A Qualitative Study on the Development of Professionalism Among Japanese Dental Students.

BACKGROUND: Professionalism is believed to vary depending on factors such as era and culture. Therefore, clarifying the meaning of professionalism in each country, region, and workplace is essential. However, how professionalism is cultivated among dental students in Japanese schools has yet to be fully elucidated. Therefore, this study examined whether professionalism among Japanese dental students changes by year. This research will contribute to effective professional education. PARTICIPANTS AND METHODS: The participants included six fourth-year dental students and nine fifth-year dental students. Semi-structured interviews were conducted from November 2018 to January 2019, and verbatim transcripts were created from the recorded data. Based on these verbatim transcripts, thematic analysis was utilized to examine and identify professionalism components for each academic year. RESULTS: Three themes based on 14 constituent concepts were obtained for fourth-year students. Three themes based on 20 constituent concepts were obtained for fifth-year students. Fourth-year students primarily focused on technical aspects. In contrast, fifth-year students placed greater emphasis on attitude and communication skills. CONCLUSION: From fourth-year students, who primarily focus on classroom learning and practical training, to fifth-year students who gain clinical experience, the constituent elements of professionalism became more complex. However, this study did not examine other aspects of healthcare professionalism, such as interprofessional collaboration. A comprehensive education program tailored to the clinical setting is necessary for cultivating professionalism.

Dental trainees reflect more critically on negative experiences: portfolio analysis using a pragmatic approach and a rubric in Japan.

BACKGROUND: Dental trainees have various clinical experiences during their internships and they grow by experiencing success and failure. When looking back on an event, it is not apparent which experiences result in more critical reflection. Therefore, we qualitatively analyzed the portfolios of dental trainees using Significant Event Analysis to investigate their depth of reflection. METHODS: We asked all Hiroshima University Hospital dental trainees who completed a 1-year training program between 2010 and 2016 to describe their most memorable event from the past year. We coded the text using a qualitative analysis method. Then, we classified the responses as positive or negative events. We evaluated the depth of reflection following a pragmatic approach to categorizing reflective material (Sandars method) and a reflective ability rubric and user guide (O'Sullivan method) and compared these results. The evaluation was performed separately by two researchers and a good rate of agreement was confirmed by the weighted kappa statistic. Comparison of the depth of reflection was performed by the Mann-Whitney U test. RESULTS: The assessments of the positive event group and negative event group were compared with the respective evaluation criteria of the Sandars and O'Sullivan methods, and reflection was found to be deeper in the negative event group. The Mann-Whitney U test revealed a significant difference (p < 0.05) in the median values of the two groups for both methods. CONCLUSIONS: Both positive and negative experiences are important for dental practitioners to grow, but negative experiences are associated with critical reflections. In promoting the growth of training dentists, it is considered important to encourage deep reflections on positive experiences that are likely to be shallow.

Impact of Type and Duration of Application of Commercially Available Oral Moisturizers on Their Antifungal Effects.

PURPOSE: To examine the impact of oral moisturizer type and application time on antifungal effects. MATERIALS AND METHODS: Seventeen oral moisturizers (7 liquids, 10 gels) and amphotericin B (AMPH-B) were tested. Antifungal effects were evaluated with newly opened moisturizer samples (0 hour) and with samples incubated for 8 hours to simulate contact during sleep. Candida albicans samples (108 cells/ml) were placed into cylindrical holes in 50% trypticase soy agar plates. Antifungal effects were evaluated based on growth-inhibitory zones after 24 hours. Equal quantities of moisturizers showing growth-inhibitory zones were mixed as additional samples. The effects of moisturizer type and application time on growth-inhibitory zones were evaluated with ANOVA. Growth-inhibitory zone sizes were compared with multiple comparisons. RESULTS: Growth-inhibitory zones were found with two liquids, one gel, moisturizer mixtures, and AMPH-B. Significant differences in antifungal effects were found among different moisturizer types and between the 0- and 8-hour groups. The growth-inhibitory zones of the 8-hour group were significantly smaller than those of the 0-hour group. In both the 0- and 8-hour groups, the growth-inhibitory zones of the liquid-gel mixtures were significantly larger than those of other moisturizer types, and were the same size as those of AMPH-B at two concentrations (1.25 and 2.5 µg/ml). Growth-inhibitory zones of individual moisturizers and liquid-liquid mixtures were the same size as those of lower AMPH-B concentrations (0.16, 0.31, and 0.63 µg/ml). CONCLUSION: Our findings suggest that mixing liquid and gel moisturizers improves their antifungal efficiency.

PRECEDE-PROCEED model modification in community-based oral health promotion by using the linear structural relations programme.

