielding an 88% response rate. In 2013, practice addresses from the West Virginia Board of Dentistry were added to the student database. The results showed that significant predictors of rural practice site were intended rural practice choice, rural hometown, and projected greater practice accessibility for indigent patients. The likelihood of students’ predicting they would choose a rural practice increased after completion of their rural rotations. After the rotations, students predicted providing greater accessibility to indigent patients; these changes occurred for those who changed their predictions to rural practice choice after the rotations and those who subsequently entered rural practice. The dental students with a rural background or a greater service orientation were also more likely to expect to enter a rural practice and actually to do so after graduation. These findings suggest that dental school curricula that include rural rotations may increase students’ sensitivity to issues of indigent patients and increase students’ likelihood of rural practice choice.
Facilitating Dental Student Reflections: Using Mentor Groups to Discuss Clinical Experiences and Personal Development
Authors: Koole Sebastiaan , Christiaens Veronique , Cosyn Jan , De Bruyn Hugo
Published: June 2020

Despite the consensus on the importance of reflection for dental professionals, a lack of understanding remains about how students and clinicians should develop their ability to reflect. The aim of this study was to investigate dental students’ and mentors’ perceptions of mentor groups as an instructional method to facilitate students’ reflection in terms of the strategy's learning potential, role of the mentor, group dynamics, and feasibility. At Ghent University in Belgium, third‐ and fourth‐year dental students were encouraged to reflect on their clinical experiences and personal development in three reflective mentor sessions. No preparation or reports afterwards were required; students needed only to participate in the sessions. Sessions were guided by trained mentors to establish a safe environment, frame clinical discussions, and stimulate reflection. Students’ and mentors’ perceptions of the experience were assessed with a 17‐statement questionnaire with response options on a five‐point Likert scale (1=totally disagree to 5=totally agree). A total of 50 students and eight mentors completed the questionnaire (response rates 81% and 89%, respectively). Both students and mentors had neutral to positive perceptions concerning the learning potential, role of the mentor, group dynamics, and feasibility. The mean ideal total time for sessions in a year was 99 minutes (third‐year students), 111 minutes (fourth‐year students), and 147 minutes (mentors). Reported reflective topics related to patient management, frustrations, and practice of dentistry. Overall mean appreciation for the experience ranged from 14.50 to 15.14 on the 20‐point scale. These findings about students’ and mentors’ positive perceptions of the experience suggest that mentor groups may be a potentially valuable strategy to promote dental students’ reflection.
Quality of Impressions and Work Authorizations Submitted by Dental Students Supervised by Prosthodontists and General Dentists
Authors: Imbery Terence A. , Diaz Nicholas , Greenfield Kristy , Janus Charles , Best Al M.
Published: June 2020

Preclinical fixed prosthodontics is taught by Department of Prosthodontics faculty members at Virginia Commonwealth University School of Dentistry; however, 86% of all clinical cases in academic year 2012 were staffed by faculty members from the Department of General Practice. The aims of this retrospective study were to quantify the quality of impressions, accuracy of laboratory work authorizations, and most common errors and to determine if there were differences between the rate of errors in cases supervised by the prosthodontists and the general dentists. A total of 346 Fixed Prosthodontic Laboratory Tracking Sheets for the 2012 academic year were reviewed. The results showed that, overall, 73% of submitted impressions were acceptable at initial evaluation, 16% had to be poured first and re‐evaluated for quality prior to pindexing, 7% had multiple impressions submitted for transfer dies, and 4% were rejected for poor quality. There were higher acceptance rates for impressions and work authorizations for cases staffed by prosthodontists than by general dentists, but the differences were not statistically significant (p=0.0584 and p=0.0666, respectively). Regarding the work authorizations, 43% overall did not provide sufficient information or had technical errors that delayed prosthesis fabrication. The most common errors were incorrect mountings, absence of solid casts, inadequate description of margins for porcelain fused to metal crowns, inaccurate die trimming, and margin marking. The percentages of errors in cases supervised by general dentists and prosthodontists were similar for 17 of the 18 types of errors identified; only for margin description was the percentage of errors statistically significantly higher for general dentist‐supervised than prosthodontist‐supervised cases. These results highlighted the ongoing need for faculty development and calibration to ensure students receive the highest quality education from all faculty members teaching fixed prosthodontics.
Developing and Testing the Short‐Form Knowledge, Efficacy, and Practices Instrument for Assessing Cultural Competence
Authors: Garvan Gerard J. , Garvan Cynthia W. , Behar-Horenstein Linda S.
Published: June 2020

