Current Trends In Complete Denture Education In Undergraduate Dental Colleges Of Pakistan.

Objective: To determine the current trends in complete denture education in undergraduate dental colleges. METHODS: The survey-based study was conducted in April and May 2020 at undergraduate dental colleges of Pakistan, and comprised heads of the Prosthodontics Department at all dental colleges across Pakistan having at least one batch of final year dental students. Data was collected using an online predesigned questionnaire that explored theoretical and practical teaching patterns of complete denture prosthodontics in the undergraduate years, and the materials and practices of students when constructing complete dentures in the clinics. The participants were given the option of choosing more than one option where needed. Data was analysed using SPSS 23. RESULTS: Of the 49 subjects approached, 40(81.6%) returned the forms duly filled; 11(27.5%) from public-sector institutions and 29(72.5%) from the private sector. There were 26(65%) institutions which required that their undergraduate students fabricate 2-4 conventional complete dentures. In all 40(100%) colleges, faculty gave live clinical demonstrations before students fabricated conventional complete dentures in the outpatient departments. Teaching strategy included small group discussions in 25(62.5%) institutions. Green stick 40(100%), zinc oxide eugenol 40(100%) and impression compound 39(97.2%) were the materials of choice for various steps of impression making. In all the 40(100%) institutions, students fabricated conventional complete dentures during their prosthodontics rotation. Immediate, copy and overdentures were constructed by students in 8(20%), 3(7.5%) and 8(20%) institutions, respectively. Conclusion: Majority of the dental schools used similar impression materials and techniques for fabricating conventional complete dentures. Didactic teaching of conventional and unconventional complete dentures was being carried out at a huge majority of the dental institutions studied.

Clinical teaching in dentistry: Evaluating a clinical oral pathology rotation while looking to the future of dental education.

PURPOSE/OBJECTIVES: Clinical teaching in dentistry has cycled through specialty-based "departmental" teaching to group practice scenarios. The aims of this study were to ascertain third-year dental students' perceptions of a specialty-based rotation supplemented by online educational tools and to compare their Objective Structured Clinical Exam (OSCE) scores to those of the students in the previous year. METHODS: This retrospective research design included the analysis of OSCE scores, and student responses to survey questions regarding their perceptions of the clinical oral pathology (COP) rotation. This study was completed in 2022. It included data from 2020 to 2021 and 2021 to 2022 corresponding to input from the Classes of 2022 and 2023, respectively. The response rate was 100%. RESULTS: The students evaluated the focused COP rotation and the online teaching modules as a positive experience. The results of the OSCE were similar to those of the previous class and showed a high average score. CONCLUSIONS: This study shows that students had a positive perception to specialty-based learning with online educational tools and that it enhanced the education they received in the comprehensive care clinic. The OSCE scores were similar to those of the previous class. These findings suggest a method of maintaining high-quality dental education through challenges as it continues evolving.

Effectiveness of face-to-face, blended and e-learning in teaching the application of local anaesthesia: a randomised study.

BACKGROUND: Local anaesthesia plays a key role in many aspects of a dentist's work. The required skills to perform anaesthesia successfully are acquired at university. To take advantage of the possibilities for new teaching formats, a blended learning concept for the local anaesthesia course was developed. The aim of the study was to compare the effectiveness of face-to-face, blended and e-learning in teaching in local anaesthesia by assessing students' knowledge gain, performance of practical skills and satisfaction with the course. METHODS: All participants (n = 37) were randomly allocated into three groups. After acquiring the theoretical background in the blended learning, e-learning or lecture groups, a test to assess knowledge gain was performed. The performance of the practical skills was assessed in a small-group seminar. Student attitudes were evaluated with a questionnaire. RESULTS: The blended group showed significantly better results (mean = 17, SD =1.5) in theoretical knowledge gain than the other two groups (e-learning group: mean = 14.7, SD = 2.2; lecture group: mean = 14.8, SD =2.3). When comparing the results of the clinical skills assessment, there was no significant difference among all three groups (p > 0.017). The participants confirmed a high overall satisfaction with the course, in particular with the blended learning approach. CONCLUSION: This study indicates that blended learning improves the learning outcome for theoretical knowledge in teaching local anaesthesia more than either face-to-face learning or e-learning alone. Furthermore, the blended learning approach is highly appreciated by the students. For acquiring practical skills, this study shows that blended learning is as effective as other teaching methods.

