An assessment of preclinical removable prosthodontics based on multiple-choice questions: Stakeholders' perceptions.

PURPOSE: Item analysis of multiple-choice questions (MCQs) is an essential tool for identifying items that can be stored, revised, or discarded to build a quality MCQ bank. This study analyzed MCQs based on item analysis to develop a pool of valid and reliable items and investigate stakeholders' perceptions regarding MCQs in a written summative assessment (WSA) based on this item analysis. METHODS: In this descriptive study, 55 questions each from 2016 to 2019 of WSA in preclinical removable prosthodontics for fourth-year undergraduate dentistry students were analyzed for item analysis. Items were categorized according to their difficulty index (DIF I) and discrimination index (DI). Students (2021-2022) were assessed using this question bank. Students' perceptions of and feedback from faculty members concerning this assessment were collected using a questionnaire with a five-point Likert scale. RESULTS: Of 220 items when both indices (DIF I and DI) were combined, 144 (65.5%) were retained in the question bank, 66 (30%) required revision before incorporation into the question bank, and only 10 (4.5%) were discarded. The mean DIF I and DI values were 69% (standard deviation [Std.Dev] = 19) and 0.22 (Std.Dev = 0.16), respectively, for 220 MCQs. The mean scores from the questionnaire for students and feedback from faculty members ranged from 3.50 to 4.04 and from 4 to 5, respectively, indicating that stakeholders tended to agree and strongly agree, respectively, with the proposed statements. CONCLUSION: This study assisted the prosthodontics department in creating a set of prevalidated questions with known difficulty and discrimination capacity.

Self-assessment skills of undergraduate dental students in the preclinical course of complete removable prosthodontics at Tehran University of Medical Sciences.

INTRODUCTION: This study evaluated the self-assessment skills of third-year dental students regarding their performance in complete removable prosthodontics (CRP) preclinical course. METHODS AND MATERIALS: This cross-sectional study was conducted on all third-year dental students attending the International Dental College of Tehran University of Medical Sciences. The students were requested to self-assess their performance in primary impression making, custom tray fabrication, border moulding, final impression making, master cast fabrication, record-base fabrication and tooth arrangement in CRP preclinical course. The performance of dental students in each step was scored by themselves and their mentors. Data were analysed by the Mann-Whitney U, Pearson's correlation and t-tests (α = 0.05). RESULTS: Totally 25 male (55.6%) and 20 female (44.4%) dental students were evaluated. Significant differences were noted between male and female dental students in self-assessment scores regarding adequate extension of the custom tray (p = .027), the correct position of tray handle (p = .020), visibility of vestibular width and depth on the cast (p = .011), the coincidence of upper and lower midlines (p = .005) and correct orientation of maxillary and mandibular planes in the articulator (p = .036). The mean self-assessment score of female students was significantly higher than that of male students (p = .01). The scores given by the mentors were not significantly different for male and female students (p = .975). The difference between the self-assessment score of students and the mentor score was not significant (p = .067) either in males or in females (p > .05). CONCLUSION: Undergraduate dental students favourably self-assessed their performance in all steps of the preclinical course of CRP, comparable with their mentor assessment.

Dental school quality assessment: Effect of student calibration on the outcomes of fixed prosthodontic cases.

BACKGROUND: Quality assurance (QA) of predoctoral dental student laboratory work is an essential part of the learning process that involves evaluating the student's ability, providing constructive feedback, helping develop the students' ability to self-assess, and promoting collegiality and communication among students, faculty, and laboratories. Faculty calibration, while often difficult to coordinate, is also necessary to providing consistent student feedback. AIM: The purpose of this study was to evaluate whether periodic calibration exercises with the fourth-year dental students and faculty impacted the number of student cases rejected during Quality Assurance evaluation of fixed prosthodontic cases submitted to The Dental College of Georgia laboratory tracking. CONCLUSION: Findings from this study provided evidence that ongoing calibration did result in a reduced number of incoming QA rejections in all periods reviewed except for one in which there was significant turnover among department faculty affecting QA calibration for that time period.

Self-assessment and peer-assessment of the psychomotor skills in preclinical prosthodontics: A prospective study.

