Reconocimiento docente de los valores éticos y morales en la formación curricular de la carrera de odontología de la Universidad de Viña del Mar, Chile / Teaching recognition of ethical and moral values in the curriculum training of the dentistry career of the Universidad de Viña del Mar, Chile

El objetivo de esta investigación es determinar la coherencia entre lo declarado por los programas de estudios de pregrado en la carrera de Odontología de la Universidad de Viña del Mar, en relación a los valores éticos y morales y, cómo son reconocidos efectivamente por los docentes en los estudiantes. El diseño de investigación corresponde a un estudio descriptivo y transversal. Para esto se adaptaron dos instrumentos, el primero: "cuestionario sobre percepción en la categorización de valores" que busca determinar la importancia que le dan los docentes a los valores. Mientras que en el segundo: "Encuesta sobre valores en estudiantes de odontología" solicita que cada docente evalúe la frecuencia con que se manifiestan ciertos valores éticos y morales en sus estudiantes. Se consideraron los 28 académicos que constituyen la totalidad del universo de docentes clínicos de los cursos de 4to y 5to años de la carrera de odontología en el año 2019. Se discuten los resultados comparándolos con experiencias similares en otras instituciones. Los resultados muestran la percepción y el reconocimiento de los valores por parte del cuerpo docente en los estudiantes, donde se identificó que los valores incorporados de mejor manera son la dignidad, el trato humano y el dialogo; mientras que la autocrítica y el conocimiento fueron los menos incorporados, estos son clave para establecer reflexión y mejoras en los planes de estudio. Se marca el punto de inicio para la generación de futuras líneas de investigación que incorporen otros aspectos como la perspectiva de los pacientes, los estudiantes, así como también continuar recabando información para utilizar metodologías que puedan contribuir a la integración de valores y poner en debate la importancia de ellos en la formación de pregrado.

The aim of this article is to determine the coherence between what is declared by the undergraduate study programs in the Dentistry career at the University of Viña del Mar, in relation to ethical and moral values and how they are effectively recognized by teachers in the students. The research design corresponds to a descriptive and cross-sectional study. Two instruments were adapted for this, the first: "questionnaire on perception in the categorization of values" that seeks to determine the importance that teachers give to values. While in the second: "Survey on values in dentistry students" requests that each teacher evaluates the frequency of certain ethical and moral values which are manifested in their students. 28 academics constituting the entire universe of clinical teachers of the 4th and 5th year courses of dentistry career in 2019 were considered. The results were discussed, comparing them with similar experiences in other institutions. Results show the perception and recognition of the values by the teaching staff in the students. These values incorporated in the best way were dignity, humane treatment and dialogue; while self-criticism and knowledge were the least incorporated. These are key values to establish a reflection and subsequent improvements in the study plans. This article marks a starting point for the generation of future lines of research that incorporate other aspects such as the perspective of patients, students, as well as continuing to collect information to use methodologies that can contribute to the integration of values and put them into a debate about the importance of them in undergraduate training.

Assessing Moral Skills in General and Post-Graduate Dental Students in the Southeast of Iran: A Cross-Sectional Study

Abstract Objective: To assess the level of moral skills in dental students and residents. Material and Methods: This cross-sectional and descriptive-analytical study was conducted on dental students and residents of Kerman University of Medical Sciences, selected by census sampling. Data collection tools included a demographic information checklist (age, gender, marital status, educational level (before basic sciences, after basic sciences, residency), and moral skills inventory questionnaire. The data were analyzed using a T-test and multiple regression analysis at a confidence level of 95%. Results: The total score of the moral skills questionnaire was about 44 out of 80, and there was no difference between males and females in moral skills (p=0.79). However, there was a significant difference in moral sensitivity between married and single students (p=0.036). Residents gained significantly higher moral integrity scores than students (p=0.046). Conclusion: The study highlights that the level of professional moral skills in Kerman dental students and residents was acceptable. Single students got higher scores in the moral sensitivity domain, although residents got the highest scores in the moral integrity domain. There was no significant correlation between gender and the level of moral skills (AU).