An emulation model in critical thinking used to develop learning outcomes in inter professional practice.

Abstract: Interprofessional education (IPE) and interprofessional practice (IPP) are essential for the comprehensive care of patients. A goal of this paper is to articulate learning outcomes likely to improve patient outcomes. Yet learning outcomes in IPE are "systematically lacking" in consistency. Objective: An approach offered here and the main purpose of this paper is to develop and implement an IPE learning outcome by applying emulation concepts from the education literature. In dental situations, emulation has been used to derive the thought process of the expert succinctly enough for the novice to apply to the next patient. Methods: The expert's thought process thus becomes the learning outcome, the learning guide, and the assessment instrument. In IPE/IPP, several experts make up the team. The resulting learning outcome is the collection of key questions from respective health care team members. Team members are primary care, pharmacy, nursing, social work, nutrition, and dentistry. The resulting list of questions has not been reported and was applied to patient planning in a geriatric/special needs clinic. Results: Students were more likely to apply questions from disciplines that were preceded by didactic instruction-primary care, pharmacy, nutrition, and dentistry-and less likely to apply questions from nursing and social work. Conclusions: Although still in the early stages, the model is viable to guide learning and assess performance to a level of grasping the concept. The exercise is student led. For the practitioner, the learning outcome becomes the performance outcome. Further model development is ongoing with limited models for comparison.

An interventional study for improving the manual dexterity of dentistry students.

OBJECTIVES: Traditionally, the acquisition of manual skills in most dental schools worldwide is based on exercises on plastic teeth placed in a "phantom head simulator". No manual trainings are done at home. Studies revealed that preliminary training of one motoric task leads to significant improvement in performance of the required motoric task that has similar components. Performing tasks indirectly via a dental mirror are complicated for the young dental students. We hypothesized that instructed training of basic skills required in dentistry at home on a tool simulating the phantom laboratory will improve the capabilities of the students and will be reflected by their clinical grades. METHODS: We developed a portable tool PhantHome which is composed of jaws, gingival tissue, rubber cover and a compatible stand. Specific teeth produced by a 3D printer with drills in different directions were placed in both jaws. Students were requested to insert pins by using tweezers and dental mirror according to instructions initiating with easy tasks and continue to ones that are more complicated. 106 first clinical year dental students participated in the study; 65 trained only in the traditional phantom lab (control). 41 trained at home by the PhantHome tool two weeks before and 2 months during the initial stage of phantom lab. The students grades routinely provided in the phantom laboratory at different stages were compared. RESULTS: Students who trained with the portable tool performed better than the control group in the first direct and second indirect preparations (p<0.05). These exams were taken when the PhantHome was available to the students. Then, the tool was returned and the phantom course continued regularly. We believe that this is why no differences between the grades of the groups were observed further on. CONCLUSIONS: Training by the PhantHome improves motor skills and consequently the clinical performances.

Student-to-Student Dental Local Anesthetic Preclinical Training: Impact on Students' Confidence and Anxiety in Clinical Practice.

