Acceptance of systematic reviews as Master/PhD theses in Brazilian graduate programs in dentistry.

OBJECTIVE: This study aimed to evaluate whether a master and PhD thesis in Brazilian graduate programs in dentistry can be based on a systematic review (SR). METHODS: In this cross-sectional study, we surveyed the coordinators of Brazilian graduate programs in dentistry using a self-administered questionnaire including questions about whether an SR meets requirements for approval of a master or PhD thesis, instructions regarding how to use an SR as the method for a master or PhD thesis, and reasons and barriers that SRs were not recognized as acceptable for a master or PhD thesis. The responses were analyzed descriptively, and tables and graphs were created to summarize the data. RESULTS: Among 101 graduate programs invited to participate in the study, 38 (37.6%) returned the questionnaire. Over three-quarters of surveyed programs (n = 30, 78.1%) answered that SRs, in whole or in part, meet the criteria for a master or PhD thesis. Likewise, most programs answered that a master or PhD thesis could be exclusively based on an SR (n = 28, 73.7%). The same number of programs pointed out that one possible reason for not recognizing SRs as a master or PhD thesis is either the lack of SR expertise among committee members (n = 28, 73.7%) or the lack of adequate training of candidates in SR methodology (n = 26, 68.4%). CONCLUSIONS: SRs are well accepted as a master or PhD thesis by Brazilian graduate programs in dentistry. Educational initiatives should be encouraged to promote understanding of SR methodology and increase acceptance among graduate programs worldwide.

Life satisfaction of Taiwanese dental graduates received residencies in the U.S.: a cross-sectional study.

BACKGROUND: Each year, more than 200 international dental graduates start U.S. specialty trainings to become specialists. It is unknown if their life satisfaction is associated with any dental career-related factor before residencies (e.g. dental school class rank, research experience, or private practice experience) and after residencies (e.g. staying in the U.S., teaching status, workplace, or board certification). This cross-sectional study aimed to identify these potential factors by surveying Taiwanese dental graduates who pursued U.S. residencies. METHODS: Life satisfaction was measured with a structured questionnaire, Satisfaction With Life Scale (SWLS), which includes five statements on a 5-point Likert scale. Online surveys were sent out to 290 Taiwanese dental graduates who were known to pursue U.S. residencies. T-test, one way analysis of variance, and multivariable adjusted generalized linear model (GLM) were used to assess the differences of mean SWLS scores from different variables. RESULTS: Surveys were completed by 158 dentists. Mean SWLS score of 125 specialists was higher (p = 0.0007) than the score of 33 residents. For the 125 specialists, multivariable adjusted GLM demonstrated better life satisfaction was positively associated with multiple independent factors, such as having research experience, being ranked in the top 26 ~ 50% of the class in dental school, starting U.S. residency within 4 years after dental school, starting residency before year 1996, and specializing in endodontics (vs. periodontics). Life satisfaction was not associated with any factors after residency (e.g. staying in the U.S. afterwards, teaching status, or workplace), but better mean life satisfaction score was significantly associated with being American specialty board certified (p < 0.001) for the specialists in the 26 ~ 75% of their class in dental school. For the 33 residents, better mean life satisfaction score was associated with better dental school class rank in both bivariate (p = 0.020) and multivariable adjusted GLM (p = 0.004) analyses. CONCLUSIONS: The life satisfaction of Taiwanese dental graduates pursuing U.S. residencies might be associated with some professional factors, such as research experience, dental school class rank, residency timing, specialty type, and specialty board certification. We hope our results may provide some objective information on making career decisions for international dental graduates/students who are preparing for U.S. residency.

Predicting professional school performance with a unique lens: are there other cognitive predictors?