PURPOSE: The PRECEDE-PROCEED (P-P) model is a framework for designing health education/promotion programmes. While the P-P model has been used to design community-based oral health programmes, outcome assessments of the model are seldom reported. The aim of the present study was to explore whether pathways in the P-P model accurately reflect the current status of environmental/behavioural assessment in a Japanese community and to examine whether using the linear structural relations (LISREL) programme would improve the model. MATERIALS AND METHODS: In a community health centre in Japan, a questionnaire with 29 items regarding oral health was distributed to 824 mothers with 3-year-old children. The items were compiled into eight variables that were tested using the LISREL programme. Goodness-of-fit index (GFI), adjusted goodness-of-fit index (AGFI) and root mean square error of approximation (RMSEA) were statistically analysed before and after P-P model modification. RESULTS: The GFI, AGFI and RMSEA were 0.913, 0.776 and 0.161 before, and 0.975, 0.939 and 0.075 after P-P model modification, respectively. Indirect effects on the quality of life from the predisposing, reinforcing and enabling factors became stronger than those in the initial P-P model. The overall fit of the modified P-P model was significantly better than that of the P-P model without modification, which did not accurately reflect the status of environmental/behavioural assessment in the community. CONCLUSIONS: The modified P-P model reflected the current status of environmental/behavioural assessment in the community. Health education models should be tested rigorously to ensure that they fit the reality of people's behaviour.

Japanese dental trainees' perceptions of educational environment in postgraduate training.

BACKGROUND: Compulsory postgraduate dental training was introduced in April 2006 to meet social requirements in Japan. AIM: The aim of the present study was to identify the difference in trainees' perception of the educational environment in two different training settings in the Hiroshima University Hospital postgraduate training program: (1) main hospitals, in Hiroshima's case, the University Hospital: (2) community dental hospitals or offices (cooperating hospitals). METHODS: In order to determine how trainees perceive their educational environment, the Postgraduate Hospital Educational Environment Measure (PHEEM) Inventory was administered to 50 vocational dental trainees for two different training settings, both of which all trainees had experienced. RESULT: The mean total PHEEM score in the main hospital was 102.4, and that in cooperating hospitals was 108.5. The scores for each of the three subscales were as follows: 'Perception of role autonomy': 33.9/56 (main hospital), 36.8/56 (cooperating hospitals); 'Perception of teaching': 38.1/60 (main hospital), 41,9/60 (cooperating hospitals), and 'Perception of social support': 30.4/44 (main hospital), 29.8/44 (cooperating hospitals) respectively. CONCLUSIONS: PHEEM provided meaningful diagnostic information on the educational environment, and showed that cooperating hospitals met trainees' needs more than main hospitals.

[A clinical case report of complete dentures using resilient denture liners].

PATIENTS: A man (68 years total edentulous) visited us because of masticatory soreness around the mandible. He also suffered from frequent fracture of the dentures. As the poor fitting and severe absorption of the mandible area was considered to be the main cause of the trouble, soft denture lining materials were used. After trying different types of soft denture liners over the new acrylic base dentures, the dentures were finally relined with fluoroelastomer. DISCUSSION: The condition was good and the patient was very satisfied with the lined dentures. The soft liner contributed to the improvement of the QOL of the edentulous patient. CONCLUSION: The use of soft liner was effective for this difficult edentulous case. This case concerns the guideline for the relining of soft liners.

Assessing communication skills for medical interviews in a postgraduate clinical training course at Hiroshima University Dental Hospital.

The study was conducted to investigate and clarify the effectiveness of our method of teaching communication and interview skills for medical interviews. Subjects were 18 first-year residents, enrolled in a postgraduate clinical training course at Hiroshima University Dental Hospital. Subjects underwent two objective structured clinical examinations (OSCEs), and the results of instructor and resident assessments of various elements dealing with necessary communication skills for conducting medical interviews were analysed. A statistically significant correlation between assessments of instructors and residents was observed in one element: confirming patient identity and introducing self (r = 0.812, p < 0.001) in the first interview. However, a statistically significant correlation between assessments of instructors and residents was observed in four elements in the second interview: greeting the patient (r = 0.548, p < 0.05), maintaining physical distance (r = 0.582, p < 0.05), showing empathy (r = 0.601, p < 0.05), summarizing and reconfirming patient complaints (r = 0.628, p < 0.01). Total scores given by instructors in the second OSCE were higher than those in the first OSCE (p < 0.001). The correlation coefficients of the total score in the first and second interviews were r = 0.020 and 0.679 (p < 0.01), respectively. These results may suggest the educational effectiveness of OSCE on the acquisition of communication skills for medical interviews. However, the results of resident self-assessments reveal that OSCE should be performed at least twice in order for residents to acquire the necessary communication skills for medical interviews.