Improvement impact of nudges incorporated in environmental education on students' environmental knowledge, attitudes, and behaviors.

This study conducted randomized controlled trials to evaluate the effectiveness of an environmental education class and the impacts of nudges and boosts implemented in this program on high school students' basic knowledge, attitudes, and behaviors regarding environmental issues in Japan. This environmental education class consisted of a lecture on reducing the use of plastic products for energy conservation in daily life, a board game for learning how to reduce plastic waste, and a worksheet for reflection. Four types of worksheets were randomly distributed: nudges, in which students were asked to set a goal regarding their level of effort in not throwing away plastic products such as plastic bags, wet wipes, and plastic bottles; boosts, in which participants were asked to write an essay to help increase their empathy for the parties impacted by environmental issues; both nudges and boosts; and none (neither nudges nor boosts). After environmental education, an end-line survey was conducted to evaluate the effectiveness of this class. This study found that the environmental education class significantly improved students' basic environmental knowledge and promoted their concerns about plastic waste. Although there was no evidence that nudges and boosts amplify the effects of the environmental education class on the students' knowledge, nudges were successful in making them more concerned about plastic waste. The results showed that students who received nudges or boosts were more likely to refuse free wet wipes offered at convenience stores but were not more likely to refuse plastic bottles. These results also indicated that interventions through environmental education can change students' pro-environmental behaviors only if the cost of behavioral change is low. The environmental education class not only increased students' environmental knowledge and attitudes, but the use of worksheets in administering nudges and boosts ensured the effectiveness of environmental education.

Civilian pharmacy involvement in Department of Defense Innovative Readiness Training.

OBJECTIVES: Innovative Readiness Training (IRT) is a United States military exercise that provides training for military personnel while providing services for communities. The objective of this paper was to describe civilian pharmacy services provided during an IRT, Operation Empower Health. SETTING: Operation Empower Health took place on May 10 to 18, 2018, in Savannah and Garden City, Georgia. Pharmacy operations included a limited formulary of medications. Civilian pharmacy volunteers were paired with military persons at 2 of 4 locations. PRACTICE DESCRIPTION: Student pharmacists, residents, preceptors, and faculty provided disease state education to patients during triage. After receiving medical or dental services, patients were provided prescription and over-the-counter medications at the dispensing and counseling station. Civilian pharmacy personnel worked with military personnel to dispense and counsel on medications. Many patients required additional health services or postclinic care. University of Georgia College of Pharmacy faculty members were able to meet with patients for follow-up. An in-service to military personnel was provided by the pharmacists regarding common medication errors. EVALUATION: Within Operation Empower Health, 7942 patients were provided health care services at no cost. A total of 11 students, 5 residents, 2 University of Georgia College of Pharmacy faculty, and 1 preceptor provided pharmacy services during the event. Civilian pharmacy personnel were able to educate 566 patients for a total of 2700 minutes. In addition to medications, patients were counseled on lifestyle interventions. CONCLUSION: Overall, IRT builds mutually beneficial civilian-military partnerships between communities and the Department of Defense. Civilian pharmacy personnel were able to offer medication and lifestyle counseling in addition to managing medication dispensing. Student pharmacists, in particular, were given a unique interprofessional learning opportunity in addition to having a culturally competent experience.

Evaluation of the Substance Abuse Research and Education Training (SARET) program: Stimulating health professional students to pursue careers in substance use research.

BACKGROUND: We developed and implemented the Substance Abuse Research Education and Training (SARET) program for medical, dental, nursing, and social work students to address the dearth of health professionals pursuing research and careers in substance use disorders (SUD). SARET has 2 main components: (1) a novel online curriculum addressing core SUD research topics, to reach a large number of students; (2) a mentored summer research experience for in-depth exposure. METHODS: Modules were integrated into the curricula of the lead institution, and of 5 external schools. We assessed the number of Web modules completed and their effect on students' interest in SUD research. We also assessed the impact of the mentorship experience on participants' attitudes and early career trajectories, including current involvement in SUD research. RESULTS: Since 2008, over 24,000 modules have been completed by approximately 9700 individuals. In addition to integration of the modules into curricula at the lead institution, all 5 health-professional partner schools integrated at least 1 module and approximately 5500 modules were completed by individuals outside the lead institution. We found an increase in interest in SUD research after completion of the modules for students in all 4 disciplines. From 2008 to 2015, 76 students completed summer mentorships; 8 students completed year-long mentorships; 13 published in SUD-related journals, 18 presented at national conferences, and 3 are actively engaged in SUD-related research. Mentorship participants reported a positive influence on their attitudes towards SUD-related clinical care, research, and interprofessional collaboration, leading in some cases to changes in career plans. CONCLUSIONS: A modular curriculum that stimulates clinical and research interest in SUD can be successfully integrated into medical, dental, nursing, and social work curricula. The SARET program of mentored research participation fostered early research successes and influenced career choice of some participants. Longer-term follow-up will enable us to assess more distal careers of the program.