BACKGROUND: We investigated the associations between admissions criteria and performance in four cohorts of pre-dental MS in Oral Health Sciences (OHS) program at Boston University Schools of Medicine and Dental Medicine. Previously we have reported that OHS serves as a successful pre-dental pipeline program for students from underrepresented groups. METHODS: We evaluated academic variables that further affect overall graduate GPA and grades in the first year dental school courses taken by OHS students at Boston University between 2012 and 2016 as part of the MS curriculum. Demographic data, region of residency, undergraduate grade point average, number of science and math credits, major of study, dental admissions test scores and undergraduate institution were collected. The competitiveness of the undergraduate institution was scored based on Barron's Profiles of American Colleges. OHS-GPA was assessed and individual grades in two first year dental school courses taken as part of the OHS curriculum were collected. Analysis of variance, the Chi-square test and Fisher's Exact test were utilized to assess associations between academic performance parameters, successful program completion and matriculation to dental school. RESULTS: Results indicate that undergraduate major, age and number of science course credits taken had no impact on MS performance in the Boston University MS in Oral Health Sciences program; however, students who took an undergraduate course in Physiology performed better than those who did not (p = 0.034). This was not the case with courses in Cell Biology and Biochemistry. Students with DAT scores over 20 academic average (p = 0.001), 18 total science average (p = 0.001) and 22 reading comprehension (p = 0.004) performed better in dental school courses taken in OHS. CONCLUSION: We report that strong test scores, attending a mid or highly rigorous undergraduate institution and completion of an undergraduate Physiology course are positive predictors. We hope these findings will guide admission's decisions and improve recruitment to, and future success of, graduate student's pursuit of professional school. Understanding alternative predictors of success may help to reduce the intrinsic bias among applicants from underrepresented groups and continue to look beyond the DATs (or MCATs) to decrease the gap between professionals from underrepresented groups and those they serve.

Knowledge and beliefs regarding temporomandibular disorders among orthodontists.

INTRODUCTION: This project was undertaken to accomplish 2 objectives: (1) to identify whether there is a discrepancy between orthodontists and experts in temporomandibular disorders (TMD) related to diagnosis and treatment of TMD patients, and (2) to influence the manner in which TMD curricula are taught in orthodontic residency programs, better preparing future orthodontic specialists to diagnose and treat (and refer) patients with TMD. METHODS: A survey invitation was e-mailed to 8870 members of the American Association of Orthodontists. Items were answered on a 6-point scale (0 = I don't know; 1 = strongly disagree; 2 = disagree; 3 = neutral; 4 = agree; 5 = strongly agree). A group consensus was attributed when more than 50% of the orthodontists supported a response. Previously published responses of TMD experts were used as a reference to evaluate the orthodontists' responses. Comparisons between the responses from the 2 groups were assessed using a z-test. RESULTS: Among the participants who responded to the questionnaire, 148 were residents, 1132 were private practitioners, and 61 were full-time faculty. Sixty-two percent of the participants did not think they received enough training in TMD during their orthodontic residency. Although 62% of participants indicated that they feel comfortable diagnosing TMD patients, 50.2% do not feel comfortable treating TMD patients. There was no significant difference between the 2 groups' responses under one-third of the questions. CONCLUSIONS: It is clear that orthodontic residencies in the U.S. need to improve methods of teaching TMD concepts. Although most orthodontists feel comfortable diagnosing TMD patients, less than half feel comfortable treating those patients, and the difference in responses with the TMD expert group was significant in 71% of the questions.

Characteristics of an excellent orthodontic residency program.

