Pro-CAD: una alternativa para profesionalizar al personal auxiliar del odontólogo / Pro-CAD: a professionalizing alternative for the dentist's auxiliary staff

El presente artículo es el resultado de una investigación orientada a la implantación de un modelo educativo, que sustenta una propuesta para la capacitación de recursos humanos de apoyo técnico en el campo de la salud. Para este propósito se denominaron: Asistentes Dentales a quienes son el personal auxiliar que se desempeña con profesionales que ejercen la odontología en forma privada en México, y que no cuentan con escuelas para su formación, considerando sus diferencias individuales e involucrando las áreas cognoscitiva (conocimientos), psicomotriz (habilidades y destrezas) y afectiva (comportamientos). Los recursos humanos compiten fuertemente por encontrar un espacio de desempeño en un mercado altamente exigente, razón por la cual el eje principal de la investigación se fundamentó en el planteamiento del Consejo Normalizador y Certificador de Competencias Laborales (CONOCER). El modelo fue diseñado durante la formación doctoral, enmarcado en la línea de innovación curricular para la calidad total como consecuencia del interés personal por evaluar las competencias del personal auxiliar que se desempeña apoyando al gremio de la odontología; la población está organizada en un colegio local de profesionales filial a la Asociación Dental Mexicana. Se utilizó el método mixto, y la herramienta para recolección de datos fue la encuesta, misma que aportó información relevante para construir una propuesta denominada modelo Pro-CAD (Programa de Capacitación Asistente Dental), que se incluye brevemente al final de este artículo (AU)

This article is the result of research aimed at the implementation of an educational model, which supports a proposal for the training of human resources of technical support in the field of health. For this purpose they were called: Dental Assistants, who are the auxiliary staff who work with professionals who practice dentistry privately in México, and who do not have schools for their training considering their individual differences and involving the cognitive areas (knowledge), psychomotor (skills and skills), affective (behaviors). Human resources compete strongly to find a performance space in a highly demanding market, which is why the main focus of the research was based on the approach of the Standardizing Council and Labour Skills Certificater (CONOCER). The model was designed during my doctoral training framed in the line of curriculum innovation for total quality as a result of the personal interest in evaluating the work skills of the auxiliary staff who perform supporting the dental guild, the population is organized in a local college of professionals affiliated with the Mexican Dental Association. The mixed method was used, and the data collection tool was the survey, which provided relevant information to build a proposal called the Pro-CAD (Dental Assistant Training Program) model that is briefly included at the end of this article (AU)

Interprofessional Education Perceptions of Dental Assisting and Radiologic Technology Students Following a Live Patient Experience.

Health professions students are often unaware of other health care providers' roles or professional expertise due to most education taking place within their single profession. This pattern may be even more prevalent for baccalaureate and associate degree programs since most interprofessional education (IPE) occurs in predoctoral programs and, when IPE is incorporated into allied health professions education, it often utilizes simulation instead of live patient experiences. The aim of this study was to determine if radiologic technology and dental assisting students' perceptions changed regarding interprofessional practice and teamwork after an IPE activity with actual patients. The participants were students in the University of Southern Indiana (USI) radiologic technology and dental assisting programs. This mixed-methods pilot study conducted in 2017 collected quantitative and qualitative data from pre and post surveys, the researchers' observations of student interactions during live patient assessment and acquisition of panoramic images, and large-group discussion. Twenty-five of the 26 students who participated in the IPE program completed both pre and post surveys, for a 96% response rate. The results showed significant differences in the participants' perceptions from the pre to post surveys on a wide variety of survey items. Most notable were the positive changes in perceptions related to trust in judgment of others within their profession (p=0.001), relationships with other professions (p=0.002), and thinking highly of other professions (p=0.002). Overall, this study found that incorporating the IPE activity with a live patient into these radiologic technology and dental assisting programs improved the students' perceptions of other allied health professionals. Future research should include more participants to increase sample size and add quantitative data collection.

Evidence-based dentistry can effectively be taught to dental care professional students - A mixed methods study.

