From outdated to outstanding: an institution's journey in reforming the dental materials science curriculum and lessons learned.

BACKGROUND: The Dental Materials Science (DMS) course within Malaysian undergraduate dental education has traditionally been taught in isolation, with a relatively stagnant delivery mode. Recent shifts in national dental competency standards have necessitated substantial reform in the DMS curriculum. This study aims to outline the journey of a local dental institute in developing and implementing a competency-based DMS curriculum. METHODS: A faculty curriculum task force was established to oversee the curriculum reform process. The reform was guided by a "bottom-up" approach using the five-step curriculum reform model: (1). Curriculum mapping, (2). Comprehensive needs assessment, (3). Clear learning objectives and outcomes, (4). Curriculum development and implementation, and (5). Continuous evaluation and improvement. RESULTS: Step 1 revealed the need to reduce content repetition and improve alignment with the new competency standards. Step 2 identified the need to include advanced materials, integrate theoretical and clinical aspects, and enhance teaching methods. The new curriculum included 25 relevant topics. Step 3 established three course learning outcomes, while Step 4 integrated DMS content horizontally and vertically across the curriculum, introduced innovative teaching methods, and diversified assessment methods. Step 5 ensured ongoing curriculum monitoring, with both short-term and long-term evaluations planned. CONCLUSION: The curriculum reform process represents a significant advancement in dental materials science while addressing challenges and aligning the curriculum with national standards. Ongoing evaluation, adaptability, interdisciplinary collaboration, and international engagement are essential for further improvements. This journey serves as a valuable reference for educators seeking to update their DMS curricula.

Desirable clinical settings in general dentistry: moving towards the improvement of the educational program.

BACKGROUND: The main task of dental schools is to prepare professional dentists with a high social responsibility. This study provided some practical suggestions from experts regarding desirable clinical settings, in order to establish an infrastructure for practical studies in Endodontics, Periodontics, Oral and Maxillofacial Surgery, Restorative Dentistry, Pediatric Dentistry, Oral and Maxillofacial Medicine, Prosthodontics, Oral Health, and Social Dentistry. METHODS: This research was conducted using a modified Delphi technique in two rounds. The first round involved qualitative content analysis. Participants in interviews were selected purposeful and maximum diversity across the country. To determine the validity and reliability of the data, the four axes proposed by Lichon and Guba were utilized. The second round involved a researcher-made questionnaire, which consisted of 55 questions. This questionnaire was distributed to all dental schools across the country. The validity of the questionnaire were evaluated and by experts and then reviewed. The reliability of the tool was determined to be 0.96 using the alpha coefficient method. RESULTS: The final codes from the interviews of the first round were divided into two categories: settings and educational programs. The final results of research were placed into 2 section: educational settings and instructors, and educational infrastructures. 70% participants agreed to use the college's clinical morning sessions. More than 80% agreed to start up a main clinic with the proposed structure and professors. The use of the hospitalization area also had an agreement of more than 80%. Additionally, community areas such as health service centers, welfare centers, special patient centers, factories, schools, etc. obtained an agreement of over 70%. CONCLUSIONS: The results of this study are presented in the form of suggestions for improving the general dentistry program in relation to educational setting, educators, and educational infrastructures. The common agreement among participants regarding educational settings and their diversity, educational programs, and desired instructors reviewed in the research shows the necessity of reviewing and changing their educational programs in Endodontics, Periodontics, Oral and Maxillofacial Surgery, Restorative Dentistry, Pediatric Dentistry, Oral and Maxillofacial Medicine, Prosthodontics, Oral Health, and Social Dentistry.

Reliability of ChatGPT in automated essay scoring for dental undergraduate examinations.

BACKGROUND: This study aimed to answer the research question: How reliable is ChatGPT in automated essay scoring (AES) for oral and maxillofacial surgery (OMS) examinations for dental undergraduate students compared to human assessors? METHODS: Sixty-nine undergraduate dental students participated in a closed-book examination comprising two essays at the National University of Singapore. Using pre-created assessment rubrics, three assessors independently performed manual essay scoring, while one separate assessor performed AES using ChatGPT (GPT-4). Data analyses were performed using the intraclass correlation coefficient and Cronbach's α to evaluate the reliability and inter-rater agreement of the test scores among all assessors. The mean scores of manual versus automated scoring were evaluated for similarity and correlations. RESULTS: A strong correlation was observed for Question 1 (r = 0.752-0.848, p < 0.001) and a moderate correlation was observed between AES and all manual scorers for Question 2 (r = 0.527-0.571, p < 0.001). Intraclass correlation coefficients of 0.794-0.858 indicated excellent inter-rater agreement, and Cronbach's α of 0.881-0.932 indicated high reliability. For Question 1, the mean AES scores were similar to those for manual scoring (p > 0.05), and there was a strong correlation between AES and manual scores (r = 0.829, p < 0.001). For Question 2, AES scores were significantly lower than manual scores (p < 0.001), and there was a moderate correlation between AES and manual scores (r = 0.599, p < 0.001). CONCLUSION: This study shows the potential of ChatGPT for essay marking. However, an appropriate rubric design is essential for optimal reliability. With further validation, the ChatGPT has the potential to aid students in self-assessment or large-scale marking automated processes.

