The Effects of Providing Advance Notice and Stress-Coping Traits on Physiological Stress of Patients during Dental Treatment.

Patients tend to feel stress in association with dental treatment due to uneasiness and fear. We investigated the effects of providing advance notice and stress-coping traits on the physiological stress of patients during dental treatment. Sixty non-dental professionals (male, n = 26; female, n = 34; mean age, 49.9 years) were recruited for this study and informed consent was obtained. Subjects were given simulated dental treatment including three stimuli, air, percussion and running of an air turbine, with or without advance notice of the stimulation during dental treatment. Real-time sympathetic nerve activity (SN) and parasympathetic nerve activity (PN) during the treatment were measured using a biological information monitor. The stress-coping traits of each subject were examined using the Lazarus-Type Stress Coping Inventory (SCI). Correlations between the nerve-activity and scores of eight stress-coping strategies of SCI and the presence/absence of advance notice were analyzed. Age, types of stimuli and order of stimuli significantly affected SN, while age, types of stimuli, and the pattern of stimulation significantly affected PN. The interaction of the stress-coping trait and presence/absence of advance notice significantly affected PN. Providing advance notice may have different effects on physiological stress depending on how the patient copes with stress.

Evaluating e-learning on an international scale: An audit of computer simulation learning materials in the field of dentistry.

BACKGROUND/PURPOSE: Global networking and e-learning courses are an effective strategy for sharing educational content and there is potential scope to use e-learning technology in dental education. Therefore, this study aimed to explicate the challenges encountered in international e-learning use and decipher optimum solutions for disseminating course/systems on an international scale. MATERIALS AND METHODS: An e-learning course with four computer-assisted simulation materials developed among international faculties was provided to dental undergraduates at dental schools in Japan and Vietnam in 2020. A post-questionnaire survey plus pre- and post-tests were conducted to obtain learners' feedback and assess the success of the course's implementation. RESULTS: Altogether, 41 students participated, with a response rate of 78.8%. The mean post-test score was significantly higher than that of the pre-test (p < 0.001). Students from both groups felt that e-learning was beneficial, useful for their future, and should be continued. CONCLUSION: This study showed that e-learning/course provision could be achieved at an international level by using a common online system, which is beneficial for students to gain a wider perspective and global dental education. Learners indicated that they learned without any major problems in learning operations. This type of educational material creation and course implementation is extremely important in global networking and dental education in the present era; and communication and cooperation between the faculties was important for course provision. More countries should be included in future studies to ensure that it has global application.

Effectiveness of computer-assisted learning in sports dentistry: studies over a multiple-year period and at two universities.

INTRODUCTION: Insufficient educational resources on sports dentistry result in varying lecture implementations across dental schools, which cause knowledge gaps amongst students. Thus, a new interactive sports dentistry-related computer-assisted learning (CAL) module was created to facilitate dental school undergraduate students' education. This study compared the CAL module's learning effectiveness with conventional video lectures (VL) and assessed its effectiveness when used over several years at a university, and examined its validation in different university contexts, and students' perceptions. MATERIALS AND METHODS: Participants were 305 fifth-year students. Students from a university in Tokyo participated for 3 years and those from a university in Saitama for 1 year. In each year, the students were divided into two groups-CAL and VL. They studied their assigned modules in 20-min lessons. A written test was administered to determine their knowledge acquisition levels, along with a questionnaire. RESULTS: Two hundred sixty-two consenting participants were included in the statistical analysis. The CAL groups' test scores at both schools were significantly higher than the VL groups' every year (p < .001). Furthermore, test results from all years revealed no gender differences or repetition of the school years at either school. Most students at both universities evaluated the CAL module as excellent. CONCLUSION: The interactive CAL module generated consistently strong results over multiple years, during which it was used by a diverse group of students at two universities. The students highly rated the module's learning process as well as its contents.

Development and evaluation of e-learning materials for dental hygiene students in six schools: Using smartphones to learn dental treatment procedures.

OBJECTIVE: The purpose of this study was to develop and evaluate the effectiveness of using e-learning on smartphones to provide dental hygiene education on dental treatment procedures. METHODS: This was a randomized controlled trial. Two-hundred ninety-three dental hygiene students in four universities, one junior college and one technical school took a preliminary examination, and based on the results, participants in each school were randomly divided into two groups, a test or control group. Both groups took pre- and post-examinations at a 4-week interval. The test groups learned dental treatment procedures and four-handed techniques with interactive learning materials using smartphones. The learning materials allowed them to watch videos of dental treatments. The control groups were not provided any learning material. RESULTS: Results of all schools combined showed that the changes from pre- to post-examination scores in the test groups were significantly higher than those of the control groups (p < .05). Post-examination scores were significantly higher than pre-examination scores in the test groups in all schools (p  < .05). Also, post-examination scores of the test groups were significantly higher than those of the control groups (p < .05). The changes from pre- to post-examination scores in the test groups of two schools were significantly higher than those of control groups (p < .05). Post-examination scores of the control groups in two schools were significantly higher than pre-examination scores (p < .05). CONCLUSIONS: Learning dental treatment procedures through e-learning on a smartphone was effective in developing participants' understanding of dental treatment procedures and four-handed techniques.

