Effectiveness of Motivational Interviewing Training for Primary Care Dentists and Dental Health Technicians: Results from a Community Clinical Trial.

Motivational interviewing (MI) is an approach that uses dialogue about behavioral change to encourage a constructive relationship between professionals and patients. The aim of this study was to evaluate the maintenance of basic MI skills in the daily practice of dentists and oral health technicians (OHTs) after a training course and for two years of follow-up in the context of primary health care (PHC). A randomized community trial, from September 2012 to September 2014, was conducted at the Community Health Service of Conceição Hospital Group in Porto Alegre, RS, Brazil. The experimental group consisted of all 41 dentists and OHTs who received an intensive eight-hour training course in basic MI principles; the control group consisted of 31 dentists and OHTs who did not receive MI training. The follow-up assessments were at one and two years using three instruments validated for MI. In the one- and two-year follow-ups, improvement was maintained in responses with a statistically significant difference for use of open questioning, reflective listening, and total percentage of correct answers (p<0.001), with a large effect size (ES=1.12). On the Helpful Responses Questionnaire, the participants continued using open questioning and reflective listening (p<0.001), maintaining an increase in the percentage of responses compatible with MI (p<0.001). Likewise, the effect size remained large (ES=1.33) over time. These results suggest that the training course with dentists and OHTs of the PHC oral health staff was effective over the two-year follow-up in enabling them to act in the spirit and techniques of MI.

Anatomical sciences: A foundation for a solid learning experience in dental technology and dental prosthetics.

Basic science courses are extremely important as a foundation for scaffolding knowledge and then applying it in future courses, clinical situations as well as in a professional career. Anatomical sciences, which include tooth morphology, oral histology, oral embryology, and head and neck anatomy form a core part of the preclinical courses in dental technology programs. In this article, the importance and relevance of anatomical sciences to dental personnel with no direct contact with patients (dental technicians) and limited discipline related contact with patients (dental prosthetists) is highlighted. Some light is shed on the role of anatomical sciences in the pedagogical framework and its significance in the educational process and interprofessional learning of dental technicians and prosthetists using oral biology as an example in the dental curriculum. To conclude, anatomical sciences allow dental technicians and prosthetists to a gain a better insight of how tissues function, leading to a better understanding of diagnosis, comprehensive treatment planning and referrals if needed. Patient communication and satisfaction also increases as a result of this deep understanding of oral tissues. Anatomical sciences bridge the gap between basic science, preclinical, and clinical courses, which leads to a holistic approach in patient management. Finally, treatment outcomes are positively affected due to the appreciation of the macro and micro structure of oral tissues. Anat Sci Educ 10: 395-404. © 2016 American Association of Anatomists.

ADEA/AAL Institute for Allied Health Educators: Program Evaluation.

Revised accreditation standards for dental and dental hygiene education programs have increased emphasis on faculty development that can improve teaching and learning, foster curricular change including use of teaching and learning technologies, and enhance retention and satisfaction of faculty. The American Dental Education Association (ADEA) and Academy for Academic Leadership (AAL) established the Institute for Allied Health Educators (IAHE) in 2007 to address faculty development needs for allied dental and allied health educators. In 2009, it was transitioned to an online program, which resulted in increased enrollment and diversity of participants. After seven years, a comprehensive program evaluation was warranted. The authors developed an online questionnaire based on Kirkpatrick's four-level model of training evaluation; for this study, levels one (satisfaction), two (knowledge and skill acquisition), and three (behavior change) were examined. Of the 400 program participants invited to take part in the study, a 38% response rate was achieved, with the majority indicating full-time faculty status. Nearly all (95-97%) of the respondents agreed or strongly agreed the program contributed to their teaching effectiveness, and 88-96% agreed or strongly agreed it enhanced their knowledge of educational concepts and strategies. In addition, 83% agreed or strongly agreed the program helped them develop new skills and confidence with technology, with 69% agreeing or strongly agreeing that it helped them incorporate technology into their own educational setting. Nearly 90% were highly positive or positive in their overall assessment of the program; 95% indicated they would recommend it to a colleague; and 80% agreed or strongly agreed they had discussed what they learned with faculty colleagues at their home institutions who had not attended the program. Positive findings from this evaluation provide evidence that the IAHE has been able to meet its goals.

Measuring team-based interprofessional education outcomes in clinical dentistry: psychometric evaluation of a new scale at an Australian dental school.