The importance of educating dental students in cultural competence has been widely emphasized, but there is a need to assess cultural competence in a consistent and reliable way. The aims of this study were to determine latent constructs for the initial measure of cultural competence for oral health providers, the Knowledge, Efficacy, and Practices Instrument (KEPI), and to determine how well these factors related to previously identified latent constructs. Data were collected in surveys of dental students and from dental hygiene, dental assisting, and dental faculty members in 44 academic dental institutions from 2012 to 2015. There were a total of 1,786 respondents to the surveys; response rates to individual surveys ranged from 35% to 100%. There were 982 (55%) female and 804 (45%) male respondents, 286 (16%) underrepresented minority (URM) and 1,500 (84%) non‐URM respondents, and 339 (19%) faculty and 1,447 (81%) student respondents. Three latent constructs were identified. Female respondents scored significantly higher on the culture‐centered practice and efficacy of assessment factors, while URM respondents had significantly higher scores on all three of the KEPI factors. Measurements indicated that the long‐form KEPI could be shortened by ten questions and still have three meaningful measurements. Continued research in assessing other health care providers’ cultural competence is needed to expand the KEPI to measure providers’ cultural competence with patients with minority sexual orientation and gender identity issues and those with physical disabilities, mental illness, and autism to advance patient‐centric communication.
Characteristics Identified for Success by Restorative Dental Science Department Chairpersons
Authors: Wee Alvin G. , Weiss Robert O. , Wichman Christopher S. , Sukotjo Cortino , Brundo Gerald C.
Published: June 2020

The primary aim of this study was to determine the characteristics that current chairpersons in restorative dentistry, general dentistry, prosthodontics, and operative dentistry departments in U.S. dental schools feel are most relevant in contributing to their success. The secondary aim was to determine these individuals’ rankings of the importance of a listed set of characteristics for them to be successful in their position. All 82 current chairs of the specified departments were invited to respond to an electronic survey. The survey first asked respondents to list the five most essential characteristics to serve as chair of a department and to rank those characteristics based on importance. Participants were next given a list of ten characteristics in the categories of management and leadership and, without being aware of the category of each individual item, asked to rank them in terms of importance for their success. A total of 39 chairpersons completed the survey (47.6% response rate; 83.3% male and 16.2% female). In section one, the respondents reported that leadership, vision, work ethic, integrity, communication, and organization were the most essential characteristics for their success. In section two, the respondents ranked the leadership characteristics as statistically more important than the management characteristics (p<0.0001) for being successful in their positions.
Dental Students’ Clinical Expectations and Experiences Treating Persons with Disabilities
Authors: Perusini Darsi J. , Llacuachaqui Marcia , Sigal Michael J. , Dempster Laura J.
Published: June 2020

Persons with disabilities (PWDs) have a disproportionate level of dental disease relative to the general population. Access to care is a cause along with dentists’ willingness to treat PWDs. The aim of this study was to investigate the expectations and experiences of dental students in providing treatment to these patients in a hospital‐based dental clinic for PWDs. Senior dental students at the Faculty of Dentistry, University of Toronto (n=92) were surveyed prior to (Phase I) and at the end of (Phase II) mandatory clinical rotations at the Mount Sinai Hospital's Dentistry Clinic for Persons with Special Needs. Response rates were 88% for Phase I and 58% for Phase II. Before the rotations, 70% of the respondents reported little or no experience with PWDs, and 46% said they did not feel comfortable providing basic dental treatment to PWDs. However, in Phase II, significantly more students reported being comfortable than in Phase I (p=0.001). Overall, the majority of respondents (Phase I 95%; Phase II 98%) indicated they would at least attempt to provide basic dental care to PWDs after graduation. The majority also identified the opportunity to provide care and interact with PWDs as the most enjoyable aspect of their experience at the clinic. They reported that the experience helped reduce their concerns about treating PWDs including being more realistic about the time required and ideal quality of the treatment they could provide. These results suggest that their experience in the clinic significantly increased students’ comfort in treating PWDs. The respondents expressed a willingness to treat PWDs once graduated and generally identified their experience as being more positive than their expectations.
Relationships Among the Knowledge, Efficacy, and Practices Instrument, Color‐Blind Racial Attitudes Scale, Deamonte Driver Survey, and Defining Issues Test 2
Authors: Behar-Horenstein Linda S. , Garvan Cynthia W.
Published: June 2020