Effective dental local anesthetic administration forms the basis of pain-free dentistry; therefore, the application of theoretical knowledge and the ability to deliver injections safely and competently are vital aspects of student learning. Student- to-student administration of the first local anesthetic injection has been a traditional method for preclinical training. The aim of this study was to evaluate oral health students' perceived value of such practice and the impact on their level of anxiety and confidence in giving their first injections to patients. A sequential mixed-methods cohort study design was used. After their local anesthesia training, all 42 second-year students in the oral health program at the Sydney Dental School, University of Sydney, Australia, in 2016-17 were asked to complete five short questionnaires. All 42 students completed each questionnaire, after which seven of them participated in a voluntary focus group. The students reported that they valued the one-on-one feedback from the educators during student-to-student preclinical training. The students' primary concern was the possible pain and discomfort that may arise when they perform the first infiltration or inferior alveolar nerve block injections on patients. Most students reported they felt "a little nervous" and experienced a similar level of confidence in administering the two types of injections. The oral health students valued the experiential learning of student-to-student preclinical dental local anaesthetic training. Students' level of anxiety and confidence was affected by the age of patients and type of local anesthetic injections. The level of anxiety students experienced was negatively correlated with their confidence in giving first local anesthetic injections to patients. Further investigation is needed to determine if this level changes with more clinical experience.

Effect of Collaborative Group Testing on Dental Students' Performance and Perceived Learning in an Introductory Comprehensive Care Course.

The use of collaboration while in dental school can help prepare dental students for the team-oriented nature of the workforce. One way to do this is via collaborative group testing (CGT), a method of assessment allowing students to learn from one another. The aim of this study was to examine the CGT method in a predoctoral dental education setting to determine if student examination performance improved with the addition of collaboration and if collaborative testing was beneficial to students' learning process. In 2016, all first-year dental students (n=76) at one U.S. dental school were assessed in an introductory comprehensive care course using a two-stage CGT in which students were assessed individually, prior to taking the same test in collaboration with an assigned partner. Three quizzes and a final examination were given in which student participants served as both control (individual assessments) and treatment (collaborative assessment). At the conclusion of the course, a questionnaire was administered to ascertain student perspectives. All assessments yielded favorable results with an overall score improvement from a mean of 81.1% on individual assessments to 91% on collaborative assessments (p=0.001), indicating that collaboration improved assessment outcomes. Additionally, retention of material was suggested with individual scores on the cumulative final surpassing average individual scores of the preceding quizzes (p<0.001). Students' responses on the questionnaire indicated that they perceived implementation of CGT was beneficial to their learning process. With these results, this testing methodology shows promise to enhance dental student learning, material retention, and teamwork.

An innovative educational approach in using instructional videos to teach dental local anaesthetic skills.

OBJECTIVE: Good clinical skills are crucial for all dental practitioners. The transfer of knowledge from didactic lectures to daily clinical application can be challenging for current millennial learners. This study aimed to evaluate the effectiveness of using instructional videos to teach dental local anaesthesia in an undergraduate oral health programme in 2017. METHODS: The philosophical basis of this study relies on the Advanced Trauma Life Support (ATLS) course which has been proven effective in practical education. Video clips were made in 3 different formats, with the addition of a quiz-embedded version to reinforce learning and revision for practical assessments. RESULTS: All the students agreed that their motivation to watch the videos was to refresh their memories before assessments. 90% of students agreed the videos helped them to learn psychomotor skills that required accuracy. There was a statistically significant correlation between the number of views of the videos on the administration of block injections and the marks received for practical assessment (r = 0.36, P = 0.05), and correlation between participating in online quizzes and theory assessment (r = 0.371, P = 0.044). Videos with narration and background music were found to be popular amongst oral health students. CONCLUSION: The use of instructional videos has been found effective in complementing the ATLS approach for teaching psychomotor skills in the administration of local anaesthetics by oral health students. Further studies are required to measure the students' retention of knowledge and application of skills on a patient in clinical settings.

HPV and Oral Cancer: The Need to Integrate Oral Health Practices Into Nursing Education.

BACKGROUND: Human papillomavirus (HPV)-associated oropharyngeal cancer has increased in recent decades. With a shortage of dental professionals, nurses may be key in detecting oral cancer and educating patients. OBJECTIVES: The aim of this study is to assess students in nursing and dental programs for their oral and oropharyngeal cancer knowledge and perceptions of responsibility and capability of performing oral screenings and HPV counseling. METHODS: 158 surveys were completed by students attending nursing and dental programs at a midwestern university. The chi-squared test and analysis of variance were used to calculate differences in frequencies of categorical and interval data. FINDINGS: Many students across programs were unaware of the potential effectiveness of the HPV vaccination in reducing oropharyngeal cancer. Nursing and nurse practitioner students were less likely to believe they could perform an examination or that it was within their perceived scope of practice.