BACKGROUND: Little research exists in the teaching of evidence-based dentistry (EBD) to students in the fields of dental hygiene, dental nursing and orthodontic therapy. This study aims to analyse the effect of a 1-day EBD programme on knowledge and confidence whilst also gaining insight into students' experience of the intervention. METHOD: A mixed methods study was utilised with explanatory sequential design. The population consisted of dental hygiene (DH), dental nursing (DN) and orthodontic therapy (OT) students (N = 44). The intervention consisted of a 1-day active learning EBD programme, delivered via group projects and lectures. In the initial quantitative phase, a standardised questionnaire pre- and post -intervention measured changes in confidence for all participants, whilst change in knowledge was measured for DH and OT students only. Following this, focus groups were scheduled for all members of each discipline 3 months post-intervention for DN and 2 months post-intervention for DH and OT students. Semi-structured focus group schedules were drawn up, and groups organised according to the outcomes of quantitative data analysis. Qualitative results were analysed using a deductive adaptation of Burnard's thematic content analysis. RESULTS: Forty-two students took part (94.45%) in this study. Median knowledge scores increased from zero to two of five (P < .001), whilst median confidence score doubled from four to eight of eight (P < .001). Results of thematic content analysis were coincident with quantitative results; however, it also provided constructive feedback regarding design and content of the course. CONCLUSIONS: A 1-day bespoke programme in EBD increased students' confidence and knowledge in EBD skills. However, the findings further suggest that two successive half-day training sessions instead of one full-day training, tied in with coursework that requires the application of the acquired skills, may increase the learning experience further.

Perception of simulation training in emergencies for dental sedation practitioners.

BACKGROUND: Simulation education is an important part of health care education and training. There is growing evidence to support the usefulness of simulation, especially in training for infrequently occurring situations, such as medical emergencies seen by dental practitioners. There are, however, few data on the longer term effects of simulation, including usefulness, relevance, emotional effect and ability to affect changes to daily practice. METHODS: Dentists and dental nurses who had undergone simulation training in medical emergencies for dental sedation practitioners undertook a semi-structured interview about their perception of the simulation experience. They explored recollection of the experience and its emotional weight, perception of usefulness and relevance, specific learning outcomes and changes to practice prompted by the simulation session. RESULTS: Participants reported finding the simulation sessions worthwhile, realistic, challenging and almost universally emotionally positive. In situ simulation training was particularly well received, both in terms of realism, as well as identifying system flaws in emergency drugs and equipment. Participants reported gaining both increased clinical knowledge and human factors skills, which were reflected in subsequent changes to their practice. There are few data on the longer term effects of simulation DISCUSSION: Our results support the usefulness and applicability of simulation education to training in medical emergencies for dental sedation practitioners. In particular, specific benefits reported from in situ sessions and in human factors concepts will prompt us to review the structure of our teaching to maximise the benefit to participants.

The Evolution of the Dental Assisting Profession.

The objectives of this article are to describe the dental assistant's role in the dental delivery system; assess the educational structure of the dental assisting profession; and project factors likely to impact the future role of the dental assistant. The article summarizes the current status and trends of the dental assisting profession including general responsibilities, credentialing, and regulation. An overview of the workforce and parameters of employment is provided with a description of the broad scope of practice, education, and licensure options, which vary by state. Existing academic models and enrollment trends in accredited dental programs are included, as are the strengths and weaknesses of the current educational system. Multiple factors may impact the future of this profession. To address the anticipated increase in the demand for and responsibilities of dental assistants, curricular revisions will be needed to prepare for implementation of interprofessional care models in which dental assistants will play a vital role. Well-educated dental assistants will be needed to support viable models of dental care and wellness in the U.S. Enhanced career opportunities and varied employment environments may increase job satisfaction and practice longevity. As protection of the public is of the utmost importance in the dental profession, this evolving dental clinician must be formally educated in all aspects of clinical practice and be permitted to perform delegated patient care, as legally allowed by their states. This article was written as part of the project "Advancing Dental Education in the 21st Century."

Does stress in a dental hygiene and dental therapy undergraduate programme contribute to a sense of well-being in the students?

Aims To use a qualitative approach to further explore the stress and well-being of dental hygiene and dental therapy students (DHDTS) during their undergraduate training.Subjects and methods Semi-structured individual interviews to explore motivation, goals, and perceived stress, were conducted with eight DHDTS from across all three years of study at the University of Portsmouth Dental Academy (UPDA). Thematic analysis of the data was undertaken using Braun and Clarke's (2006) six phases of thematic analysis.Results Three main themes of 'fulfilment', 'the learning environment', and 'perception of stress' were identified. Within these themes, a further 12 sub-themes were identified. Analysis suggested that a strong sense of passion to become a clinician mitigated most, but not all, of the stressful experiences of the DHDTS undergraduate learning environment.Conclusions DHDTS' perceived sources of stress during their undergraduate programme were strongly linked to a sense of meaningfulness.Listen to the author talk about the key findings in this paper in the associated video abstract. Available in the supplementary information online and on the BDJ Youtube channel via http://go.nature.com/bdjyoutube.