Leadership competencies for dentists: What do undergraduate students think?

Dentists face difficult situations and challenges every day, but undergraduate dental students in Pakistan are not formally taught leadership skills or assessed for these skills. This study aims to explore the perception of undergraduate dental students on various leadership competencies. A multi-institutional cross-sectional observational study was conducted on undergraduate students in five institutions by using universal sampling technique. Students were asked to self-assess various leadership competencies for dentists based on 15 competencies using a validated questionnaire utilizing Likert scale response format. Responses to these items were presented as frequency and percentage. The overall scores were presented in mean and standard deviation and median and interquartile range. The differences in median scores of all items of the questionnaire between male and female students were determined with Mann Whitney U tests. The year-wise differences in the median of all response items of the questionnaire were determined using Kruskal Wallis H test. A total of 750 students, of which 570 (76%) were females and 180 (24%) were males, participated in the study. Most of the students (n = 708, 94.4%) did not attended any leadership course or workshop in the last five years. Majority of the students perceived that their leadership competencies were fair to excellent. Empathy was perceived as 'excellent' by the majority of the students (n = 294, 39.2%). Majority of the students (n = 319, 42.5%) perceived that their 'authenticity' skills were 'good'. Statistically significant differences were reported between male and female students in most of the leadership skills including 'compassion', 'advocacy skills', 'inquiry skills', 'empathy', 'integrity', 'ability to build trust with others', 'managing conflict', 'leading groups/teams', 'dealing with difficult personalities', and 'likelihood to exercise leadership during a crisis' (p < 0.05). There were also significant differences in the median item scores in 13 out of 15 leadership domains and the year of study (p < 0.05). The study identified the perceptions of students regarding different leadership competencies. It gives indications that which leadership competencies need to be incorporated, promoted, and enhanced in leadership curriculum to make them effective dental practitioners and leaders in future. Incorporating these targeted leadership courses into the curriculum can provide participants with the opportunity to refine their existing leadership strengths and develop a well-rounded set of competencies essential for making a significant contribution in their chosen fields.

Performance of ChatGPT-3.5 and GPT-4 in national licensing examinations for medicine, pharmacy, dentistry, and nursing: a systematic review and meta-analysis.

BACKGROUND: ChatGPT, a recently developed artificial intelligence (AI) chatbot, has demonstrated improved performance in examinations in the medical field. However, thus far, an overall evaluation of the potential of ChatGPT models (ChatGPT-3.5 and GPT-4) in a variety of national health licensing examinations is lacking. This study aimed to provide a comprehensive assessment of the ChatGPT models' performance in national licensing examinations for medical, pharmacy, dentistry, and nursing research through a meta-analysis. METHODS: Following the PRISMA protocol, full-text articles from MEDLINE/PubMed, EMBASE, ERIC, Cochrane Library, Web of Science, and key journals were reviewed from the time of ChatGPT's introduction to February 27, 2024. Studies were eligible if they evaluated the performance of a ChatGPT model (ChatGPT-3.5 or GPT-4); related to national licensing examinations in the fields of medicine, pharmacy, dentistry, or nursing; involved multiple-choice questions; and provided data that enabled the calculation of effect size. Two reviewers independently completed data extraction, coding, and quality assessment. The JBI Critical Appraisal Tools were used to assess the quality of the selected articles. Overall effect size and 95% confidence intervals [CIs] were calculated using a random-effects model. RESULTS: A total of 23 studies were considered for this review, which evaluated the accuracy of four types of national licensing examinations. The selected articles were in the fields of medicine (n = 17), pharmacy (n = 3), nursing (n = 2), and dentistry (n = 1). They reported varying accuracy levels, ranging from 36 to 77% for ChatGPT-3.5 and 64.4-100% for GPT-4. The overall effect size for the percentage of accuracy was 70.1% (95% CI, 65-74.8%), which was statistically significant (p < 0.001). Subgroup analyses revealed that GPT-4 demonstrated significantly higher accuracy in providing correct responses than its earlier version, ChatGPT-3.5. Additionally, in the context of health licensing examinations, the ChatGPT models exhibited greater proficiency in the following order: pharmacy, medicine, dentistry, and nursing. However, the lack of a broader set of questions, including open-ended and scenario-based questions, and significant heterogeneity were limitations of this meta-analysis. CONCLUSIONS: This study sheds light on the accuracy of ChatGPT models in four national health licensing examinations across various countries and provides a practical basis and theoretical support for future research. Further studies are needed to explore their utilization in medical and health education by including a broader and more diverse range of questions, along with more advanced versions of AI chatbots.