Report on World Workshops on Oral Medicine (WWOM) IV and V: research themes and citation impact: WWOM VI steering committee.

The first World Workshop on Oral Medicine (WWOM) was held in 1988. The portfolio has continued to expand in scope and impact over the past 26 years. Five World Workshops were conducted between 1988 and 2010, focusing on creation of systematic reviews in biomedicine and health care of importance to the international oral medicine community. WWOM VI was conducted in April 2014 and further extended this modeling. This most recent Workshop also fostered creation of the inaugural joint meeting between the American Academy of Oral Medicine and the European Association of Oral Medicine, together with The British Society for Oral Medicine and the Oral Medicine Academy of Australasia. The goal of the WWOM portfolio is to strategically enhance international oral medicine research, education, and clinical practice. To this end, this report summarizes subject areas for WWOM IV (2004) and research recommendations for WWOM V (2010), as well as citation metrics relative to publications from these two conferences. The information is designed to provide research and clinical context for key issues in oral medicine as delineated by the WWOM portfolio over the past 10 years, as well as for projected outcomes of WWOM VI over the next 12 months.

Establishing Intervention Fidelity of an Oral Motor Intervention for Preterm Infants.

PURPOSE: To establish intervention fidelity of the premature infant oral motor intervention (PIOMI) Design and sample: A rating tool was developed and tested for interrater reliability before being used to test the fidelity of intervention behaviors. A purposeful convenience sample of three users was recruited to perform the intervention under direct observation. MAIN OUTCOME VARIABLES: Three types of reliabilities were calculated: (1) interrater reliability to test the rating tool, followed by (2) interuser reliability, and (3) test-retest reliabilities to test the intervention behaviors of several registered nurses (RNs) over repeated performances of the intervention. RESULTS: The rating tool demonstrated a high interrater reliability (97.57 percent), indicating its accuracy for systematically rating the specific intervention behaviors. Subsequently, the rating tool was used to determine interuser and test-retest performances of the PIOMI and resulted in high reliabilities (97.59 percent and 97.58 percent, respectively). This demonstrates that the intervention can be reliably delivered as prescribed, supporting intervention fidelity.

Inspiratory muscle training abolishes the blood lactate increase associated with volitional hyperpnoea superimposed on exercise and accelerates lactate and oxygen uptake kinetics at the onset of exercise.

We examined the effects of inspiratory muscle training (IMT) upon volitional hyperpnoea-mediated increases in blood lactate ([lac(-)](B)) during cycling at maximal lactate steady state (MLSS) power, and blood lactate and oxygen uptake kinetics at the onset of exercise. Twenty males formed either an IMT (n = 10) or control group (n = 10). Prior to and following a 6-week intervention, two 30 min trials were performed at MLSS (207 ± 28 W), determined using repeated 30 min constant power trials. The first was a reference trial, whereas during the second trial, from 20 to 28 min, participants mimicked the breathing pattern commensurate with 90% of the maximal incremental exercise test minute ventilation ([Formula: see text]). Prior to the intervention, the MLSS [lac(-)](B) was 3.7 ± 1.8 and 3.9 ± 1.6 mmol L(-1) in the IMT and control groups, respectively. During volitional hyperpnoea, [Formula: see text] increased from 79.9 ± 9.5 and 76.3 ± 15.4 L min(-1) at 20 min to 137.8 ± 15.2 and 135.0 ± 19.7 L min(-1) in IMT and control groups, respectively; [lac(-)](B) concurrently increased by 1.0 ± 0.6 (+27%) and 0.9 ± 0.7 mmol L(-1) (+25%), respectively (P < 0.05). Following the intervention, maximal inspiratory mouth pressure increased 19% in the IMT group only (P < 0.01). Following IMT only, the increase in [lac(-)](B) during volitional hyperpnoea was abolished (P < 0.05). In addition, the blood lactate (-28%) and phase II oxygen uptake (-31%) kinetics time constants at the onset of exercise and the MLSS [lac(-)](B) (-15%) were reduced (P < 0.05). We attribute these changes to an IMT-mediated increase in the oxidative and/or lactate transport capacity of the inspiratory muscles.