INTRODUCTION: Although unquantifiable features, such as faculty passion and dedication to teaching, play a vital role in defining the quality of residency education, determinable features that are fundamental to the definition of a "top tier" orthodontic residency program also exist. The objective of this study was to identify those features. METHODS: A survey with 32 items was developed and validated to assess the features of an excellent orthodontic program based on the following 3 major domains: faculty, education, and resident/graduate student/alumni. The survey was sent to 62 orthodontic residency programs in the United States. RESULTS: Thirty-nine programs (63%) completed the survey. Recurring attributes that were identified in what constitutes an excellent program included the following: an adequate number of full-time clinical orthodontic faculty, with each member providing 1 day per week clinic coverage. The average of all respondents was 4, and the range was 1-6; a healthy mix of part-time faculty members with ≥1 full-time faculty member who monitors every clinical session; 80% full-time faculty members who are American Board of Orthodontics (ABO) certified; a craniofacial faculty member; 4 residents/graduate students per each faculty member who covers a clinical session; resident/graduate student exposure to a wide range of treatment modalities and appliances; approximately 70 new case starts per resident/graduate student (50%-60% of patients who are started are debonded by the starting resident/graduate student); patients with craniofacial anomalies and orthognathic surgery patients should be started by each resident/graduate student; 1.5 operatory chairs per resident or graduate student; 1 dental assistant per 4 residents/graduate students; 1 laboratory person; 1 receptionist/secretary per 4 residents; 100% of residents/graduate students successfully completing ABO written examination upon graduation; 60% of residents/graduate students obtaining ABO certification within 5 years of graduation; 50% of residents/graduate students presenting at national meetings would be ideal; and 50% of living alumni contributing financially to the department during the past 5 years. CONCLUSIONS: Based on the responses from the majority of the US orthodontic residency programs, this study has identified certain features that educators feel are ideal for an excellent orthodontic program.

Instructional design of a clinical photography course for undergraduate dental students.

Clinical and dental photography is an acquired skill. It is learned, developed and practised at post-graduate level by medical photographers across the U.K. But where does the medical photography profession stand in terms of transmitting slowly acquired skills to a wider clinical audience? If some or all skills need to be passed on, how and to whom should they be taught? This paper considers how dental practitioners may benefit from training in specific aspects of clinical photography and suggests a tried and tested model of instructional design for a clinical photography course utilised and implemented for undergraduate dental students studying at the University of Leeds. The authors found a course of this nature demanded skills and theoretical understanding of cognitive architecture beyond the purview of most clinical field experts. A collaborative approach to instructional design between a field expert and clinical educator was implemented, which allowed the design of a dental photography course that worked effectively by linking new to prior knowledge.

Expert Consensus on Growth and Development Curricula for Predoctoral and Advanced Education Orthodontic Programs.

Dental students and orthodontic residents must demonstrate competence in various areas prior to graduation. However, the Commission on Dental Accreditation (CODA) definition of competence is broad. The aims of this study were to obtain expert consensus on Growth and Development topics and subtopics in predoctoral and advanced education programs in orthodontics and to determine the level of cognition on the subtopics necessary to demonstrate learner competence. A modified Delphi method with a consensus threshold of 70% was used. In Round One, academic orthodontists who met the expert panel inclusion criteria were surveyed to determine whether a topic was necessary to the curricula. Round Two identified the subtopics under each topic and the level of cognition necessary to demonstrate learner competence using Bloom's taxonomy, which defines the ascending levels of remember, understand, apply, analyze, evaluate, and create. Round Three involved analyses and interpretation of Round Two results. The academic orthodontists determined that six topics (n=24) and 29 subtopics (n=15) were necessary for Growth and Development curricula. For all subtopics, they determined the mean level of cognition for predoctoral education was understand; for advanced education, it was analyze. This consensus on Growth and Development curricular content suggests that these levels are necessary for a beginning dentist and a beginning orthodontist to be deemed competent. Findings from this study can serve to guide curricular development and instruction by using the identified learning objectives to build instructional and assessment measures.

Can Noncognitive Components of Admissions Data Predict Dental Student Performance and Postdoctoral Program Placement?

The aim of this retrospective cohort study was to evaluate whether the noncognitive factors of the dental student application, including undergraduate major and interview score, predicted success in the predoctoral program and placement in postdoctoral programs. The study population consisted of 169 students in the Harvard School of Dental Medicine DMD graduating Classes of 2012 through 2016. Noncognitive factors in the dental application, including letters of recommendation, extracurricular activities, undergraduate major, and dental school admission interview performance, were collected for the study population. Groups were analyzed for differences among undergraduate majors and any association between postgraduate placement and dental school performance. Dental school performance measures were grades obtained in the third and fourth years in a combination of preclinical and clinical course assessments. The results showed that neither interview score nor undergraduate major was significantly associated with dental school performance or postdoctoral program placement. There was a non-significant association between interview score and performance in the course Treatment of Active Disease. These results suggest that noncognitive factors of the dental school application offered low yield to predicting predoctoral student performance and residency placements, with interview performance possibly outweighing undergraduate major in selection of successful predoctoral candidates.

