Effectiveness of online training of first and second year AEGD residents in identifying, referring, and managing patients at-risk for substance use and opioid disorders.

BACKGROUND AND OBJECTIVES: Dentists have contributed greatly to the opioid epidemic, dispensing roughly 8.6% of opioids totaling over 18 million prescriptions in a 12-month period from July 2016 to June 2017 and report educational gaps regarding screening techniques for substance misuse and an unfamiliarity with available referral resources. The purpose of this study was to determine the knowledge and comfort level of residents in identifying, referring, and managing patients who are at risk for opioid use or substance use disorder in the dental setting before and after an online case-based training course. METHODS: Thirty-five first year (PGY1) and 11 second year (PGY2) advanced education in general dentistry (AEGD) residents participated in an online training course that aimed to assess knowledge in the domains of identifying, referring, and managing patients at risk for substance abuse disorder and opioid use in an academic setting. There were nine subdomains within the three major domains that further assessed resident comfort and knowledge. Before and after training, data were collected and analyzed. RESULTS: Analysis of the results indicated that (1) the training modules increased resident comfort in identifying (p = 0.011), referring (p = 0.032), and managing (p = 0.002) patients at risk for opioid substance use. (2) PGY1 residents benefited more than PGY2 residents in identifying (p = 0.034) and the manage domains (p < 0.001). (3) Residents viewed the module quality, usefulness, and applicability favorably. Further analysis of the nine subdomains is presented. CONCLUSION: Our study suggests that dental curricula would benefit from incorporating training of residents in identifying, referring, and managing patients at risk for substance use disorder and opioid use.

Impact of Dental Students' Faculty Group Leader, Intended Postgraduate Training, and Clinic Schedule on Their Clinical Performance: A Retrospective Study at a U.S. Dental School.

The aim of this study was to investigate the effects of dental students' faculty group leader in clinic, intended postgraduate training, and clinic schedule on their clinical performance. This retrospective study used de-identified transcript data from the Columbia University College of Dental Medicine Classes of 2013, 2014, and 2015, a total of 238 students. The impact factors analyzed were the assigned faculty member who served as clinical group leader and mentor; area of students' intended postgraduate training; and variations in timing of students' summer clinic assignments and vacations. Clinical performance, consistent with the school's graduation criteria, was measured with summative assessments (completion of competencies); completion of care for patients assigned (case completions); and overall patient encounter rate. The results showed that group leader assignment correlated with significant differences among students in completion of cases (p=0.001), competencies completed (p<0.001), and patient encounter rate (p=0.018). Students who intended to pursue general practice residencies and prosthodontics specialty training completed fewer cases than students pursuing other types of postgraduate training (p<0.001). Students who had full-time clinic in June and vacation later in the summer of their third- to fourth-year transition completed more cases (p<0.001), completed more competencies (p=0.008), and had more patient visits (p=0.012) than those who had full-time clinic later in the summer. There were significant correlations among case completions, completion of competencies, and patient encounter rate. Overall, this study found that the students' intended postgraduate training, clinic schedules, and faculty mentors influenced their progress in clinical training and should be taken into consideration in student evaluation and patient care.

Dental and Nurse Practitioner Student Attitudes About Collaboration Before and After Interprofessional Clinical Experiences.

The aim of this study was to investigate the effect that an interprofessional clinical experience (IPCE) had on dental and adult-gerontology primary care nurse practitioner (NP) students' attitudes towards health care collaboration. A survey study was conducted with dental and NP students before and after completing IPCE rotations in a dental clinic and a tertiary care setting in the 2016-17 academic year. All dental students (N=159) and all NP students enrolled in the adult-gerontology primary care program (N=37) participated in the IPCE. Students were asked to complete the Readiness for Interprofessional Learning Scale (RIPLS) survey anonymously prior to and immediately after the experience. All 37 NP students completed both pretest and posttest, for a 100% response rate on both. Among the dental students, 120 completed the pretest, for a 75% response rate, and 106 completed the posttest, for a 67% response rate. The results showed a significant increase in total RIPLS score for both the dental and NP students following the experience (p<0.001). Attitudes about teamwork and collaboration and about roles and responsibilities improved for both the dental and NP students (p<0.001) following the IPCE. There was a difference between dental students' and NP students' teamwork and collaboration subscale scores before IPCE (p=0.006), but it diminished after the intervention (p=0.09). These results suggest the IPCE succeeded in building positive attitudes about interprofessional collaboration between dental and NP students. Clinical rotations should be considered to enhance the scope of students' experiences with interprofessional patient care.