Psychosocial student functioning in comprehensive dental clinic education: A qualitative study.

INTRODUCTION: The aims were to describe first-year clinical dental students' psychosocial experiences in a known well-functioning comprehensive clinic teaching group (F+Grp) and a known dysfunctional group (Dys-Grp) and, thus, discover and describe phenomena related to psychosocial functioning of students. These groups were compared and contrasted regarding negative stress symptoms, perfectionism and coping with stress. METHODS: Eight female dental students (mean 26 years old), four in each group, were interviewed after the first clinical year about learning and emotional experiences. The students also rated their perceived stress using a 0-10 scale, where 0 is no stress, and 10 is highest stress. Qualitative analyses involved searching for recurring themes and discovery of categories of clinical and social functioning. All 8 students were revisited as dentists after 8 years and filled out a 15-item survey as longitudinal validation of their first-year clinical experiences and to estimate group consensus and informant accuracy. RESULTS: Both groups suffered from negative stress symptoms attributed to lack of time for clinical tasks, worries about work quality with confusion about their own expectations and worries about how others perceived them. Dys-Grp experienced higher negative stress and maladaptive perfectionism and described crying behaviours, withdrawal and unwillingness to cooperate with others. In contrast, students in F+Grp provided rich content about mutual cooperation related to social networking and positive support. The 8 subjects exhibited high internal consistency (α  =  .98) in their responses to the follow-up survey about their first year of clinic. CONCLUSIONS: The comprehensive care teaching clinic environment with students working in groups appeared to provide a possibility for students to support each other for improved stress coping. Unfortunately, the opposite also occurred. Positive, supportive teacher supervision of student challenges related to perfectionism and stress is crucial and requires specific attention.

The effect of viewing video clips of paediatric local anaesthetic administration on the confidence of undergraduate dental students.

INTRODUCTION: Dental treatment for children requires not only technical skills, but also the knowledge and confidence to provide behaviour management to support children of differing ages and stages of development. It is not surprising then that dental students find treating children especially stressful. Paediatric dentistry training is therefore a vital element of the undergraduate dental curriculum. MATERIALS AND METHODS: Eighty-six fourth-year undergraduate dental students received standard lectures and seminars about behaviour management techniques for children having local anaesthetic. The students were then randomly divided into groups using cluster randomisation. The intervention group received an intervention-based around video clips (VCs) demonstrating behaviour management techniques (BMTs) for children receiving local anaesthetic The intervention and control groups completed self-administered questionnaires to determine their level of confidence in managing local anaesthetic for children. RESULTS: There was a statistically significant difference in the level of confidence between the groups immediately after the teaching intervention (P=.003) and at 4 months (P=.001) in favour of the video group. DISCUSSION: Previous studies on the use of video as a teaching aid have reported favourable results in terms of both student attitudes and learning outcomes. The results from this study confirm the benefits of this style of teaching paediatric behaviour skills in the undergraduate dental curriculum, and the benefits were maintained at 4 months. CONCLUSION: This study has demonstrated that VCs as an additional teaching aid are an effective method in improving students' confidence for BMTs when delivering local anaesthetic.

Enhancing Dental Students' Understanding of Poverty Through Simulation.