INTRODUCTION: Students' self-assessment and peer assessments are essential to understand the rubrics criteria and improve their psychomotor skills. The purpose of this study was to assess the impact of self-assessment score (SAS), peer-assessment score (PAS) and teacher assessment score (TAS) on the final scores of the psychomotor skills of dental students in a preclinical fixed prosthodontics course. MATERIALS AND METHODS: A prospective study included D2 students in a preclinical fixed prosthodontics course for two consecutive academic years from September 2017 to May 2019. Students' performance of various procedures over 14 sessions was assessed by SAS, PAS and TAS. Repeated-measures ANOVA was used to assess differences between the three scores and control charts showed their change over time. Multivariable linear regression was used to assess the association between two outcome variables: TAS and the total preclinical score and the explanatory variables: SAS, PAS, TAS, gender and GPA. The significance level was set at 5%. RESULTS: SAS had a significantly higher mean (80.21) than TAS (79.32) and PAS (78.58). SAS reached higher levels earlier than TAS and PAS. PAS had a stronger association with TAS than SAS (partial eta squared, η2 = 0.17 and 0.13), whereas SAS significantly predicted total preclinical score (p < .0001). CONCLUSIONS: PAS helped develop the skills of dental students during training, while SAS had an impact on their total preclinical score. Different student-centred activities are needed to support students' preclinical training in fixed prosthodontics courses.

Student perception and assessment outcomes using a pilot condensed format ("boot camp") in a Fixed Prosthodontics course.

INTRODUCTION: The purpose of this study was to assess student perception as well as course outcomes (final written examination grades) when using a pilot condensed format in an undergraduate Fixed Prosthodontics course, which was implemented as a response to the global pandemic of Covid-19. MATERIALS AND METHODS: The course was delivered in a condensed format, with a total of 28 direct contact hours in the Simulation Clinic within a 4 day period. Asynchronous remote learning was employed for the didactic portion of the course. Students completed surveys before and after the course, to assess their perception of the condensed format, and written examination grades were compared with previous years' grades. Data were entered in an Excel database (Microsoft Excel 2016) and analysed using a statistical analysis software program (IBM SPSS Statistics, v26; IBM Corp). The level of significance was set to α = 0.05. RESULTS: Overall, student perception of the condensed format was positive. At the beginning of the course, female students had less confidence in their skills compared to male students (p < .05). Written examination grades were significantly lower compared to previous years' grades (p = .04). CONCLUSION: The use of a condensed format can allow a course to be delivered in smaller student cohorts and provides the ability to reduce the total number of direct contact hours allotted to the course, creating space within the curriculum. Student perception of this format was generally positive. However, written examination scores were negatively impacted, indicating possible knowledge gaps resulting from the condensed course format. More studies are needed to assess the effect of the various curricular modifications that have been implemented due to the Covid-19 pandemic.

Effect of self-assessment in a removable prosthodontics preclinical course on skills and competence.

PURPOSE: Self-assessment is increasingly implemented in medical professions' curricula. In this research, the authors measure the effects of self-assessment within a preclinical removable prosthodontics course among dental students in a private dental school according to the European qualifications framework descriptors. MATERIALS AND METHODS: Thirty subjects, all fourth-year dental students, were included in this experiment. Fifteen subjects were included in each of the experimental and control groups during one semester. The experimental group subjects used the study roadmap tool in their preclinical tasks. The control group subjects executed the same preclinical tasks under instructor supervision only. All subjects were filmed, and an autonomy score was given to every subject per session. At the end of the semester, cognitive skills development was compared using the Kember et al. questionnaire while practical skills development was compared using a comparison of grades. Two focus groups were undertaken with experimental group subjects. Qualitative and quantitative data were collected and statistically analyzed (p < 0.005). RESULTS: Subjects from the experimental group showed development in critical thinking, practical skills, autonomy, and taking responsibility, thus development in the competence level. CONCLUSION: Implementation of self-assessment within preclinical courses may develop skills and competence among dental students, yet more studies are needed.

Retrospective Evaluation of the Status of Advanced Dental Education in Prosthodontics from 2006 to 2016.

