Reviewing Assessment Strategies in European Dental Schools.

OBJECTIVES: Effectively assessing dental students' knowledge and skills is an important part of their education. Assessment techniques available to teachers, have become more diverse as new technologies are introduced. This study aimed to investigate what dental educators thought about current and future assessment techniques. METHODS: This was a mixed method study; quantitative data being collected at an annual dental educators' conference, via on-screen questions requesting: i) demographic information; ii) type of student assessment currently used; iii) impact of Covid-19 on student assessment, and iv) future perceptions of assessment. Questions were posed in real time using the 'Vevox' platform. Descriptive statistical analysis was employed. Qualitative data were collected on 'post-its' and analysed thematically. RESULTS: 101 participants attended the study. 59.1% (n=60) had >11 years' experience. 64% (n=55) considered their summative and formative assessments were effective in developing student learning. Few participants reported students' involvement in creating their own assessments (n=8; 9.75%). 41.68% (n=36) participants agreed it was a good idea for students to be involved in developing assessments, but only 9.75% (n=8) reported it was already happening. Qualitative data indicated a reluctance to wholeheartedly embrace technology (including AI) when planning assessments. Most participants were not in favours of Co-creation or the use of some technologies. CONCLUSIONS: Participants, reflected on the challenges of adopting a universal assessment approach. Dental educators should be given the institutional support and autonomy to implement the best assessment methods for their students. Most of this cohort of experienced dental educators reported that assessments facilitated student learning. CLINICAL SIGNIFICANCE: The role of assessment for dental students is essential as dental educators must ensure that dental students graduate with appropriate knowledge and technical skills to be safe when in general dental practice. The use of various assessment techniques needs to reflect the diversity of skills the students need to demonstrate.

Teacher feedback and student learning-The students' perspective.

INTRODUCTION: Feedback from teachers to students plays an important role in informing students about the outcome of their assessments. It contributes to students' ongoing learning. The aim of this study was to investigate dental students' perceptions of the feedback given to them by their teachers in Europe. MATERIALS & METHODS: An online questionnaire was completed by dental students throughout Europe in this quantitative study. Data were collected via Google Forms, transferred to an excel spreadsheet and analysed using SPSS software Version 24. RESULTS: 234 students studying in 9 different European countries completed the questionnaire. These students were born in 36 different countries within and beyond Europe. 84% (n = 197) were undergraduate students. 20.3% (n = 48) students reported receiving feedback following summative assessments. 81.2% (n = 190) students reported constructive criticism as their preferred mode of receiving feedback. 11.3% (n = 26) students did not know who delivered the feedback to them. 71% (n = 166) students felt that the feedback they received had a significant impact on their future learning. CONCLUSION: It would appear that there is some diversity in dental students' perceptions of: i) who delivers feedback, ii) when feedback is given, iii) the consistency of feedback received, and iv) the style of feedback they preferred compared to that delivered by tutors. Feedback is being provided to dental students in an appropriate and helpful manner, although there is still room for improvement. Students were aware of the significance of feedback and its impact on future learning. CLINICAL SIGNIFICANCE: Most European dental students prefer to receive constructive feedback. Feedback was seen to have a significant impact on future learning despite over one in five students not knowing who had delivered their feedback. Feedback following clinical teaching should have a positive effect on students' skills and motivation to learn.

Teachers' feedback practices in COVID-19: Has anything changed?

OBJECTIVES: Feedback delivered by teachers to dental students has a profound impact on students' ongoing learning and development. The aim of this study was to investigate changes to feedback practices as a result of the global COVID-19 pandemic and the ensuing challenges to delivering quality dental education. METHODS: This was a mixed method study. Quantitative data were collected through a bespoke questionnaire delivered to attendees of the Association for Dental Education in Europe (ADEE) annual conference. Qualitative data were collected via four focus groups at the conference, each discussing a particular theme. The questionnaire and conference were delivered online via Gmail and MS Teams, respectively. Quantitative data were analysed descriptively; qualitative data were analysed narratively, and both were triangulated. RESULTS: 67 questionnaire responses were received which represented a 26% response rate. Respondents came from 12 different countries within Europe and beyond and reported having a variety of roles in their dental schools. 77.6% (n = 52) respondents indicated they had changed their delivery of feedback due to the pandemic. One-third of respondents reported giving more feedback and 76% (n = 51) increased their quantity of feedback delivered online. The increased incidence of online learning had resulted in a greater emphasis on teaching small groups, increased use of technology, increased emphasis on student centred learning and heightened awareness of changing the style of feedback delivery. CONCLUSIONS: The COVID-19 pandemic has enforced rapid changes to the delivery of feedback by teachers to dental students, which could pave the way for a more positive, inclusive, individualistic and effective approach for delivering feedback now and in the future. CLINICAL SIGNIFICANCE: The COVID-19 pandemic resulted in a significant shift from face-to-face teaching to online tuition, which promoted a need to re-evaluate the best method of delivering feedback to students. The ongoing changes in teaching approaches have a profound impact on clinical skills acquisition for dental students. The quality of the feedback students receive may help to enhance the synergies between theoretical online teaching and hands-on clinical skills acquisition, which has been altered and disrupted due to the ongoing pandemic.

