Impact of simulated patients on students' self-assessment of competency in practice of geriatric dentistry.

PURPOSE: The evaluation of the effectiveness of simulation training in dentistry has previously been focused primarily on psychomotor hand skills. This study explored the impact of simulated patient (SP) encounters in simulation on students' self-assessment of competency in their clinical and communication abilities with geriatric patients. METHODS: Students from 2 cohorts were recruited for this study. Cohort 1 (n = 30) participated in the standard curriculum with no simulation training and served as the control group. Cohort 2 (n = 34) participated in a SP experience, simulating the initial stages of a care visit for 2 nursing home patients. Students' perceptions of competency to perform these clinical and communication tasks were assessed. A group debriefing session was held 5 weeks post-simulation where Cohort 2 completed a student feedback form. RESULTS: A statistically significant change (P < 0.00001) was noted for both cohorts in their self-reported competence to perform clinical tasks following exposure to an independent clinical experience. In addition to this gain, individuals in Cohort 2 demonstrated improvements following simulation and expressed different responses of impact to questions related to treatment, pharmacology, and managing a complex medical history. CONCLUSIONS: This study suggests that simulation of patient interactions using SPs can strengthen students' self-assessment of competency in their abilities, leading to more genuine interactions with actual patients. These findings will help inform the design of future SP encounters as a component of an evolving humanistic curriculum.

Personality Types: Predictors for Pediatric Dentists-Pilot Study.

Personality Types of Pediatric Dentistry Residents and Residency Applicants PURPOSE: Dentists may possess unique personality traits that distinguish them from the general population. Within the profession, there may be personality traits that are more prevalent in one specialty than another. This project was designed to determine if personality profiling could be a predictor for success in a specialty field, i.e. pediatric dentistry. The Myers-Briggs Type Indicator (MBTI) was developed to make the theory of psychological types, described by Carl Jung, understandable and useful to people's everyday lives. Jung's theory is that much of what seems like random human behavior is due to basic differences in the . way people use their perception and judgment. The purpose of this study was to determine if interviewees to a pediatric dentistry residency program possessed similar personality traits to pediatric dentistry faculty/residents by comparing the Meyers-Briggs Type Indicator (MBTI) results of the 2 groups. METHODS: Thirty-one pediatric dentistry faculty/residents were.compared with 46 pediatric dentistry residency interviewees. Each member of both groups anonymously completed the MBTI profile. RESULTS: This study indicates that there are no significant differences in MBTI personality types between pediatric dentistry faculty/residents versus interviewees to a pediatric dentistry residency (p=0.168), except that interviewees were more likely to exhibit the ESFJ type than were faculty/ residents (p=0.015). ESFJ represents E, extrovert, S, sensing, F, feeling and J, judging. All comparisons were conducted with the asymptotic chi-square test, except when expected cell counts were <5. For the latter comparisons, the Fisher's exact version of the chi-square test was used, p< .05 CONCLUSION: It is concluded that no common personality type, as determined by the MBTI, exists between pediatric dentistry faculty/residents and interviewees for residency, and that personality characteristics cannot be used as predictive factors in selection of pediatric dentistry residents.

Identifying the effect of cleft type, deprivation and ethnicity on speech and dental outcomes in UK cleft patients: a multi-centred study.

BACKGROUND: Outcome measures are increasingly important in the modern National Health Service. In the care of children born with cleft lip and/or palate there are many different outcomes to consider but only a few reliable, validated outcome measures exist. The dmft (decayed, missing and filled teeth) index and cleft speech characteristics (CSCs) are used regularly by cleft teams throughout the UK to assess outcomes in children with cleft lip and/or palate. We hypothesized that these two outcome measures might be significantly influenced by the demographics of the populations studied independent of the care provided. METHODS: A retrospective review of all patients aged between five and six referred to three regional cleft centres during a twelve month period were included in the study. Speech and dental outcomes were compared with patient ethnicity, cleft type and level of deprivation as determined by the Carstairs score. RESULTS: The data of 287 patients were used. Speech was significantly affected by cleft type (p < 0.03), whereas dentition was significantly affected by ethnicity (p = 0.002) and deprivation (p = 0.012). CONCLUSIONS: This study demonstrates that the demographics of cleft populations can significantly affect the measures of outcome used to assess the quality of care provided by cleft teams. It has also demonstrated that these demographics are not evenly distributed across the country and that some cleft teams will have a more 'at risk' population than others. LEVEL OF EVIDENCE: Risk, level II.

Multiple Individual Audit Outcome Web--a novel tool to evaluate patient outcomes.