The aim of this study was to analyze information about advanced education programs in prosthodontics (AEPPs) collected in American Dental Association (ADA) surveys on advanced dental education from 2006-07 to 2016-17. Data recorded included number of AEPPs and information on program directors, applicants, and enrollees in AEPPs. The results showed that, from 2006 to 2016, there was an increase in the number of AEPPs and enrollment of prosthodontic residents, and the number of applicants per program more than doubled. Despite these increases, steps are needed to increase the number of underrepresented minority residents in prosthodontics. Also, a periodic survey of prosthodontic residents to identify their goals, experiences during training, and career plans could benefit the specialty by providing more insight into the future prosthodontic workforce.

Comparative Assessment of a New Holistic-Oriented and an Old Specialty-Specific Undergraduate Curriculum in Removable Prosthodontics: A Study Based on Senior Students' Perceptions.

PURPOSE: A survey was conducted in the Dental School, Aristotle University, Thessaloniki, Greece, (i) to assess the perceptions and experiences of senior dental students, Classes of 2014 and 2015, toward the old, specialty-specific (OC) and new, holistic-oriented (NC) undergraduate curriculum, respectively, in removable prosthodontics and (ii) to identify areas of improvement in prosthodontic training. MATERIALS AND METHODS: Structural components of both curricula were collected, including the total number of (i) laboratory/lecture/clinical training hours, (ii) written examinations, (iii) mandatory clinical cases, and (iv) European Credit Transfer and Accumulation System (ECTS) credits. A 20-item closed-type questionnaire using a five-point Likert scale was distributed in two consecutive groups of seniors, Classes of 2014 (n = 54) and 2015 (n = 57); 54 OC and 57 NC senior students filled out the questionnaire. RESULTS: A greater percentage of NC students stated that (i) they felt less confident to carry out jaw relation recording and removable partial denture metal framework design and (ii) the time allocated for clinical training was less sufficient. Students of both curricula reported that the laboratory courses and lectures contributed little to their clinical performance. Implant restorations and prosthetic management of patients with craniomandibular disorders were the most popular treatment options that the respondents felt that should be incorporated in the undergraduate curriculum. CONCLUSIONS: As a general trend, students completing the revised curriculum reported more difficulties during their training and felt more insecure about their clinical competences. To enhance students' self-confidence in prosthodontics, more effective preclinical training methods, introduction of additional treatment options, and alternative educational methods should be considered.

Pilot study on the effectiveness and students' attitude towards undergraduate training provided by industry.

INTRODUCTION: Rapid developments in CAD/CAM technology necessitate the adaptation of curriculum content. Limited resources hinder institutions in holding state of the art equipment available for student training. MATERIALS AND METHODS: A workshop given by an industry partner was organised as part of the final pre-clinical course in prosthodontics for the academic years 2015 and 2016. The workshop on dental ceramics and CAD/CAM technology comprised of lectures and practical demonstrations. Multiple-choice examinations prior to and after the workshop as well as questionnaires were used for assessing effectiveness and students' perception. The test scores and evaluation results were compared using Fisher's exact test of homogeneity (α = 0.05). RESULTS: The workshop improved students' performance in the written examination. With the exception of 1 question, students having attended the workshop performed significantly better (P < .05). The majority of students felt that the workshop fostered their knowledge in the field of dental ceramics and CAD/CAM. Whilst only a small portion (<10%) disapproved industry-supported education, up to 45% of the participants considered the workshop as sales promotion. The students were undecided on whether or not competitor companies should be invited to present on the same topic and whether or not more industry-supported courses would be beneficial. DISCUSSION: Industry-supported education appears to be a necessity in the field of CAD/CAM dentistry, but care has to be taken to select adequate partners, and the content of courses has to be controlled.

Dental Students' Perceptions of Digital Assessment Software for Preclinical Tooth Preparation Exercises.