Assessment in a global context: An international perspective on dental education.

Assessments are widely used in dental education to record the academic progress of students and ultimately determine whether they are ready to begin independent dental practice. Whilst some would consider this a "rite-of-passage" of learning, the concept of assessments in education is being challenged to allow the evolution of "assessment for learning." This serves as an economical use of learning resources whilst allowing our learners to prove their knowledge and skills and demonstrating competence. The Association for Dental Education in Europe and the American Dental Education Association held a joint international meeting in London in May 2017 allowing experts in dental education to come together for the purposes of Shaping the Future of Dental Education. Assessment in a Global Context was one topic in which international leaders could discuss different methods of assessment, identifying the positives, the pitfalls and critiquing the method of implementation to determine the optimum assessment for a learner studying to be a healthcare professional. A post-workshop survey identified that educators were thinking differently about assessment, instead of working as individuals providing isolated assessments; the general consensus was that a longitudinally orientated systematic and programmatic approach to assessment provide greater reliability and improved the ability to demonstrate learning.

Natural position of the head: review of two-dimensional and three-dimensional methods of recording.

Both the correct position of the patient's head and a standard system for the acquisition of images are essential for objective evaluation of the facial profile and the skull, and for longitudinal superimposition. The natural position of the head was introduced into orthodontics in the late 1950s, and is used as a postural basis for craniocervical and craniofacial morphological analysis. It can also have a role in the planning of the surgical correction of craniomaxillofacial deformities. The relatively recent transition in orthodontics from 2-dimensional to 3-dimensional imaging, and from analogue to digital technology, has renewed attention in finding a versatile method for the establishment of an accurate and reliable head position during the acquisition of serial records. In this review we discuss definition, clinical applications, and procedures to establish the natural head position and their reproducibility. We also consider methods to reproduce and record the position in two and three planes.

Occlusal traits in children with neurofibromatosis type 1.

OBJECTIVES: Literature is poor of data about the occlusion in children affected by neurofibromatosis type 1 (NF1). This case-control study investigated the occlusal traits in a group of children with NF1. SETTING AND SAMPLE POPULATION: A hundred and fifteen children with NF1 were enrolled; non-NF1 controls were sequentially selected among subjects referred to the Pediatric Dentistry Department. MATERIAL AND METHODS: All patients underwent a clinical dental examination and a panoramic radiography. The following orthodontic variables were considered: molar relationship, overjet, overbite, cross-bite, scissor bite, and crowding/spacing. RESULTS: Class III molar relationship resulted significantly (p = 0.01) more common in children with NF1 than in the control group as well as the unilateral posterior cross-bite (p = 0.0017). Forty-three children with NF1 (37.3%) showed radiographic abnormalities; in one case, a plexiform neurofibroma was detected. CONCLUSIONS: An early orthodontic evaluation might be planned in the management of children with NF1 to prevent or decrease the need for extensive orthodontic interventions.

Acceptability of a reflective e-portfolio instituted in an orthodontic specialist programme: a pilot study.

AIM: The purpose of the study was to highlight students' and mentors' acceptability of a reflective e-portfolio instituted in a postgraduate orthodontic programme in the UK. METHODS: A reflective e-portfolio was developed on the basis of principles provided by a literature search and was piloted for 2 months with six students and seven mentors. At the end of the experience, mentors' and students' acceptability of the e-portfolio with a reflective component was studied using questionnaires. The data were analysed using basic quantitative and qualitative methods. RESULTS: Students' response highlighted acceptability issues related to each aspect of the e-portfolio derived from the literature: relevance of the e-portfolio reflective part; time required for the process; support and mentoring; the implementation method; and the electronic medium. Mentors showed a more positive attitude towards the e-portfolio, expressing only some concerns about the time involved in using it. Furthermore, the analysis of the data highlighted some other acceptability matters: the specificity of the e-portfolio, the communication amongst students and the relationship between students and mentors. CONCLUSIONS: The future successful implementation of the reflective e-portfolio will depend on the productive management of the acceptability issues identified by students and mentors, in particular:(i)the specificity of the e-portfolio that would avoid its overlapping with other part of the programme;(ii)the increasing communication amongst students to improve their knowledge of the reflective writing process; and (iii)the development of a relationship between students and mentors helping to create the appropriate environment for reflection.