Dental students should develop an understanding of the barriers to and frustrations with accessing dental care and maintaining optimal oral health experienced by persons with limited resources rather than blaming the patient or caregiver. Developing this understanding may be aided by helping students learn about the lives of underserved and vulnerable patients they will encounter not only in extramural rotations, but throughout their careers. The aim of this study was to determine if dental students' understanding of daily challenges faced by families with low income changed as a result of a poverty simulation. In 2015 and 2016, an experiential poverty simulation was used to prepare third-year dental students at one U.S. dental school for their upcoming required community-based rotations. In 2015, United Way staff conducted the simulation using the Missouri Community Action Poverty Simulation (CAPS); in 2016, faculty members trained in CAPS conducted the simulation using a modified version of the tool. In the simulation, students were assigned to family units experiencing various types of hardship and were given specific identities for role-playing. A retrospective pretest and a posttest were used to assess change in levels of student understanding after the simulation. Students assessed their level of understanding in five domains: financial pressures, difficult choices, difficulties in improving one's situation, emotional stressors, and impact of community resources for those living in poverty. The survey response rates in 2015 and 2016 were 86% and 74%, respectively. For each of the five domains, students' understanding increased from 58% to 74% per domain. The majority reported that the exercise was very valuable or somewhat valuable (74% in 2015, 88% in 2016). This study found that a poverty simulation was effective in raising dental students' understanding of the challenges faced by low-income families. It also discovered that framing the issues in the context of accessing dental care was important.

Caracterización de la enseñanza-aprendizaje del diagnóstico de anomalías dentomaxilofaciales en Sancti Spíritus. 2016 / Characterization of teaching-learning of the diagnosis of dentomaxillofacial anomalies in Sancti Spíritus. 2016

Fundamento: El diagnóstico de anomalías dentomaxilofaciales es una de las funciones del estomatólogo general, de allí la importancia de su enseñanza-aprendizaje con enfoque desarrollador. Objetivo: Caracterizar la enseñanza-aprendizaje del diagnóstico de anomalías dentomaxilofaciales en Sancti Spíritus. Metodología: Se realizó un estudio descriptivo transversal en la Universidad de Ciencias Médicas de Sancti Spíritus, se seleccionó una población de 6 profesores y 32 estudiantes de cuarto año de la carrera Estomatología en el curso 2014-2015. Se emplearon métodos del nivel teórico, empírico y estadístico con procedimientos matemáticos. Resultados: Predominó el reconocimiento por parte de estudiantes y profesores de la importancia de este contenido en la asignatura Ortodoncia de la carrera Estomatología, existe experiencia de los profesores, prevaleció la educación en el trabajo entre las formas organizativas del trabajo docente, concurren limitaciones para utilizar el diagnóstico pedagógico, precisar los objetivos, estructurar y controlar los contenidos en correspondencia con el método clínico, aplicar alternativas, lograr la implicación activa de los estudiantes durante las tareas docentes y, no siempre se realiza en relación con el contexto laboral del futuro profesional. Conclusiones: A pesar de haber fortalezas para la enseñanza-aprendizaje del diagnóstico de anomalías dentomaxilofaciales, se identificaron limitaciones que la alejan del enfoque desarrollador que debe caracterizar la didáctica contemporánea. Palabras clave: Ortodoncia, diagnóstico clínico, anomalías maxilofaciales, anomalías dentarias, educación en odontología

Caracterización de la enseñanza-aprendizaje del diagnóstico de anomalías dentomaxilofaciales en Sancti Spíritus. 2016 / Characterization of teaching-learning of the diagnosis of dentomaxillofacial anomalies in Sancti Spíritus. 2016

Fundamento: El diagnóstico de anomalías dentomaxilofaciales es una de las funciones del estomatólogo general, de allí la importancia de su enseñanza-aprendizaje con enfoque desarrollador. Objetivo: Caracterizar la enseñanza-aprendizaje del diagnóstico de anomalías dentomaxilofaciales en Sancti Spíritus. Metodología: Se realizó un estudio descriptivo transversal en la Universidad de Ciencias Médicas de Sancti Spíritus, se seleccionó una población de 6 profesores y 32 estudiantes de cuarto año de la carrera Estomatología en el curso 2014-2015. Se emplearon métodos del nivel teórico, empírico y estadístico con procedimientos matemáticos. Resultados: Predominó el reconocimiento por parte de estudiantes y profesores de la importancia de este contenido en la asignatura Ortodoncia de la carrera Estomatología, existe experiencia de los profesores, prevaleció la educación en el trabajo entre las formas organizativas del trabajo docente, concurren limitaciones para utilizar el diagnóstico pedagógico, precisar los objetivos, estructurar y controlar los contenidos en correspondencia con el método clínico, aplicar alternativas, lograr la implicación activa de los estudiantes durante las tareas docentes y, no siempre se realiza en relación con el contexto laboral del futuro profesional. Conclusiones: A pesar de haber fortalezas para la enseñanza-aprendizaje del diagnóstico de anomalías dentomaxilofaciales, se identificaron limitaciones que la alejan del enfoque desarrollador que debe caracterizar la didáctica contemporánea. Palabras clave: Ortodoncia, diagnóstico clínico, anomalías maxilofaciales, anomalías dentarias, educación en odontología