Concordance studies indicate the degree to which instruments measure the same or similar constructs or something different. The aims of this study were to identify the factor structure of the Deamonte Driver Survey and determine the relationship between the Deamonte Driver (a measure of social class stereotyping), the Defining Issues Test 2 (DIT2; a measure of ethical sensitivity), the Color‐Blind Racial Attitudes Scale (CoBRAS; a measure of racial stereotyping), and the Knowledge, Efficacy, and Practices Instrument (KEPI; a measure of cultural competence). The results showed a three‐factor solution for the Deamonte Driver Survey and significant relationships between CoBRAS and DIT2 subscales and between CoBRAS and Deamonte Driver subscales. Significant relationships between the measures and exploratory variables, underrepresented minority status, age, citizenship, marital status, political stance, English as a first language, and gender were found. The lack of a significant relationship between the KEPI and Deamonte Driver, DIT2, or CoBRAS subscales suggests that the KEPI is measuring a unique construct. These findings showed how these scales contributed to the assessment of cultural competence among dental students and faculty.
Identifying Multilevel Barriers to Tobacco Intervention in Postdoctoral Dental Education
Authors: Albert David A. , Bruzelius Emilie , Ward Angela , Gordon Judith S.
Published: June 2020

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.
Impact on Junior Faculty of Teaching Opportunities During Predoctoral Education: A Survey‐Based Study
Authors: Hum Lauren , Park Sang E.
Published: June 2020

Dental schools have addressed full‐time faculty shortages by utilizing part‐time faculty and postdoctoral students as teachers. Studies have also shown that peer tutors in dental schools can be used effectively in addition to or in place of faculty, but there has been little research on whether the peer tutoring experience influences tutors to pursue academic careers. This study surveyed junior faculty at 60 U.S. dental schools about their predoctoral tutoring and teaching experiences. Data from 122 respondents were analyzed. The results indicated that more recent graduates had more peer tutoring opportunities available than those who graduated prior to the 1980s and that the teaching experiences influenced the respondents’ decisions to pursue academic careers. Additionally, those peer tutoring programs that placed more responsibility on the peer tutors, signifying trust from the institution, were the most successful in influencing respondents’ decisions to pursue academia. Finally, when comparing their predoctoral teaching experiences to faculty development of teaching skills at their current institutions, the majority of the respondents reported that the faculty development was better. However, the peer tutoring programs considered equal to or better than faculty development were more influential in stimulating participants’ academic career interest. These results suggest that dental schools can look to peer tutoring and teaching programs to stimulate students’ interest in academia that can help reduce faculty shortages in the long term, but only if programs are developed that place greater responsibility and trust in students and that equal the quality of faculty development programs.
Evidence‐Based Practice Knowledge, Perceptions, and Behavior: A Multi‐Institutional, Cross‐Sectional Study of a Population of U.S. Dental Students
Authors: Straub-Morarend Cheryl L. , Wankiiri-Hale Christine R. , Blanchette Derek R. , Lanning Sharon K. , Bekhuis Tanja , Smith Becky M. , Brodie Abby J. , Oliveira Deise Cruz , Handysides Robert A. , Dawson Deborah V. , Spallek Heiko
Published: June 2020

The aim of this study was to help inform faculty and curriculum leaders in academic dental institutions about the knowledge, skills, perceptions, and behavior of an institutionally diverse population of dental students with respect to evidence‐based practice (EBP). A survey utilizing the validated Knowledge, Attitudes, Access, and Confidence Evaluation instrument developed by Hendricson et al. was conducted in 2012 with fourth‐year dental students at seven geographically dispersed U.S. dental schools. The survey addressed elements of EBP knowledge, attitudes toward EBP, behavior in accessing evidence, and perceptions of competence in statistical analysis. A total of 138 students from the seven schools participated. A slight majority of these students correctly responded to the knowledge of critical appraisal questions. While the students demonstrated positive attitudes about EBP, they did not report high levels of confidence in their critical appraisal skills. The findings also showed that the students accessed various sources of evidence with differing frequencies. The most frequently accessed resources were colleagues, the Internet (excluding Cochrane Database of Systematic Reviews), and textbooks. The results of this study help to identify areas for improvement in EBP education in order to advance dental students’ preparation to become evidence‐based practitioners.
Instructor and Dental Student Perceptions of Clinical Communication Skills via Structured Assessments
Authors: McKenzie Carly T.
Published: June 2020

