Appraisal of the IADT fellowship - A member survey.

BACKGROUND/AIM: The International Association of Dental Traumatology (IADT) is considered the foremost authority in Dental Traumatology. Fellowship status was introduced in 2015 and is considered an international standard of excellence. The Fellowship Committee of the IADT believed it was essential to survey members seeking information on the benefits of the IADT Fellowship and potential considerations for future development. This survey aimed to explore the perceptions of members of IADT surrounding the fellowship process in terms of interest, accessibility, equality, perceived prestige, and value to the membership. MATERIAL AND METHODS: The survey was sent to 546 IADT members, of whom 89 were fellows (as of 31 July 2022) from 74 countries via an email invitation. Answers were analysed using the Chi2 and Fisher's exact test (p < .05). RESULTS: The response rate to the survey was 20.69% (n = 113), including 28 fellows (24.78%). Forty-six respondents (40.71%) were female, and 67 (59.30%) were male. Dentists identified as specialists were significantly more likely to be involved in teaching dental trauma (p = .000008). A majority of respondents (87.76%; 86/98) expressed interest in obtaining fellowship, with increased interest from more recent graduates. Learning opportunities, obtaining expertise, networking and a sense of community and prestige, were key factors in considering fellowship. There was interest in alternate pathways other than examination alone, with 60.2% of 98 respondents suggesting a combination of publications /service to IADT/ reviewer for Dental Traumatology, 57.14% suggesting the submission of case reports, and 42.86% suggesting Honorary Fellowship. Respondents (73%) were willing to participate in online discussion forums and other professional development opportunities. This preference was more notable among non-fellows (75.29%) than fellows (67.85%). CONCLUSIONS: The survey indicates the diverse motivations and perceptions regarding the IADT Fellowship, despite the low participation of IADT members. Achieving fellowship status is desired by 87.7% of non-fellows. The majority of respondents were aware of the process, but main concerns were identified as eligibility criteria and examination difficulty. Options for alternate pathways and other initiatives promoting engagement were identified. Further exploration of these issues is required to be representative of the entire IADT membership. Addressing these obstacles could significantly enhance fellowship participation and overall member satisfaction within the IADT community.

Evaluation of clinical versus non-clinical continuing education in terms of preferences and value for oral healthcare workers.

BACKGROUND: Continuing professional development (clinical) and continuing education (non-clinical) is fundamental to education and self-improvement of all categories of staff within a large healthcare facility. AIM: This study sought to examine the attendance preferences and perceived value of clinical and non-clinical oral healthcare workers towards clinical continuing professional development (CPD) and non-clinical, continuing education (CE) activities. METHODS: A retrospective cross-sectional survey design was used capturing 8640 self-reported evaluations collected across 8 successive years and 160 CPD and CE activities in a large dental hospital. Analysis was performed using descriptive statistics including mean scores, independent t-test and cross tabulations using chi-square. RESULTS: A strongly significant association (p < 0.001) was found between attendee position type (clinical or non-clinical) and attendance preference to either clinical or non-clinical education. Dental assistants, compared to Dentist/Specialist (p < 0.001) found the programs more accurate, relevant, improved their knowledge, would use what was learned and rated the sessions higher overall. Clinical CPD was deemed more relevant (p = 0.025) and improved knowledge (p = 0.01) while non-clinical CE had higher presenter quality (p < 0.001) and overall mean scores (p = 0.015). CONCLUSION: There was a preference towards attending clinical CPD over non-clinical CE, by not only clinical, but also non-clinical oral healthcare workers. Non-clinical CE was scored higher by both clinical and non-clinical participants and should therefore be considered for inclusion in CPD education programs with similar settings.

A Scoping Review of Ethical Considerations of Mandatory COVID-19 Vaccination of Healthcare Workers.

Duty of care is the core ethical responsibility of healthcare workers. Getting the workforce vaccinated will provide safety to the public, protect the vulnerable population and provide a safe working environment. While most agree that healthcare workers should be prioritised in the vaccination programme, mandatory vaccination remains a complicated and contentious issue with political, legal and ethical dimensions. This study aims to determine the ethical considerations associated with mandatory vaccinations among healthcare workers. A total of 152 abstracts were identified of which, 142 were excluded based on abstracts because they did not meet the inclusion criteria. The remaining ten articles were further evaluated with three articles that fit the inclusion criteria specifically discussing mandatory vaccination among healthcare workers and the ethical issues. Benefits, risks, effectiveness, equity and justice, autonomy, reciprocity and trust were used as a framework to discuss the ethical considerations which resonated both directly from the included papers, as well as more generally from the other literature associated with this search. There is limited literature on the topic of ethical considerations associated with COVID-19 mandatory vaccination of healthcare workers, as a systematic review identified only 3 papers. Benefits, risks, effectiveness, equity and justice, autonomy, reciprocity and trust were among the seven ethical considerations identified and discussed.