Challenges of Dental Assisting Students in Their Pursuit of Academic Success.

The aim of this study was to identify the challenges encountered by dental assisting students, especially those from underrepresented racial and ethnic groups (UREG), that affected their achieving academic success. In 2016, directors of the nine northern California dental assisting programs were contacted via email to explain the study and request an opportunity to administer the 26-item survey to their currently enrolled students. Student responses were entered into a survey research program, which tabulated the data and calculated the frequency of responses to each item. All nine programs participated, and the overall student response rate was 98%. Most (71%) of the 215 respondents agreed that they had experienced challenges in achieving academic success. Respondents reported the following challenges that made it difficult to perform well at school: financial responsibilities (41%), family responsibilities (33%), and language challenges (21%). These challenges, as well as difficulty understanding the language and vocabulary of instructional materials and cost of tuition and supplies, were statistically related to respondents' perceptions of their challenges to academic success. Most (83%) of the respondents perceived that faculty members supported their academic success. One-third of the respondents were from UREG: Hispanic, African American, and Native American. Higher percentages of UREG than non-UREG participants worked more hours/week (p=0.03) and tended to perceive financial (52%/32%) and family (42%/28%) responsibilities as challenges. Since both UREG and non-UREG respondents experienced these challenges, all students should be informed of institutional and programmatic resources that can assist them in achieving academic success.

A randomized controlled trial of cluster audit and feedback on the quality of dental sealant for rural schoolchildren.

THE OBJECTIVE: To examine whether audit and feedback could improve the quality of the application of dental sealant in rural Thai school children. RESEARCH DESIGN: A single blind, cluster randomized controlled trial was conducted. CLINICAL SETTING: Hospital-based and school-based school sealant applied by dental nurses in Southern province of Thailand. PARTICIPANTS: Dental nurses and school children who received dental sealant were involved. INTERVENTION: The intervention consisted of confidential feedback of data and tailor-made problem-solving workshops. MAIN OUTCOME MEASURES: Sealant quality was measured by sealant retention and caries on sealed surfaces at six-month after sealing. The teeth examinations were done among different groups of children prior and after the intervention. RESULTS: After the intervention, the sealant retention rate increased dramatically in the intervention group, whereas in the control group the rate was similar to that found at baseline. The rate of caries after the intervention was stable in the intervention group and increased slightly in the control group. At the beginning of the study, the adjusted odds ratio of complete sealant retention between the intervention and control group was 0.47 which increased to 1.99 at the end of the study. However, no effect on caries on sealed surfaces was observed. CONCLUSIONS: The intensive focus on actual problems during the audit and feedback improved the dental nurses' performance and the quality of the dental service, although it had no statistical impact on the incidence of caries.

Assessing Faculty Development Needs among Florida's Allied Dental Faculty.

PURPOSE: Professional schools rarely prepare prospective academic faculty for the responsibilities of college and university teaching. Without this training, faculty are often left to discover on their own and to varying degrees of success what is expected of them once they enter the academy. At the same time, universities and colleges recognize that retention of faculty depends on the successful transition of academics into the related roles and responsibilities of the professoriate. The purpose of this study was to assess the faculty development needs among allied dental faculty, specifically the state of Florida's dental hygiene and dental assisting faculty, by measuring the following: the relationship between their knowledge and priorities for further training, their level of satisfaction with current faculty development opportunities and mentoring, and their perceptions of what additional training and resources might advance their careers. METHODS: Two hundred and four full-time and part-time faculty were invited to participate in this survey research study. McNemar's test for paired binary data was used to analyze the level of agreement between knowledge and indicated priority. Responses to open ended questions were coded and categorized thematically. RESULTS: There were 115 responses (n=204, 74%). There were statistically significant differences between participants' ratings of knowledge and priorities for further training on many items related to teaching, scholarship and leadership skills. Participants also identified 5 categories of unmet needs. CONCLUSION: The findings suggest that universities and colleges need to offer learning experiences aimed at strengthening the teaching, scholarship and leadership skill needs of their allied dental faculty. Additionally, professional schools might consider offering a program track that provides prospective allied dental faculty with the types of opportunities that develops teaching, scholarship and mentoring skills prior to graduation.