[Evaluation of the role of standardized periodontal probing training on the teaching of undergraduates using the Florida probe system].

PURPOSE: To evaluate the effect of standardized periodontal probing training on the teaching of periodontal clinical probing for undergraduates by using Florida probe system. METHODS: Twenty undergraduates who practiced in the Department of Periodontology of Changzhou Stomatological Hospital from May 2022 to November 2022 were selected as the study objects and randomly divided into two groups with 10 students in each group. The experimental group received standardized periodontal probing training, while the control group did not receive training. Two groups of students used the traditional probe and the Florida probe to probe the left and right half-mouth teeth of one patient. In addition, a periodontal specialist used Florida probe to conduct full oral examination of the same patient, and the results were compared with those of the two groups of students. SPSS 26.0 software package was used for statistical analysis of the obtained data. RESULTS: There was no significant difference of probing depth(PD) between undergraduates and periodontal specialist in the experimental group (P＞0.05), while there was significant difference in the control group (P＜0.05). In the control group, PD values in the anterior area were not statistically different from those of periodontal specialist (P＞0.05), while PD values in the posterior area were statistically different (P＜0.05). Both groups of patients reported that the Florida probe system was more comfortable. CONCLUSIONS: Standardized periodontal probing training is helpful to improve the clinical probing ability of undergraduates. The use of Florida probe system can not only evaluate the teaching effect, but also improve the comfort level of patients, which is worthy of further application in the teaching course of periodontal probing for undergraduates.

Clinical skills examination as part of the Swedish proficiency test of dentists educated outside of the EU/EEA.

INTRODUCTION: The increase in the migration of dentists educated outside the EU/EEA calls for the sharing of information and evaluation of recognition processes within countries in the EU. In 2017, the Swedish National Board of Health and Welfare implemented the Proficiency test, a recognition process for dentists who have completed an education programme outside the EU/EEA. The Proficiency test consists of a theoretical and an integrated clinical skills examination, followed by a 6-month clinical practice. The clinical skills examination is a two-part examination that includes an OSCE and an operative test on a dental manikin. This paper presents data from proficiency tests between 2018 and 2022, and explores factors related to grade fail, that is, demographics, theoretical exam scores and language comprehension. MATERIALS AND METHODS: In a cohort study, demographics and factors associated with grade fail were explored using test results from theoretical and clinical skills examinations (n = 181) from 2018 to 2022. Pearson correlation coefficient and linear regression analysis were used for studying correlations and associations between exam results. Univariable linear and logistic regression models were used for background variable associations with clinical skills exam outcomes. RESULTS: Higher age was a significant risk factor for failing the clinical skills examination and the OSCE. Higher scores in the theoretical exam reduced the odds of failing the OSCE but were not associated with results in the operative test or the overall results of the clinical skills examination. Regarding the OSCE there was a statistically significant difference within all professional qualifications explored between participants who passed and participants who failed the OSCE. CONCLUSIONS: Four years of data collection reveal that age and previous theoretical exam results influence the odds of failing the clinical examination. The study results also highlight the necessity of multiple assessment formats to assess clinical and communication skills of foreign-trained dentists.

'Sustainability in the NHS': a novel method for teaching sustainable dentistry and quality improvement to dental core trainees.

The practice of dentistry contributes to 3% of the carbon footprint of the NHS. As awareness and concern about climate change increases, all dental care professionals must play their part in reducing the environmental impact of the care they provide. This paper aims to describe a novel method of teaching, both the theory and practical application of sustainable dentistry, by integrating sustainable quality improvement methods into the existing management and leadership requirements of dental core training.

Analysis of satisfaction levels and perceptions of clinical competency: a mixed method study on objective structured clinical examinations in undergraduate dental students.

