Perception of recently graduated Dutch dentists of their education.

INTRODUCTION: The curriculum of the three dental schools in the Netherlands consists of a three-year bachelor's and three-year master's course. The education programmes focus inter alia on clinical dental reasoning, thinking and acting scientifically, general oral healthcare activities, and communication and (inter)professional cooperation. This study examined how recently graduated dentists, in the light of their work experience, evaluate their education in retrospect. MATERIALS AND METHODS: All 1074 dentists who graduated between 2012 and mid-2017 were invited by e-mail to answer a web survey. Of those, 314 (29%) took part in the study. RESULTS: The majority of dentists were positive about their knowledge of general and clinical oral healthcare fields when they graduated (70% and 68%, respectively). Fewer dentists were satisfied with their skills in terms of some specific procedures (50%) and clinical professional areas (33%). By far, the majority (85%) were satisfied with the educational skills of their teachers. The majority (70%) felt that their education fitted in well with their professional practice. Nevertheless, 60% thought a year's trainee work experience would be a good idea. The overall evaluation of dentists who have their own practices was less positive than those who do not. CONCLUSION: Knowledge and skills relating to managing a practice were not sufficiently addressed in the programme. The introduction of a practical internship would be desirable, preferably during the education. But when they look back, the majority of recently graduated dentists in the Netherlands are generally positive about the education they received.

Impact of career choice motivation on academic burnout in senior dental students: A cross-sectional study.

BACKGROUND: Motivation triggers all human activities including learning and lack of career motivation can lead to decreased efficiency. This study assessed the association between academic burnout and career choice motivation in senior dental students. METHODS: This cross-sectional study was performed on senior dental students of all four dental schools in Tehran in 2017. Dental students voluntarily filled out a 33-item questionnaire that comprised three sections. The first section included the Burnout Clinical Subtype Questionnaire (BCSQ-SS) with 12 questions addressing academic burnout. The second section consisted of 8 questions about career choice motivation, and the third section concentrated on 13 questions dealing with demographics. The individual scores of each section and the total scores were reported. The factor analysis of 8 questions about dental career choice motivation yielded 3 factors of social status and security, altruism, and others' advice motivations. The data were analyzed using regression test. RESULTS: Totally, 131 students filled out the questionnaire (response rate = 86%). The total score of academic burnout was 38.89% ± 1.13%. The highest and the lowest burnout scores belonged to the domains of "overload" (46.69%± 1.46%) and "neglect" (31.98%± 1.32%), respectively. The most and the least frequently mentioned source of motivation for choosing dentistry were high income and failing to enter other fields, respectively. The burnout score was higher in students with altruism motivations (P = 0.007) and lower in students with others' advice motivations (P = 0.004). The burnout score was higher in students with inadequate or moderate financial support from the family and lower in students whose mothers' educational level was high-school diploma or lower. CONCLUSION: Senior dental students in Tehran encountered different levels of academic burnout. In the present study, low financial support and altruism as career choice motivations were associated with higher level of academic burnout.

Burnout and Work Engagement Among US Dentists.

BACKGROUND: Burnout is a threat to patient safety. It relates to emotional exhaustion, depersonalization, and lack of personal accomplishment. Work engagement conversely composed of levels of vigor, dedication, and absorption in one's profession. The aim of this study was to examine burnout and work engagement among US dentists. METHODS: This study used the extensively validated Maslach Burnout Inventory-Human Services Survey and Utrecht Work Engagement Scale to measure burnout in a self-administered survey of 167 US dentists who attended continuing education courses held in Boston, Pittsburg, Iowa City, and Las Vegas. The mean scores on the 3 subscales of Maslach Burnout Inventory-Human Services Survey and Utrecht Work Engagement Scale were computed. The interscale correlations between the components of burnout and work engagement were assessed using Pearson correlations. We used 1-way analysis of variance and independent 2 sample t tests to examine the relationship between burnout and work engagement across sex and various age categories. Prevalence of burnout in our study population was also computed. RESULTS: We observed that 13.2% of our study population experienced burnout and 16.2% of our study population was highly work engaged. There was a statistically significant, unadjusted association between burnout risk and work engagement (χ2 = 22.51, P < 0.0001). Furthermore, the scores in the subscales of burnout were significantly correlated with scores in the subscales of work engagement. CONCLUSIONS: In this preliminary study, we observed some evidence of burnout among practicing US dentists. It is imperative that the dental profession understands this and works to promote professional practices that increase work engagement and decrease burnout.

Dentists' opinions on using digital technologies in dental practice.