SURVEY OF DENTAL STUDENTS' ATTITUDE REGARDING ORIENTAL MEDICINE/COMPLEMENTARY AND ALTERNATIVE MEDICINE: COMPARISON BETWEEN TWO JAPANESE DENTAL SCHOOLS.

BACKGROUND: The present study aimed to examine the impact of "curricula for undergraduate education in oriental medicine (OM)/complementary and alternative medicine (CAM)" on student awareness of OM. A questionnaire survey was conducted involving the Nagasaki University School of Dentistry (NUSD), a university that implements education in OM as part of its undergraduate curriculum, and Tokyo Dental College (TDC), which does not teach OM. MATERIALS AND METHODS: The third- and fifth-year students of both NUSD and TDC underwent the anonymous questionnaire survey, which included questions regarding their knowledge of OM and CAM, interests in these subjects, and their opinions on the necessity of teaching OM in the undergraduate dental education, and the results were collected for analysis. RESULTS: Whereas 33% of 5th year NUSD students had knowledge of OM/CAM was 33%, only 10% of 5th year TDC students reported knowledge on the subject. 69% of 5th year NUSD students interested in OM/CAM, while 5th year TDC students who interest them were only 45%. Although 77% of 5th year NUSD students were in favor of OM education implemented in the Faculty of Dentistry, the percentages of TDC students of that were smaller (46% in 3rd year and 48% in 5th year). Whereas 26% of 5th year TDC students did not recognize the necessity of oriental medicine education, only one 5th year NUSD student (2%) did not so. CONCLUSION: Introduction of education in OM in the undergraduate dental education program helps students to increase their interests in dental clinical applications.

Assessment of Thiel-Embalmed Cadavers as a Teaching Tool for Oral Anatomy and Local Anesthesia.

The aim of this study was to determine whether Thiel-embalmed cadavers would provide a useful anatomy teaching tool for topics that cannot be approached using formalin-fixed cadavers such as oral cavity examination and maxillary anesthesia. The suitability of Thiel-embalmed bodies for performing oral examinations was assessed by asking first-year dental and dental hygiene students at a dental school in Ireland to identify oral structures on a classmate and on a Thiel-embalmed body. The study was conducted in 2016. The ease of location was compared in the two settings, and their quality was assessed on the cadavers. The suitability of Thiel-embalmed cadavers to teach maxillary anesthesia was assessed by students' performing mock injections at five adjacent sites daily for five consecutive days, followed by inspection of the gingival surface by experienced anatomists and dentists. Data were obtained from 57 students, but only the 54 forms that were fully completed were analyzed, for an overall response rate of 85.7%. The results showed that most oral structures were more difficult to locate on cadavers. The texture and appearance of features in the cadavers were rated at a midpoint between realistic and unrealistic. The relative inexperience of the participants, the accumulation of fixative in the oral cavity, and discoloration were mentioned as potential confounding factors. Visual analysis of images obtained following repeated injections revealed no deterioration of the tissue. Importantly, the puncture marks appeared to reduce over time, suggesting that the gingival tissue maintains some elasticity following Thiel fixation. These findings suggest that Thiel-embalmed cadavers may be a useful tool to provide students more time to localize and study aspects of the oral cavity. Likewise, the recoiling capacity of gingival tissue suggests that Thiel-embalmed cadavers may provide an ideal tool for teaching injection technique of local anesthetics.

