Dental students' reflective learning from a geriatric interview assignment.

OBJECTIVES: As part of geriatric education at the University of British Columbia's Faculty of Dentistry, undergraduate students are required to interview an older adult over 65 years old and critically reflect in writing on the meaning of this interview to themselves and their professional lives in not more than 2000 words. They are also encouraged to use a life grid. This study explored the impact of this assignment on the students as learners and on their views about their profession. METHODS: Interview assignments were collected from the entire cohort of 54 third-year students in 2021 and analyzed in 5 stages, using an exploratory thematic analysis, including an interactive coding process to identify patterns (themes) within the assignments using NVivo R1 software. Two researchers coded assignments individually and met to reach a consensus about the codes, to mitigate potential biases. RESULTS: Five main themes were identified, including communication, life course journey, person-centered care, social determinants of health, and access to care. A wide range of ideas emerged under each theme, including several practical suggestions to improve future practice as an oral health professional. A little over 40% of the students used the life grid in their interviews. Modifications on the interview assignment are suggested. CONCLUSION: Students' reflections highlighted their observations on a wide range of ideas within each theme, many pertaining to their future profession. They also discussed how this knowledge would inform their future practice in terms of their interactions with, and providing care to, patients with similar situations.

Community-led, peer-facilitated Advance Care Planning workshops prompt increased Advance Care Planning behaviors among public attendees.

Objective: Despite recognized benefits, engagement in Advance Care Planning (ACP) remains low. Research into peer-facilitated, group ACP interventions is limited. This study investigated the acceptability of community-led peer-facilitated ACP workshops for the public and whether these workshops are associated with increased knowledge, motivation and engagement in ACP behaviors. Methods: Peer-facilitators from 9 community organizations were recruited and trained to deliver free ACP workshops to members of the public with an emphasis on conversation. Using a cohort design, workshop acceptability and engagement in ACP behaviors was assessed by surveying public participants at the end of the workshop and 4-6 weeks later. Results: 217 participants returned post-workshop questionnaires, and 69 returned follow-up questionnaires. Over 90% of participants felt they gained knowledge across all 6 learning goals. Every ACP behavior saw a statistically significant increase in participant completion after 4-6 weeks. Almost all participants were glad they attended (94%) and would recommend the workshop to others (95%). Conclusion: This study revealed an association of peer-facilitated ACP workshops and completion of ACP behaviors in public participants. Innovation: This innovative approach supports investment in the spread of community-based, peer-facilitated ACP workshops for the public as important ACP promotion strategies.

Exploring stressors and coping strategies among dental students during COVID-19 pandemic in British Columbia.

OBJECTIVE: The COVID-19 pandemic has caused stress among undergraduate dental students; coping mechanisms might be employed to deal with such stress. A cross-sectional study was conducted to explore the coping strategies employed by dental students at the University of British Columbia (UBC) in response to their self-perceived stressors during the pandemic. METHODS: An anonymous 35-item survey was distributed to all four cohorts of UBC undergraduate dental students enrolled in the 2021-2022 academic year, 229 students in total. The survey gathered sociodemographic information, self-perceived COVID-19-related stressor, and coping strategies via the Brief Cope Inventory. Adaptive and maladaptive coping were compared among the years of study, self-perceived stressors, sex, ethnicity, and living situations. RESULTS: Of the 229 eligible students, 182 (79.5%) responded to the survey. Of the 171 students that reported a major self-perceived stressor, 99 (57.9%) of them were stressed about clinical skill deficit due to the pandemic; fear of contraction was reported by 27 (15.8%). Acceptance, self-distraction, and positive reframing were the most used coping strategies among all students. The one-way ANOVA test revealed a significant difference in the adaptive coping scores among the four student cohorts (p = 0.001). Living alone was found to be a significant predictor for maladaptive coping (p < 0.001). CONCLUSION: The main cause of stress related to the COVID-19 pandemic for dental students at UBC is their clinical skills being negatively affected. Coping strategies including acceptance and self-distraction were identified. Continued mitigation efforts should be made to address students' mental health concerns and create a supportive learning environment.

"Now I get what's important" - Shifting philosophies of hospice society staff and trained volunteers involved in peer-facilitated Advance Care Planning workshops for the public.

