Shaping tomorrow's dentists: a multi-institutional survey of undergraduate dental students' perceptions towards interprofessional education.

BACKGROUND: Interprofessional education (IPE) is essential to foster collaboration among healthcare professionals for holistic patient care. However, Malaysian dental education remains discipline-centric, hindering multidisciplinary learning approaches. Hence, this study aimed to explore Malaysian undergraduate dental students' perceptions of IPE. METHODS: The present cross-sectional study employed convenience sampling to survey undergraduate dental students from four Malaysian institutions using a modified questionnaire with 20 close-ended and 2 open-ended questions. The questionnaire covered three domains (effectiveness, preference, importance) to assess students' perceptions using a five-point Likert scale. Psychometric validation was performed to assure validity and reliability of the modified questionnaire. Quantitative analysis (descriptive and inferential statistics), and qualitative analysis (content analysis) were subsequently performed. RESULTS: 397 students responded, and positive perceptions were generally noted with mean scores ranging from 4.13 to 4.35 across all domains. Questions 2 and 3, assessing the improvement in understanding the roles and responsibilities, and communication among healthcare professionals, received the highest mean scores. Meanwhile, Question 15 concerning the incorporation of IPE into educational goals received the lowest mean score. Regression analysis identified gender and clinical phase as significant factors, with females and preclinical students exhibiting more favourable perceptions. Motivators for IPE included a keen interest in diverse perspectives and recognising the importance of teamwork, while barriers encompassed tightly packed schedules, lack of understanding about IPE, misconceptions regarding dental education, and students' nervousness and fear of participation. CONCLUSION: This study produced a valid and reliable instrument to measure undergraduate dental students' perceptions towards IPE. Strategic planning, such as overcoming logistical challenges, improving awareness, and creating a supportive learning environment are crucial for successful IPE integration into existing curricula, especially in resource-constrained developing countries like Malaysia.

Navigating the assessment landscape: Dental students' perceptions of extended-matching questions versus single-correct answers.

PURPOSE: The present study aims to evaluate students' perceptions of different types of written assessment within the context of dental materials science and to identify how various learning styles exhibited by dental students, as well as gender and ethnicity, may influence their perceptions of these assessment methods. METHODS: The study was conducted among second-year dental students in a dental materials science class, during which students participated in a mock assessment that included extended matching questions (EMQs) and single correct answer (SCA) questions. An online questionnaire comprising three sections: demographic information, Honey and Mumford's Learning Styles Questionnaire, and 15 closed-ended questionnaire items employing a 5-point Likert scale were administered to assess students' perceptions of the assessment methods. Statistical analyses were conducted using the Kruskal-Wallis test, Mann-Whitney U test, and a post-hoc Bonferroni test. RESULTS: All 70 students participated in the study with the majority being female, Chinese, and activist learners. Median total scores among various learning styles, gender, and ethnicity did not exhibit significant differences. Analysis of individual questionnaire items revealed mixed perceptions regarding EMQs. Reflectors generally held more positive perceptions of EMQs, while theorists showed the lowest total median scores toward EMQs. Most students did not prefer EMQs over SCAs, and some students expressed confusion about EMQs, especially those with a theorist learning style. CONCLUSION: Although students generally showed good perceptions towards these assessment methods, further research is needed to better understand the interplay of learning styles, assessment preferences, and educational outcomes in dental education.

Students' perceptions towards the ethical considerations of using artificial intelligence algorithms in clinical decision-making.

Aim The present study aimed to explore the perceptions of dental students regarding the ethical considerations associated with the use of artificial intelligence (AI) algorithms in clinical decision-making.Methods All the undergraduate clinical-year dental students were invited to take part in the study. A validated online questionnaire which consisted of 21 closed-ended questions (five-point Likert scales) was distributed to the students to evaluate their perceptions on the topic. Mean perception scores of the students from different years were analysed using a one-way ANOVA test, while independent t-tests were used to compare the scores between sexes.Results In total, 165 students participated in the present study. The mean age of the respondents was 23.3 (± 1.38) years and the majority were female, Chinese students. Respondents showed positive perceptions throughout all three domains. Uniform and comparable perceptions were seen across various academic years and sexes, with female respondents expressing stronger agreement regarding patient consent and privacy prioritisation.Conclusion Undergraduate clinical dental students generally showed positive perceptions regarding the ethical considerations associated with the integration of AI algorithms in clinical decision-making. It is essential to address these ethical considerations to ensure that AI benefits patient outcomes while upholding fundamental ethical principles and patient-centred care.

