Measurable reflection in simulation: A pilot study.

PURPOSE: Debriefing is considered a cornerstone in the success of simulated learning practices. For debriefing to be productive and meaningful, reflection of the learners is essential. Measuring reflection during debriefing has proven to be difficult. This study aimed to validate a reflection rubric based on Kolb's Theory of Experiential Learning and integrate the assessment tool into simulation debriefing practice. METHODS: This research was a non-experimental mixed-methods, sequential explanatory design. Validation for the rubric was accomplished by expert content review and an observation process. Students participated in a standardized patient simulation (SPS) portraying a patient with bipolar disorder. The SPS debriefings were recorded and thematically coded to determine the quality and level of reflection of the students according to the following rubric criteria based on Kolb's theory: (1) Concrete Experience, (2) Reflective Observation, (3) Abstract Conceptualism, and (4) Active Experimentation. A descriptive statistical analysis of student responses was applied. RESULTS: The Debriefing Reflection Rubric was successful in determining the level of reflection in the dental hygiene students; further descriptive results were evaluated by a thematic analysis of student responses (N = 173). Student responses demonstrated reflective observations and concrete experiences (n = 112); however, dental hygiene students demonstrated limited responses (n = 61) to abstract conceptualism and connecting their experience to future goals and experimentation. CONCLUSION: The Debriefing Reflection Rubric, based on Kolb's Theory of Experiential Learning, was successful in measuring a learner's level and quality of reflection during a simulation debriefing.

The Benefits and Challenges of Collaborative Learning: Educating Dental and Dental Hygiene Students Together.

Most often, members of the dental team are educated in separate programs. These professionals then come together in practice to work as a team, often with limited knowledge about each other's roles. The aim of this study was to assess the perspectives of dental and dental hygiene students regarding collaborative learning after taking two courses together. Five years (2010-14) of survey data were collected from a convenience sample of dental and dental hygiene students. The dental hygiene students were in their first and second years (DH1 and DH2) at Eastern Washington University (EWU). The dental students were in the University of Washington (UW) Regional Initiative in Dental Education (RIDE) program, taking their first year of courses in Eastern Washington with EWU's dental hygiene and UW's medical students. Eight first-year dental (D1) students participate in the RIDE program each year, totaling 40 across the five years. Because the same D1 students take both courses, this target population was 80. The number of DH1 and DH2 students in these courses ranges from 32-36 each year, for a target population of 323 across the five years. A total of 193 survey responses were collected, for an overall response rate of 48%; the D1 response rate was 72%, and the DH response rate was 42%. In the results, students perceived that learning collaboratively helped them think positively about other dental professionals, benefitted their problem-solving skills, increased their understanding of clinical problems, helped them become better team members, improved trust and respect, and improved their understanding of course content. These results suggest that collaborative learning had a positive impact on both groups. In comments, students suggested they would benefit from more shared learning experiences in the clinic and agreed that collaborative learning would help them create a more cohesive team.

High-Fidelity Simulation: Preparing Dental Hygiene Students for Managing Medical Emergencies.

Medical emergencies can occur at any time in the dental office, so being prepared to properly manage the situation can be the difference between life and death. The entire dental team must be properly trained regarding all aspects of emergency management in the dental clinic. The aim of this study was to evaluate a new educational approach using a high-fidelity simulator to prepare dental hygiene students for medical emergencies. This study utilized high-fidelity simulation (HFS) to evaluate the abilities of junior dental hygiene students at Eastern Washington University to handle a medical emergency in the dental hygiene clinic. Students were given a medical emergency scenario requiring them to assess the emergency and implement life-saving protocols in a simulated "real-life" situation using a high-fidelity manikin. Retrospective data were collected for four years from the classes of 2010 through 2013 (N=114). The results indicated that learning with simulation was effective in helping the students identify the medical emergency in a timely manner, implement emergency procedures correctly, locate and correctly utilize contents of the emergency kit, administer appropriate intervention/treatment for a specific patient, and provide the patient with appropriate follow-up instructions. For dental hygiene programs seeking to enhance their curricula in the area of medical emergencies, this study suggests that HFS is an effective tool to prepare students to appropriately handle medical emergencies. Faculty calibration is essential to standardize simulation.

Point-of-care HbA1c screening predicts diabetic status of dental patients.

PURPOSE: Mutual production of proinflammatory cytokines causes a deleterious cyclic relationship between uncontrolled diabetes and periodontal disease. The prevalence of diabetes is escalating out of control. Early detection of pre-diabetes and diabetes may respectively prevent or delay disease onset and eliminate or decrease complications. The dental office offers an opportune site for diabetes screening. This study investigated the ability to precisely screen previously unidentified dental patients for diabetes and pre-diabetes. METHODS: In this predictive correlational study, participants were chosen by convenience sampling, and were included based on self-proclaimed risk factors. A point-of-care (POC) fingerstick HbA1c screening identified participants for confirming venous HbA1c laboratory screenings. Kendall's tau analyzed the relationship between POC HbA1c results and classification as diabetic or pre-diabetic based on laboratory HbA1c results. Chi Square, Likelihood Ratio, Cramer's V and Lambda compared the expected and observed results. RESULTS: Of the 104 diabetes risk questionnaires completed, 75 participants were included in the POC screening. Of these, 34 (71% female and 29% male) had HbA1c levels at or above the American Diabetes Association's (ADA) recommended 5.7% cut-point for pre-diabetes. Three participants were less than age 44, 10 were 44 to 57, and 21 were over 57. Laboratory results categorized 6 participants as normoglycemic and 28 with HbA1c greater than or equal to 5.7%. Kendall's tau (p=0.004) determined POC results can predict diabetic or pre-diabetic laboratory group assignment. Pearson's chi-square (p=0.004), Likelihood ratio (p=0.004) and Cramer's V (p<0.001) concluded a relationship existed between group assignment based on POC HbA1c results and those of subsequent laboratory HbA1c results; Lambda (p=0.145) did not. CONCLUSION: Within the limits of this study, it was established that a safe and minimally invasive dental chair-side POC HbA1c screening unveiled previously unidentified diabetic and pre-diabetic patients.

Dental Team Experience (DTE): a five year experience.

PURPOSE: Several European countries have interprofessional training for health care professional students, including dental and dental hygiene students. However, very little training exists in the U.S. where dentists and dental hygienists are educated together. The 4th World Congress of Preventive Dentistry and the American Dental Education Association have stated that teamwork must be taught in the dental professions. In 2005, Eastern Washington University began an interdisciplinary team experience in which graduating dental hygiene, dental assisting and dental students worked in an interdisciplinary team providing care to the underserved. A new team was formed each year for the next 5 years. This paper addresses the establishment and outcomes of this interdisciplinary experience.