Exploring Dental Student Performance in Moral Reasoning Using the Defining Issues Test 2.

The aim of this study was to assess the initial levels of moral reasoning among four cohorts of dental students in the first semester of their first year of study. All 332 students at one U.S. dental school were invited to take the Defining Issues Test 2 (DIT2) during the first semester of their first year while enrolled in a mandatory ethics course in 2015-18. Students' mean scores on the DIT2 subscales were compared to their gender, underrepresented minority (URM) status, citizenship, English as primary language, and single status. The four subscales were personal interests (PI), in which self-motivated interests are the main focus; maintaining norms (MN), which takes into consideration what is expected from society; post-conventional (PC), which upholds ethical principles that promote the good of society; and N2 index, which indicates one's ability to discriminate between lower stage and higher stage items. A total of 245 students participated (74% response rate). The results showed no differences between gender, URM status, citizenship, or English as primary language and any of the DIT2 subscales. Single participants scored significantly higher on the PC and N2 subscales and significantly lower on the MN subscale. There was a significant correlation between humanitarian liberalism (HL) and all four subscales. Religious (Christian) orthodoxy (RO) was significantly correlated with MN, PC, and N2. The DIT2 subscale scores were not impacted by various exploratory variables, with the exception of relationship status, which had significantly higher MN and N2 scores. Participants with higher scores on HL and RO had higher moral reasoning scores, and females had higher levels of moral reasoning than males on their PC and N2 scores. These findings have implications for implementing educational activities that may help develop students' moral reasoning abilities over the course of dental school.

Reflections on the encouragement of altruism in dental education.

Dental ethics and professionalism are often relegated to being taught on the coat-tails of other disciplines, if they are taught at all. The assumption that students develop professionalism as a by-product of other learned competencies in dentistry is well documented to be false, and yet, little has been done in many institutions to deal with this. This article seeks to propose that altruism should be championed in dental education and that traditional learning through the preaching of professional codes is not the appropriate way to achieve this. The environment of dental schools needs to be challenged and reformed so that altruism is promoted. If we fail to address declines in altruism in the dental profession, then damage to the professional status of dentistry is inevitable and the ability to fulfil the profession's social contract with society will be inhibited.

The use of virtual patient scenarios as a vehicle for teaching professionalism.

OBJECTIVES: This study aimed to measure students' perceptions of virtual patient scenarios (VPs) for developing ethical reasoning skills and to explore features in VP design that are necessary to promote professionalism. METHODS: Sixty-five dental students participated in learning sessions that involved collaborative practice with five VPs (four high fidelity and one low fidelity), followed by reflection sessions. Students' perceptions towards the use of VPs in developing ethical reasoning skills were assessed using a questionnaire that involved 10 closed and three open-ended questions. RESULTS: High-fidelity VPs were perceived as significantly better for developing ethical reasoning skills than low-fidelity VPs. Analyses of answers to open-ended questions revealed two new features that are specific for VPs intended for teaching professionalism, which are VP dramatic structure and how it should end. CONCLUSION: VPs intended for teaching professionalism need to have high fidelity, follow a specific dramatic structure and should include multiple plausible endings. The use of VPs as part of a collaborative activity that is followed by a reflection session is perceived as an effective tool for the development of ethical reasoning skills in dental education.

A review of teaching ethics in the dental curriculum: challenges and future developments.

This study considers the role and status of the teaching of ethics on the dental undergraduate curriculum. The study reviews current developments in the delivery of dental ethics education and in particular focuses on the development of new pedagogies and curricula content. The study then critically considers the consequences of a squeezed curricula and the consequent reliance on professional regulation as shorthand for the ethical development of students. The study concludes that, although great strides have been made in improving the teaching of ethics in dental education, further dialogue is needed to better include patient views and develop a more theoretically robust approach to self-reflection.