Objective self-assessment is essential to learning and continued competence in dentistry. A computer-assisted design/computer-assisted manufacturing (CAD/CAM) learning software (prepCheck, Sirona) allows students to objectively assess their performance in preclinical prosthodontics. The aim of this study was to evaluate students' perceptions of CAD/CAM learning software for preclinical prosthodontics exercises. In 2014, all third-year dental students at Harvard School of Dental Medicine (n=36) were individually instructed by a trained faculty member in using prepCheck. Each student completed a preclinical formative exercise (#18) and summative examination (#30) for ceramometal crown preparation and evaluated the preparation using five assessment tools (reduction, margin width, surface finish, taper, and undercut) in prepCheck. The students then rated each of the five tools for usefulness, user-friendliness, and frequency of use on a scale from 1=lowest to 5=highest. Faculty members graded the tooth preparations as pass (P), marginal-pass (MP), or fail (F). The survey response rate was 100%. The tools for undercut and taper had the highest scores for usefulness, user-friendliness, and frequency of use. The reduction tool score was significantly lower in all categories (p<0.01). There were significant differences in usefulness (p<0.05) and user-friendliness (p<0.05) scores among the P, MP, and F groups. These results suggest that the prepCheck taper and undercut tools were useful for the students' learning process in a preclinical exercise. The students' perceptions of prepCheck and their preclinical performance were related, and those students who performed poorest rated the software as significantly more useful.

Clinical Teaching of Prosthodontics in Undergraduate Courses in a German Dental School: Patients, Visits, Efforts, and Incentives.

It is unknown what disadvantages are faced by patients deciding for a prosthodontic treatment by inexperienced students. Commonly, the related extra effort and time are compensated by cost reduction of treatment fees. Thereby, the dental schools subsidize treatments to teach clinical prosthodontics. The aim of this study was to clarify the benefits to patients as well as the efforts of the dental school. Data collected from three courses in a dental school in Germany were patient gender, age, occupation, zip code, number of visits, scope of treatment including costs, financial discount, and remaining copayment. Travel costs were calculated based on zip code. Balance of travel costs and treatment discount was defined as financial benefit. The results showed that 185 patients (95 male) aged 32 to 82 years (median=58) were treated with fixed restorations (FR, n=110), telescopic dentures (TD, n=87), complete dentures (CD, n=17), or other (RD, n=3). The mean number of visits was 11 for FR, 12 for TD, and 9 for CD. Single distance to the clinic ranged from 0.6 to 65 miles (median=12). Total costs of prosthodontics were reduced by 19% on average. The mean financial benefit was 429 USD (median=298, min=-482, max=4025). The financial benefits were found to differ widely, including additional expenditures of patients. Participation, travel burden, and copayment did not depend on age, gender, or occupation. The financial benefit was relativized because students needed at least twice the sessions of a dentist. As a result, the financial efforts of dental schools are significant and compromise a cost-covering education.

Dental School Vacant Budgeted Faculty Positions, Academic Years 2011-12 Through 2013-14.

The American Dental Education Association (ADEA) Survey of Dental School Faculty is conducted annually to provide an overview of the hiring and retention activity of U.S. dental school faculty. The survey collects data on the dental faculty workforce, including vacant budgeted positions by appointment and discipline, number of new and lost positions, sources of new hires, and reasons for faculty separations. This report highlights the results of three years of survey data, from the 2011-12 academic year through the 2013-14 academic year. After declining in previous years, the number of vacant faculty positions in U.S. dental schools has begun to increase, rising to 242 full-time and 55 part-time positions in 2013-14. Additionally, the number of schools having more than ten vacancies increased from five to 12. Although the number of vacancies has increased, the length of faculty searches that took more than one year declined from 25% to 16% in the same period. Retirements as a share of full-time faculty separations increased from 14% in 2008-09 to 31% in 2013-14. The current average retirement age of dental school faculty members is 69.7 years. The percentage of full-time faculty members leaving for the private sector remained constant over the last three years at approximately 16%. Full-time faculty members were more likely to be recruited from other dental schools, while part-time faculty members were more likely to come from the private sector.

Students' self-assessment: a learning tool and its comparison with the faculty assessments.