Enhancing identification and counseling skills of dental undergraduate students using a customized Tobacco Counseling Training Module (TCTM) - A piloting of the process using ADDIE framework.

BACKGROUND: Tobacco use has emerged as a major public health problem. But, most graduates in medical and dental schools receive limited systematic training. The objective of this education innovation project was to enhance dental undergraduate student's ability to identify tobacco users through oral manifestations and improve their counseling skills using a customized Tobacco Counseling Training Module (TCTM). METHODS: A TCTM for students of dentistry was developed using ADDIE framework as a guide. Content and construct validation of the module was done by six subject experts using Delphi technique for obtaining consensus. Pilot testing was done on 20 students of third year BDS. Pre- and post-intervention assessment of knowledge, attitude, self-confidence was done using learning outcomes questionnaire. Ability to correctly identify oral manifestations was assessed using extended item MCQs and tobacco counseling skills using a modified KEECC. The difference in mean scores were computed and subjected to further statistical analysis using SPSS version 22. RESULTS: There was a significant improvement in post intervention scores for mean knowledge (5.5 ± 1.4 to 13.2 ± 1.1), attitude (5.6 ± 0.9 and 8.5 ± 0.5), self-confidence (1.5 ± 0.5 and 3.1 ± 0.2), ability to correctly identify oral manifestations (5.2 ± 1.4 and 9.4 ± 0.8) and tobacco counseling skills. CONCLUSION: It is possible to introduce the module in the existing curriculum and its effectiveness evaluation shows benefit in terms of Kirkpatrick's Level 1, 2, 3 (improvement in knowledge, attitude, self-confidence, ability to identify oral manifestations, and tobacco counseling skills) of training effectiveness.

Drawing in 3D: Using 3D printer pens to draw chemical models.

Development of three-dimensional (3D) printing technology has started a new chapter for in-classroom modeling of chemical molecules. The technology provides the opportunity to design and produce various types of personalized models. However, using classical 3D printers is time consuming, and it is hard to involve students in the modeling process during traditional class times. One solution can be using hand-held 3D printers (3D pens) that allow users to instantly draw geometrical structures. Unfortunately, drawing directly in 3D is very difficult, and precise modeling of even small molecules is simply not possible. In this article, a new approach to 3D modeling is described. It is based on 3D templates that enable the drawing of molecular models directly in three dimensions. The modular nature of the templates allows for the creation of a wide variety of structures. The resulting models provide an accurate representation of molecules including correct bond angles and geometry. This approach makes 3D pens a powerful tool for the modeling of chemical structures.

Awareness of Anterior Cruciate Ligament Injury-Preventive Training Programs Among Female Collegiate Athletes.

CONTEXT: Neuromuscular training programs can reduce the rate of noncontact anterior cruciate ligament (ACL) injuries, particularly in female athletes. OBJECTIVE: To assess the awareness of, experience with, and factors associated with participation in preventive training programs (PTPs) among female collegiate athletes and their knowledge of ACL injuries. DESIGN: Cross-sectional study. SETTING: National Collegiate Athletic Association (NCAA) sports programs. PATIENTS OR OTHER PARTICIPANTS: A total of 440 female NCAA athletes (age = 20 ± 1 years) representing 20 sports during the 2017-2018 academic year. MAIN OUTCOME MEASURE(S): We used a 12-item survey to collect data on each participant's age, sport, position, college, NCAA division, and awareness of and experience with PTPs. We performed descriptive statistics and used odds ratios (ORs) to assess relationships between demographic data and awareness of or interest in PTPs. RESULTS: Of the 440 respondents, 85% (n = 373) knew that female athletes were at higher risk for sustaining ACL injuries than male athletes, and 89% (n = 391) knew that ACL injuries were preventable. Thirty-three percent (n = 143) were familiar with the concept of ACL PTPs. Only 15% (n = 64) had ever performed PTPs, but 89% (n = 391) reported they would perform a daily PTP if it could prevent ACL injuries. Fifty-two of the 64 respondents (81%) who had performed PTPs said athletic trainers or coaches oversaw the PTPs. Participants were more likely to be familiar with ACL PTPs if they (OR = 3.5; 95% confidence interval [CI] = 2.0, 5.8) or a teammate (OR = 4.6; 95% CI = 2.1, 9.8) had sustained an ACL injury. Respondents were more willing to perform PTPs if they (OR = 2.3; 95% CI = 0.80, 6.6) or a teammate (OR = 3.4; 95% CI = 1.8, 6.6) had sustained an ACL injury. CONCLUSIONS: Although 89% of respondents expressed interest in performing daily ACL PTPs, only 15% had performed such programs, and only 33% were familiar with the concept of ACL PTPs.

