Integrating Evidence-Based Practice Into Oral Health Clinical Practice: Students' Perspectives.

OBJECTIVES: Evidence-based practice (EBP) provides an approach to oral health care that incorporates a structured process of systematically reviewing and critically appraising scientific evidence to answer specific clinical questions. The need to integrate EBP concepts into the undergraduate oral health curriculum is evident as the profession transitions into using research evidence to make informed clinical decisions. The didactic component provides an overview of the theory, and the application component offers opportunities to incorporate valid scientific evidence into clinical practice. The objective of this study was to evaluate undergraduate oral health students' perspectives on integrating EBP into clinical practice in the Bachelor of Oral Health program at the University of Sydney (BOH Sydney). METHODS: A structured questionnaire with a five-point Likert scale was designed to align with the course-specific outcomes. It focused on knowledge and understanding of EBP, the process of accessing evidence, students' confidence in critical appraisal skills, and clinical application. Sixty-two (97%) undergraduate oral health students from 2-year cohorts participated in the survey. RESULTS: All students agreed that EBP influenced their clinical decision. Over 90% of students agreed that EBP should be an integral part of clinical practice. Eighty percent of students reported they were confident in EBP application. There is a significant positive correlation between teaching EBP in clinical practice and students' perceived confidence in the EBP process. CONCLUSION: Clinical educators are instrumental in providing guidance and support to oral health students' learning of EBP. The evaluation supported integrating EBP into clinical practice but revealed some issues with implementation in this study.

Assessment of work-integrated learning: comparison of the usage of a grading rubric by supervising radiographers and teachers.

IntroductionProfessional work-integrated learning (WIL) that integrates the academic experience with off-campus professional experience placements is an integral part of many tertiary courses. Issues with the reliability and validity of assessment grades in these placements suggest that there is a need to strengthen the level of academic rigour of placements in these programmes. This study aims to compare the attitudes to the usage of assessment rubrics of radiographers supervising medical imaging students and teachers supervising pre-service teachers. MethodsWIL placement assessment practices in two programmes, pre-service teacher training (Avondale College of Higher Education, NSW) and medical diagnostic radiography (Faculty of Health Sciences, University of Sydney, NSW), were compared with a view to comparing assessment strategies across these two different educational domains. Educators (course coordinators) responsible for teaching professional development placements of teacher trainees and diagnostic radiography students developed a standards-based grading rubric designed to guide assessment of students' work during WIL placement by assessors. After ∼12 months of implementation of the rubrics, assessors' reaction to the effectiveness and usefulness of the grading rubric was determined using a specially created survey form. Data were collected over the period from March to June 2011. Quantitative and qualitative data found that assessors in both programmes considered the grading rubric to be a vital tool in the assessment process, though teacher supervisors were more positive about the benefits of its use than the radiographer supervisors. ResultsBenefits of the grading rubric included accuracy and consistency of grading, ability to identify specific areas of desired development and facilitation of the provision of supervisor feedback. The use of assessment grading rubrics is of benefit to assessors in WIL placements from two very different teaching programmes. ConclusionRadiographers appear to need more training in the rubric's use, whereas teachers are found to generally use it appropriately. There are implications drawn from this finding that are applicable to health science and medical education in general.

Effectiveness of a brief educational workshop intervention among primary care providers at 6 months: uptake of dental emergency supporting resources.

INTRODUCTION: Dental emergencies often present to primary care providers in general practice and Emergency Departments (ED), who may be unable to manage them effectively due to limited knowledge, skills and available resources. This may impact negatively on patient outcomes. Provision of a short educational workshop intervention in the management of such emergencies, including education in supporting resources, may provide a practical strategy for assisting clinicians to provide this aspect of comprehensive primary care. METHODS: This descriptive study used a validated questionnaire survey instrument to measure the effectiveness of a short multimodal educational intervention through the uptake and perceived usefulness of supporting resources at 6 months following the intervention. Between 2009 and 2010, 15 workshops, of which eight were for regional and rural hospital ED doctors, were conducted by the same presenter using the same educational materials and training techniques. A sample of 181 workshop participants, 63% of whom were in rural or remote practice and engaged in providing primary care medical services, returned responses at 6 months on the perceived usefulness of the dental emergencies resource. RESULTS: Thirty percent of clinicians had used the dental emergencies resource within the six-month follow-up period. Significance was demonstrated between professional category and use of the resource, with emergency registrars utilising this resource most and GPs the least. The Dental Handbook, specifically designed for ED use, and tooth-filling material contained within this resource, were deemed the most useful components. There were overall positive open-ended question responses regarding the usefulness of the resource, especially when it was made available to clinicians who had attended the education workshops. CONCLUSION: Utilisation and perceived usefulness of a supporting resource at 6 months are indicators of the effectiveness of a short workshop educational intervention in the management of dental emergencies by primary care providers. This education may have greater relevance to rural and remote practice where dental services may be limited.

Managing dental emergencies: a descriptive study of the effects of a multimodal educational intervention for primary care providers at six months.