The aim of this study was to use structured assessments to assess dental students’ clinical communication skills exhibited during patient appointments. Fourth‐year dental students (n=55) at the University of Alabama at Birmingham evaluated their own interpersonal skills in a clinical setting utilizing the Four Habits Coding Scheme. An instructor also assessed student‐patient clinical communication. These assessments were used to identify perceived strengths and weaknesses in students’ clinical communication. Both instructor assessments and student self‐assessments pinpointed the following clinical communication skills as effective the most often: patient greeting, avoidance of jargon, and non‐verbal behavior. There was also relative agreement between instructor assessments and student self‐assessments regarding clinical communication skills that were rated as not effective most frequently: ensuring patient comprehension, identification of patient feelings, and exploration of barriers to treatment. These resulted pointed to strengths and weaknesses in the portion of the curriculum designed to prepare students for effective provider‐patient communication. These results may suggest a need for the school's current behavioral science curriculum to better address discussion of potential treatment barriers and patient feelings as well as techniques to ensure patient comprehension.
The Buffalo Model: Shifting the Focus of Clinical Licensure Exams in Dentistry to Address Ethical Concerns Regarding Patient Care
Authors: Gambacorta Joseph E. , Glick Michael , Anker Ashley E. , Shampaine Guy S.
Published: June 2020

Most jurisdictions grant dental licensure to graduating students following successful completion of a clinical exam. Testing agencies, which are independent of dental schools, nevertheless conduct their exams at school facilities. Patient participation in these exams raises ethical concerns regarding such issues as unlicensed providers’ performing irreversible procedures with minimal supervision and graduates’ limited accessibility to provide follow‐up treatment. To address these concerns, a collaborative effort between University at Buffalo School of Dental Medicine faculty and testing agency personnel was launched. The aims of this article are to describe the development and implementation of the resulting Buffalo Model, to highlight ethical advantages in its application, and to identify areas of improvement to be addressed in future iterations. With the Buffalo Model, modifications were made to the traditional exam format in order to integrate the exam into the school curriculum, enabling candidates to take it at various points during their fourth year. In addition, after calibration of school faculty members, 98.5% of cases verified by faculty were accepted by the Commission on Dental Competency Assessments for use in the exam. In two cases, restorative treatment completed during the exam did not meet the school's competency standard. This new approach ameliorates ethical concerns associated with clinical licensure exams because treatment is provided only to patients of record within a sequenced treatment plan and timely and appropriate treatment is provided to all patients. The results of this first year of implementation also suggest that calibrated faculty members will not show bias in the selection of lesions or competency evaluations of candidates.
Impact of Community‐Based Dental Education on Attainment of ADEA Competencies: Students’ Self‐Ratings
Authors: McFarland Kimberly K. , Nayar Preethy , Ojha Diptee , Chandak Aastha , Gupta Niodita , Lange Brian
Published: June 2020

Fourth‐year dental students at the College of Dentistry, University of Nebraska Medical Center participate in a community‐based dental education (CBDE) program that includes a four‐week rotation in rural dental practices and community health clinics across Nebraska and nearby states. The aim of this study was to assess the impact of participation in the CBDE program on the self‐rated competencies of these students. A retrospective survey was administered to students who participated in extramural rotations in two academic years. The survey collected demographic data and asked students to rate themselves on a scale from 1=not competent at all to 5=very competent on attainment of the American Dental Education Association (ADEA) Competencies for the New General Dentist for before and after the rotations. A total of 92 responses were obtained: 43 students for 2011–12 and 49 students for 2012–13 (95% response rate for each cohort). The results showed that the students’ mean pre‐program self‐ratings ranged from 3.28 for the competency domain of Practice Management and Informatics to 3.93 for Professionalism. Their mean post‐program self‐ratings ranged from 3.76 for Practice Management and Informatics to 4.31 for Professionalism. The students showed a statistically significant increase in self‐ratings for all six competency domains. The increase was greatest in the domain of Critical Thinking and least in Communication and Interpersonal Skills. Overall, these results suggest that the CBDE program was effective in improving the students’ self‐perceptions of competence in all six domains and support the idea that a competency‐based evaluation of CBDE programs can provide valuable information to dental educators about program effectiveness.
A Systematic Review of the Use of Self‐Assessment in Preclinical and Clinical Dental Education
Authors: Mays Keith A. , Branch-Mays Grishondra L.
Published: June 2020