OBJECTIVE: This study compared the student's self-grades versus the examiners grades, inter examiner grades and grades of anterior with posterior teeth in a preclinical prosthodontic course. METHODS: 75 students and 2 examiners participated in the study. The students prepared one anterior (upper central incisor) and one posterior (lower first molar) teeth for full veneer crowns in allocated time of 2 hours and 30 minutes. After the preparations, the students self-graded their preparations based on criteria-based evaluation forms. The examiners also completed the grading for the prepared teeth. All the grades were recorded, comparisons were made using SPSS version 21 and results tabulated. RESULTS: The means of grades (8.32) by the students themselves were found to be higher compared to the examiners grades (7.3) for the anterior as well as posterior teeth. Comparison of the grades for the anterior/posterior teeth and the overall grades showed a statistically significant difference (p=0.000). A moderate correlation (0.399) and a strong correlation (0.601) were found between the grades of the faculty and the students for the anterior and posterior teeth respectively. The overall grading for the anterior and posterior teeth by the two faculty members showed no statistically significant difference (p=0.053) and a very strong correlation (0.784). The results of the test showed a significant difference (p=0.001) between the overall grading for anterior and posterior teeth. CONCLUSION: Students tended to grade their teeth preparations higher compared to the examiner grades, inter examiner variation in the grades existed and the grades of the anterior teeth were higher compared to the posterior teeth.

Implementation of new technologies in U.S. dental school curricula.

With dentistry rapidly evolving as new technologies are developed, this study aimed to identify the penetration of emerging dental technologies into the curricula of U.S. dental schools and to explore whether certain school characteristics affected adoption of these technologies. A 19-question survey was sent to the academic deans of all 62 U.S. dental schools. In addition to questions about characteristics of the school, the survey asked respondents to indicate where in their curricula the technology was incorporated: preclinical didactic, preclinical laboratory, clinical didactic, and/or clinical patient experience. Of 62 eligible schools, 33 useable responses were received, for a 52% response rate. The results showed that the greatest overall penetration of dental technologies was in preclinical didactic courses and the lowest was in the preclinical laboratory. Specific technologies implemented in the largest percentage of responding schools were digital radiography and rotary endodontics. The technologies with the lowest penetration were CAD/CAM denture fabrication and hard tissue lasers. These results suggest that the incorporation of technology into dental schools is following that of private practice as the most widely adopted technologies were those with the greatest acceptance and use in private practice. Among the respondents, factors such as class size and age of the school had greater impact on incorporation of technology than funding source and geographic location.

Dental students' perceptions of and experiences with prosthodontics: ten graduating classes at one institution.

It is important for members of the dental specialties to understand what motivates students to enter the specialty in order to ensure its continuing development and ability to meet patient needs. The aim of this study was to compare ten graduating classes at Harvard School of Dental Medicine (HSDM) regarding students' experiences with and perceptions of prosthodontics and factors influencing those interested in pursuing prosthodontics as a specialty. In 2013, HSDM students in the classes of 2012-16 were surveyed, achieving a response rate of 81%. Survey questions sought information regarding specialty choice, factors influencing the choice, student experiences with prosthodontics, and student perceptions of the dental disciplines. Responses were compared to those from a prior study of the HSDM classes of 2007-11. The responses showed a decrease in negative student experiences with prosthodontics. The students regarded prosthodontics highly for its impact on patient quality of life; however, students interested in pursuing prosthodontics as a specialty decreased. All students said provider enjoyment was most important in choice of specialty. Cost of program, patient type, and program location were factors that especially influenced students interested in prosthodontics. The improved student experiences with and perspectives on prosthodontics may be a result of a curriculum change that led to more prosthodontics procedures and case completions by students. The fall in students interested in prosthodontics may have resulted from prosthodontic faculty transitions that occurred when the survey was conducted, as well as large debt burdens in spite of the fact that prosthodontists' earnings are among the highest in dentistry. Faculty must educate and mentor students about the realities of the profession, provide positive learning experiences in the field, and encourage students who enjoy prosthodontics to pursue specialty training.

Dental students' opinions of preparation assessment with E4D compare software versus traditional methods.