BACKGROUND: Clinicians providing primary emergency medical care often receive little training in the management of dental emergencies. A multimodal educational intervention was designed to address this lack of training. Sustained competency in managing dental emergencies and thus the confidence to provide this care well after an educational intervention is of particular importance for remote and rural healthcare providers where access to professional development training may be lacking. METHODS: A descriptive study design with a survey instrument was used to evaluate the effectiveness of a brief educational intervention for primary care clinicians. The survey was offered immediately before and at six months following the intervention. A Wilcoxon signed rank test was performed on pre and six month post-workshop matched pair responses, measuring self-reported proficiency in managing dental emergencies. The level of significance was set at p < 0.001. Confidence intervals (CI) were calculated for participants who scored an improved proficiency. RESULTS: The educational intervention was associated with a significant and sustained increase in proficiency and confidence to treat, especially in oral local anaesthesia, management of avulsed teeth and dental trauma, as reported by clinicians at six months after the education. This was associated with a greater number of cases where dental local anaesthesia was utilised by the participants. Comments from participants before the intervention, noted the lack of dental topics in professional training. CONCLUSIONS: The sustained effects of a brief multimodal educational intervention in managing dental emergencies on practice confidence and proficiency demonstrates its value as an educational model that could be applied to other settings and health professional groups providing emergency primary care, particularly in rural and remote settings.

Can a four-hour interactive workshop on the management of dental emergencies be effective in improving self reported levels of clinician proficiency?

BACKGROUND: Management of dental emergencies is a clinical problem facing many primary care providers who have often received little training in this area. AIM: This study evaluated the impact of a four-hour interactive workshop on clinicians' self reported proficiency in managing common dental emergencies. METHOD: A descriptive study design using a questionnaire type survey instrument was used to evaluate the effectiveness of a brief interactive workshop. RESULTS: The workshop positively impacted proficiency, especially in oral local anaesthesia, management of avulsed teeth and dental trauma. Open comments from participants focused on the lack of dental topics in professional training. RECOMMENDATIONS: Further education is required in the management of dental emergencies such as odontogenic infections, dental local anaesthesia, trauma, intra-oral haemorrhage and in dental nomenclature. CONCLUSIONS: An effective interactive workshop intervention employing blended instructional techniques may help improve the management of dental emergencies and patient outcomes.

Academic perceptions amongst educators towards eLearning tools in dental education.

This paper reports an explorative study about academic educators' perceptions towards learning management systems (LMS) and eLearning tools as used in dental education. Fifty-five educators participated in an online survey which explored their views on eLearning tools within the context of their own professional training background and teaching needs. In general, educators felt that the eLearning LMS (also known as WebCT/Blackboard) was a tool that suited their teaching and learning needs in terms of flexibility, interactivity and accessibility despite a significant level of self-reported lack of competence in the technology. The paper describes current eLearning professional development initiatives in light of these findings.

Management of dental emergencies by medical practitioners: recommendations for Australian education and training.

Dental emergencies commonly present to EDs and primary care consultations. The medical practitioner is often ill-prepared in the primary management of dental emergencies because of a lack of education in this field of practice. A published work review covering the nature, incidence, education and training surrounding this topic is presented together with recommendations for Australian practice.

Dental clinical teaching: perceptions of students and teachers.

The objective of this study was to explore perceptions of dental student clinicians and clinical teachers about dental clinical teaching to provide primary data for dental researchers and educators. Student focus group data provided background for development of a questionnaire that explored three themes related to clinical teaching. Twenty-one teachers and forty-five student respondents completed the twenty-five-item questionnaire in 2003. In the theme of the teacher/student relationship, no statistically significant differences were seen between teacher and student group perceptions. In the theme of educational theory applied in dental clinical teaching, a statistically significant difference was seen between teacher and student groups in the value of preclinical instruction in senior clinical years and in the value of a clinical log book. In the theme of skills required for clinical dental practice, a statistically significant difference was seen between teacher and student groups in the value of a critical appreciation of evidence-based practice as one of the skills. The study overall indicates that the dental clinical learning environment supports close perceptual conformity between students and clinical teachers in regard to what each group considers to be "good practice" in clinical teaching. The findings of this study indicate that some techniques that have been advocated to enhance clinical learning, such as evidence-based teaching methods, require further investigation.

Student use and perceptions of different learning aids in a problem-based learning (PBL) dentistry course.

First-year dental students in a new problem-based learning (PBL) course, the Bachelor of Dentistry (BDent) Program at the University of Sydney, Australia, completed the Study Process Questionnaire and two other questionnaires in this study. The study aimed to identify student perceptions of a written formative assessment and the helpfulness of various learning aids used to prepare for this assessment and preparing to be a dental clinician. Correlations between approach to learning and perceptions of assessment and learning aids showed theoretically expected associations. Surface learning was associated with students' concerns regarding whether assessment items reflected curriculum content, a valuing of lectures as a learning aid, and low scores for theme sessions. Deep learning was associated with a perception that the assessment tested application of basic and clinical sciences and a valuing of both independent study groups and learning topics as learning aids. An achievement orientation to learning was associated with a valuing of formative assessment as a learning aid and an intention to modify study habits as a result of participating in formative assessment. The findings provide insight into student learning in a PBL context that will help teachers and curriculum developers better understand the value of teaching aids provided in the program and the impact assessment has on study styles.