OBJECTIVES: To investigate which opinions among dentists are associated with level of technology use, when characteristics of the dentist and dental practice, as well as motivating work aspects are taken into account. METHODS: A total of 1000 general dental practitioners in the Netherlands received a questionnaire on digital technologies they use, opinions on using technologies and related motivating work aspects. Questions were derived from expert interviews, the Dentists' Experienced Job Resources Scale and literature on technology implementation. Technology use was measured as the number of technologies used, and divided into three technology user groups: low (using 0-4 technologies, mostly administrative and radiographic technologies), intermediate (using 5-7, more varied technologies) and high technology users (using 8-12, including more innovative diagnostic technologies). Opinions on technology use and motivating work aspects were analysed using principal components analysis (PCA) and exploratory factor analysis. Scores on all components and factors were calculated for each respondent by computing the mean of all valid responses on the underlying items. Differences in these scale scores on opinions among the technology user groups were assessed using one-way analysis of variance and Kruskal-Wallis tests. A multiple linear regression analysis assessed the association of scale scores about opinions on technology use with the sum of technologies used, taking into account motivating work aspects and characteristics of the dentist and dental practice. RESULTS: The response rate was 31%. Dentists who were high technology users perceived technologies as yielding more improvements in quality of care, adding more value to the dental practice and being easier to use, than low technology users. High technology users thought technologies added more value to their work and they reported higher skills and resources. They also focused more on technologies and thought these are more ready to use than low technology users. High technology users derived more motivation from "Immediate results" and "Craftsmanship" than low technology users. Personal and practice characteristics, motivating work aspects, and the opinion scales "Focus" and "Added value to dentist" explained 50% of the variance in the number of technologies a dentist uses. CONCLUSION: Opinions on digital technologies among dentists and motivating work aspects vary with level of technology use. Being more focused on technologies and perceiving a higher added value from using them are associated with using more digital dental technologies, when taking into account motivating work aspects and characteristics of the dentist and dental practice.

The impact of a formal complaint on Dutch dentists' professional practice: a survey study.

BACKGROUND: A complaint from a patient can have a serious impact on the well-being of dentists. Little is known, however, about the nature and the extent of this impact. METHODS: Therefore in 2013 an anonymous survey was conducted among 955 dentists and dental specialists who were involved in a complaints procedure dealt with by the Complaints Committee of the Royal Dutch Dental Association (KNMT) in the period of mid-2008 to mid-2013. RESULTS: In total 413 (43 %) of these dentists participated in the study. As a result of a formal complaint 71 % of the respondents experienced a considerable impact in their professional practising, while 52 % stated that it had (also) seriously influenced their attitude towards colleagues and patients. Furthermore, 60 % (also) mentioned effects of a complaints procedure regarding their mental and/or physical well-being. CONCLUSIONS: Being confronted with a formal complaint from a patient leads to a considerable impact on dentists' professional practice and personal well-being. It is remarkable this did not only pertain to a 'negative' impact, but also to a 'positive' impact. Despite unpleasant feelings, several dentists regarded the complaint as a 'wake-up call'. Furthermore, given the relatively high number of successful mediation attempts it can be concluded that this form of complaint handling appears to be a successful way of solving problems that have arisen between patients and dentists.

Adoption and use of digital technologies among general dental practitioners in the Netherlands.

OBJECTIVES: To investigate (1) the degree of digital technology adoption among general dental practitioners, and to assess (2) which personal and practice factors are associated with technology use. METHODS: A questionnaire was distributed among a stratified sample of 1000 general dental practitioners in the Netherlands, to measure the use of fifteen administrative, communicative, clinical and diagnostic technologies, as well as personal factors and dental practice characteristics. RESULTS: The response rate was 31.3%; 65.1% replied to the questionnaire on paper and 34.9% online. Each specific digital technology was used by between 93.2% and 6.8% of the dentists. Administrative technologies were generally used by more dentists than clinical technologies. Dentists had adopted an average number of 6.3 ± 2.3 technologies. 22.5% were low technology users (0 to 4 technologies), 46.2% were intermediate technology users (5 to 7 technologies) and 31.3% were high technology users (8 to 12 technologies). High technology users more frequently had a specialization (p<0.001), were younger on average (p=0.024), and worked more hours per week (p=0.003) than low technology users, and invested more hours per year in professional activities (p=0.026) than intermediate technology users. High technology use was also more common for dentists working in practices with a higher average number of patients per year (p<0.001), with more dentists working in the practice (p<0.001) and with more staff (p<0.001). CONCLUSION: With few exceptions, all dentists use some or a substantial number of digital technologies. Technology use is associated with various patterns of person-specific factors, and is higher when working in larger dental practices. The findings provide insight into the current state of digital technology adoption in dental practices. Further exploration why some dentists are more reluctant to adopt technologies than others is valuable for the dental profession's agility in adjusting to technological developments.

Why seek treatment for temporomandibular disorder pain complaints? A study based on semi-structured interviews.