Exploring dental student participation in interdisciplinary care team conferences in long-term care.

OBJECTIVE: The purpose of this study was to explore how the participation of dental hygiene students in interdisciplinary care conferences conducted in long-term care (LTC) facilities influenced the staff's awareness of oral health, the student's provision of care as well as the student's ability to work on an interdisciplinary team. BACKGROUND: Oral health in LTC continues to be poor despite many educational and clinical interventions. The care of a frail elder requires an interdisciplinary team approach, yet dental professionals are often absent from these teams. As an educational intervention, dental hygiene students, in addition to providing clinical care to residents and education to staff in a LTC facility, have been participating in interdisciplinary care conferences for 4 years. METHODS: Nine LTC facility staff and eight students participated in two focus groups and five personal interviews to discuss their experiences of the care conferences. Narratives were transcribed verbatim and thematic analysis was conducted. RESULTS: Four major themes emerged that described the essence of the experience of involving dental professionals within interdisciplinary care conference: (i) addressing oral health, (ii) reciprocal learning, (iii) dealing with complexity and (iv) impact of collaborative care. CONCLUSION: Overall, students found the educational intervention to be worthwhile that allowed for the development of interdisciplinary skills and a greater understanding of dental geriatrics. The dental support in care conferences was welcomed by the staff as it facilitated a new way of exchanging knowledge and experiences so that a more holistic approach to care could be undertaken by all.

Empowerment in a model of outreach undergraduate dental education.

Aim To undertake a quantitative and qualitative examination into what aspects of the students' experience in outreach at University of Portsmouth Dental Academy (UPDA) are encouraging their empowerment as autonomous practitioners, ready to graduate as 'safe beginners'.Methods The study was devised as part of the educational service evaluation of outreach education at the UPDA. For the two most recent cohorts of 160 students (2014-16) an additional domain was added specifically investigating the students' sense of how their experience of outreach at the UPDA has impacted on their development to be ready for independent practice (safe beginner). The questionnaire was completed anonymously in their last week of attendance just before graduation.Results A 91% response rate for the questionnaire was achieved. To the question about 'being given an opportunity to become an independent dentist', 83% of the respondents strongly agreed. Two themes with seven subthemes were identified from the free text responses. The two themes were 'self-actualisation: developing self-awareness and self-confidence' and 'delivery of care as a dentist'.Conclusion Within the limitations of this educational evaluation, students enjoyed the increase of autonomy they gained during the year-long placement and felt that the clinical teachers empowered, encouraged and supported them to develop as autonomous dental practitioners and as 'safe beginners', to deliver holistic care in the National Health Service.

Design and Outcomes of a Comprehensive Care Experience Level System to Evaluate and Monitor Dental Students' Clinical Progress.

A Comprehensive Care Experience Level (CCEL) system that is aligned with Commission on Dental Accreditation (CODA) standards, promotes comprehensive care and prevention, and addresses flaws observed in previous Relative Value Units (RVU)-based programs has been implemented at the School of Dental Medicine, Case Western Reserve University since 2011. The purpose of this article is to report on the design, implementation, and preliminary outcomes of this novel clinical evaluation system. With the development of the CCEL concept, it was decided not to award points for procedures performed on competency exams. The reason behind this decision was that exams are not learning opportunities and are evaluated with summative tools. To determine reasonable alternative requirements, production data from previous classes were gathered and translated into CCEL points. These RVU points had been granted selectively only for restorative procedures completed after the initial preparation stage of the treatment plan, and achievement of the required levels was checked at multiple points during the clinical curriculum. Results of the CCEL system showed that low performing students increased their productivity, overall production at graduation increased significantly, and fluoride utilization to prevent caries rose by an order of magnitude over the RVU system. The CCEL program also allowed early identification and remediation of students having difficulty in the clinic. This successful implementation suggests that the CCEL concept has the potential for widespread adoption by dental schools. This method also can be used as a behavior modification tool to achieve specific patient care or clinical educational goals as illustrated by the way caries prevention was promoted through the program.