OBJECTIVE: To analyze the satisfaction levels, perceptions of developing clinical competencies through objective structured clinical examination and to explore the experiences, challenges, and suggestions of undergraduate dental students. METHODS: The study adopted a mixed-method convergent design. Quantitative data were collected from 303 participants through surveys, evaluating satisfaction levels with objective structured clinical examination (OSCE). Additionally, qualitative insights were gathered through student focus group interviews, fundamental themes were developed from diverse expressions on various aspects of OSCE assessments. The Chi-Square tests, was performed to assess associations between variables. Data integration involved comparing and contrasting quantitative and qualitative findings to derive comprehensive conclusions. RESULTS: The satisfaction rates include 69.4% for the organization of OSCE stations and 57.4% for overall effectiveness. However, a crucial challenge was identified, with only 36.7% of students receiving adequate post-OSCE feedback. Furthermore, a majority of students (50%) expressed concerns about the clinical relevance of OSCEs. The study showed a significant associations (p < 0.05) between satisfaction levels and years of study as well as previous OSCE experience. Student focus group interviews revealed diverse perspectives on OSCE assessments. While students appreciate the helpfulness of OSCEs, concerns were raised regarding time constraints, stress, examiner training, and the perceived lack of clinical relevance. CONCLUSION: The students anticipated concerns about the clinical relevance of OSCEs, highlighting the need for a more aligned assessment approach. Diverse perspectives on OSCE assessments reveal perceived helpfulness alongside challenges such as lack of feedback, examiner training, time constraints, and mental stress.

Mutual recognition of qualifications, health workforce migration, and graduate outcomes: a comparative mapping study of undergraduate dental education in Europe.

BACKGROUND: The resource needs of health services are served by the recognition of qualifications across borders which allows professionals to migrate between countries. The movement of dentists across the European Union (EU), especially into the United Kingdom (UK), has provided a valuable boost to workforce supply. Recent changes to policy recognising overseas qualifications have brought attention to the equivalence of qualifications awarded in EU countries. Professional regulators need to be confident that dentists who qualified elsewhere have the appropriate knowledge, skills and experience to practise safely and effectively. The aim of this study was to compare UK and EU dental curricula, identify any differences, and compare the extent of pre-qualification clinical experience. METHODS: This was a mixed methods study comprising a questionnaire and website searches to identify information about curricula, competences, and quality assurance arrangements in each country. The questionnaire was sent to organisations responsible for regulating dental education or dental practice in EU member states. This was supplemented with information obtained from website searches of stakeholder organisations for each country including regulators, professional associations, ministries, and providers of dental education. A map of dental training across the EU was created. RESULTS: National learning outcomes for dental education were identified for seven countries. No national outcomes were identified 13 countries; therefore, learning outcomes were mapped at institution level only. No information about learning outcomes was available for six countries. In one country, there is no basic dental training. Clinical skills and communication were generally well represented. Management and leadership were less represented. Only eight countries referenced a need for graduates to be aware of their own limitations. In most countries, quality assurance of dental education is not undertaken by dental organisations, but by national quality assurance agencies for higher education. In many cases, it was not possible to ascertain the extent of graduates' direct clinical experience with patients. CONCLUSIONS: The findings demonstrate considerable variation in learning outcomes for dental education between countries and institutions in Europe. This presents a challenge to decision-makers responsible for national recognition and accreditation of diverse qualifications across Europe to maintain a safe, capable, international workforce; but one that this comparison of programmes helps to address.

Determining the psychometric properties of a written test to assess safe dental practice.

INTRODUCTION: Safe practice in medicine and dentistry has been a global priority area in which large knowledge gaps are present.Patient safety strategies aim at preventing unintended damage to patients that can be caused by healthcare practitioners. One of the components of patient safety is safe clinical practice. Patient safety efforts will help in ensuring safe dental practice for early detection and limiting non-preventable errors.A valid and reliable instrument is required to assess the knowledge of dental students regarding patient safety. OBJECTIVE: To determine the psychometric properties of a written test to assess safe dental practice in undergraduate dental students. MATERIAL AND METHODS: A test comprising 42 multiple-choice questions of one-best type was administered to final year students (52) of a private dental college. Items were developed according to National Board of Medical Examiners item writing guidelines. The content of the test was determined in consultation with dental experts (either professor or associate professor). These experts had to assess each item on the test for language clarity as A: clear, B: ambiguous and relevance as 1: essential, 2: useful, not necessary, 3: not essential. Ethical approval was taken from the concerned dental college. Statistical analysis was done in SPSS V.25 in which descriptive analysis, item analysis and Cronbach's alpha were measured. RESULT: The test scores had a reliability (calculated by Cronbach's alpha) of 0.722 before and 0.855 after removing 15 items. CONCLUSION: A reliable and valid test was developed which will help to assess the knowledge of dental students regarding safe dental practice. This can guide medical educationist to develop or improve patient safety curriculum to ensure safe dental practice.