Assessment, Education, and Access: Kona Hawai'i WIC Oral Health Pilot Project.

The Kona WIC oral health pilot project was developed to assess the oral health beliefs and behaviors of parents of children and pregnant women at the Kona WIC site and to demonstrate the ease of providing oral health education to families in order to improve oral health behaviors. Data were collected from 50 families about the oral health behaviors and dental care of a total of 73 children, including 5 pregnant women, four of whom had a child enrolled in WIC and one pregnant woman without any previous children. Data revealed that 68% of children with teeth had been seen by a dentist within 6 to 12 months of the study visit. Mothers were seen less often, with 55% stating that they had not been seen for a dental visit for over one year. Parental knowledge about the effects of fluoride on teeth was limited; however, 90% of the parents would allow fluoride varnish applied to their child's teeth, 88% would give daily fluoride drops/tablets to their child, and 78% would support water fluoridation if it would help to improve their children's oral health. Additionally, for children old enough to receive fluoride supplementation, 60% were not given a prescription by their health care providers, and 58% had not received any fluoride varnish applications. By offering oral health education in a WIC clinic and assisting clients to seek out comprehensive care within a dental home, children and caregivers can be provided essential education and resources early in a child's life or women's pregnancies to reduce poor oral health outcomes.

Graduate Periodontics Programs' Integration of Implant Provisionalization in Core Curricula: Implementation of CODA Standard 4-10.2.d.

The aim of this descriptive study was to provide an overview of the status of implementation of Commission on Dental Accreditation (CODA) Standard 4-10.2.d (Provisionalization of Dental Implants) by U.S. graduate periodontics programs since its introduction in 2013. Surveys were sent in May 2015 to 56 accredited postdoctoral periodontics program directors to ascertain program director characteristics; status of planning, implementation, and curriculum resulting from adoption of Standard 4-10.2.d; preferred clinical protocols for implant provisionalization; interdisciplinary educational collaborators; and competency assessment mechanisms. The survey response rate was 52% (N=29); the majority were male, aged 55 or older, and had held their position for less than ten years. Among the responding programs, 93% had formal educational curricula established in implant provisionalization. Graduate periodontics (96%) and prosthodontics (63%) faculty members were predominantly involved with curriculum planning. Of these programs, 96% used immediate implant provisionalization, with direct (chairside) provisionalization protocols (86%) being preferred over indirect protocols (14%) and polyethylethylketone provisional abutments (75%) being preferred to titanium (25%) provisional abutments. Straight and concave transmucosal emergence profile designs (46% each) were preferred in teaching, with only 8% of programs favoring convex transmucosal profiles. A majority of responding programs (67%) lacked protocols for communicating to the restorative referral a mechanism to duplicate the mature peri-implant mucosal architecture. Regional location did not play a significant role in any educational component related to implant provisionalization for these graduate periodontal programs. Overall, this study found that a clear majority of graduate periodontics programs had established formal curricula related to implant provisionalization, with substantial clinical and philosophical consensus within the specialty.

[Essential questions of training of dentists for accreditation]. / Aktual'nye voprosy podgotovki vrachei-stomatologov k akkreditatsii spetsialistov.

The paper presents sociological study aimed to analyze the conditions and methodological rationale for the basic directions of optimization of accreditation procedure for dentists. The study included 129 graduates of dental faculties of educational institutions of Sechenov First Moscow State Medical University. The material was collected by questionnaire survey and interviewing. The obtained results show that the introduced system of professionals' accreditation is an innovative educational technology allowing objectively assess the level of theoretical and practical training of dentists. Much of its effectiveness depends on the quality of produced and updated on a timely basis uniform base of assessment tools, the selection of the most prepared members for the accreditation commissions and creation of adequate conditions for its implementation in educational and scientific organizations.