Systematic review: bioethical implications for COVID-19 research in low prevalence countries, a distinctly different set of problems.

BACKGROUND: The COVID-19 pandemic has presented extraordinary challenges to worldwide healthcare systems, however, prevalence remains low in some countries. While the challenges of conducting research in high-prevalence countries are well published, there is a paucity from low COVID-19 countries. METHODS: A PRISMA guided systematic review was conducted using the databases Ovid-Medline, Embase, Scopus and Web of Science to identify relevant articles discussing ethical issues relating to research in low prevalence COVID-19 countries. RESULTS: The search yielded 133 original articles of which only 2 fit the inclusion criteria and aim, with neither specific to low prevalence. Most of the available literature focused on clinical management and resource allocation related to high prevalence countries. These results will be discussed under the ethical dimensions of equity, individual liberty, privacy and confidentiality, proportionality, public protection, provision of care, reciprocity, stewardship and trust.. CONCLUSIONS: A systematic review failed to identify articles relating to COVID-19 research ethics, specific to low prevalence countries. It shows that there is a significant gap in the literature that warrants further investigation. Common ethical principles were used to present a distinct set of challenges experienced by a country with a low prevalence of COVID-19. This unique perspective of some of the common ethical problems surrounding research, may help guide further discussion and guide research in similar countries.

Assessment of Health Research Capacity in Western Sydney Local Health District (WSLHD): A Study on Medical, Nursing and Allied Health Professionals.

BACKGROUND: Research should inform clinical decision-making and evidence-based practice for all health professionals. To build research capacity among all health professionals, there is a need to measure the levels of research capacity and identify the gaps and needs of health-care professionals. The aim of the study was to better understand the research culture and capacity of health professionals (medical, nursing and allied health) in Western Sydney Local Health District, Sydney, Australia. METHODS: A research capacity and culture tool (RCCT) survey was electronically distributed to all health staff in WSLHD. Data were collected between November 2016 and January 2017. Participants were surveyed through a 10-point Likert scale that measured research capacity at the individual, team and organisational levels. RESULTS: A total of 393 health staff responded to the study: allied health practitioners (46.3%), nursing staff (35.4%) and medical practitioners (18.3%). Females made 76% of the sample, and 54% were aged between 35 and 54 years. Individual responses were different across professions, with an average median score for medical 6.3 (95% CI 5.8-6.9), allied health 5.3 (95% CI 4.9-5.7) and nursing 4.5 (95% CI 4.1-5.0) after adjustment for age and gender. Team responses for medical staff (average median score 5.9 95% CI 5.3-6.4) were higher than allied health (4.1 95% CI 3.7-4.6) and nursing (4.3 95% CI 3.8-4.8), after adjusting for age and gender. However, there were no differences between the three professions for the organisational responses. Allied health and nursing staff were less confident in obtaining research funding, submitting ethics applications, writing for publication and mentoring colleagues about research. CONCLUSION: This study demonstrates the individual research capacity for medical, allied health and nursing professionals are different. Research capacity building needs to be individually tailored to the specific needs of each profession. This research will inform future capacity building activities and training for health professionals in a large public health organisation of Sydney, Australia.

Why video health education messages should be considered for all dental waiting rooms.

OBJECTIVE: Video is an effective, accessible, and low cost method of delivering health education messages to a wide audience. Dental waiting rooms provide an opportunity to deliver video oral health education interventions to receptive viewers. In this study we aim to evaluate firstly video oral health education in regards to patient preference, and secondly its ability to change both immediate and sustained self-reported intended health behaviours by patients. METHOD: Data from 253 individuals from a public hospital dental waiting room were gathered using a previously validated survey following an oral health education video intervention, and analysed using descriptive analysis, Fischer's Exact Test, and Wilcoxon Signed Ranks Test across 3 time intervals. RESULTS: Participants across all ages evaluated the video oral health education approach as easy to follow and understand (p<0.001), the content practical and useful (p<0.001), and that it was a better experience (p<0.01). Those watching between 5 and 20 minutes reported that video was the best format to present oral care information (p<0.02). At follow up, significant improvement in the tools used by participants to clean teeth was seen (39.8%, p<0.001), as well as reported reduction in sweet consumption frequency (21.3%, p<0.001) and in smoking (44.8%, p<0.02). CONCLUSION: Video format oral health education used in dental waiting rooms was found to be effective in educating patients and instigating both immediate and sustained self-reported behaviour change. Significant improvement in tools used for oral hygiene and a reduction in sweets consumption were demonstrated, both of which are essential factors in reducing caries rates and improving oral health.