Use of a flipped classroom in ophthalmology courses for nursing, dental and medical students: A quasi-experimental study using a mixed-methods approach.

BACKGROUND: Traditional teaching is associated with dilemmas, such as low motivation to learn and passive learning. In contrast, use of a flipped classroom with the proper learning design has the potential to promote accelerated learning, bolster transmission of competencies (i.e., critical thinking, communication and problem-solving skills) and improve teamwork capacity, all of which are of great significance in professional healthcare practice, including nursing, dentistry and medicine. OBJECTIVE: The aim of the study was to examine the effects of using a flipped classroom in ophthalmology courses for undergraduate nursing students, dental students and higher vocational medical students. DESIGN: A quasi-experimental design was used with an intervention (n = 100) and a comparison group (n = 100), pre-/post-testing measures and a mixed-methods approach. SETTING: A university in China. PARTICIPANTS: A total of 200 students were included. METHODS: Students' self-rated learning ability was measured before and after the courses, and skill exams were performed after the courses. In addition, interviews were conducted with the clinical medical students concerning their experiences of the flipped classroom. RESULTS: Students' self-rated learning ability improved significantly more in the intervention than in the comparison group, for the total scale and the three factors 'learning goals', 'self-efficacy and social learning' and 'problem-solving'. Skill exam scores were statistically significantly better in the intervention than in the comparison group. On the whole, the clinical medicine students felt the flipped classroom had a positive impact and improved their learning ability as well as knowledge in ophthalmology. CONCLUSIONS: Use of a flipped classroom for nursing, dental and clinical medical students in ophthalmology courses shows promising results in the form of students' skill exam scores and self-rated learning ability.

Training High School Student "Citizen Scientists" to Document School Water Access: A Feasibility Study.

BACKGROUND: Youth water consumption is inadequate. Increasing adolescent water consumption could support decreased dental caries and body mass index (BMI). Most schools are required to provide free, potable water. However, there is evidence that schools' self-reported compliance data overestimate access to water in schools. We tested the feasibility of using student citizen scientists to collect high quality observational data about water sources in schools. METHODS: We trained 12 teams of high school students to use a validated photo-evidence protocol to photograph and submit data on water sources in elementary and secondary schools. We surveyed students and advisors to assess student learning, advisor burden, and project feasibility. RESULTS: Students submitted data for 325 water sources across 40 racially and economically diverse schools. We were able to use 99% of the student-submitted photographs to measure water source wear, cleanliness, accessibility, and flow. The majority of students (72%, N = 70) spent under 2 hours photographing each school. The majority of students and advisors felt the project was valuable and feasible. CONCLUSIONS: High school students can use a photographic method to collect data for analysis, and understand access to water in schools. This is a feasible, scalable, cost-effective method to gather valid water source data.

Development of critical thinking in health professions education: A meta-analysis of longitudinal studies.