Does dental undergraduate education and postgraduate training enable intention to provide inhalation sedation in primary dental care? A path analytical exploration.

AIM: To examine how quality standards of dental undergraduate education, postgraduate training and qualifications together with confidence and barriers could be utilised to predict intention to provide inhalation sedation. METHODS: All 202 dentists working within primary dental care in NHS Highland were invited to participate. The measures in the questionnaire survey included demographic information, undergraduate education and postgraduate qualifications, current provision and access to sedation service, attitudes towards confidence, barriers and intention to provide inhalation sedation. A path analytical approach was employed to investigate the fit of collected data to the proposed mediational model. RESULTS: One hundred and nine dentists who completed the entire questionnaire participated (response rate of 54%). Seventy-six per cent of dentists reported receiving lectures in conscious sedation during their undergraduate education. Statistically significantly more Public Dental Service dentists compared with General Dental Service (GDS) dentists had postgraduate qualification and Continuing Professional Development training experience in conscious sedation. Only twenty-four per cent of the participants stated that they provided inhalation sedation to their patients. The findings indicated that PDS dentists had higher attitudinal scores towards inhalation sedation than GDS practitioners. The proposed model showed an excellent level of fit. A multigroup comparison test confirmed that the level of association between confidence in providing inhalation sedation and intention varied by group (GDS vs. PDS respondents). Public Dental Service respondents who showed extensive postgraduate training experience in inhalation sedation were more confident and likely to provide this service. CONCLUSION: The quality standards of dental undergraduate education, postgraduate qualifications and training together with improved confidence predicted primary care dentists' intention to provide inhalation sedation.

Should PGY-1 Be Mandatory in Dental Education? Two Viewpoints: Viewpoint 1: PGY-1 Provides Benefits That Support Making It Mandatory and Viewpoint 2: PGY-1 Should Be Available for Dental Graduates But Not Mandatory.

This Point/Counterpoint considers whether a general dentistry postgraduate year one (PGY-1) residency should be required for all new graduates who do not pursue specialty training. Currently, New York and Delaware require PGY-1 for dental licensure, while other states offer it as an alternative to a clinical examination for obtaining licensure. Viewpoint 1 supports the position that PGY-1 should be mandatory by presenting evidence that PGY-1 residencies fulfill new graduates' need for additional clinical training, enhance their professionalism and practice management skills, and improve access to care. The authors also discuss two barriers-the limited number of postdoctoral positions and the high cost-and suggest ways to overcome them. In contrast, Viewpoint 2 opposes mandatory PGY-1 training. While these authors consider the same core concepts as Viewpoint 1 (education and access to care), they present alternative methods for addressing perceived educational shortcomings in predoctoral curricula. They also examine the competing needs of underserved populations and residents and the resulting impact on access to care, and they discuss the potential conflict of interest associated with asking PGY-1 program directors to assess their residents' competence for licensure.

A national follow-up survey of UK graduates opinion of undergraduate oral surgery teaching.

INTRODUCTION: A national follow-up survey was undertaken to determine whether dental graduates from 2009 perceived that their undergraduate oral surgery education had equipped them for general dental practice 4 years after graduating. MATERIALS AND METHODS: Graduates from the same 13 United Kingdom dental schools who had taken part in the original survey were invited to take part in this follow-up online survey. Their contact details were identified via the general dental council register, social media and alumni groups. RESULTS: In total, 161 responded (2009b) which represents 16% of the graduates of the original survey in 2009a. A similar percentage of these respondents perceived that the teaching in oral surgery had given them sufficient knowledge to undertake independent practice (83% and 79% in 2009a and 2009b, respectively). Most respondents (99% in both years) reported confidence in undertaking simple forceps exodontia. Confidence in surgical exodontia was poor in both surveys, but one area that appeared improved in the follow-up related to the sectioning of teeth (84% in 2009b compared with 49% in 2009a). Areas of weakness identified in 2009 were reported to be improved in the follow-up. CONCLUSION: This follow-up survey supports the findings of the original survey. Future longitudinal studies would allow institutions to identify possible weaknesses in their curriculum and to track the career development of their graduates and facilitate robust data collection.