The use of feedback in teaching undergraduate dental students: feedback sandwich or Ask-Tell-Ask model?

BACKGROUND: Feedback is regarded as a key component of formative assessment and one of the elements with the greatest impact on students' academic learning. The present study aimed to evaluate and compare students' perceptions of the use of two feedback models, namely feedback sandwich and Ask-Tell-Ask (ATA), in teaching dental materials science courses. METHODS: All undergraduate second-year dental students were invited to participate in the dental materials science practical session and were randomly allocated into two groups: Group 1 (feedback) sandwich and Group 2 (ATA). The session began with the teacher giving a short briefing on the commonly used dental materials, followed by a short demonstration of the manipulation of those materials. Students were then allowed to mix and manipulate the materials, and teachers provided feedback accordingly. At the end of the session, 16 close-ended (five-point Likert scales) and an open-ended questionnaire were distributed to students to evaluate their perceptions of the feedback given. Internal reliability of the questionnaire items was evaluated using Cronbach's alpha. Mean feedback scores were analysed using an independent t-test with ANCOVA for controlling gender and ethnicity. Thematic analysis was used to code the qualitative data. RESULTS: Sixty-nine students participated in the present study with the majority being females (72.5%) and Chinese (79.7%). Cronbach's alpha analysis suggested removing three Likert-scale items, with the remaining 13 items being accepted. Generally, no significant difference was noted between the two groups (p = 0.197), but three items were found to be significant (p < 0.05), with higher mean scores in the feedback sandwich group. Moreover, no significant difference was noted between the two feedback models (p = 0.325) when controlling gender and ethnicity. The open-ended question showed that students in the feedback sandwich group expressed greater positive perceptions. CONCLUSION: Although students generally had positive perceptions of both feedback models, they tended to favour the feedback sandwich. Neither gender nor ethnicity affected the students' perceptions of the two feedback models.

Perceptions on using the International Caries Detection and Assessment System (ICDAS) among Malaysian private dentists: a qualitative study / Percepções sobre o uso do Sistema Internacional de Detecção e Avaliação de Cárie (ICDAS) entre dentistas privados da Malásia: um estudo qualitativo

Objetivo: explorar as percepções de dentistas particulares da Malásia sobre o uso do Sistema Internacional de Detecção e Avaliação de Cárie (ICDAS) em sua prática odontológica. Material e Métodos: este estudo qualitativo envolveu entrevistas individuais com doze clínicos gerais que trabalham no setor privado, que foram expostos ao treinamento ICDAS durante seu estudo de graduação. Uma amostra intencional foi realizada com dentistas particulares na Malásia de vários estados com intuito de refletir a diversidade. As entrevistas foram gravadas e transcritas. A análise dos dados foi realizada pela análise temática. Resultados: cinco barreiras principais foram identificadas durante o processo de codificação, ou seja, fatores como o tempo, falta de treinamento, o não planejamento do tratamento, dificuldades de registro e baixa conscientização do paciente sobre prevenção. Foram identificados como fatores facilitadores um melhor treinamento e uma forte exigência das autoridades para usar este sistema. Conclusão: dentistas particulares na Malásia encontraram uma infinidade de desafios na adoção do índice ICDAS. Portanto, é necessário fornecer treinamento e assistência adequados para entender os benefícios da utilização do sistema ICDAS e da informatização da entrada de dados (AU)