Multiple Individual Audit Outcome Web (MIAOW) is a pictorial representation of outcomes, which is used widely in industry, finance, and sports, but not, to the best of our knowledge, in our specialty. It was developed to display multiple audit outcomes for patients in cleft surgery and we show its use in that area, but equally it could be applied to other areas such as orthognathic surgery, and head and neck oncology. We report how it can be used to display surgical outcomes.

Case report of a family with benign familial neutropenia and the implications for the general dental practitioner.

UNLABELLED: Benign familial neutropenia (BFN) is a condition where there is a decrease in circulating neutrophils in the blood and patients suffer from oral manifestations which include: persistant periodontal disease, recurrent neutropenic ulceration and candidal infections. This report discusses a family affected by BFN and the effects on their oral health. CLINICAL RELEVANCE: Benign familial neutropenia is a rare condition and this article aims to raise awareness among general dental practitioners so that prompt referral and management in secondary care can be arranged.

Facing forward: meeting the rehabilitation needs of cancer survivors.

Decreased physical functioning, either transient or enduring, is encountered by many individuals at various points in the cancer trajectory. Oncology nurses are well positioned to promote functional recovery, as they have intensive contact with cancer patients in multiple settings and throughout all phases of the disease continuum. This article reviews effective screening tools that nurses can use to identify the rehabilitation needs of individual patients and initiate appropriate interventions or referrals for additional rehabilitation services. It also outlines realistic rehabilitation protocols that can help oncology nurses to reduce and prevent impairments that may occur during cancer and its treatment. As will be discussed, patients' functional performance can also be directly improved by enhanced incorporation of rehabilitation principles into oncology nursing practice.

Cancer rehabilitation: challenges, approaches, and new directions.

Impairments and disability in cancer patients can be caused by the disease process or by its treatment, including the effects of surgery, chemotherapy, and radiation. The prevalence of all cancers, with an estimated 1.4 million new cases in 2006, the development of new treatment options, and improved outcomes have created a constantly growing population of cancer survivors whose function and quality of life have been affected by their diagnoses. This article reviews the theoretical framework, clinical interventions, and research initiatives pertinent to providing rehabilitation services for patients who have been diagnosed with cancer.

Cardiopulmonary rehabilitation and cancer rehabilitation. 3. Cancer rehabilitation.

UNLABELLED: This self-directed learning module highlights the treatment and rehabilitation of patients with cancer. It is part of the study guide on cardiac, pulmonary, and cancer rehabilitation in the Self-Directed Physiatric Education Program for practitioners and trainees in physical medicine and rehabilitation. This article reviews medical and rehabilitation issues in patients with various types of cancer. Cases were selected to allow discussion of problems seen in both younger and older patient populations. Identification of common sequelae of cancer and cancer treatments, associated rehabilitation challenges, and appropriate interventions are included. OVERALL ARTICLE OBJECTIVE: To summarize the medical and rehabilitation issues in patients with various types of cancer.

Cancer-related fatigue.

UNLABELLED: This self-directed learning module highlights the role of cancer-related fatigue in the rehabilitation of people with oncology diagnoses. It is part of the chapter on cardiac, pulmonary, and cancer rehabilitation in the Self-Directed Physiatric Education Program for practitioners and trainees in physical medicine and rehabilitation. This article identifies the most common causes and features of cancer-related fatigue and presents a general approach and specific recommendations for appropriate intervention. OVERALL ARTICLE OBJECTIVE: To equip physiatrists to evaluate and treat the common problem of cancer-related fatigue in patients with oncologic diagnoses.

Breaking the smoking habit: behavioral aspects of tobacco cessation.

The development of a smoking habit is unique to each individual. Any smoking cessation effort should also be tailored to the individual. The dentist in clinical practice should be familiar with the 5 A's, with dosages and forms or nicotine replacement therapy, and with counselors and community resources for possible referral. The dentist who is trying to assist his/her patient to stop smoking must be supportive, positive, patient and encouraging and relaize that it might take multiple attempts before a smoker is able to quit once and for all.

Interventions in chronic pain management. 3. New frontiers in pain management: complementary techniques.

UNLABELLED: This self-directed learning module highlights complementary and alternative therapies that are often used by patients seen in the typical physiatric practice. This article contains information on acupuncture and its use to treat low back pain, recent therapeutic approaches to lateral epicondylitis, movement therapies appropriate for the osteoporotic patient, and spa therapies. Scientific literature and standards of clinical practice in these areas have been reviewed to put forth the most recent recommendations regarding these diagnoses and therapeutic interventions. OVERALL ARTICLE OBJECTIVES: (a) To familiarize the physiatrist with complementary techniques that are increasingly popular in the United States and (b) to identify when therapies, such as acupuncture, movement therapies, bodywork, and the like, may be integrated into a comprehensive treatment approach for common physiatric clinical scenarios.