A novel model for curriculum design: Preparation, planning, prototyping, and piloting.

Dental education continuously strives to provide students with positive and meaningful learning experiences. Developing or improving a curriculum usually encompasses three main phases: design, implementation, and evaluation. Most research on curriculum development in dental education has focused on the last two phases. Our commentary addresses this gap by describing a new model for curriculum design that effectively guided the design phase of the complete overhaul of the four-year Doctor of Dental Surgery curriculum at the School of Dentistry, University of Alberta. Built on the strengths of pre-existing curriculum design models, the new model provided enough structure and rigour to support the complexity required during a complete curriculum redesign whilst still allowing sufficient consultation and flexibility to encourage stakeholder engagement. The steps of the new 4P's model (preparation, planning, prototyping, and piloting) and main actions within each step are described. Challenges observed in each step and strategies to address them are reported. Other institutions embarking on renewing or redesigning a curriculum at a program level may benefit from using a curriculum design process similar to the 4P's model. Recommendations are discussed including the inclusion of educational consultants in the curriculum renewal committee, the importance of a leadership that effectively supports curriculum reform, purposeful engagement of stakeholders during each step of the design phase and ensuring that project and change management occur concurrently.

Lobodontia in the primary and permanent dentition: a condition requiring individualized care.

Lobodontia is a rarely documented dental condition associated with pointed or conical cusps on premolars and canines, multitubercular occlusal surfaces on molar teeth, and irregularly shaped incisors. Information on this uncommon condition continues to be scarce, with particularly little information available on the primary dentition. The purpose of this article is to describe 6 cases of lobodontia and discuss the variability in presentation and management. Previously unreported manifestations in the primary dentition are included. The cases described in the current study demonstrate the spectrum of clinical and radiographic features of the condition, and show that a varied, individualized approach to treatment is necessary.

La lobodontie est une affection dentaire rarement documentée liée à des cuspides pointues ou coniques sur les prémolaires et les canines, à des molaires ayant des surfaces occlusales multituberculées et à des incisives de forme irrégulière. Les informations sur cette affection peu courante continuent à être rares, notamment en ce qui concerne la dentition primaire. L'objectif de cet article est de décrire 6 cas de lobodontie et de discuter de la variabilité en matière de présentation et de gestion. Des manifestations de la dentition primaire qui n'avaient pas été déclarées auparavant sont incluses. Les cas décrits dans la présente étude illustrent le spectre des caractéristiques cliniques et radiographiques de cette affection et montrent que le traitement nécessite une approche variée et personnalisée.

Development of an electronic learning progression dashboard to monitor student clinical experiences.

INTRODUCTION: Clinical experience tracking mechanisms for students at dental schools provide patient assignment, student experience, and learning progression feedback. The purpose of this study was to evaluate dental students' clinical experiences following the implementation of a learning progression dashboard (LPD). METHODS: After developing and deploying an electronic LPD using PHP, secondary data analysis on dental students' clinical experiences from 2017-2019 was conducted. Student experience differences were compared between the year before continuous use of the LPD and the first year using it. LPD data contained the required clinical procedures dentistry students must perform across all disciplines and the number of planned, in progress, and completed tasks each student has accomplished. Using two time points, the students' experiences were compared. Univariate statistics and independent t-tests were conducted in R for detecting the differences in the number and categories of codes. RESULTS: The number and category of codes showed significant differences between the academic year 2017-2018 and 2018-2019 for both third- and fourth-year dental students after one and two terms. Overall, students recorded a 26% greater number of treatment codes and experienced a 26% greater number of code categories compared to the previous year. CONCLUSION: Applying information management methods such as dashboards can better inform educators on student clinical experiences and improve clinical learning outcomes for students.

Intraoral Imaging in Dental Private Practice - A Rectangular Collimator Study.

OBJECTIVE: To gain a better understanding of the extent to which rectangular collimation is being used in private practice and the barriers to adoption by practitioners. METHODS: Licensed dentists in private practice were asked to answer a survey composed of 17 multiple-choice questions and 1 open-ended question regarding demographics, radiation safety, image receptor type, intraoral imaging techniques and use of rectangular collimation. RESULTS: Among all participants (n = 82), 86.6% used digital systems (n = 71) and 13.4% conventional film (n = 11). Most (74.0%, n = 60) were aware of the benefits of using rectangular collimation, with 5.5% reporting not knowing of the existence of this device (n = 3). Only 12.9% of the dentists reported using rectangular collimation routinely (n = 10). The youngest and oldest age groups had the lowest compliance rates, 5.6% and 0%, respectively. CONCLUSION: Although 74.0%, (n = 60) of private practitioners were aware of the benefits of using rectangular collimation to reduce radiation dose, only 12.2% (n = 10) used it routinely for intraoral imaging. Barriers to implementing rectangular collimation in private practice settings included challenges in training support staff and fear of an increase in the occurrence of technical errors that would result in re-exposure of patients.

Dental faculty and student views of didactic and clinical assessment: A qualitative description study.

OBJECTIVE: Although assessment is essential to accurately represent student learning, little is currently known about student and faculty perceptions of assessment in dental schools. Our study aimed to explore faculty and student views of didactic and clinical assessments in the School of Dentistry at the University of Alberta. METHOD: Qualitative description informed the study design. Data were collected through focus groups and analysed inductively using manifest content analysis. RESULTS: Five focus groups were conducted with faculty (n = 34) and three with students (n = 19). Faculty and student views of assessment were related to improvements made (perceived positive changes), improvements needed (perceived limitations) and improvements recommended (recommendations to improve perceived limitations). Faculty and students reported that improvements made (eg adequacy of assessment to students' levels of training) varied across instructors, courses and learning environments. Both faculty and students perceived clinical assessments as less appropriate than didactic assessments. Faculty perceived limitations were mostly related to assessment appropriateness, especially assessment accuracy and comprehensiveness, whilst student perceived limitations included other issues related to appropriateness (eg misalignment with course objectives) as well as issues related to assessment volume, pace and scheduling. Similarly, faculty recommendations focused on enhancing the assessment of clinical competencies, whilst students' recommendations aimed to also improve assessment scheduling, volume and usage (eg for learning purposes). CONCLUSIONS: Faculty and student views of assessment complemented one another. Our data show that assessment in dental education is multidimensional, so that multilevel strategies may be needed to improve this component of dental curricula.