OBJECTIVE: Community-led approaches can increase public engagement in Advance Care Planning (ACP). Better understanding of the experiences and perspectives of community staff and volunteers who host and facilitate community-led, peer-facilitated ACP workshops is valuable when considering the spread of these approaches. METHODS: Content analysis of qualitative data from community-based hospice societies delivering ACP workshops to the public in British Columbia: one-on-one interviews with 5 organizational representatives and focus groups with 13 peer facilitators. RESULTS: Three main categories emerged: 1) ACP is about 'Living well'; 2) Transitioning focus from legal forms to conversations; 3) Benefits to all involved. CONCLUSIONS: Community staff and volunteers acknowledge the role they could play in promoting ACP in their communities. They recognize the benefits to the facilitators and public participants from following a community-led approach that emphasizes the importance of ACP conversations over the completion of relevant legal forms. Additional potential benefits of this approach, as reported by the organizational representatives, are increased volunteer engagement, more community partnerships, and an enhanced organizational profile. PRACTICE IMPLICATIONS: This community-led model can be a meaningful and approachable way to engage the public in ACP. Hospice societies are well positioned in the community to incorporate ACP workshops into their programming.

Prostate cancer peer navigation: an observational study on navigators' well-being, benefit finding, and program satisfaction.

PURPOSE: The study investigated peer and caregiver navigators' motivations for providing support, i.e., benefit finding, their mental and physical health, and program satisfaction. METHODS: A web-based peer navigation program was conducted for prostate cancer patients and caregivers over a 6-month time period. In a one-arm observational study, peer and caregiver navigators were asked to complete standardized mental health (Hospital Anxiety and Depression Scale, Cancer Worry Scale), quality of life (EQ-5D-5L, EQ-VAS), and social support (ENRICHD Social Support Instrument) scales pre- and post-intervention and questionnaires addressing motivations, benefits, and program satisfaction post-intervention. RESULTS: Both peer and caregiver navigators reported very low anxiety and depressive symptoms across time. Cancer worry increased over time with 25% of participants exceeding the symptom threshold at baseline and 33% at follow-up. Quality of life was very high but slightly decreased over time (90.0% vs. 84.4%; p = .005), indicative of a greater number of navigators reporting pain/discomfort at follow-up. Social support was high (86.9% vs. 85.9%) and remained so. Top five role endorsements were (1) a feeling of belonging, (2) being involved in something good, (3) giving back, (4) feeling better as a person, and (5) improved communication skills. Program satisfaction was very high with support from program staff rated highest. CONCLUSIONS: The study indicates that peer and caregiver navigators exhibited favorable physical and mental health across time. Furthermore, they experienced several benefits from navigation including a sense of meaning and the wish to give back. Results suggest that support provision within the peer and caregiver navigation program has also salutary effects for navigators.

Theory-Guided Remote Cooperative Learning-Based Preventive Dental Education as Part of the School Curriculum.

BACKGROUND: Oral health is fundamental to overall well-being. As teens are at high risk for tooth decay, we require a unique approach to motivate them to maintain oral health. METHODS: Sixty-four adolescents (10-13 years) were recruited from 2 schools. Oral health education was based on cooperative learning guided by the social determination theory (SDT) principles. Students' oral health knowledge and oral self-care skills were assessed at baseline (before education), 3 weeks, and 6 months after the education. RESULTS: Complete data were available for 51 students (follow-up rate 79.7%). There were significant (p < 0.001) changes in the mean (SD) toothbrushing score from 10.1 (±6.3) (baseline) to 26.5 (±6.0) (follow-up 1) and to 28.1 (±5.3) (follow-up 2). The mean (SD) tooth brushing time significantly (p < 0.001) increased from the baseline of 84.0 (±43.5) to the first follow-up to 107.0 (±39.8) and to 102.3 (±33.1) at the second follow-up. The mean (SD) diet knowledge scores significantly (p < 0.001) increased from 8.2 (±2.1) at the baseline to 10.2 (±2.7) at the first follow-up and remained the same at the second follow-up. CONCLUSION: Social determination theory-guided cooperative learning was efficient in improving student oral health-related knowledge and oral self-care skills, and this improvement was maintained for 6 months after the discontinued education.

Web-Based Peer Navigation for Men with Prostate Cancer and Their Family Caregivers: A Pilot Feasibility Study.