Interprofessional Education in U.S. Dental Hygiene Programs: A National Survey.

Although there are many benefits of interprofessional health care, no previous research has sought to define the status of interprofessional education (IPE) in U.S. dental hygiene programs. The aims of this study were to assess how these programs engage in IPE, the challenges they encounter, and the value they place on IPE. Additionally, the study explored how program characteristics are related to IPE. Data were collected with a web-based survey sent to all 322 U.S. dental hygiene program directors (response rate: 33% of the 305 successfully contacted). The majority of the responding programs were located at institutions with nursing (90%) and other allied health programs (85%). They were likely to collaborate with nursing (50%), other allied health (44%), and dental assisting programs (41%), but were less likely to collaborate with dental schools (28%). IPE was most likely to occur in volunteer activities (68%), basic science courses (65%), and communication training/behavioral science courses (63%/59%). The most frequently reported challenges for IPE were schedule coordination (92%) and curriculum overload (76%). The majority of the respondents agreed that IPE was a priority for the dental hygiene profession in the U.S. (59%) and for the program directors personally (56%). Programs granting bachelor degrees were more likely to have IPE as a priority than programs that did not grant such degrees (scale of 1-5 with 5=most important: 3.81 vs. 2.88; p<0.01). The longer the students spent in the programs, the more those programs engaged in IPE (r=0.21; p<0.05). The data collected in this study can contribute to future efforts to help dental hygiene programs engage in meaningful IPE and contribute to developing interprofessional care in the U.S. health care system.

Dental and allied dental students' attitudes towards and perceptions of intraprofessional education.

Interprofessional and intraprofessional learning opportunities in health professions education are vital to emphasize evidence-based practice, quality improvement, and cost-effectiveness in patients' oral health care. The aim of this study was to assess dental, dental hygiene, and dental assisting students' readiness for intraprofessional education and to evaluate their attitudes towards and perceptions of intraprofessional teamwork, communication, respect, and understanding of professional roles. In 2013, students at one dental school (N=247) were surveyed, and focus groups were conducted for this convergent parallel mixed-methods study. Survey response rates were as follows: senior dental students 54.4% (N=43), senior dental hygiene students 100% (N=32), dental assisting students 95% (N=19), junior dental students 51.8% (N=42), and junior dental hygiene students 100% (N=33). The results showed that the dental hygiene students had more positive responses about intraprofessional education than the dental and dental assisting students (p<0.05). Most (94%, N=160) of the respondents in the combined groups agreed that intraprofessional learning would help them become more effective members of the oral health care team. The three focus group sessions (N=17) revealed consistency among the groups regarding the value of an integrated clinical design and intraprofessional education. These students were eager and positive about intraprofessional learning and agreed that a shared learning model can improve communication and respect among team members, provide a better understanding of roles, and ultimately enhance patient care.

Tobacco dependence education in U.S. Dental assisting programs' curricula.

The aim of this study was to assess the level of tobacco dependence education (TDE) in the curricula of U.S. dental assisting programs and to compare the findings to those from a similar assessment of dental hygiene curricula. In the 2012-13 academic year, a 51-item survey was sent to directors of all 298 accredited dental assisting programs. Assessed were curricular TDE content, time spent on each topic, expected levels of clinical competence, and resources used. Of the 298 potential participants, 89 programs returned completed surveys, for a response rate of 30%. Of the 13 TDE-related content areas, those most often covered were oral disease related to tobacco use (100%) and general diseases related to tobacco use (93%); those least often covered were stages of (behavior) change (29%), how to develop a comprehensive tobacco intervention program in a private office setting (23%), and strategies for community-based tobacco control (22%). Responding program directors indicated the following levels of tobacco cessation intervention at which students should demonstrate competence: brief, 44%; moderate, 55%; intensive, 8%. Less than half of the reporting programs conducted a formal assessment of clinical competence in any TDE-related skills; however, skills in assessing patient tobacco use and associating head and neck findings to tobacco use were formally or informally assessed by 74% and 61%, respectively. Compared to dental hygiene programs, TDE appeared to play a smaller role in the curricula of dental assisting programs, and dental assisting programs were less likely to formally assess clinical competence in TDE.