The Role of Self- and Peer Assessment in Dental Students' Reflective Practice Using Standardized Patient Encounters.

The aim of this study was to gain insight into the nature of the role played by self- and peer assessment in the development of dental students' reflective practice skills and the value gained through structured encounters with standardized patients. Four standardized patient encounters in an objective structured clinical exam (OSCE) format served as a learning experience for students to demonstrate decision making and communication skills in complex scenarios regarding issues of ethics. Self- and peer assessment and peer-to-peer discourse were used to enhance student reflection. A sample of 16 peer pairs was randomly selected from the population of 108 fourth-year students who participated in the 2014 Clinical Dental Ethics OSCE. Data were collected from self- and peer assessment forms. Five overall performance themes (personal affect, verbal communication, professional demeanor, relationship-building, and patient management) and three student learning themes (application and knowledge, ways to change, and impressed with peer/increased confidence in self) were identified. The results showed that peer assessment ratings were consistently higher than those in the self-assessments, but overall the students deemed both their peers' and their own decision making and communication skills to be quite good. These students rated their experience with the OSCE and self- and peer assessments as positive, appreciating the importance of reflection and learning from their peers. These results provide support for the continued formative use of standardized patient OSCEs and self- and peer assessment to help students develop skills in decision making, communication, professionalism, and reflection.

Conversation Salons: A Flexible Format for Open Discourse in Dental Education.

A series of conversation salons was created at the University of Minnesota School of Dentistry as an innovative format with the objective of engaging students, faculty, staff, and practitioners in discussion to promote reflection. The aim of this study was to explore the nature of students' abilities in the salons to connect experiences through reflection and apply what they learned to practice. Reflective essays (written during the summer and fall semesters of 2014) from 108 fourth-year dental students (all members of the Class of 2015) were read and assessed for the nature of reflection, number of connections, references to the past, applications to the future, and use of examples. For analysis, the theoretical works of Schön and Mezirow provided a useful framework. Overall, the results showed that the participants found the salon experience to be positive, and student participation was strong. When asked about learning, the most frequent responses were topic-related. At this stage of dental education, the students were largely focused on their future practice and found it easier to connect to an imagined future than a past experience. In terms of student abilities to reflect, the majority were skilled at simple reflection, based on these essays since only 18% were non-reflective and 15% showed strong critical reflection skills. The open and respectful environment of the salons enabled discussion and promoted reflection. These results suggest that more opportunities for collegial conversations and instruction in reflective practice earlier in the dental curriculum may be beneficial.

EDUCATING THE DEVELOPING DENTAL STUDENT IN ETHICS AND PROFESSIONALISM.

Ethics education has been a required part of accreditation standards for dental and dental hygiene programs since the 19lJs. The dominant approach uses a combination of lectures and small, case-based seminars to teach ethical principles and provide practice in decision-making procedures to reason through dilemmas where there are several "right" ways to act. Detail is provided about three such programs.

Social Media in the Dental School Environment, Part B: Curricular Considerations.

The goal of this article is to describe the broad curricular constructs surrounding teaching and learning about social media in dental education. This analysis takes into account timing, development, and assessment of the knowledge, skills, attitudes, and behaviors needed to effectively use social media tools as a contemporary dentist. Three developmental stages in a student's path to becoming a competent professional are described: from undergraduate to dental student, from the classroom and preclinical simulation laboratory to the clinical setting, and from dental student to licensed practitioner. Considerations for developing the dental curriculum and suggestions for effective instruction at each stage are offered. In all three stages in the future dentist's evolution, faculty members need to educate students about appropriate professional uses of social media. Faculty members should provide instruction on the beneficial aspects of this communication medium and help students recognize the potential pitfalls associated with its use. The authors provide guidelines for customizing instruction to complement each stage of development, recognizing that careful timing is not only important for optimal learning but can prevent inappropriate use of social media as students are introduced to novel situations.

Perception of studying dental law and ethics among postgraduate dental students in the UK.

