A systematic review of computer-assisted learning in endodontics education.

Results of the efficacy and time efficiency of computer-assisted learning (CAL) in endodontics education are mixed in the literature. The objectives of this study were to compare the efficacy and time efficiency of CAL with traditional learning methods or no instruction. The search strategy included electronic and manual searches of randomized controlled trials (RCTs) completed in English up to June 2009. The intervention comprised any method of CAL, while the control group consisted of all traditional methods of instruction including no further instructions. Various outcome measures of CAL efficacy were considered and were categorized using Kirkpatrick's four-level model of evaluation: reaction, learning, behavior, results, with the addition of return on investment as a fifth level. The time efficiency of CAL was measured by the time spent on the learning material and the number of cases covered in a unit period. Seven RCTs met the inclusion criteria. Overall, students' attitudes were varied towards CAL. Results from the knowledge gain outcome were mixed. No conclusions can be made about students' performance on clinical procedures or cost-effectiveness of CAL. Better time efficiency was achieved using CAL compared to traditional methods. CAL is as efficacious as traditional methods in improving knowledge. There is some evidence to suggest that CAL is time efficient compared to traditional methods. Overall, the number of studies included in this review was small, thus warranting the need for more studies in this area and the exploration of various CAL techniques.

A comparative study of the health care systems of Canada and Saudi Arabia: lessons and insights.

INTRODUCTION: Understanding the structure of a health care system is essential in improving public health policies and health outcomes. OBJECTIVES: To describe and compare the health care systems of Canada and Saudi Arabia; to discuss possible lessons that could be learned from both for policy-making purposes. METHODS: A comprehensive method was used to describe the national health care systems of both countries. For each country, the system is described by: context, ownership, delivery, financing, organisational structure, target groups, and comprehensiveness of services. RESULTS: In Canada, the Medicare system provides comprehensive medical services except for dental, optometric, chiropractic, pharmacologic and home care services. The dental care system is financed privately (94%) and is owned and delivered by private for-profit dental practitioners. In Saudi Arabia, the government sector is owned, delivered, and financed by the government and provides free comprehensive medical and dental services. The same services are provided by the private sector, but under governmental supervision. Among the relevant lessons: access to care, accountability, quality assurance, mix and reimbursement of providers. CONCLUSIONS: Canada can learn about different approaches to socialising the dental care system. Saudi Arabia can improve the implementation of quality assurance practices and management.

The pattern of combined maxillofacial and cervical spine fractures.

PURPOSE: Prompt recognition of cervical fractures in patients with facial fractures is of prime importance, as failure to diagnose such injuries carries a significant risk of causing neurologic abnormalities, long-term disabilities, and even death. The aim of this retrospective case study is to describe the different patterns of combinations of maxillofacial and cervical spine (C-spine) injuries to provide guidance in diagnosis and care of patients with combined injuries. PATIENTS AND METHODS: The trauma directory of 1 academic institution was searched for records of 701 patients admitted with cervical spine fractures between January 2000 and June 2006. Patients who did not sustain a facial fracture in addition to their C-spine fracture were excluded. The search was narrowed to 44 patients (6.26%) who presented with combined C-spine and facial fractures. Descriptive statistics were performed in which the frequencies of the variables were presented and then exploration of the interaction between the different variables was carried out. RESULTS: A 6.28% incidence rate of combined C-spine and maxillofacial fractures is noted in this study. The most common cause of trauma was motor vehicle accidents (45.5%), followed by falls (36.4%). In regards to the types of maxillofacial fractures, 27.3% of the cases presented with isolated orbital fractures and 13.6% with isolated mandibular fractures. A total of 68.2% of the combined C-spine and facial fracture cases involved orbital fractures of some form. The most frequent level of C-spine fracture was isolated C2 fractures (31.8%) followed by isolated C4 and C6 fractures (6.8% each). When the mechanism of trauma were compared to the types of C-spine and maxillofacial fractures, falls were found to be the most frequent mechanism causing both isolated orbital and C2 fractures. CONCLUSION: The rule of presuming that all patients with maxillofacial fractures have an unstable C-spine injury should stand. This should be emphasized in patients with orbital fractures and we plead for a higher index of suspicion for C-spine injuries in such patients.