Objective: to explore the perceptions of Malaysian private dentists on the use of the International Caries Detection and Assessment System (ICDAS) in their dental practice. Material and Methods: this qualitative study involved individual interviews with twelve general dental practitioners working in the private sector, who has been exposed to ICDAS training during their undergraduate study. Purposive sampling was carried out among private dentists in Malaysia from various states to reflect diversity. The interviews were recorded and transcribed. Data analysis was conducted by thematic analysis. Results: five main barriers were identified through the coding process, namely time factors, lack of training, having no effect on treatment planning, charting difficulties, and low patient awareness on prevention. Better training and a strong requirement by the authorities to use this system were identified as the enabling factors. Conclusion: private dentists in Malaysia encountered a myriad of challenges in adopting the ICDAS index. Hence, it is necessary to provide adequate training and assistance in understanding the benefits of utilizing the ICDAS system, and computerization of data input (AU)

Lifestyle factors associated with poor sleep quality among undergraduate dental students at a Malaysian private university.

Objective: The purpose of this study was to look into the associations between lifestyle factors, gender, clinical level, and sleep quality among undergraduate dental students at a private university in Malaysia. Material and Methods: A self-administered Pittsburg sleep quality index (PSQI) scale and the lifestyle and habits questionnaire-brief (LHQ-B) were used in this cross-sectional study. A global PSQI score of greater than 5 indicates poor sleep quality. All university dental students were invited to take part. Descriptive statistics and logistic regression analyses were used to analyze the data. Results: A total of 338 students took part in the study, with a response rate of 90.4%. The proportion of females was higher (68.3 %) and more than half of the respondents (56.7 %) were in their clinical years. The prevalence of poor sleep quality was 36.7%. At multivariable level, poor sleep quality was associated with being male (OR=1.72 [95% confidence interval (1.05, 2.83)] and engaging in an unhealthy lifestyle for psychological health (OR=2.64 [95% confidence interval (1.34, 5.21)] and nutrition (OR=2.48 [95% confidence interval (1.028, 4.82)]. Conclusion: The prevalence of poor sleep quality among undergraduate dental students in our study was comparable to that found in other studies. Male students were more likely to have poor sleep quality than female students. Our findings indicate that poor sleep quality (PSQI score >5) may be linked to unhealthy lifestyle habits related to psychological health and nutrition. Health education that emphasizes these domains is essential for improving their lifestyle habits and sleep quality.

Complementary alternative medicine use amongst breast cancer patients in the Northern region of peninsular Malaysia.

BACKGROUND: Breast cancer is a common cancer affecting women in Malaysia and the use of complementary/ alternative medicine (CAM) has been associated with delays in getting treatment. The aim of the study was to explore the use of CAM and the influencing factors in the Northern region of Peninsular Malaysia. MATERIALS AND METHODS: This was a cross-sectional descriptive study on a convenience sample of 100 Malaysian breast cancer survivors. FINDINGS: The reported use of CAM among the breast cancer survivors was lower than in other studies but the types of CAM used had a similar pattern with nutrition supplements/vitamins being the most common. The factors that positively influenced the use of complimentary/traditional therapy were income and getting information from television or radio. Survivors with access to internet/blogs appear to have lower odds of using complimentary/traditional therapy compared to the respondents who reported no such access. CONCLUSIONS: Information transmitted via television and radio appears to have a positive influence on CAM use by breast cancer patients compared to other information sources and it is important to ensure that such information is accurate and impartial.

Motorcycle accident is the main cause of maxillofacial injuries in the Penang Mainland, Malaysia.

