Assessing the application of knowledge in clinical problem-solving: The structured professional reasoning exercise.

INTRODUCTION: Clinical reasoning is a fundamental and core clinical competence of healthcare professionals. The study aimed to investigate the utility of the Structured Professional Reasoning Exercise (SPRE), a new competence assessment method designed to measure dental students' clinical reasoning in simulated scenarios, covering the clinical areas of Oral Disease, Primary Dental Care and Restorative Dentistry, Child Dental Health and Dental Practice and Clinical Governance. MATERIALS AND METHODS: A total of 313 year-5 students sat for the assessment. Students spent 45 minutes assimilating the scenarios, before rotating through four pairs of 39 trained examiners who each independently assessed a single scenario over a ten-minute period, using a structured marking sheet. After the assessment, all students and examiners were invited to complete an anonymous perception questionnaire of the exercise. These questionnaires and the examination scores were statistically analysed. RESULTS AND DISCUSSION: Oral Disease showed the lowest scores; Dental Practice and Governance the highest. The overall Intraclass Correlation Coefficient (ICC) was 0.770, whilst examiner training helped to increase the ICC from 0.716 in 2013 to 0.835 in 2014. Exploratory factor analysis revealed one major factor with an eigenvalue of 2.75 (68.8% of total variance). The Generalizability coefficient was consistent at 0.806. A total of 295 students and 32 examiners completed the perception questionnaire. Students' lowest examination perceptions were an "Unpleasant" and "Unenjoyable" experience, whilst the highest were "Interesting", "Valuable" and "Important". The majority of students and examiners reported the assessment as acceptable, fair and valid. CONCLUSION: The SPRE offers a reliable, valid and acceptable assessment method, provided it comprises at least four scenarios with two independently marking and trained assessors. 3.

The influence of splinting procedures on the periodontal and peri-implant tissue damping characteristics. A longitudinal study with the Periotest device.

The aim of the present study was to evaluate the capability of the Periotest device in detecting and monitoring functional changes in the periodontal as well as in the pari-implant damping characteristics. In the first part of this study, 107 teeth were splinted by means of 40 full acrylic fixed prostheses (AFP) and another 37 teeth were splinted by means of 14 ceramometallic fixed prostheses (C-MFP). The Periotest measurements of individual teeth were done the day the fixed prostheses were cemented temporary (PTV 1), and again after a mean observation period of 27.4 days (PTV 2). In the 2nd part, 78 osseointegrated two-stage implants were splinted by means of 23 full acrylic fixed prosthesis (AFP) and other 18 implants were left without it. Using the same abutment length, Periotest measurements were performed, at abutment connections and before installation of the final prosthesis. In a 3rd part, using both implants and teeth as abutments, 29 osseointegrated implants were connected with 25 abutment teeth by means of 7 AFP. The measurements were performed at the beginning of the prosthetic treatment and 2, 4 and 6 weeks later. After splinting teeth by means of AFP for the observation period, no statistically significant reduction in PTVs was found. When on the other hand, a C-MFP was used, PTV 2 showed a significant reduction. The PTVs at abutment connection went down after a period of time, during which some implants were interconnected by means of an AFP and others were not.(ABSTRACT TRUNCATED AT 250 WORDS)