A desired outcome of dental and dental hygiene programs is the development of students’ self‐assessment skills. To that end, the Commission on Dental Accreditation states that “graduates must demonstrate the ability to self‐assess.” However, it is unclear that merely providing opportunity for self‐assessment actually leads to the desired outcome. The aim of this study was to systematically review the literature on self‐assessment in dental education. A search of English‐language articles for the past 25 years (January 1, 1990, to June 30, 2015) was performed using MEDLINE Medical Subject Heading terms. Each abstract and/or article was validated for inclusion. The data collected included student classification, self‐assessment environment, faculty assessment, training, faculty calibration, predictive value, and student perceptions. A qualitative analysis was also performed. From an initial list of 258 articles, 19 were selected for inclusion; exclusion criteria included studies that evaluated a non‐preclinical or non‐clinical exercise or whose subjects were not predoctoral dental or dental hygiene students. The results showed limited information regarding any kind of systematic training of students on how to perform a self‐assessment. The majority of the studies also did not specify the impact of self‐assessment on student performance. Self‐assessment was primarily performed in the second year and in the preclinical environment. Students received feedback through a correlated faculty assessment in 73% of the studies, but 64% did not provide information regarding students’ perceptions of self‐assessment. There was a trend for students to be better self‐assessors in studies in which a grade was connected to the process. In addition, there was a trend for better performing students to underrate themselves and for poorer performing students to overrate themselves and, overall, for students to score themselves higher than did their faculty evaluators. These findings suggest the need for greater attention to systematically teaching self‐assessment in dental and dental hygiene curricula and for further research on the impact of self‐assessment on desired outcomes.
A Cavity Preparation Evaluation System in the Skill Assessment of Dental Students
Authors: Zou Huiru , Jin Shufeng , Sun Jianping , Dai Yanmei
Published: June 2020

The aim of this study was to compare a computerized, laser‐scanning Cavity Preparation Skill Evaluation System (CPSES) with conventional teachers’ eye‐hand grading assessment of dental students’ Class I cavity preparation evaluations. Thirty‐eight cavity preparations of lower left first molars made by junior dental students at a dental school in China were tested from September 2013 to November 2014. The outline and retention form, smoothness, depth, wall angulation, and cavity margin index of the preparations were evaluated by CPSES and then by teachers’ eye‐hand grading. The mean difference in scores for each method was considered, as was the variability of scores within each method. Compared with the teachers’ eye‐hand grading method, CPSES provided objective evaluation results that had statistically significant differences (p<0.05). A questionnaire was also designed and distributed to the students; the response rate was 100%. The results indicated that most of the students recognized CPSES effects in the preclinical teaching; 92.1% perceived that CPSES provided high simulation and appropriate practice guidance for them; and 94.7% reported that the evaluation results provided by CPSES gave targeted and objective recommendations. These findings suggest that CPSES can consistently and reliably scan a student's tooth preparation, compare it to a theoretically ideal preparation, and provide objective feedback. The application of CPSES in preclinical operative training can help students better understand the desired parameters for occlusal cavity preparation skills and encourage students in their self‐paced learning and independent practice.
Dental Hygiene Faculty Calibration Using Two Accepted Standards for Calculus Detection: A Pilot Study
Authors: Santiago Lisa J. , Freudenthal Jacqueline J. , Peterson Teri , Bowen Denise M.
Published: June 2020