BACKGROUND/AIM: Maxillofacial injuries are among the commonest forms of body injuries. There are three divisions, namely, facial bone fractures, soft tissue injuries, and dentoalveolar injuries. Etiologies include motor vehicle accidents, assaults, falls, and sporting injuries. The aim of this study was to determine the profiles including the causes of maxillofacial injuries seen in an urban government hospital in the mainland of Penang State, Malaysia. MATERIALS AND METHODS: This was a cross-sectional study that recruited cases reported within a period of 1 year. The source population was maxillofacial injury patients presenting to the Oral and Maxillofacial Surgery Department of an urban hospital in the Penang Mainland, North Malaysia between May 2007 and May 2008. Cases of patients involved in accidents that occurred outside the reference vicinity were excluded. A case report form was developed and completed by the attending clinicians. Data were analyzed using spss version 12.0. RESULTS: A total of 194 cases were studied, with the mean patient age being 27.8 (SD 15.20) years. The majority of patients were Malay men between 20 and 29 years of age. The main cause of injury was motorcycle accident (53.6%). The commonest injury (in isolation/combination with other injuries) involved the soft tissues (87.2%), dentoalveolar region (33.4%), and facial bones (23.9%). Laceration was the commonest soft tissue injury, and crown fracture was the most frequent dentoalveolar injury. The facial bone that was most highly involved in the injury was the zygoma. Subjects involved in motorcycle accidents had a significantly higher incidence of sustaining facial bone fractures. CONCLUSIONS: Motorcycle accidents were the commonest cause of maxillofacial injuries in the Penang Mainland, Malaysia. Most patients were young men. Hence, it is prudent to reinforce appropriate road safety and awareness interventions particularly focusing young male motorcyclists so as to reduce the risk of accidents.

Association of carcinoma breast: grade and estrogen progesterone receptor expression.

OBJECTIVE: To determine the association between histological grade of tumour and estrogen progesterone receptors (ER/PR) expression in unselected invasive carcinoma of breast in Malaysian patients. STUDY DESIGN: An observational study. PLACE AND DURATION OF STUDY: Advanced Medical and Dental Institute and Hospital, Kepala Batas, from year 2002 to 2007. METHODOLOGY: Ethical approval from Ministry of Health of Malaysia was obtained. Retrospective case records of patients presented between 2002- 2007 were reviewed for obtaining information on grade of tumour and expression of ER/PR in unselected carcinoma of breast patients. Records with missing data were discarded. RESULTS: Out of 195 cases evaluated, 42 cases of grade-I tumour were recorded of which 08 (19%) tested positive for ER and 34 (81%) tested negative, 86 cases represented grade-II tumour of which 33 (38%) tested positive for ER and 53 (62%) were negative for ER, while out of 67 grade-III tumours 22 (33%) were positive for ER receptors while 45 (67%) were negative, (chi2 statistic (df) 4.831, p=0.089). For PR, 192 cases were evaluated and data was missing for 3 cases on PR status. Grade-I tumour consisted of 39 cases of which PR +ve represented 07 (17.94%) and 32 (82.05) cases PR -ve; 86 cases were of grade-II of which 31 (36.04%) were PR +ve and 55 (63.95%) PR -ve. Sixty seven cases of grade-III tumour of which 19 (28.35%) were PR +ve and 48 (71.64) were PR -ve (chi2 statistic (df): 4.297; p=0.117). CONCLUSION: ER/PR positivity trend was highest for grade-II tumours compared to grade-I and grade-III tumours. In general ER positivity was more with grade-II and grade-III tumours compared to grade I tumours. Although results did not reach statistical significance but there was a trend towards ER/PR positivity in grade-II and III tumours. So far, studies from South East Asia reported ER/PR expression more with low grade tumours.

Immunohistochemical determination of the P15 protein expression in cutaneous squamous cell carcinoma.

The tumor suppressor gene p15(INK4b) is a cyclin-dependent kinase inhibitor, in which its inactivation has been determined in primary tumors and in several tumor-derived cell lines. The precise role of p15(INK4b) protein expression in cutaneous squamous cell carcinoma (SCC) is currently not known. In a previous study, we have shown the frequent occurrence of allelic imbalance/loss of heterozygosity in cutaneous SCC using two microsatellite markers flanking the p15(INK4b) gene. This study is a continuation of our previous study and aims to determine the possible role of p15(INK4b) protein expression in the genesis of cutaneous SCC. P15(INK4b) protein expression was determined using immunohistochemical approach in 107 cases of cutaneous SCC tissue arrays and 19 cases of normal human skin tissues. The expression of p15(INK4b) was significantly reduced in the cutaneous SCC cases as compared with normal human skin (p = 0.017 and p < 0.05). However, there were no significant relationship between clinicopathologic variables of the patients (age, sex and tumor grade) and p15(INK4b) protein expression. The absence of p15(INK4b) expression in the majority of tissue microarray cores of cutaneous SCC indicated that p15(INK4b) could possibly be involved in the pathogenesis of cutaneous SCC.