Evaluation of bevelled needle tip deformation with Dental Inferior Alveolar Nerve blocks.

The study aimed to investigate whether any correlation existed between bevel orientation and needle tip deformation following the administration of a standard inferior alveolar nerve block (IANB) technique during patient treatment. Ninety-three needles of a single brand were collected from a group of eleven similarly trained Australian dentists' following either single or dual insertion and bone contact. Specimens were examined under scanning electron microscopy at 500x, and both the direction of deformation (either towards or away from lumen) and the extent of deformation were calculated using image processing software. Results showed no correlation between bevel orientation and either the direction (P = 0.8787) or degree (P = 0.0752) of deformation. Significance was demonstrated, regardless of bevel orientation, following multiple needle use with respect to extent of needle tip deformation (P < 0.0001). A clinical recommendation can be made that the dental needle should be routinely replaced when subsequent injections are required during the delivery of a typical IANB.

The potential of a lecture series in changing intent and experience among health professionals to conduct research in a large hospital: a retrospective pre-post design.

BACKGROUND: Promoting research capacity within public health can encourage and engage employees to undertake research, utilising their understanding of the complex needs that exist within the public health system to provide more relevant research outcomes. Despite this, there are a number of reasons cited by health care professionals as to why research is not undertaken, and a lack of support for research participation results in missed opportunities for experienced clinical and public health staff to gain research experience, expand the evidence base, and promote and support research. The aim of this study is to identify if education in research, delivered through a series of lectures at a large tertiary referral hospital, results in an increase in the experience and intent to conduct research. METHODS: A series of six lectures to aid in the understanding and development of research were delivered to health employees, health care professionals, students and their associates within a large public Australian hospital. Following these lectures, a validated instrument was developed and asked respondents to assess their research activity, research training history, and experience in conducting research using a retrospective pre/post- test design. RESULTS: Over half (57.1%) of respondents (n = 49) reported no previous researcher education training prior to the lectures. Following the lectures, reported researcher experience increased significantly in the areas of writing a research protocol, using qualitative research methods, publishing research, writing and presenting a research report, analysing and interpreting results, using quantitative research methods, generating research ideas, and applying for research funding. At 6 months following the lecture series intent to be involved in further research was seen in the areas of submitting an ethics application, analysing qualitative and quantitative research data, and research funding applications. CONCLUSIONS: Six one hour face to face research lectures can improve self-reported levels of intention to become involved in research as well as research experience amongst hospital health care professionals at 6 months. This traditional modality of education should still be considered as relevant strategy in building research capacity as measured innovatively using a retrospective pre/post test methodology.

What are the important outcomes in traumatic dental injuries? An international approach to the development of a core outcome set.

BACKGROUND/AIMS: There are numerous treatment options following traumatic dental injury (TDI). Systematic reviews of different treatments are challenging owing to the diversity of outcomes reported between clinical studies. This issue could be addressed through the development and implementation of a agreed and standardized collection of outcomes known as a core outcome set (COS). The aim of this study was to develop a COS for TDI in children and adults. The secondary aim was to establish what, how, when and by whom these outcomes should be measured. MATERIALS AND METHOD: The project was registered with Core Outcomes Measures in Effectiveness Trials (COMET). A web-based survey was developed to capture the opinions of dentists globally as to which outcomes should be recorded. A list of outcomes was entered into a Delphi Survey and scored by an Expert Working Group (EWG). The scoring was repeated, followed by conference calls to discuss, refine and finalize the COS. The EWG split into small groups of subject-specific experts to determine how, when and by whom each outcome would be measured. RESULTS: The questionnaire was completed by 1476 dentists. The EWG identified 13 core outcomes to be recorded for all TDI's. An additional 10 injury-specific outcomes were identified. A table has been produced for each outcome detailing what, when, and how each outcome should be recorded. CONCLUSIONS: A robust consensus process was used to develop an international COS for TDI in children and adults. This includes both generic and injury-specific outcomes across all identified domains.