Thinking ecologically about clinical education in dentistry.

Traditional approaches to clinical education (CE) in dentistry have primarily focused on the needs and interests of students (student-centred), patients (patient-centred) or individuals receiving care (person-centred). Research has shown that giving priority to the interests of one stakeholder (eg students) may negatively affect the interests of others (eg patients, instructors and administrators). In this commentary, we discuss some limitations of traditional approaches to CE and suggest an eco-centred approach that assumes that the interests of all stakeholders must be considered when planning CE due to the interdependent relationships between stakeholders. A description of this new approach is provided, whilst research and innovation are encouraged to develop an ecologically informed system of CE.

Assessing students' confidence in interpreting dental radiographs following a blended learning module.

OBJECTIVE: This study assessed senior dental hygiene (DH) students' self-reported confidence in interpreting dental radiographs following the introduction of a blended learning (BL) module for radiology interpretation. The assessment of students was conducted five months prior to graduation. METHODS: A BL oral radiology module was designed. In order to capture the context, descriptions and differences of students' experience and confidence, a qualitative research approach was selected. Data were captured using a semi-structured interview process and analysed using phenomenographic methods. RESULTS: Sixteen students were interviewed. Blinded transcripts were analysed, and the main themes relating to confidence were extracted and arranged into categories. The categories were coded as to how confident (low, medium or high) each of the students felt specific to varying contexts and complexities of radiographic interpretation. CONCLUSION: Predominately, the BL model had a positive impact on DH students' confidence in the interpretation of radiographic findings. However, when asked about their level of overall confidence in interpreting dental radiographs, students still did not describe themselves as confident for all potential findings on radiographs at this point in their education. The students highlighted the importance of having patient history details and clinical assessment findings included in the interpretation exercises and expressed a desire to collaborate with other professionals when interpreting radiographs.

Evidence on radiation dose reduction using rectangular collimation: a systematic review.

BACKGROUND: The goal of an intraoral radiograph is to be a valuable diagnostic tool while keeping the radiation exposure dose as low as reasonably achievable. The International Commission on Radiological Protection (ICRP) has strong recommendations for patient dose-reduction strategies. OBJECTIVE: To answer the following research question: 'In either patient or in phantoms, does rectangular collimation compared with other forms of collimation reduce the radiation absorbed dose during intraoral imaging?' METHODS: The search strategy was developed specifically for each electronic database. Information was collected from MEDLINE, all EBM Reviews including the Cochrane Library, EMBASE, LILACS, PubMed and Web of Science, and from a search of the grey literature via Google Scholar. Studies were included if they reported the radiation dose in intraoral imaging using rectangular collimation compared with any other type of collimation or the absence of it. Studies that did not involve comparison/control groups were excluded. A qualitative appraisal of the included studies was performed. The Methodological Index for NOn-Randomised Studies (MINORS) tool assessed the potential risk of bias among the studies, while the Grading of Recommendations, Assessment, Development and Evaluation (GRADE) approach determined the level of available evidence. RESULTS: Thirteen studies using different types of receptors, including D-speed film, E-speed film, phosphor storage plates (PSP) and direct digital sensors, were included. Different methods to access absorbed and effective dose by exploring distinct technical parameters, such as distance object-receptor, long- and short-cone, kVp and mA, exposure time and beam filtering, were used. High heterogeneity between the studies was found. The level of evidence was classified as moderate. The radiation dose reduction ranged from 40% to 92% compared with circular collimation. The limitations of the cross-sectional design and in vivo studies were discussed. As this systematic review applied validated tools and guidelines designed for population-based studies, the application for studies based on computer simulations and dosimetry measurements was challenging. CONCLUSION: There is moderate evidence suggesting that rectangular collimation significantly reduces radiation dose when compared with round collimation, justifying its implementation in clinical settings/private practices while taking intraoral radiographs.

Digital Intraoral Imaging Re-Exposure Rates of Dental Students.

A guiding principle of radiation safety is ensuring that radiation dosage is as low as possible while yielding the necessary diagnostic information. Intraoral images taken with conventional dental film have a higher re-exposure rate when taken by dental students compared to experienced staff. The aim of this study was to examine the prevalence of and reasons for re-exposure of digital intraoral images taken by third- and fourth-year dental students in a dental school clinic. At one dental school in Canada, the total number of intraoral images taken by third- and fourth-year dental students, re-exposures, and error descriptions were extracted from patient clinical records for an eight-month period (September 2015 to April 2016). The data were categorized to distinguish between digital images taken with solid-state sensors or photostimulable phosphor plates (PSP). The results showed that 9,397 intraoral images were made, and 1,064 required re-exposure. The most common error requiring re-exposure for bitewing images was an error in placement of the receptor too far mesially or distally (29% for sensors and 18% for PSP). The most common error requiring re-exposure for periapical images was inadequate capture of the periapical area (37% for sensors and 6% for PSP). A retake rate of 11% was calculated, and the common technique errors causing image deficiencies were identified. Educational intervention can now be specifically designed to reduce the retake rate and radiation dose for future patients.