S100A4 overexpression proves to be independent marker for breast cancer progression.

BACKGROUND: Breast cancer is the most common cancer and cause of deaths in women around the world. Oncogene amplification usually occurs late in tumor progression and correlates well with aggressiveness of tumor. In fact the function of the S100A4 protein and its role in metastasis is unclear at present. The purpose of the study was to determine the expression of S100A4 protein in the invasion status and metastatic potential of breast cancer by using tissue microarray and to determine its role in breast cancer based on the expression of S100A4 gene product. METHODS: S100A4 protein expression was examined by immunohistochemistry (IHC) using commercially available tissue microarray containing malignant and normal breast tissue cores from 216 patients. RESULTS: S100A4 was absent in normal breast tissues while positive in 45.1% of infiltrating ductal carcinoma (IDC) node negative and 48.8% of infiltrating lobular carcinoma node negative. In paired samples, S100A4 protein was expressed in 13.5% of IDC node positive cases and 35.1% of matched lymph node metastasis. CONCLUSION: S100A4 protein expression appears widely expressed in early and advanced breast cancer stages compared with normal breast. Our study suggests S100A4 may play a role in breast cancer progression and may prove to be an independent marker of breast cancer which appears to be down regulated in more advanced stages of breast cancer.

Methylthioadenosine phosphorylase expression in cutaneous squamous cell carcinoma.

The methylthioadenosine phosphorylase (MTAP) gene is a tumour suppressor gene, located on chromosome 9p21, 100 kb telomeric of the p15 and p16 genes, which are often deleted in tumor cells. The role of MTAP protein expression in the genesis of cutaneous squamous cell carcinoma (SCC) is currently not known. In a previous study we have shown the frequent occurrence of allelic imbalance/loss of heterozygosity (AI/LOH) in cutaneous SCCs using AI/LOH markers flanking the p15, p16, and MTAP genes and demonstrated reduction in p15 and p16 protein expression in comparison to normal human skin. The present study is a continuation to our previous studies, aimed at determining possible roles played by MTAP protein expression in the genesis of cutaneous SCC. The expression of MTAP protein was detected using immunohistochemical approach in 109 micro array cutaneous SCC and 20 normal human skin tissue samples. The expression of MTAP was not significantly different in the cutaneous SCC cases as compared with normal human skin. This may indicate that MTAP protein expression does not contribute to the genesis of cutaneous SCC.

Nuclear localization and intensity of staining of nm23 protein is useful marker for breast cancer progression.

BACKGROUND: Breast cancer is the most common cause of cancer death in the western world. The expression differences of many proteins are associated with breast cancer progression or suppression. The purpose of the study was to determine the expression of nm23 protein in the invasion status and metastatic potential of breast cancer by using tissue microarray and to determine its role in breast cancer based on the expression of nm23 gene product. METHOD: nm23 protein expression was examined by immunohistochemistry (IHC) using commercially available tissue microarray containing malignant and normal breast tissues from 216 patients. RESULTS: a similar percentage of cases showed positive cytoplasmic/nuclear staining for nm23 in normal breast tissue (85.7%), primary breast carcinoma node negative (97.5%) and carcinoma with lymph node metastasis (92.1%). Nuclear localization of staining for nm23 protein was higher in infiltrating ductal carcinoma (IDC) node positive (24.3%) and in matched lymph mode metastasis (18.9%) compared to IDC node negative (4.9%). Strong intensity of cytoplasmic/nucleus staining was observed in IDC node negative (42.6%), in IDC node positive (57.1%), and Infiltrating lobular carcinoma (ILC) node negative (44%) compared to normal breast tissue (16.7%). CONCLUSION: nm23 protein expression appears widely expressed in normal breast, early and advanced breast cancer stages. Interestingly our study found that strong staining intensity and nuclear localization of nm23 protein may prove to be a useful marker of breast cancer progression.