This study assessed the feasibility, acceptability and potential effects of True North Peer Navigation (PN)­a web-based peer navigation program for men with prostate cancer (PC) and their family caregivers. A one-arm, pre-post pilot feasibility study was conducted at two cancer centres in Canada. Participants were matched through a web-app with a specially trained peer navigator who assessed needs and barriers to care, provided support and encouraged a proactive approach to health for 3 months. Descriptive statistics were calculated, along with paired t-tests. True North PN was feasible, with 57.9% (84/145) recruitment, 84.5% (71/84) pre-questionnaire, 77.5% (55/71) app registration, 92.7% (51/55) match and 66.7% (34/51) post-questionnaire completion rates. Mean satisfaction with Peer Navigators was 8.4/10 (SD 2.15), mean program satisfaction was 6.8/10 (SD 2.9) and mean app usability was 60/100 (SD 14.8). At 3 months, mean ± SE patient/caregiver activation had improved by 11.5 ± 3.4 points (p = 0.002), patient quality of life by 1.1 ± 0.2 points (p < 0.0001), informational support by 0.4 ± 0.17 points (p = 0.03), practical support by 0.5 ± 0.25 points (p = 0.04) and less need for support related to fear of recurrence among patients by 0.4 ± 19 points (p = 0.03). The True North web-based peer navigation program is highly feasible and acceptable among PC patients and caregivers, and the associated improvements in patient and caregiver activation are promising. A randomized controlled trial is warranted to determine effectiveness.

Enhancing learning in an online oral epidemiology and statistics course.

Background: Students in the Faculty of Dentistry at the University of British Columbia have articulated challenges in understanding learning objectives in their oral epidemiology and statistics course. This study aimed to measure the impact of a course renewal intended to enhance student learning. Examples of educational interventions included providing more time for activities, increasing student interactivity, and integrating more hands-on applicable exercises using statistical software. Methods: An online mixed-methods survey using a 5-point Likert scale and open-ended questions was distributed to 43 dental hygiene students before the course renewal and again to a second cohort of 43 students after course revisions. The survey asked students to rank their levels of challenge and self-confidence in learning 23 of the course objectives throughout each academic year. Four semi-structured interviews were also conducted with faculty and staff members involved in teaching or coordinating this course to understand their experiences after the course revisions. Results: Response rates were 32% to 57%. After the course renewal, the extent to which students in the entry-to-practice cohort felt extremely challenged to learn each objective was significantly reduced (25% vs. 3%, p < 0.001), and students' self-confidence scores significantly increased (12% vs. 30%, p < 0.001).The changes on the challenge and confidence scores in the degree-completion cohort were not statistically significant (23% vs. 24% and 31% vs. 36%, respectively). Student satisfaction levels increased in all 6 categories measured. Conclusion: Providing students with more time to absorb their learning, increasing interactivity, offering timely feedback, and integrating applicable exercises using statistical software resulted in an enhanced learning environment.

Contexte: Les étudiants de la Faculté de dentisterie de l'Université de la Colombie-Britannique ont exprimé les difficultés à comprendre les objectifs d'apprentissage de leur cours d'épidémiologie et de statistiques buccodentaires. La présente étude vise à mesurer l'effet du renouvellement d'un cours afin d'améliorer l'apprentissage des étudiants. Les exemples d'interventions éducatives comprennent : accorder plus de temps aux activités, augmenter l'interactivité étudiante, et intégrer plus d'exercices pratiques, applicables au moyen de logiciels statistiques. Méthodologie: Un sondage en ligne, effectué au moyen d'une méthodologie mixte qui utilise l'échelle de Likert en 5 points et des questions ouvertes a été distribué à 43 étudiants en hygiène dentaire avant le renouvellement du cours et une fois de plus à une deuxième cohorte de 43 étudiants après les révisions du cours. Au sondage, les étudiants devaient classer leurs niveaux de difficulté et de confiance en soi relativement à l'apprentissage de 23 des objectifs de cours, tout au long de chaque année universitaire. Quatre entrevues semi-structurées ont aussi été menées auprès du corps professoral et des membres du personnel qui participent à l'apprentissage ou à la coordination de ce cours en vue de comprendre leurs expériences à la suite des révisions du cours. Résultats: Le taux de réponse était de 32 % à 57 %. Après le renouvellement du cours, la mesure dans laquelle les étudiants de la cohorte d'entrée en pratique ont éprouvé de la difficulté à apprendre chaque objectif a été réduite de manière significative (25 % par rapport à 3 %, p < 0,001), et les cotes de confiance en soi des étudiants ont augmenté de manière significative (12 % par rapport à 30 %, p < 0,001). Les changements de cotes de difficulté et de confiance en soi de la cohorte qui termine son diplôme n'étaient pas statistiquement significatifs (23 % par rapport à 24 % et 31 % par rapport à 36 %, respectivement). Les niveaux de satisfaction des étudiants ont augmenté dans les 6 catégories mesurées. Conclusion: Offrir plus de temps aux étudiants pour assimiler leur apprentissage, augmenter l'interactivité, offrir de la rétroaction ponctuelle, et intégrer des exercices applicables à l'aide de logiciels statistiques ont créé un meilleur environnement d'apprentissage.