Faculty calibration studies for calculus detection use two different standards for examiner evaluation, yet the only therapeutic modality that can be used for nonsurgical periodontal treatment is scaling/root debridement or planing. In this study, a pretest‐posttest design was used to assess the feasibility of faculty calibration for calculus detection using two accepted standards: that established by the Central Regional Dental Testing Service, Inc. (CRDTS; readily detectible calculus) and the gold standard for scaling/root debridement (root roughness). Four clinical dental hygiene faculty members out of five possible participants at Halifax Community College agreed to participate. The participants explored calculus on the 16 assigned teeth (64 surfaces) of four patients. Calculus detection scores were calculated before and after training. Kappa averages using CRDTS criteria were 0.561 at pretest and 0.631 at posttest. Kappa scores using the scaling/root debridement or planing standard were 0.152 at pretest and 0.271 at posttest. The scores indicated improvement from moderate (Kappa=0.41–0.60) to substantial agreement (Kappa=0.61–0.80) following training using the CRDTS standard. Although this result differed qualitatively and Kappas were significantly different from 0, the differences for pre‐ to post‐Kappas for patient‐rater dyads using CRDTS were not statistically significant (p=0.778). There was no difference (p=0.913) in Kappa scores pre‐ to post‐training using the scaling/root debridement standard. Despite the small number of participants in this study, the results indicated that training to improve interrater reliability to substantial agreement was feasible using the CRDTS standard but not using the gold standard. The difference may have been due to greater difficulty in attaining agreement regarding root roughness. Future studies should include multiple training sessions with patients using the same standard for scaling/root debridement used for evaluation of students.
Exploring How U.S. Dental Schools Teach Removal of Carious Tissues During Cavity Preparations
Authors: Nascimento Marcelle M. , Behar-Horenstein Linda S. , Feng Xiaoying , Guzmán-Armstrong Sandra , Fontana Margherita
Published: June 2020

Approaches for managing carious tissues during cavity preparations vary considerably among clinicians, which may reflect inconsistencies in the teaching of this subject by dental schools. The aims of this study were to investigate practices related to the preclinical and clinical teaching of caries removal at U.S. dental schools and the relationship between that teaching and requirements for U.S. dental licensure examinations. The electronic survey included questions about terminology, methods, instruments and materials, treatment planning, criteria for clinical exams, faculty calibration sessions, and licensure exams. The faculty members at U.S. dental schools responsible for teaching cariology were invited to participate; 54 of the 65 schools had identified a contact person at the time of the survey in October 2015. Of those 54 invited to participate, 43 completed the survey (response rate of 79.6%). Most of the respondents indicated that depth of carious lesions was a clinical determinant of the amount of carious dentin being removed in cavity preparations. Caries removal was used as a criterion in restorative clinical examinations by 95% of responding schools. Marked differences were observed regarding the criteria used for assessment and removal of carious tissues, management of deep carious lesions, and definition of “caries remaining at cavity preparations,” which is considered a critical error on licensure exams. Faculty calibration sessions on caries removal were reported to occur in 65% of these schools and at different time frames. Overall, the study found a wide range of teaching practices related to caries removal. Best evidence in caries management needs to be aligned with teaching and the criteria used to calibrate faculty members and examiners.
The Embedded Counseling Model: An Application to Dental Students
Authors: Adams David Francis
Published: June 2020

Prior research has suggested that dental students experience high rates of stress, anxiety, and mood concerns, which have been linked to poor academic performance, health concerns, and substance abuse. The aim of this study was to evaluate the impact of an embedded counseling office at the University of Iowa College of Dentistry & Dental Clinics in its first three academic semesters. Data were gathered from students attending appointments, and two inventories were used to monitor students’ counseling progress and gather psychological outcomes data: the Counseling Center Assessment of Psychological Symptoms‐34 (CCAPS‐34) and the Outcome Rating Scale (ORS). In the three semesters, 55 students attended 251 counseling appointments, with an average of 4.5 appointments per student. Their presenting psychological concerns included academic concerns, time management, test anxiety, study skills, low self‐esteem, self‐care, interpersonal conflicts, anxiety, depression, stress management, sexual concerns, substance abuse, eating/body image concerns, work‐life balance, and financial issues. The CCAPS‐34 data showed that, at initial clinical assessment, students experienced moderate levels of depression, generalized anxiety, social anxiety, academic distress, and overall psychological distress; 45 (82%) showed clinically significant symptoms on at least one CCAPS‐34 subscale. The ORS data further showed that the students entered counseling experiencing high levels of psychological distress. A positive relationship was found between number of counseling appointments and increased overall functioning. These results suggest that an embedded counseling office can help dental schools meet the needs of their students.
Power of Peers: Students’ Perceptions of Pairing in Clinical Dental Education
Authors: Mills Denise A. , Hammer Christine L. , Murad Aseel
Published: June 2020