Law and ethics is an integral part of medical and dental professional practice. The subject is touched upon in the undergraduate curriculum. Historically, dentists interested in postgraduate study in this subject have accessed courses on medical law and ethics. While there are areas of shared interest (for example, consent, confidentiality) there are differences in emphasis and content (for example, end of life care, organ transplants, etc) which are not relevant to dentistry. A new postgraduate certificate (PgCert) course was approved by the University of Bedfordshire designed specifically for dental practitioners, making it the only university accredited course in the UK that is specific to dental staff. Students' perception of the subject of dental law and ethics at a postgraduate level was not known. The first PgCert student cohort was assessed at the start and the end of the course using two questionnaires. Sixteen students, all qualified dental practitioners working in the UK, took part. The perception toward the subject of dental law and ethics was in-line with the current guideline and regulations governing the dental profession. Perception of dental law was clearer at the end of the course compared to the beginning while dental ethics remained a challenging subject.

Ethical decision making in dental education: a preliminary study.

BACKGROUND: In terms of ethical decision making, every clinical case, when seen as an ethical problem, may be analyzed by means of four topics: medical indications, patient preferences, quality of life, contextual features. The aim of this study was to compare the performance of 4th year dental students on Ethical Decision Making before and after a course on ethics. METHODS: Fourth year dental students (n = 37) from academic year 2013-2014 participated in the study. A 3-h lecture, which was about four topics approach to clinical ethical case analysis, was given to the students. The lecture was based on case scenarios related with dental ethics. After the completion of lectures,a case scenario was presented to the students to assess their ethical decision making abilities. At the end of the exam, four topics and ethical judgment were evaluated. Their performances on this examination were evaluated before and after lectures. Statistical evaluation was performed with the significance level set at p < 0.05. RESULTS: A statistically significant difference was found between the means of four topics (p < 0.05). There was no statistically significant difference between the mean scores of judgment of ethical decision (p > 0.05). The mean total score of the students after the course was significantly higher than before course (67.5 and 54.4, respectively; p < 0.05). CONCLUSION: More lectures should be implemented to the curriculum to increase the student awareness of ethical issues and to reach the ultimate goals of dental education.

The Francis Report--Implications for the Education and Training of Dental Professionals.

This paper explores the implications of the Francis Report for education of the dental team. It considers selection of candidates for training, issues relating to the curriculum itself, including assessment and the importance of listening to trainees. The overriding importance of the 'informal' or 'hidden' curriculum, through which students and trainees observe their teachers and develop a sense of the professional and ethical culture within an educational institution, is stressed. Clinical relevance: Sound education, rooted in the recognized ethical principles highlighted in the Francis Report, is essential to the delivery of a dental work force that will deliver care according to the fundamental standards laid down by the GDC.

Health professions ethics rubric: validation of reliability in an interprofessional health ethics course.

The aim of this study was to validate a health professions ethics rubric by an interprofessional team. The rubric was used by two pharmacy and two dental faculty members to score ethics cases submitted by 16 teams comprised of 80 pharmacy and 50 dental students. A debriefing session for each case was moderated by a non-rater faculty member to arrive at a consensus score for the cases. Interrater reliability was calculated for the four raters and the debriefing scores as well as the four raters without the debriefing scores. The overall interrater correlations were in the range of 0.790 to 0.906 for the four raters. Issues ranged from 0.320 to 0.758. Principles ranged from 0.610 to 0.838. Options ranged from 0.655 to 0.843. Analysis ranged from 0.667 to 0.918. Solution ranged from 0.739 to 0.886. With the inclusion of the consensus scores, the interrater correlations were even higher. The best correlations were for the overall score and solution components of the rubric. With further edits in the rubric and enhanced training by faculty raters and changes in the ethics learning session, the revised rubric could be evaluated again for grading. Further training for faculty using the rubric for grading student cases should enhance its reliability. Demonstrating to students the ethical decision making process using the rubric should enhance the validation process.