INTRODUCTION: While reports of critical thinking exist in the health professions literature, development of critical thinking across a broad range of health-professions students has not been systematically reviewed. METHODS: In this meta-analysis, multiple databases and journals were searched through February 2016 to identify longitudinal studies using standardized tests of critical thinking [California Critical Thinking Skills Test (CCTST), Health Science Reasoning Test (HSRT), and Defining Issues Test (DIT)] in any language. Two reviewers extracted information and collected information regarding primary author, publishing journal, health profession, critical thinking test, and time1/time2 means and standard deviations. Standardized mean differences (SMD) with 95% confidence intervals (CI) were reported using a random-effects model. RESULTS: Four hundred sixty-two studies were screened, and 79 studies (representing 6884 students) were included. Studies contained 37 CCTST, 22 DIT, and 20 HSRT. Health professions comprised nursing, pharmacy, physical therapy, occupational therapy, dentistry, medicine, veterinary medicine, dental hygiene, clinical laboratory sciences, and allied health. Cohen's kappa was strong (0.82) for inter-reviewer agreement. Both the CCTST (SMD = 0.37, 95% CI = 0.23-0.52) and DIT (SMD = 0.28, 95%CI = 0.18-0.39) demonstrated significant increases in total scores, but the HSRT (SMD = 0.03, 95%CI = -0.05-0.12) did not show improvement. DISCUSSION/CONCLUSIONS: In this meta-analysis, students from the majority of health professions consistently showed improvement in development of critical thinking. In this diverse population, only the CCTST and DIT appeared responsive to change.

Motivational Advising Workshop: Utilizing Motivational Interviewing Theory to Facilitate and Engage Intrinsic Motivation to Change Learners' Behavior.

Introduction: Motivational interviewing (MI) is a counseling method that utilizes a patient's own motivation to effect personal change. MI has been applied routinely and successfully to managing medical conditions (e.g., substance abuse). Employing MI techniques to engage medical learners (termed motivational advising [MA]) may help them overcome professional and/or personal challenges limiting their career development. Methods: Medical educators from four academic medical centers developed a module focused on teaching fellow educators MI theory and techniques for MA using didactic and interactive components. Participants participated in facilitated role-plays to practice MA delivery techniques and observed videos of a traditional advisor-advisee interaction as well as an MA-focused engagement. A postworkshop survey was used to evaluate the workshop. Results: In a survey of 48 educators attending the workshop at two medical conferences, over 80% of respondents demonstrated an interest in learning more about MA. Additionally, over 60% indicated that they would seek opportunities to practice and/or implement MA with their advisees. Knowledge of the technical components of MA also increased significantly in pre- and posttest analysis. Discussion: This module introducing the concept of MA was well received by medical educators and was viewed as a valuable tool in advising medical learners. The provided components enable replication of this workshop in other settings with or without an expert in MI techniques. Although the workshop has been conducted with physicians involved in medical education, it would be applicable to other health professionals who advise trainees such as nursing, dentistry, pharmacy, or veterinary medicine.

Athletic Training Student Core Competency Implementation During Patient Encounters.

CONTEXT: Health care research evidence suggests that early patient encounters (PEs), as well as the purposeful implementation of professional core competencies (CCs), for athletic training students (ATSs) may be beneficial to their ability to provide care. However, no investigators have related facets of the clinical education experience with CC implementation as a form of summative assessment of the clinical experience. OBJECTIVE: To determine the relationship between the frequency and length of PEs, as well as the student's role and clinical site during PEs, and the students' perceived CC implementation during these encounters. DESIGN: Cross-sectional study. SETTING: Professional athletic training program, National Collegiate Athletic Association Division I institution. PATIENTS OR OTHER PARTICIPANTS: We purposefully recruited 1 athletic training program that used E*Value software; 40 participants (31 females, 9 males) enrolled in the professional phase (12 first year, 14 second year, 14 third year) participated. INTERVENTION(S): Participants viewed a 20-minute recorded CC educational module followed by educational handouts, which were also posted online for reference throughout the semester. The E*Value software was used to track PEs, including the type of encounter (ie, actual patient, practice encounter, didactic practice scenario), the type of site where the encounter occurred (university, high school), and the participant's role (observed, assisted, performed), as well as responses to an added block of questions indicating which, if any, of the CCs were implemented during the PE. MAIN OUTCOME MEASURE(S): Variables per patient were PE length (minutes), participant role, site at which the encounter occurred, and whether any of the 6 CCs were implemented ( yes/ no). Variables per participant were average encounter length (minutes), encounter frequency, modal role, clinical site assignment, and the number of times each CC was implemented. Separate 1-way analyses of variance were used to examine the relationships between role or clinical site and implementation of total number of CCs. Multiple linear regressions were used to determine how the average length and frequency of PEs were related to the average and total number of implemented CCs. Binary logistic regression models indicated how the length of each encounter, role of the participant, and type of clinical site related to the implementation of each CC. RESULTS: The roles of participants during PEs were related to their ability to implement the total number of CCs ( F = 103.48, P < .001). Those who observed were likely to implement fewer total CCs than those who assisted (M diff = -0.29, P < .001); those who assisted were likely to implement more total CCs than those who performed (M diff = 0.32, P < .001). Frequency of encounters was the only significant variable in the model examining all independent variables with CC implementation ( b4,32 = 3.34, t = 9.46, P < .001). CONCLUSIONS: The role of the student, namely assisting during PEs, and the volume of PEs should be considered priorities for students to promote greater CC implementation.