Evaluating student performance assessment methods in Objective Structured Clinical Exam: perspectives and comparisons.

PURPOSE: This study aims to evaluate how student performance and perspectives changed when the Objective Structured Clinical Exam (OSCE) assessment system was changed from a composite score to discipline-specific grading at the Harvard School of Dental Medicine. METHODS: The retrospective study population consisted of all students (n = 349) who completed three OSCEs (OSCE 1, 2, and 3) as part of the predoctoral program during the years 2014-2023. Data on the students' OSCE scores were obtained from the Office of Dental Education, and data on students' race/ethnicity and gender were obtained from their admissions data. RESULTS: The likelihood of a student failing the OSCE after the assessment system change significantly increased with an adjusted odds ratio of 20.12. After the change, the number of failed subjects per student decreased with an adjusted mean ratio of 0.48. Students perceived the OSCE as being less useful after the change. Independent of the grading change, OSCEs 1 and 2 were seen as more useful compared to OSCE 3, which is administered in the last year of the Doctor of Dental Medicine program. CONCLUSION: The discipline-specific nature of the new assessment system helps focus on specific areas of remediation, rather than blanket remediation used previously, in order to isolate the actual areas of deficiency and to focus remediation efforts so that students can align their learning needs appropriately. Therefore, although the actual number of fails identified increased for the course, the assessment change has allowed for more directed, actionable information to be gained from the OSCE to prepare students to work toward competency standards.

Situational simulation teaching effectively improves dental students' non-operational clinical competency and objective structured clinical examination performance.

BACKGROUND: Appropriate communication with dental patients enhances treatment outcomes and patient satisfaction. Implementing simulated patient interviews courses can improve patient-centered care and reduce conflict during clerkship training. Therefore, this study explored the relationship among student participation in a situational simulation course (SSC), academic performance, clerkship performance, and objective structured clinical examination (OSCE) performance. METHODS: This study was conducted with a sample of fifth-year dental students undergoing clerkship training. After implementing a situational simulation course to investigate the relationship among participation in SSC, academic performance, clerkship performance, and OSCE performance, a path analysis model was developed and tested. RESULTS: Eighty-seven fifth-year dental students were eligible for the SSC, and most (n = 70, 80.46%) volunteered to participate. The path analysis model revealed that academic performance had a direct effect on OSCE performance (ß = 0.281, P = 0.003) and clerkship performance (ß = 0.441, P < 0.001). In addition, SSC teaching had a direct effect on OSCE performance (ß = 0.356, P < 0.001). CONCLUSIONS: SSCs can enhance dental students' non-operational clinical competency and OSCE performance effectively. Simulated patient encounters with feedback, incorporated into the dental curricula, have led to improved communication. Based on our findings, we suggest implementing SSC teaching before the OSCE to improve communication and cognitive skills.

American Dental Education Association Compendium Entrustable Professional Activities Workgroup report.

PURPOSE: Entrustable professional activities (EPAs) are discrete clinical tasks that can be evaluated to help define readiness for independent practice in the health professions and are intended to increase trust in the dental graduate. EPAs provide a framework that bridges competencies to clinical practice. This report describes the work of the American Dental Education Association (ADEA) Compendium EPA Workgroup to develop a list of EPAs for dental education and supportive resources, including specifications and a glossary. METHODS: Preliminary work including literature and resource review, mapping of existing competencies, and review of other health professions' EPAs informed the development of our EPAs list. Workgroup members achieved consensus using a modified Delphi process. A Qualtrics survey using a validated rubric for the assessment of EPAs as described in peer-reviewed literature was used. Dental educators, including academic deans, were surveyed for feedback on the content and format of the EPAs. RESULTS: Based on findings in the literature analysis of existing EPAs and competencies in health professions, a list of EPAs was developed along with a description of specifications. The EPA workgroup (nine members from multiple institutions) used the Delphi process in receiving feedback from various experts. A list of 11 core EPAs was vetted by dental educators including academic deans (n = âˆ¼23), and the process of development was reviewed by EPAs experts outside dental education. A glossary was developed to align language. CONCLUSION: These EPAs define the scope of dental practice. This report represents Phase 1 of the EPA framework development and vetting process. Future directions will include a broader vetting of the EPA list, faculty development, and national standardized technology that support this work to optimize implementation.