Effectiveness of a brief educational workshop intervention among primary care providers at 6 months: uptake of dental emergency supporting resources.

INTRODUCTION: Dental emergencies often present to primary care providers in general practice and Emergency Departments (ED), who may be unable to manage them effectively due to limited knowledge, skills and available resources. This may impact negatively on patient outcomes. Provision of a short educational workshop intervention in the management of such emergencies, including education in supporting resources, may provide a practical strategy for assisting clinicians to provide this aspect of comprehensive primary care. METHODS: This descriptive study used a validated questionnaire survey instrument to measure the effectiveness of a short multimodal educational intervention through the uptake and perceived usefulness of supporting resources at 6 months following the intervention. Between 2009 and 2010, 15 workshops, of which eight were for regional and rural hospital ED doctors, were conducted by the same presenter using the same educational materials and training techniques. A sample of 181 workshop participants, 63% of whom were in rural or remote practice and engaged in providing primary care medical services, returned responses at 6 months on the perceived usefulness of the dental emergencies resource. RESULTS: Thirty percent of clinicians had used the dental emergencies resource within the six-month follow-up period. Significance was demonstrated between professional category and use of the resource, with emergency registrars utilising this resource most and GPs the least. The Dental Handbook, specifically designed for ED use, and tooth-filling material contained within this resource, were deemed the most useful components. There were overall positive open-ended question responses regarding the usefulness of the resource, especially when it was made available to clinicians who had attended the education workshops. CONCLUSION: Utilisation and perceived usefulness of a supporting resource at 6 months are indicators of the effectiveness of a short workshop educational intervention in the management of dental emergencies by primary care providers. This education may have greater relevance to rural and remote practice where dental services may be limited.

Managing dental emergencies: a descriptive study of the effects of a multimodal educational intervention for primary care providers at six months.

BACKGROUND: Clinicians providing primary emergency medical care often receive little training in the management of dental emergencies. A multimodal educational intervention was designed to address this lack of training. Sustained competency in managing dental emergencies and thus the confidence to provide this care well after an educational intervention is of particular importance for remote and rural healthcare providers where access to professional development training may be lacking. METHODS: A descriptive study design with a survey instrument was used to evaluate the effectiveness of a brief educational intervention for primary care clinicians. The survey was offered immediately before and at six months following the intervention. A Wilcoxon signed rank test was performed on pre and six month post-workshop matched pair responses, measuring self-reported proficiency in managing dental emergencies. The level of significance was set at p < 0.001. Confidence intervals (CI) were calculated for participants who scored an improved proficiency. RESULTS: The educational intervention was associated with a significant and sustained increase in proficiency and confidence to treat, especially in oral local anaesthesia, management of avulsed teeth and dental trauma, as reported by clinicians at six months after the education. This was associated with a greater number of cases where dental local anaesthesia was utilised by the participants. Comments from participants before the intervention, noted the lack of dental topics in professional training. CONCLUSIONS: The sustained effects of a brief multimodal educational intervention in managing dental emergencies on practice confidence and proficiency demonstrates its value as an educational model that could be applied to other settings and health professional groups providing emergency primary care, particularly in rural and remote settings.

Can a four-hour interactive workshop on the management of dental emergencies be effective in improving self reported levels of clinician proficiency?

BACKGROUND: Management of dental emergencies is a clinical problem facing many primary care providers who have often received little training in this area. AIM: This study evaluated the impact of a four-hour interactive workshop on clinicians' self reported proficiency in managing common dental emergencies. METHOD: A descriptive study design using a questionnaire type survey instrument was used to evaluate the effectiveness of a brief interactive workshop. RESULTS: The workshop positively impacted proficiency, especially in oral local anaesthesia, management of avulsed teeth and dental trauma. Open comments from participants focused on the lack of dental topics in professional training. RECOMMENDATIONS: Further education is required in the management of dental emergencies such as odontogenic infections, dental local anaesthesia, trauma, intra-oral haemorrhage and in dental nomenclature. CONCLUSIONS: An effective interactive workshop intervention employing blended instructional techniques may help improve the management of dental emergencies and patient outcomes.

Management of dental emergencies by medical practitioners: recommendations for Australian education and training.

Dental emergencies commonly present to EDs and primary care consultations. The medical practitioner is often ill-prepared in the primary management of dental emergencies because of a lack of education in this field of practice. A published work review covering the nature, incidence, education and training surrounding this topic is presented together with recommendations for Australian practice.