Comparisons between referred and non-referred patients to a university paediatric dental clinic.

BACKGROUND: Referrals of paediatric patients to a university clinic have been increasing over the last several years. AIM: To evaluate characteristics of referred and non-referred patients at the University of Iowa's Pediatric Dental Clinic (UIPDC). DESIGN: A retrospective chart review included dental records of 340 referred and 383 non-referred patients from July 1, 2015, to May 31, 2016 (n = 723). Age, distance to the clinic, size of the patient's community, insurance, number of teeth with decay, treatment needs, educational level of the provider, and presence of patient special health care needs were obtained. Descriptive statistics, bivariate analysis, and multivariable logistic regression were performed to analyze the outcomes (alpha = .05). RESULTS: Referred patients were more likely to live >60 miles away, live in a community of >75 000 people, have special health care needs, have caries/greater number of teeth with decay, need endodontic treatment, and were less likely to remain patients at the clinic (p < .0001). Referred patients were also more likely to need extractions (p = .0104), but less likely to need space maintenance/comprehensive orthodontic treatment (p = .0002). CONCLUSION: There was a difference in the complexity of patient treatment needs between referred and non-referred patients.

The Impact of the Covid-19 Pandemic on Applicants to Advanced Education in Pediatric Dentistry Programs and Recommendations for Virtual Interviews.

Purpose:To assess the impact of the Covid-19 pandemic on applicants for advanced education programs in pediatric dentistry in the United States and provide recom- mendations for virtual interviews (VI).
Methods:A cross-sectional survey was emailed to pediatric dentistry applicants in the 2020-2021 cycle.
Results:One hundred seventy-five applicants responded. Virtual interviews were the universal format during this timeframe. Forty-four percent admitted to applying to programs they were not initially strongly considering and 42 percent accepted inter- views they would have declined if they had to travel. Applicants found social events with residents only (80 percent), a program overview presentation (86 percent), a virtual tour (77 percent) and a question-and-answer session with residents (85 percent) to be helpful. One-on-one or paired faculty interviews were the most preferred inter- view method. More than half (55 percent) thought programs were not able to learn about them as effectively through virtual compared to an in-person format.
Conclusions: VI caused different applicant behavior due to the low time and financial investment. Applicants valued their time with residents to learn about programs, but were split in their preferences for virtual, in-person or hybrid interviews. Programs can use findings from this study to plan future recruitment cycles.

A tool for incorporating interprofessional perspectives into dental students decision-making: A 2-year follow-up on this learning outcome.

OBJECTIVES: To analyze student performance when using a sustainable teaching tool developed to guide learning toward interprofessional perspectives. METHODS: This study compiled data about D4 students' performance when using an interprofessional education (IPE) teaching tool reported previously in this journal, during their 5-week Geriatric and Special Needs Program rotation in the academic years 2018-2019 and 2019-2020. Ninety-two students were introduced to IPE concepts and teaching tools during their orientation. Students were then asked a question regarding the perspective of each healthcare team member and whether they would contact these healthcare team members for collaboration during the provision of oral care with regard to various patient cases. Students were scored on whether they answered the question about the perspective of each health care team member. The same two independent evaluators also noted whether the student thought each member of the health care team should be contacted. RESULTS: A majority (90.2%-95.7%) of dental students applied their knowledge to questions regarding each health care team member's perspectives. The profession that dental students most often indicated they wished to contact for collaboration was primary care providers (n = 70; 76.1%), followed by family caregivers (n = 54; 58.7%), and pharmacists (n = 46; 50.0%). The results of the interrater agreement between the two-faculty scoring students were between 86.7% and 100%. CONCLUSIONS: The teaching tool is sustainable and succinct. Students considered the perspectives of each health care team member at a rate above 90%, and the interrater agreement was high among the faculty evaluators. Students considered contacting primary care providers, family caregivers, and pharmacists more often than the other health care team members. We see this model as one approach to begin the articulation of learning outcomes for IPP.

Teaching Tool for Teledentistry Modeled with Pediatric Dentistry Residents.

Purpose: To present a patient interaction teaching tool for synchronous teledentistry visits following concepts in critical thinking and report on the viability, assessment and implementation of the tool in an academic pediatric dentistry clinic.
Methods: A teaching tool was derived from interviews with pediatric dental residents and clinicians. The tool contained six main sections and 26 steps. The main sections included: greeting, medical, dental and behavioral histories; airway assessment; treatment recommendations; behavioral modalities of treatment; and follow-up. A faculty member assigned each interviewer dichotomous values of yes and no for implementation of each step of the teaching tool.
Results: Six pediatric dentistry residents participated in a tool use demonstration with 21 patients. The purpose of each interview was to gain information for procedural treatment at the first onsite visit. All pediatric dental residents completed over 90 percent of the steps in each section. The interview duration ranged from eight to 29 minutes (median: equals 18 minutes). Eighteen of the 21 patients were scheduled for follow-up visits.
Conclusions: The emulation model for provisional treatment planning is viable for teledentistry. Pilot results showed students consistently completed over 90 percent of skillset steps and that this teaching tool serves as a framework for teledentistry appointments.

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.

Evaluation of a disease-specific instrument for idiopathic clubfoot outcome.

UNLABELLED: In 2001, Roye et al. developed a disease-specific instrument (DSI) to measure outcomes of treatment for clubfoot. We assessed this instrument using a cohort of 62 patients, ages 5 through 12 years (mean, 8.6 years), with idiopathic clubfoot who were treated as infants by various methods. Treatment groups were defined by whether the patient received joint-invasive surgery (posterior or posteromedial release surgery) or joint-sparing treatment only (manipulation and casting with or without tendo-Achilles lengthening or anterior tibial tendon transfer). The DSI scales demonstrated internal consistency reliability of 0.74 to 0.85 using Cronbach's alpha. Higher (better) DSI scores were associated with "excellent" general health ratings and better health-related quality of life; lower DSI score were related to special healthcare needs. Patients treated using joint-sparing techniques only (eg, Ponseti technique) had higher DSI scores than those who had received joint-invasive surgery. DSI scores for patients who had received posterior or posterior medial release surgery were very similar to those reported by Roye et al. in New York for a comparable group of patients. Our findings suggest the DSI is sensitive to differences in treatment technique or underlying severity of disease. These data support the use of the Roye DSI as an outcome measure for idiopathic clubfoot in children. LEVEL OF EVIDENCE: Level III, diagnostic study. See the Guidelines for Authors for a complete description of levels of evidence.