Associations between demographic factors and the academic trajectories of medical students in Japan.

BACKGROUND: Group-based trajectory modeling is a useful tool for categorizing students' academic trajectories and their determinants. Using insights gained from the analyses, we can identify students at risk for poor academic performance and monitor them to provide support. To date, studies investigating the associations between demographic factors and academic performance trajectories among medical students are scarce. The study objective was to examine the associations between demographic factors and academic performance trajectories in medical students using group-based trajectory modeling. METHODS: Participants included all medical students admitted to Tokyo Medical and Dental University in Japan in 2013 and 2014 (n = 202). Academic performance was evaluated by biannual grade point average (GPA) scores in preclinical years. We used group-based trajectory modeling to categorize students into GPA trajectories. Multinomial logistic regression was used to examine the association between the odds of being in a certain GPA trajectory group and demographic factors such as high school type, high school geographical area, admission test type, high school graduation year, whether the student was a biology major, and sex. RESULTS: Students' GPA trajectories were classified into four trajectory groups as well as another group that consisted of students who withdrew or repeated years. We found that students whose high school geographical area was outside the National Capital Region were 7.2 times more likely to withdraw or repeat years in comparison with students whose school was inside the National Capital Region (OR: 7.21, 95% CI: 1.87, 27.76). In addition, admission test type, high school graduation year, and sex were associated with GPA trajectories. CONCLUSIONS: High school geographical area, admission test type, high school graduation year, and sex were associated with GPA trajectories. These findings provide important insights into identifying students at risk for poor academic performance and strategies for monitoring them to provide adequate and timely support.

Dental Hygiene Learning Outcomes Obtained Through Computer-Assisted Simulation Modules.

Purpose: Education reflecting current knowledge is required for competent health care providers but the number of educators and/or lecture/clinical contact hours are often limited. The purpose of this study was to evaluate the learning outcomes and practicality of interactive simulation modules developed for a computerized learning system in dental hygiene education.Methods: Twenty-nine Japanese fourth-year dental hygiene undergraduates were given access to five interactive modules, delivered via a learning management system (LMS), for one month. The modules provided virtual clinical settings to take learners through decision-making processes for explaining procedures and treatments, and making appointments in English. Pre- and post-tests and a questionnaire were used to evaluate the knowledge gained and to receive learner's feedback. Participants were classified into two groups (study group and non-study group), based on their use/non-use of modules made available during the five-week period for statistical analysis.Results: Post-test scores were significantly higher in the study group (n = 22) than in the non-study group (n = 6), (p = 0.024). Post-test scores were also significantly higher than the pre-test scores in the study group (p = 0.001). No significant differences in the post- versus pre-test scores were found in the non-study group. The questionnaire response rate of 100% (n = 29) indicated that participants considered the interactive modules, including the system operation, as convenient and beneficial.Conclusion: Modules made available via a LMS for self-study were beneficial for Japanese undergraduate dental hygiene students in the acquisition of knowledge and skills for clinical decision-making in English.

Differential effects of individual and school factors on the academic trajectories of Japanese dental students.

OBJECTIVE: Dental students follow different academic performance trajectories in response to increasing study load, based on individual and school factors. Group-based trajectory modeling is useful for clarifying the underlying trajectory patterns of students' academic performance and its determinants. To our knowledge, no studies have used group-based trajectory modeling to examine the effects of individual and school factors on academic performance trajectories in dental students. The objective of this study was to examine the effects of individual and school factors on academic performance trajectories in Japanese dental students using group-based trajectory modeling. METHODS: The analytical sample consists of 103 dental students admitted to Tokyo Medical and Dental University, Tokyo, Japan, in 2013 and 2014. Students' academic performance was assessed by biannual grade point average (GPA) score and GPA in the preclinical phase (second to fourth grade) was used for this study. We used group-based trajectory modeling to categorize students' GPA trajectories into different groups. A multinomial logistic regression model was fit to examine associations between students' individual and school factors, and odds of being assigned to certain GPA groups. RESULTS: GPA trajectories of dental students were classified into 4 different groups. Students' past academic performance in high school was associated with lower GPA trajectories and withdrawal or repeating years. Males were significantly associated with lower GPA trajectories and withdrawal or repeating years, even after adjusting for past academic performance. CONCLUSIONS: Past lower academic performance and being male were positively associated with lower academic performance trajectories in Japanese dental students.

Effects of an interactive simulation material for clinical dentistry on knowledge acquisition.