AIMS: To identify potential predictors of self-reported sleep bruxism (SB) within children's family and school environments. METHODS: A Aims: To assess possible differences between care seekers and non-care seekers with temporomandibular disorder (TMD) pain complaints, by using semi-structured interviews. METHODS: Semi-structured interviews were held with 16 subjects who had TMD- pain complaints: 8 care seekers and 8 non-care seekers, matched for age, sex, pain intensity, and fear of movement. Subjects were selected from a previously held survey study, with their consent. The interviews were audiotaped, transcribed verbatim, and analyzed according to qualitative content analysis. RESULTS: From the analysis, seven themes differentiating care seekers from non-care seekers were identified: catastrophizing, pain management, assertiveness, critical attitude towards health care, confidence in medical care, recognition, and adequate referral. CONCLUSION: Aspects upon which care seekers differed from non-care seekers were mainly person-related characteristics. Next to these characteristics, it appeared that inadequate referrals may play a role in care seeking. The use of semi-structured interviews may further improve insights into processes that determine care seeking among people with TMD pain complaints.

Care seeking for orofacial pain.

AIMS: To determine the contribution of a wide range of factors to care-seeking behavior in orofacial pain patients, expressed as (A) decision to seek care and (B) number of health care practitioners visited. METHODS: Subjects with orofacial pain complaints were recruited in seven TMD clinics and from a nonclinical population sample. They received a questionnaire including a wide range of possible predictors. To study which predictive variables were associated with the decision to seek care and with the number of health care practitioners visited, multiple regression models were built. RESULTS: Two hundred three persons with orofacial pain participated in the study. Of these participants, 169 (140 females) had visited at least one health care practitioner (care seekers), while the other 34 persons (25 females) did not (non-care seekers). The decision to seek care was not only associated with the pain intensity (P < .05), but, in women, also with fear of jaw movements (P < .01): Women with more fear of jaw movements were more likely to seek care. Pain intensity and disability were not associated with the number of health care practitioners visited. Instead, the main predictors were catastrophizing (P = .004) and the use of painkillers (P = .008). CONCLUSIONS: Pain intensity and fear of jaw movements play an important role in the decision to seek care for orofacial pain. The continuous search for help is associated with catastrophizing and the use of painkillers.

Burnout and engagement in relation with job demands and resources among dental staff in Northern Ireland.

OBJECTIVES: To investigate the psychological health--in particular, levels of burnout and engagement, job demands, job resources, and general psychological distress--among dental staff in Northern Ireland. METHODS: Three hundred questionnaires were administered to all dental offices in the western part of Northern Ireland. The questionnaire consisted of 'Maslach Burnout Inventory (MBI)', 'Job Demands in Dentistry measure', 'Utrecht Work Engagement Scale (UWES)', 'Job Resources in dentistry measure', and 'General Health Questionnaire (GHQ)'. RESULTS: Overall response rate among all staff members was 45% (for general dental practitioners: 65%). Burnout mean scores were unfavourable when compared with MBI manual norm scores, 26% had scores in the 'high' categories of both emotional exhaustion (EE) and depersonalization (DP). This is an indication of severe burnout risk. Time pressure, financial worries, and difficult patients appeared to be the most prominent work demands (mean scores >3). All job demands' scales correlated significantly (P < 0.01) and positively with both EE and DP: 0.30 > r < 0.62. Mean scores for UWES, and all job resources' subscales were all well above each subscale's range midpoint. Treatment results appeared the most prominent work resource. GHQ mean score for all was 1.05 (SD = 0.51). No difference in mean score was found between dentists and other staff (F(1,123) = 1.08, NS). With 'case level' set at a score >3 as a cut-off point, 25% of the subjects have to be considered cases. CONCLUSION: Burnout is a serious threat for the dental team in this region of Northern Ireland, especially among general dental practitioners. One-quarter of the dentists were categorized as having a serious burnout risk. Dentists appeared to have most trouble with the work environment aspects: time pressure and financial worries. Furthermore, the proportion of those suffering from psychological distress was unusually high. In contrast to these findings, encouraging levels of engagement were identified. It is recommended that attention for burnout risk is given priority by dental associations.

Promoting professional behaviour in undergraduate medical, dental and veterinary curricula in the Netherlands: evaluation of a joint effort.