Effects of a therapeutic intervention for foster preschoolers on diurnal cortisol activity.

Atypical diurnal patterns of hypothalamic-pituitary-adrenal (HPA) axis activity have been observed in samples of individuals following early life adversity. A characteristic pattern arising from disrupted caregiving is a low early-morning cortisol level that changes little from morning to evening. Less well understood is the plasticity of the HPA axis in response to subsequent supportive caregiving environments. Monthly early-morning and evening cortisol levels were assessed over 12 months in a sample of 3-6-year-old foster children enrolled in a randomized trial of a family-based therapeutic intervention (N=117; intervention condition, n=57; regular foster care condition, n=60), and a community comparison group of same-aged, non-maltreated children from low-income families (n=60). Latent growth analyses revealed stable and typical diurnal (morning-to-evening) cortisol activity among non-maltreated children. Foster children in the intervention condition exhibited cortisol activity that became comparable to the non-maltreated children over the course of the study. In contrast, children in regular foster care condition exhibited increasingly flattened morning-to-evening cortisol activity over the course of the study. In sum, improvements in caregiving following early adversity appear to have the potential to reverse or prevent disruptions in HPA axis functioning.

Building Resilience for Wellness: A Faculty Development Resource.

Introduction: The National Academy of Medicine recently published "A Multifaceted Systems Approach to Addressing Stress Within Health Professions Education and Beyond," which calls for greater attention to the wellness of health care providers, students, and educators. Suggested actions include "creating and training positive role models." In order for faculty to role-model behaviors of wellness, they need to understand what this means and how to incorporate it into their lives. At present, there is only one other MedEdPORTAL resource on wellness and resilience that includes faculty as audience members. Methods: This 60-minute workshop is designed to provide faculty with a basic framework for wellness, with an emphasis on the emotional process aspect of resilience. Strategies for stress and anxiety management are reviewed. The workshop is interactive, with large- and small-group discussions, as well as a guided meditation. Results: This workshop was given at the 2017 Council of Faculties Business Meeting at the American Dental Education Association Annual Session, with 40 participants. Workshop evaluations, completed by 34 (85%) attendees, showed an overall rating of 4.0 on a 5-point Likert scale, with 5 = excellent. The workshop was repeated at the School of Dentistry at the University of California, San Francisco, with 11 attendees; there, the overall rating was 4.7. Discussion: In order to contribute to a culture of wellness and resilience in their organization, faculty need training on the concepts, as well as practical skills for implementation. This workshop provides introductory-level knowledge and skills.

Effects of training on odor judges scoring intensity.

OBJECTIVE: This pilot study was intended to test whether a training protocol improved validity of odor judges (OJs), with or without experience, and whether odorant types differed in error proneness. METHODS: The OJs (four experienced, two inexperienced) completed a 4-phase training protocol based on the American Society of Testing and Materials standards (ASTM): (i) introduction to sensory scales, n-butanol reference, sniffing techniques; (ii) pretraining measurements; 20 samples of varying intensities of four unpleasant and three pleasant odorants; (iii) exercises assessing quality, intensity, ranking, and matching; and (iv) post-training measurements. MAIN OUTCOME MEASURES: Subjects' intensity scores were analyzed as the absolute difference from the 'true' intensity (ASTM n-butanol standard) using repeated measures ANOVA. RESULTS: Training significantly (P = 0.02) reduced OJ errors. Experienced and novice judges did not differ in average errors (P = 0.99), or in improvement in error from pre- to post-training (P = 0.94). Improvement was consistent from pre- to post-training for all odorants except dimethylsulfide for which errors worsened (P = 0.01). Unpleasant and pleasant odorants differed (P = 0.006) in error. After removing water the effects of water control scores from the pleasant odorants, the difference was not significant (P = 0.26). CONCLUSIONS: The OJs improved in their ability to assess odor intensity irrespective of previous experience. Training is recommended for all OJs prior to research trials.