A Delphi approach to define learning outcomes and assessment.

AIM: The aim of this study was to use a Delphi process for curriculum revision facilitating staff collaboration and curriculum 'alignment' in the orthodontic specialist training programme in Cardiff. METHOD: A 2-round modified Delphi process was employed to achieve consensus amongst a heterogeneous panel with regard to the learning outcomes and assessment methods, which initially were defined according to formal directives and local initiatives. The panel comprised of nine staff members (five consultants, a professor, a reader, a lecturer and a student) who were working in the orthodontic department in Cardiff and involved in the process of curriculum revision. RESULTS: The response rate to the questionnaires was 77.8%. The staff members' consensus achieved in the Delphi process was 98.4% for the learning outcomes and assessment. The results of the Delphi process provided a list of outcomes and their appropriate assessment methods for the specialist orthodontist in Cardiff. DISCUSSION AND CONCLUSION: The results show that the Delphi process was an efficient and cost-effective technique to achieve consensus of opinion on the learning outcomes and the assessment methods for the specialist orthodontist as part of the process of curriculum revision in Cardiff.

Use of CBCT in the orthodontic diagnosis of a patient with pycnodysostosis.

The pycnodysostosis is a genetically determined, autosomal recessive osteosclerosis, due to deficiency of cathepsin K. It is characterized by short stature, massive skull, hands and feet with short terminal phalanges, dysplastic nails. Oral and maxillofacial manifestations include hypoplasia of the mandible and maxillary sinus, obtuse mandibular gonial angle deciduous teeth and permanent impacts, or malposition, frequent overcrowding, periodontal lesions. Bone sclerosis is already detectable in X-rays during childhood, often present open fontanelles and sutures, wormian bones; frequent pathological fractures. This article presents the case of a male patient, Caucasian, age 9 years and 11 months suffer from pycnodysostosis, mutation of the gene in heterozygotes p.R241X, already followed at the Pediatric Endocrinology Clinic of the Spedali Civili of Brescia. After evaluation at the Department of Maxillofacial Surgery of the Spedali Civili of Brescia, for surgical reasons required a cone beam computed tomography (CBCT) scanner with NewTom 3G, was presented to our observation at the Department of Orthodontics of the Dental Clinic of the University of Brescia. CBCT findings including detailed information about the anatomy of the upper and lower jaw, dental elements, their relationship with the surrounding anatomical structures and the spatial position. The only radiographic examination currently available that obtains 3D images and the volume of the life-size area, without exposing patient to dose of radiation from a classic multi-layer CT is CBCT that, even through the 3D reconstructions with dedicated programs can make a correct diagnosis, prognosis and treatment in patients with maxillofacial dysmorphism. This examination allows to obtain images from around the skull that permit a complete orthodontic diagnosis, not only restricted to the area of surgical interest, taking into account the reports of the dental arches to each other and with surrounding structures.

Evidence-based care and the curriculum.

An evidence-based (EB) approach has been a significant driver in reforming healthcare over the past two decades. This change has extended across a broad range of health professions, including oral healthcare. A key element in achieving an EB approach to oral healthcare is educating our practitioners, both current and future. This involves providing opportunities integrated within simulated and actual clinical settings for practitioners to learn and apply the principles and processes of evidence-based oral healthcare (EBOHC). Therefore, the focus of this discussion will be on ways in which EBOHC and associated research activities can be implemented into curricula, with the aim of improving patient care. This paper will initially define the scope of EBOHC and research, what these involve, why they are important, and issues that we need to manage when implementing EBOHC. This will be followed by a discussion of factors that enable successful implementation of EBOHC and research into curricula. The paper concludes with suggestions on the future of EBOHC and research in curricula. Key recommendations related to curricula include strengthening of the culture of a scientific approach to education and oral healthcare provision; complete integration of EBOHC into the curriculum at all levels; and faculty development to implement EBOHC based on their needs and evidence of effective approaches. Key recommendations to support implementation and maintenance of EBOHC include recognition and funding for high-quality systematic reviews and development of associated methodologies relevant for global environments; building global capacity of EBOHC researchers; research into improving translation of effective interventions into education and healthcare practice, including patient-reported outcomes, safety and harms, understanding and incorporation of patient values into EB decision-making, economic evaluation research specific to oral healthcare and effective methods for changing practitioner (faculty) behaviours; and extend access to synthesized research in 'user friendly' formats and languages tailored to meet users' needs. Realizing these recommendations may help to improve access to effective healthcare as a basic human right.