Prior studies have identified many benefits of peer mentoring in higher education, but the subject has not been widely examined in dental clinical education. Students at Midwestern University College of Dental Medicine‐Arizona are paired with a partner for the duration of the clinical phase of education. The initial vision behind pairing was to train students in a realistic four‐handed, efficient general practice model. The aim of this study was to assess the students’ perceptions of the peer mentoring component of pairing third‐ and fourth‐year dental students in the clinical phase of their education. A survey was developed to seek answers to three questions: 1) Did the students perceive that the peer mentoring supported principles of adult learning? 2) Did the students feel they were prepared to enter into the peer learning relationship? 3) What were the students’ perceptions of peer mentoring in their clinical education? Data were collected through an online survey delivered to third‐ (n=114) and fourth‐year (n=104) students at the completion of the 2014–15 school year. The 19‐question survey had a 61% response rate. The benefits of pairing were found to go far beyond the initial vision of promoting a general practice model. The majority (70.1%) of responding students perceived that it added to the educational experience, and 68.5% frequently/always agreed that the mentor‐mentee relationship motivated them to learn. Although the students expressed many benefits of pairing, 29.3% identified a need for more focused training prior to entering into the mentor‐mentee relationship.
The Relationship Between Mock Boards and Clinical Board Examinations in Dental Hygiene Education
Authors: Martin Victoria M. , Rogo Ellen J. , Hodges Kathleen O. , Piland Neill F. , Osborn Popp Sharon E.
Published: June 2020

Research on the effectiveness of clinical mock boards for future oral health professionals is conflicting and limited. Despite this, U.S. dental hygiene programs rely on clinical mock board experiences as essential components for preparing students for their clinical board examinations. Differences in programs’ mock board characteristics may relate to board exam outcomes. The validity and reliability of mock boards can be questioned when deviations from exam criteria and procedures are made and grading mechanisms are not consistent. The aim of this study was to determine which mock board characteristics were critical in preparing students by exploring the relationships between programs’ dental hygiene, local anesthesia, and restorative mock boards and their 2013–14 candidates’ performance on the corresponding three Western Regional Examining Board (WREB) licensure exams. Of the 23 U.S. dental hygiene education programs in four states invited to participate, 15 agreed to do so, and 13 consented to have WREB provide their programs’ test result data. The mock board coordinators provided data on characteristics of their programs’ mock boards with an online questionnaire distributed in 2014. Scores calculated from the responses were compared to performance of the programs’ candidates on the corresponding WREB exam. Of the 45 questionnaires (on three exams each x 15 programs), 33 were completed (73.3%). Significant relationships were found between candidates’ WREB exam results and the mock boards’ intensity scores, remediation, multiple experiences, and examiner calibration scores. The results of this study provide fundamental information about mock board characteristics that may assist educators in facilitating experiences to more effectively prepare students for these high‐stakes exams.
Dental Students’ Perceptions of Learning Value in PBL Groups with Medical and Dental Students Together versus Dental Students Alone
Authors: Amin Maryam , Zulla Rosslynn , Gaudet-Amigo Gisele , Patterson Steven , Murphy Natalie , Ross Shelley
Published: June 2020

At a dental school in Canada, problem‐based learning (PBL) sessions were restructured from an integrated dental‐medical model to a separate dental model, resulting in three groups of students available for study: those who had participated in the two‐year dental and medical combined, the one‐year dental and medical combined, the one‐year dental alone, and the two‐year dental alone. The aim of this qualitative study was to examine the extent to which the PBL structure affected the dental students’ perceptions of the learning value of PBL in the different models. A total of 34 first‐, second‐, and third‐year dental students participated in six focus groups in May and June 2011 (34% of students in those total classes). Semistructured questions explored their experiences in the different PBL structures. The interviews were recorded and transcribed verbatim, and thematic analysis was employed. The results showed positive and negative perceptions for both the combined dental and medical settings and the settings with dental students alone. For students in the combined PBL groups, positive perceptions included gaining information from medical peers, motivation to learn, and interdisciplinary collaborations. The negative perceptions mainly related to irrelevant content, dominating medical students, and ineffective preceptors. Members of the separate dental groups were more positive about the content and felt a sense of belonging. They appreciated the dental preceptors but were concerned about the inadequacy of their medical knowledge. Overall, the dental students valued the combined PBL experience and appreciated the opportunity to learn with their medical colleagues. Close attention, however, must be paid to PBL content and the preceptor's role to optimize dental students’ experience in combined medical and dental groups.
An Overview of the Models in Reporting School Data on Dental Credentialing Examinations
Authors: Tsai Tsung-Hsun , Spielman Andrew I. , Kramer Gene A.
Published: June 2020