The aim of this study was to examine the effectiveness of interactive simulation materials with decision making in knowledge acquisition and anxiety reduction. Dental students in their fourth year at Tokyo Medical and Dental University were randomly divided into Groups I and D. Participants read a scenario, learned with interactive-type (Group I) or display-type (Group D) learning materials about pulpectomy, and took the State-Trait Anxiety Inventory-JYZ, a quiz for measuring learning effects, and a questionnaire for evaluation of the material. Except for requesting decision making in the interactive-type material, the contents of both materials were the same. The results were compared using the unpaired Student's t-test, Fisher's exact test, and the two-way repeated measures ANOVA with the Bonferroni post hoc test. The mean quiz score was significantly higher in Group I than in Group D (I: 75.4±1.4, D: 60.6±2.7, p<0.001). There was no significant correlation between the groups and the responses except for one question about operability (p<0.05). A significant main effect on state anxiety was found between examination points (p<0.001), and state anxiety significantly increased after reading the scenario (p<0.001) and reduced after learning (p<0.001). Interactive simulation materials with decision making might be effective in knowledge acquisition.

Effects of an interactive simulation material for clinical dentistry on knowledge acquisition and memory retention in dental residents.

With the development of technology, the knowledge and skills needed to become a dentist are increasing. Computer-assisted simulation learning materials have been utilized for dental education because of their high efficiency and efficacy. However, it is not well understood which material design is strongly associated with an education effect. We therefore investigated the effects of interactivity with learning materials on learners' knowledge acquisition, memory retention, and anxiety reduction. Learning effects and degree of anxiety were compared between dental residents who learned using an interactive-type material, which required decision making and provided feedback (Group I, n=26), and those who learned using a display-type material, which merely displayed the appropriate action on a computer screen (Group D, n=23). Quiz scores immediately after learning and 3 weeks later were significantly higher in Group I than those in Group D (p<0.001 and 0.016, espectively). Regarding anxiety, state anxiety after learning with interactive material was significantly decreased in Group I (p<0.05), whereas no significant change was observed in Group D. Our results suggest that interactivity with computerassisted simulation materials is more effective for knowledge acquisition, memory retention, and anxiety reduction.

Effectiveness of a Specially Designed Dental Model for Training, Evaluation, and Standardization of Pocket Probing.

The aim of this study was to evaluate the effectiveness of a dental model in training, evaluation, and standardization of examiners in pocket probing and to determine the appropriate thresholds of accuracy and measuring time when using this model for evaluation of probing skills without measuring patients' pockets repeatedly. In 2011-12, a total of 66 dental professionals and 20 dental students in Japan measured the probing depths of 24 artificial teeth using the six-point method on a dental model. All examiners measured the probing depths of six tooth groups and then checked the correct depths in each group. Each examiner measured four groups in a group-by-group manner. For each group, the measuring time and examiner's accuracy were recorded. Receiver operating characteristic (ROC) curves for various thresholds of measuring time were drawn for thresholds of accuracies to determine the passing mark as a skilled examiner. The accuracy significantly increased from the first to the fourth measurements, and the measuring time was significantly reduced for both the professionals and students. The total measuring time was significantly longer for the students than the professionals. The students' accuracy was significantly lower than that of the professionals in the first measurement group. The increasing rate of accuracy was significantly higher for the students than the professionals. These results and ROC curves suggested that the dental model is effective for periodontal pocket probing training and for the evaluation and standardization of examiners' probing skill at a preclinical level. An examiner having accuracy ≥80% within four minutes for six tooth measurements in this model could be considered a skilled examiner.

An Inter- and Intraprofessional Education Program in Which Dental Hygiene Students Instruct Medical and Dental Students.

The aim of this study was to develop, implement, and evaluate an inter- and intraprofessional education program with a peer support joint practice in which dental hygiene students teach medical and dental students about oral health care for older people requiring long-term care. In 2015 at Tokyo Medical and Dental University, 22 dental hygiene students in their third year at the School of Oral Health Care Sciences (OH3), 110 students in their third year at the School of Medicine (M3), and 52 students in their third year at the School of Dentistry (D3) participated in this program. The OH3 students practiced with a whole-body-type simulator to learn oral health care for older people and then taught the methods to the M3 and D3 students according to their self-designed teaching plan. All M3 and D3 students experienced being both practitioner and patient. The number of respondents and response rates on the questionnaires after the training were 22 (100%), 102 (92.7%), and 52 (100%) for the OH3, M3, and D3 students, respectively. Self-assessment by the OH3 students indicated that they could supervise other students sufficiently (77-86%), and 91% of them found the preclinical practice with the simulator efficient for the peer support joint practice. Almost all the M3 and D3 students reported that they gained understanding of the methods (99%), significance (100%), and important points of oral health care for older people (97%) in addition to the jobs and roles of dental hygienists (93%) because of this program. The M3 students understood the methods and significance of oral health care more deeply than did the D3 students (p<0.05). This study found that an interprofessional program with a peer support joint practice to cultivate practical clinical ability aided in increasing understanding and cooperation between medicine and dentistry.