The aim of this study was to evaluate dental students' opinions regarding the utilization of a new grading software program for student self-assessment and a faculty-grading tool in a preclinical course. Using surface mapping technology, this program, called E4D Compare, yields a digital model of a student's preparation that is color-coded to show deficient areas. The program has now been used for two years at the James B. Edwards College of Dental Medicine at the Medical University of South Carolina, and the students previously assessed with E4D Compare have now entered into the dental clinics. For this study, students were asked to complete an anonymous survey for the investigators to evaluate students' attitudes and opinions on the effectiveness of this software in their preclinical courses to determine if this type of feedback helped them develop clinical skills. The survey also sought to collect students' opinions on the traditional objective criteria-based grading system. The survey was distributed to all members of the Classes of 2014 and 2015; it yielded a 59 percent response rate for the two classes, with a total of eighty-one students responding. Overall, the majority of students preferred the E4D Compare grading system over traditional hand-grading methods. The grading system provided instant, objective, and visual feedback that allowed students to easily see where their deficiencies were and encouraged them to work towards an ideal final product.

Introducing CAD/CAM into a predoctoral dental curriculum: a case study.

This article describes the decision making and implementation process used at Indiana University School of Dentistry to incorporate a CAD/CAM system into the predoctoral curriculum and presents data regarding the opinions of students and faculty members after one year. Using a non-validated survey instrument, D1 students rated their experience fabricating a CAD/CAM-generated crown. Eighty-eight of the 105 D1 students (84 percent response rate) responded to the four multiple-choice questions, and a varying number provided written responses. Eighty percent of the responding students rated the overall learning experience as good or excellent, and 43 percent judged that they were prepared to fabricate a crown independently. Students' comments about the experience were generally positive. The twelve supervising faculty members were also surveyed after the first year. When asked to evaluate the initial quality of the crowns at placement, they rated 89 to 98 percent of them good or excellent on the measures of marginal fit, axial contours, proximal contacts, and occlusal contacts. In their judgment, CAD/CAM-generated crowns were as good as or better than those received from commercial labs. After one year, the school's experience has been that the performance of these crowns is consistent with the literature and that they are a viable option. Also, the students are enthusiastic about this addition to the curriculum.

The effects of student self-assessment on learning in removable prosthodontics laboratory.

It has been consistently shown that there is a weak association between student self-assessment and faculty member assessment of student projects in preclinical technique laboratory settings and that students overestimate their performance. Greater overestimation is observed among students judged by faculty to be the weakest, and these students also use a wider range of scores. This study hypothesized that student self-assessment is a function of capacity to perform, accuracy of understanding grading standards, and psychological factors. Further it hypothesized that learning, defined as change in performance, is a function of ability and self-assessment. Dental students at one U.S. dental school self-assessed their performance on two projects in a removable prosthodontics laboratory course separated by a six-month period. Faculty evaluations of these projects were used to determine students' understanding of the criteria for the projects, and a standardized psychological test was used to assess the learning orientation of the students. A statistical correction was made for the artifact of regression toward the mean. The study found that self-assessment was a better predictor of future learning under these circumstances than was evaluation by faculty members.

Are predoctoral students able to provide single tooth implant restorations in the maxillary esthetic zone?

The objective of this study was to assess the ability of the University of Illinois at Chicago College of Dentistry (UIC-COD) predoctoral students to provide single tooth implant (STI) prostheses in the maxillary esthetic zone. The patient's esthetic satisfaction and the correlation between prosthodontists' and patients' perspectives were examined. Twenty-seven patients were recruited for recall examinations at the UIC-COD predoctoral implant program and underwent clinical and radiographic examination with clinical photographs of the implant sites. The patients completed a semantic differential scale questionnaire. The collected information was formulated into a PowerPoint presentation for two Diplomate of the American Board of Prosthodontists to use the Pink/White Esthetic Score (PES/WES) to evaluate the esthetic outcome. Descriptive analyses, Cohen kappa test, and Spearman rank correlation coefficient test were performed. The average PES/WES were above 6.0 (out of 10). The median for the patient satisfaction and esthetic outcome questionnaires were 10 and 9, respectively, on a scale with 10=highest. There was a medium and positive correlation between prosthodontists' and patients' perspectives in esthetic outcome. This study found that, with strict guidance and proper selection criteria, predoctoral students were able to provide esthetically acceptable STI prostheses in the maxillary esthetic zone and patients were satisfied with the treatment provided.