The development and dissemination of meaningful and useful performance reports associated with examinations involved in the licensure process are important to the communities of interest, including state boards, candidates, and professional schools. Discussions of performance reporting have been largely neglected however. The authors recognize and reinforce the need for such discussions by providing prototypes of performance reporting in dentistry with examples and recommendations to guide practice. For illustrative purposes, this article reviews and discusses the different reporting models used over the past ten years with Part I and Part II of the National Board Dental Examination (NBDE). These reporting models are distinguished by such features as the following: 1) scores in each discipline covered on the exam (four for Part I and nine for Part II) and an overall average are reported in a standard‐score metric; 2) a single overall score in a standard‐score metric is reported; and 3) performance on the exam is reported as pass/fail. Standard scores on the NBDE range from 49 to 99, with 75 being a passing score. Sample data, without identifying information, are used to illustrate the reporting models.
Cross‐Sectional Analysis of National Dental Residency Match Data
Authors: Prakasam Sivaraman , Brady Patrick , Allareddy Veeratrishul , Rampa Sankeerth , Shin Kyungsup , Nalliah Romesh , Allareddy Veerasathpurush
Published: June 2020

The Dental Residency Match (DRM) program provides an ethical and unbiased selection process for applicants to postdoctoral dental programs, based on mutual interests of applicants and programs. The aims of this study were to conduct a descriptive analysis of DRM metrics for the years 2008 to 2015 and to test the hypothesis that there was a difference in number of ranks submitted between programs that filled all their offered positions and those that did not. DRM metrics data from years 2008 to 2015 were obtained from the National Matching Service. Trend analyses and panel data assessments were made. Six types of postdoctoral dental programs (GPR, AEGD, oral and maxillofacial surgery, pediatric dentistry, orthodontics, and dental anesthesiology) participate in the DRM program. The results showed that the number of programs participating and number of residency positions offered increased over the study period. The programs that filled all their positions ranked more applicants than the programs that did not fill their positions (p<0.05). The number of acceptable applicants increased over the study period for all programs except those in dental anesthesiology. These results suggest that participation in DRM is increasing, most programs are able to fill their positions with acceptable applicants, and programs seeking to fill all their positions need to submit a large number of ranks.
Assessing Student Satisfaction with Face‐to‐Face Synchronous Distance Education in a Dental Hygiene Program
Authors: Libby Lory A. , Boyd Linda D. , Perry Kristeen R. , Dominick Christine
Published: June 2020

As universities and colleges seek to reach more students in efficient ways, the use of synchronous distance education (SDE) can be an alternative to traditional classrooms. This study focused on face‐to‐face SDE, in which classrooms equipped with interactive synchronous technologies allow students in both classrooms and the professor to synchronously see and hear one another. The aims of the study were to aid educators in understanding student concerns, determine whether face‐to face SDE was sacrificing overall student satisfaction, and investigate whether satisfaction improved as the program matured. This mixed‐methods study utilized a convenience sample of two cohorts of dental hygiene students (n=122) in one program: Cohort 1, which graduated in 2014 as the first class to experience face‐to‐face SDE; and Cohort 2, which graduated in 2015. The response rate for the two cohorts was 95%. Perceptions of face‐to‐face SDE versus traditional classroom experiences and characteristics of face‐to‐face SDE were measured using pre‐ and post‐program surveys. The results showed no difference in student perceptions and expectations pre‐course vs. post‐course, although Cohort 2 had a more positive perception of SDE than did Cohort 1 (p<0.001). Perceptions of characteristics related to the classroom setting and instructor satisfaction were overall positive (p<0.001). The qualitative data suggested that technological support and faculty familiarity with SDE were substantial influences on students’ satisfaction. Overall, there was no significant difference in satisfaction with face‐to‐face SDE when students compared it to their previous classroom experiences.