Survey of Australian oral health practitioners and their smoking cessation practices.

BACKGROUND: Smoking is a significant health and economic burden in Australia. Studies of smoking cessation practices in dental settings have primarily concentrated on dentists rather than other oral health practitioner (OHP) groups (dental hygienists, dental therapists and oral health therapists). The aim of this study was to measure Australian OHPs' attitudes, behaviours, interest and barriers to delivering smoking cessation interventions. METHODS: Members of the two peak professional bodies representing Australian OHPs were invited to participate in an anonymous online questionnaire. RESULTS: There were discrepancies between practitioner attitudes and current smoking cessation practices. While the majority of practitioners (90.1%) frequently screened for smoking behaviour, fewer (51.1%) assisted patients to quit smoking. The principal form of assistance was referral to Quitline (45.7%) or to a general medical practitioner (44.4%). The most prevalent barriers identified were lack of knowledge of pharmacological treatments (45.8%) and lack of access to smoking cessation resources (44.2%). Contrary to international studies, time and financial incentive were not commonly cited barriers to delivering smoking cessation interventions. CONCLUSIONS: This survey identifies a need for continuing education in smoking cessation practice. Dissemination of policies, guidelines and resources may assist OHPs to become more engaged and confident in delivering smoking cessation interventions as part of their routine practice.

Communication skills for extended duties dental nurses: the childsmile perspective.

Good communication and influencing skills are key competency areas for dental nurses and are highly relevant when working with children and their families/carers in Childsmile, a national oral health improvement programme for children in Scotland. The General Dental Council (GDC) identifies communication skills as one of the nine principles for registrants; a large number of complaints seen by the GDC relate to allegations around communication and patient expectations not being fully met. Much time and investment has been spent in researching the role of the Extended Duties Dental Nurse (EDDN) and ensuring appropriate training is provided. While there is specific training for EDDNs delivering the Childsmile programme, the programme appreciates that good communication skills are a core component of all training programmes for dental nurses. This paper sets out to explore the role of EDDNs in Childsmile and specifically looks at the importance of good communication skills and how it facilitates and impacts on the delivery of the Childsmile programme in a variety of settings.

Extending dental nurses' duties: a national survey investigating skill-mix in Scotland's child oral health improvement programme (Childsmile).

BACKGROUND: Childsmile is Scotland's national child oral health improvement programme. To support the delivery of prevention in general dental practice in keeping with clinical guidelines, Childsmile sought accreditation for extended duty training for dental nurses to deliver clinical preventive care. This approach has allowed extended duty dental nurses (EDDNs) to take on roles traditionally undertaken by general dental practitioners (GDPs). While skill-mix approaches have been found to work well in general medicine, they have not been formally evaluated in dentistry. Understanding the factors which influence nurses' ability to fully deliver their extended roles is necessary to ensure nurses' potential is reached and that children receive preventive care in line with clinical guidance in a cost-effective way. This paper investigates the supplementation of GDPs' roles by EDDNs, in general dental practice across Scotland. METHODS: A cross-sectional postal survey aiming to reach all EDDNs practising in general dental practice in Scotland was undertaken. The survey measured nurses': role satisfaction, perceived utility of training, frequency, and potential behavioural mediators of, preventive delivery. Frequencies, correlations and multi-variable linear regression were used to analyse the data. RESULTS: Seventy-three percent of practices responded with 174 eligible nurses returning questionnaires. Respondents reported a very high level of role satisfaction and the majority found their training helpful in preparing them for their extended role. While a high level of preventive delivery was reported, fluoride vanish (FV) was delivered less frequently than dietary advice (DA), or oral hygiene advice (OHA). Delivering FV more frequently was associated with higher role satisfaction (p < 0.001). Those nurses who had been practising longer reported delivering FV less frequently than those more recently qualified (p < 0.001). Perceived difficulty of delivering preventive care (skills) and motivation to do so were most strongly associated with frequency of delivery (p < 0.001 for delivery of FV, DA and OHA). CONCLUSIONS: This study has provided insight into EDDNs' experiences and demonstrates that with appropriate training and support, EDDNs can supplement GDPs' roles in general dental practice in Scotland. However, some barriers to delivery were identified with delivery of FV showing scope for improvement.