Differences between Computer-Based and Paper-Based Assessments of the Clinical Reasoning Competency of Dental Students.

Clinical reasoning competency is essential for an appropriate clinical dental treatment. Among the tools for the assessment of clinical reasoning competency, computer-based testing (CBT) is considered more useful than paper-based testing (PBT), because teachers can control the timing of information given to the examinees. Such timings could possibly affect the thinking process of examinees. However, few studies reported differences of reasoning between the two testing modes. In the present study, we developed an assessment of clinical reasoning and applied it using CBT and PBT to compare the examinees' performance. The participants comprised 60 students in the fifth-year class in 2012 of the School of Dentistry, Faculty of Dentistry, Tokyo Medical and Dental University. The tests comprised 25 problems, each with four questions, totaling 100 questions. The contents of the questions were the same in CBT and PBT. The students were assigned to CBT (Group C, n = 30) and PBT (Group P, n = 30) groups, with an almost equal gender ratio in the groups. The difference between scores was analyzed with a univariate analysis of variance. No significant intergroup differences were found regarding the test duration, total score, and average score of each question. The number of problems with perfect marks was higher in Group P than in Group C (P < 0.05), probably because Group P students could access the information of the previous question (s) within a problem. Thus, the differences of the examinees' performance between the two testing modes were small.

Evaluation of simulation learning materials use to fill the gap in Japanese dental English education.

Even though English is most frequently the common language when the patient's native language differs from that of a dentist, the opportunities for Japanese undergraduate dental students to learn dental English are now quite limited. The purposes of our study were to investigate: the effectiveness and feasibility of the computer-assisted simulation materials as one solution strategy for dental English education in Japan, and the needs and demands for dental English from the learners' side. Interactive simulation materials for medical interviews in English and clinical cases which were translated to English, were delivered via Learning Management System (LMS) to nineteen trainee residents of dentistry (residents). Evaluation for the materials, learners' knowledge and interests in the contents, and ease of operation were obtained by post-questionnaire (response rates were 100% and 95%, respectively). Both questionnaire-surveys received positive feedback toward the materials, yet 47% answered that they lacked the level of knowledge about contents of the medical interview in English. Results were sufficient to suggest that the residents would like to have the opportunity to study or practice medical interview in English, or English related to dentistry, and that the simulation materials could be one of the solution strategies for opportunity provision.

Development and evaluation of a new dental model at Tokyo Medical and Dental University for the practice of periodontal pocket probing.

Dental and dental hygiene students must acquire the skill of measuring periodontal pockets and learn to identify the bottom of a pocket, especially of deep periodontal pockets. A new dental model that would enable students to practice measuring deep periodontal pockets was developed at the Tokyo Medical and Dental University. The purpose of this study was to evaluate the feasibility and effectiveness of this model. Twenty dental hygiene students in their third year at the school and twenty-four instructors or dental hygienists of the University Hospital measured periodontal pockets on the newly designed dental model. Feasibility and effectiveness of the model were evaluated based on periodontal probing by the students and instructors, as well as results of a questionnaire. The results demonstrated an intraexaminer agreement (within ±1 mm) averaging 91 percent. The mean percentages of correct answers of the students and instructors were 82 percent and 80 percent, respectively. More than 90 percent of the instructors and students reported that the new model would be suitable for pocket probing training. In the questionnaire, they responded that this practice using the new model would contribute to students' future and that they wanted to try other dental models with various probing depths. The new dental model designed for periodontal pocket probing training was reported to be feasible and effective for student practice.

Live broadcast lectures on complete denture prosthodontics at Tokyo Medical and Dental University: comparison of two years.

A live broadcasting system was developed as part of dental education with Information and Communication Technology (ICT) at Tokyo Medical and Dental University. The purpose of this study was to utilize this system in complete denture prosthodontics, especially for the procedure of making a definitive impression with custom tray border molding in edentulous patients, and to evaluate its effectiveness. Live broadcast lectures on complete denture prosthodontics were given to fourth-year students in 2009 (fifty-nine students) and in 2010 (sixty-five students). To evaluate this lecture, a questionnaire was distributed to the students and faculty members after the lecture. Almost all the students and faculty members rated the lecture as good. Students commented that the lecture was "intelligible," "inspiring," "improved understanding," "good because they could ask questions in real time," "helped to know the actual time," "good for all the students to see the same case," and "close to real experience and induced a sense of tension." The results of this study suggested that a live broadcast lecture would help students experience the real clinical situation and aid in teaching complete denture prosthodontics.