Efecto de una Intervención Educativa vía WhatsApp en la Higiene Oral de Pacientes con Ortodoncia / Effect of an Educational Intervention via WhatsApp on the Oral Hygiene of Orthodontic Patients

RESUMEN: La higiene oral en pacientes con ortodoncia fija se encuentra comprometida y las nuevas tecnologías de información podrían convertirse en una herramienta valiosa de educación en salud oral. El objetivo fue determinar el efecto de una intervención educativa vía whatsapp en la higiene oral de pacientes con aparatología de ortodoncia fija. La muestra del estudio estuvo conformada por 46 pacientes (18.65 ± 3.21 años de edad) que iniciaron tratamiento de ortodoncia fija. Se realizó el índice de placa de O´Leary y se aplicó un cuestionario para medir el nivel de conocimiento en higiene oral. Los participantes se dividieron en un grupo experimental y control, mediante asignación aleatoria. Al grupo experimental se le envió una intervención educativa elaborada mediante la herramienta Play Ground Versión 2.0, vía la aplicación para mensajería instantánea WhatsApp Messenger Versión 2.19.153 y al grupo control se brindó las instrucciones de rutina sobre higiene oral. Después de 6 semanas, se evaluó el índice y cuestionario. Para el análisis de datos se utilizó el Coeficiente de Correlación de Concordancia, la prueba de Shapiro Wilk y la prueba T de Student para muestras relacionadas e independientes. Los pacientes del grupo experimental tuvieron diferencias estadísticamente significativas en el control de placa (p = 0.001) y nivel de conocimiento después de la intervención educativa (p = 0.016), a comparación del grupo control. La intervención educativa vía WhatsApp tuvo un efecto positivo en la higiene oral, con respecto al control de placa y al nivel de conocimientos de pacientes con ortodoncia fija.

ABSTRACT: Oral hygiene in patients with fixed orthodontics is compromised and new information technologies could become a valuable tool for oral health education. The objective of the study was to determine the effect of an educational intervention via WhatsApp on the oral hygiene of patients with fixed orthodontic appliances. The study sample consisted of 46 patients (18.65 ± 3.21 years old) who started fixed orthodontic treatment. The O'Leary plaque index was performed and a questionnaire was applied to measure the level of knowledge in oral hygiene. Participants were divided into an experimental and control group, by randomization. The experimental group was sent an educational intervention prepared using the Play Ground Version 2.0 tool, via the WhatsApp Messenger versión 2.19.153 instant messaging application, and the control group was given routine instructions on oral hygiene. After 6 weeks, the index and questionnaire were evaluated. For data analysis, the concordance correlation coefficient, the Shapiro Wilk test and the Student's T test for related and independent samples were used. The patients in the experimental group had statistically significant differences in plaque control (p = 0.001) and level of knowledge after the educational intervention (p = 0.016), compared to the control group. The educational intervention via WhatsApp had a positive effect on oral hygiene, with respect to plaque control and the level of knowledge of patients with fixed orthodontics.

E-Model for Online Learning Communities.

PURPOSE: The purpose of this study was to explore the students' perspectives on the phenomenon of online learning communities while enrolled in a graduate dental hygiene program. METHODS: A qualitative case study method was designed to investigate the learners' experiences with communities in an online environment. A cross-sectional purposive sampling method was used. Interviews were the data collection method. As the original data were being analyzed, the researchers noted a pattern evolved indicating the phenomenon developed in stages. The data were re-analyzed and validated by 2 member checks. RESULTS: The participants' experiences revealed an e-model consisting of 3 stages of formal learning community development as core courses in the curriculum were completed and 1 stage related to transmuting the community to an informal entity as students experienced the independent coursework in the program. The development of the formal learning communities followed 3 stages: Building a Foundation for the Learning Community, Building a Supportive Network within the Learning Community and Investing in the Community to Enhance Learning. The last stage, Transforming the Learning Community, signaled a transition to an informal network of learners. The e-model was represented by 3 key elements: metamorphosis of relationships, metamorphosis through the affective domain and metamorphosis through the cognitive domain, with the most influential element being the affective development. CONCLUSION: The e-model describes a 4 stage process through which learners experience a metamorphosis in their affective, relationship and cognitive development. Synergistic learning was possible based on the interaction between synergistic relationships and affective actions.