BACKGROUND: From 2002 onwards, a nationwide working group of representatives from all medical (8), dental (3) and veterinary medicine (1) schools collaborated in order to develop and implement recommendations for teaching and assessing professional behaviour. AIM: The aim of this article is to describe the outcomes of this process, including hurdles encountered and challenges to be met. METHOD: By a qualitative survey, information was requested on teaching professional behaviour, assessment, instruments used, consequences of unprofessional behaviour and faculty training. RESULTS: All schools have adopted at least parts of the 2002 recommendations. Differences exist mainly in the organisational structure of teaching and assessment as well as in the assessment instruments used. In all schools a longitudinal assessment of professional behaviour was accomplished. CONCLUSION: All schools involved have made progress since 2002 with regard to teaching and assessment of professional behaviour, resulting in a shift from an instrumental to a cultural change for some schools. A stimulating factor was society's call to focus on patient safety and therefore on assessment of unprofessional behaviour. Hurdles yet to be taken are the involvement of students in the assessment process, teacher confidence in personal assessment capacities, remediation programmes and logistic and administrative support.

Burnout development among dentists: a longitudinal study.

Knowledge on the development of burnout among dentists is important for purposes of prevention and intervention. Using a two-wave longitudinal design, this study examined the chronological sequence of the three dimensions of the Maslach Burnout Inventory: emotional exhaustion; depersonalization; and personal accomplishment. Structural Equation Modelling was employed among a representative sample of Dutch dentists to examine the fit of several models proposed in earlier research. The results indicated that a model in which emotional exhaustion precedes depersonalization, which in turn precedes personal accomplishment, shows an adequate fit among dentists. However, an alternative model, in which personal accomplishment precedes emotional exhaustion, had an even better fit. In addition to the test of these a priori models, an ad hoc model was constructed that best fitted the current data. This model indicated emotional exhaustion to precede the development of depersonalization and personal accomplishment independently. Although not univocal, the results showed that emotional exhaustion should not be discarded as an early sign of burnout. This is in line with the view that emotional exhaustion can be considered as the key dimension of burnout.

Positive engagement and job resources in dental practice.

OBJECTIVES: The aim of this study is to determine the level of engagement among dentists, and subsequently, to investigate which dental job resources are positively correlated with engagement. METHODS: By stratifying on gender, age, and region, a representative sample of 848 general dental practitioners was drawn at random, plus an extra group of 95 female dentists for gender comparison purposes. Engagement was assessed using the Utrecht Work Engagement Scale (UWES), consisting of three subscales: Vigor, Dedication; and Absorption. Job resources were measured using the Dentists' Experienced Job Resources Scale (DEJRS). RESULTS: Six hundred and thirty two dentists (67%) responded, 76% male and 25% female. Mean age: 44.6 years (SD = 9.0). Engagement: Dedication and Absorption mean scores were higher among dentists when compared with manual norm scores, based upon a variety of professions, whereas Vigor mean scores were comparable to manual norm scores. Job resources:'Immediate results / Aesthetics' and '(Long term) Patient results' showed highest mean scores among all dentists. Gender differences were found on '(Long term) Patient results' and 'Patient care'. Engagement and job resources: All DEJRS subscales and the full scale showed statistically significant positive correlations (pmcc) with the UWES subscales. CONCLUSION: Dentists showed relatively high mean scores on an engagement measure when compared with manual norm scores. No gender differences in mean scores were found. Job resources most valued were 'Immediate results / Aesthetics'. The job resources, 'Idealism/Pride' and 'Patient care', showed most predictive value with regard to engagement among dentists. In order to prevent burnout, it is recommended to raise dentists' awareness of the importance to create sufficient time and space for stimulating aspects in their work.

Dentist-assistant communication style: perceived gender differences in The Netherlands and Northern Ireland.

OBJECTIVES: To assess communication style differences with the (female) dental assistant, as perceived by male and female dentists. METHODS: Data were collected from 216 Dutch (male: 99; female: 117) and 261 Northern Irish (male: 135; female: 126) dentists (overall response rate: 60%). Respondents filled in a self-report questionnaire (one follow-up mailing), with 22 items on staff communication style. Using principal component analysis, four distinguishable factors could be extracted: businesslike leadership style (seven items, Cronbach's alpha = 0.87), friendly leadership style (seven items, alpha = 0.87), professional interacting style (four items, alpha = 0.83) and gender interacting style (four items, alpha = 0.83). RESULTS: manova indicated a main effect for gender [F(8,946) = 10.905, P < 0.001] and for country [F(4,474) =4.197, P = 0.002] on the communication style scales. Male dentists, compared with female colleagues, showed higher mean scores on businesslike leadership style and gender interacting style, whereas female dentists showed higher mean scores on friendly leadership style and professional interacting style. Dutch dentists showed higher mean scores on friendly leadership style and professional interacting style than their Northern Irish colleagues. No interaction effect between gender and country was found. Dentist's age and length of assistant's employment (in years) partly explained differences in means. CONCLUSION: Male and female dentists perceive their communication with the assistant differently; male dentists tend to be influenced by the gender differences, female dentists by striving for friendliness. Some country differences were found. Increasing influx of young female dentists underlines the relevance of this topic in dental education and for future research.