Developmental regulation of lifelong dental experiences and beliefs in Guangzhou and Hong Kong.

AIMS: The aim of this study was to explain through the life-course and life-span perspectives of developmental regulation theory the controls on dental experiences and beliefs throughout the lives of older people in Guangzhou and Hong Kong. BACKGROUND: Dental diseases and disabilities among older people are serious public health concerns in China. METHODS: A facilitator conducted eight focus groups, three in Hong Kong and five in Guangzhou, involving a total of 51 participants. She encouraged discussions about lifetime events to explain dental experiences and beliefs. Transcripts were coded and analysed using a constant comparative approach to identify themes that explained the regulators of dental experiences throughout the participants' lives. RESULTS: Participants explained the influence of culture and history through critical events, and how external and internal factors regulated their current oral health status and beliefs. They emphasised the role of Traditional Chinese Medicine and family, and the stress of social upheaval compounded by a scarcity of dental services. They revealed also how current choice of dental services and health promotional programs, helped by personal food choice, self-reliance, and scepticism, helped them to adjust and cope with dental diseases and disabilities and the commercialisation of dental services. CONCLUSIONS: Dental experiences and beliefs of older people living in Guangzhou and Hong Kong were regulated strongly during personal development by culture and history during critical events, and by various controlling factors, such as health promotion and choice of services supplemented by food choice, nutritional balance, self-reliance, scepticism and social adjustments.

Oral healthcare challenges for older Punjabi-speaking immigrants.

This study explored how older Punjabi-speaking South-Asian immigrants (four focus groups; 33 participants) in Surrey, British Columbia, perceive oral health and related problems. Content analysis revealed two umbrella themes: (a) interpretations of mouth conditions and (b) challenges to oral health. The umbrella themes had four sub-themes: damage caused by heat (wai), disturbances caused by caries, coping with dentures, and quality of life. Three challenges were considered: home remedies, Western dentistry, and difficulties accessing dentists. Participants explained oral diseases in terms of a systemic infection (resha), and preferred to decrease imbalances of wai in the mouth with home remedies from India. We conclude that older Punjabi-speaking immigrants interpret oral health and disease in the context of both Western and Ayurvedic traditions, and that they manage dental problems with a mix of traditional remedies supplemented, if possible, by elective oral health care in India, and by emergency dental care in Canada.

Implementation of clinical practice guidelines in dental settings.

OBJECTIVE: This study aimed to determine the knowledge and application of current expert recommendations on antibiotic prophylaxis (AP) to prevent infective endocarditis (IE) both in the United Kingdom and Iran. METHODS: The study used a 3-part postal questionnaire survey of dentists in the United Kingdom (n=467) and Iran (n=200) covering demographic data, antimicrobial prophylaxis prescribing habits for adults treated under local analgesia, and sources of information about recommended schedules and changes in dentists' prophylaxis regimens. RESULTS: Most UK dentists (87%) reported following the British National Formulary guidelines (BNF) on AP. Seventy-five percent of Iranian dentists follow the guidelines of the American Heart Association (AHA). A significant proportion of practitioners prescribed the correct antibiotic regimens for patients who are nonallergic or allergic to penicillin in the United Kingdom, but in Iran the knowledge of and compliance with the available guidelines regarding antibiotic regimens was poor. Although dentists were familiar with the dental procedures that could place their patients at risk, and more than 80% prescribed prophylaxis for patients with "prosthetic heart valves" and "previous bacterial endocarditis," they also considered AP for patients with medical conditions not known to be at risk. For the UK dentists, the most common source of information on AP is medical and dental journals, whereas for Iranian dentists, academic meetings, colleagues, and textbooks were cited as sources of information on AP. Furthermore, 80% of participants in both countries would like to attend further courses about this topic. CONCLUSION: Generally, dentists in the United Kingdom were more familiar with the current expert recommendations on AP than dentists in Iran; however, dentists in both countries tended to overprescribe. This could contribute to the problem of antimicrobial resistance. Educational initiatives aimed at implementing updated recommendations and continuous assessment of dental practice might reverse this trend.