Preparedness of Entering Pediatric Dentistry Residents: Advanced Pediatric Program Directors' and First-Year Residents' Perspectives.

For children to receive needed oral health care, adequate training at both the predoctoral and postdoctoral levels of dental education is required, but previous studies have found inadequacies in predoctoral education that lead to general dentists' unwillingness to treat certain young populations. As another way of assessing predoctoral preparation, the aim of this study was to determine the perspectives of first-year residents and pediatric program directors about residents' preparedness to enter advanced education programs in pediatric dentistry. Surveys were sent to all 74 U.S. program directors and 360 first-year residents. The survey focused on procedures related to prevention, behavior management, restorative procedures, pulp therapy, sedation, and surgery, as well as treating patients funded by Medicaid and with special health care needs. Among the first-year residents, 173 surveys were returned for a 48% response rate; 61 directors returned surveys for an 82% response rate. Only half of the residents (55%) reported feeling adequately prepared for their first year in residency; less than half cited adequate preparation to place stainless steel crowns (SSCs) (42%) and perform pulpotomies (45%). Far fewer felt adequately prepared to provide treatment for children six months to three years of age, including examinations (29%), infant oral exams (27%), and children with severe caries (37%). The program directors were even less positive about the adequacy of residents' preparation. Only 17% deemed them adequately prepared to place SSCs and 13% to perform pulpotomies. Approximately half reported their first-year residents were inadequately prepared to treat very young children and children with severe caries (55% each). This study found that the perceived inadequacy of predoctoral education in pediatric dentistry was consistent at both the learner and educator levels, supporting previous studies identifying inadequacies in this area.

An introduction to standard setting methods in dentistry.

The aim of this paper is to give readers an overview of contemporary standard setting methods used within dental education, and to provide a better understanding of the subject. We hope that it will be of benefit not just to those in academic dentistry, but all practitioners involved with both undergraduate and postgraduate assessment.

[The extra value of training dental students in surgical skills]. / Evaluatie van het Chirurgisch Profiel binnen de 6-jarige opleiding in Nijmegen.

In 2010, the revised 3-year master's programme was introduced in the Netherlands, which meant that the full programme of dental education was extended to 6 years. In Nijmegen, this was structured to include a set of profile programmes, next to the existing curriculum. Three profiles were chosen, one of which was the Surgical Profile. The aim of this programme was that the more complex procedures and the treatment of medically compromised patients would be carried out by those students in the 6-year educational programme who participated in the Surgical Profile. The experiences of students following this profile were evaluated by means of a questionnaire. In a second questionnaire, distributed 1 year after the students had graduated, respondents were asked whether they were still making use of the skills that they had been taught. The conclusion was that the training of master's students in dental surgery results in a high degree of satisfaction. The study revealed moreover that 93% of the students who completed the Surgical Profile put the skills they had been taught to use during the first year as dentists and even wanted to build on that knowledge by means of relevant post-graduate courses.

The MRCS examination--an update on the latest facts and figures.

The Intercollegiate Committee for Basic Surgical Examinations (ICBSE) is responsible for the standard, quality assurance, and continued development of both the MRCS and the Diploma in Otolaryngology and Head and Neck Surgery (DOHNS). It is accountable to the 4 Royal Colleges of Surgeons in the U.K. and Ireland, and the General Medical Council (GMC). This article gives information and an update (including pass rates) for candidates and trainers on the 2013 MRCS format, and summarises the most recent changes to the examination made by the ICBSE with the approval of the GMC.