Previous research on interprofessional education (IPE) assessment has shown the need to evaluate the influence of team-based processes on the quality of clinical education. This study aimed to develop a valid and reliable instrument to evaluate the effectiveness of interprofessional team-based treatment planning (TBTP) on the quality of clinical education at the Griffith University School of Dentistry and Oral Health, Queensland, Australia. A scale was developed and evaluated to measure interprofessional student team processes and their effect on the quality of clinical education for dental, oral health therapy, and dental technology students (known more frequently as intraprofessional education). A face validity analysis by IPE experts confirmed that items on the scale reflected the meaning of relevant concepts. After piloting, 158 students (61% response rate) involved with TBTP participated in a survey. An exploratory factor analysis using the principal component method retained 23 items with a total variance of 64.6%, suggesting high content validity. Three subscales accounted for 45.7%, 11.4%, and 7.5% of the variance. Internal consistency of the scale (α=0.943) and subscales 1 (α=0.953), 2 (α=0.897), and 3 (α=0.813) was high. A reliability analysis yielded moderate (rs=0.43) to high correlations (0.81) with the remaining scale items. Confirmatory factor analyses verified convergent validity and confirmed that this structure had a good model fit. This study suggests that the instrument might be useful in evaluating interprofessional or intraprofessional team-based processes and their influence on the quality of clinical education in academic dental institutions.

Knowledge on dental trauma management and caries prevention.

PURPOSE: This study evaluated the knowledge of dental assistants (DA) and hygienists (DH) on dental trauma management and dental caries prevention. Secondarily, other aims were 2-fold: (1) to update the assistants/hygienists through courses supported on scientific evidence-based information and (2) to evaluate their job satisfaction. METHODS: A cross-sectional study was conducted with 46 participants, DHs and Das, working in the Secretary of Education of the city of Brasilia (Federal District, Brazil). The information was gathered through 2 self-administered questionnaires during 2 training meetings. The first questionnaire was applied before the first meeting and the second questionnaire after the last meeting. All participants were women older than 38 years and with more than 15 years of experience. RESULTS: The participants demonstrated knowledge on dental trauma types but lack of knowledge on dental trauma first-aid approaches. Concerning to dental caries, the professional demonstrated knowledge on both etiology and prevention. CONCLUSION: Lectures, periodical training, and inclusion in multidisciplinary training groups aiming to caries prevention and dental trauma are necessary.

Perceptions of uncivil student behavior in dental education.

Students and faculty members in the health professions classroom are expected to exhibit professional behaviors that are conducive to maintaining a positive learning environment, but there is little published research concerning incivility in the area of dental education. The aim of this study was to evaluate differences in perceptions of incivility between dental faculty and students, between students in different courses of study, and between students in different years of dental study. The study utilized an anonymous electronic survey of all dental faculty and administrators and all dental, dental hygiene, and dental laboratory technology students at a single institution. The survey instrument contained questions concerning perceived uncivil behavior in the classroom and clinical settings. Response rates were 54% for faculty and administrators and ranged from 60% to 97% for students in various years and programs. The results were analyzed based on gender, course of study, year of study, and ethnicity. Significant differences were found regarding perceptions of civil behaviour between faculty and students, male and female students, the year of study, and the course of study. These differences point to the need for further research as well as administrative leadership and faculty development to define guidelines in this area in order to ensure a positive learning environment.

Attitudes towards shared learning of trainee dental technicians and undergraduate dental students.

The challenges of health care are increasingly complex and subject to frequent change. Meeting these demands requires that health professionals work in partnership with each other and the patient. One way of contributing to this is for students to learn together. However, effective teamwork requires an education system that helps to foster understanding among all those entering the health workforce. The purpose of this study was to investigate the attitudes towards shared learning of undergraduate dental students and trainee dental technicians in a university dental school/hospital in the United Kingdom. Twenty-five trainee dental technicians and 75 undergraduate dental students took part in the study over five academic years. Data were collected using structured questionnaires. A 100% response rate was achieved from the questionnaires. The results indicated the majority of students recognized the benefits of shared learning and viewed the acquisition of teamworking skills as useful for their future working lives, beneficial to the care of their patients, and likely to enhance professional working relationships. The study also found a positive association of being valued as an individual in the dental team by all student groups. Future dental curricula should provide opportunities to develop effective communication between these two groups and encourage teamworking opportunities. These opportunities need to be systematically developed in the dental curriculum to achieve the desired goals.

Communicating prosthetic prescriptions from dental students to the dental laboratory: is the message getting through?

The aim of this research was to investigate the quality of written prosthetic prescriptions provided by fourth-year dental students to a commercially operated dental laboratory and to ascertain the contribution of interprofessional education to improving prescription quality. Based on guidelines established by the Medicines and Healthcare Products Regulatory Agency of the European Union (Medical Device Directive 93/42/EEC), an audit was conducted prior to and after an educational intervention was delivered by a dental technician to a dental student cohort at one Australian dental school. Prior to the intervention, thirty-nine dental prosthetic prescriptions were collected, analyzed, and audited to determine the clarity of written communication and instructions from dental student to dental technician. Following the intervention, a further forty prosthetic prescriptions were collected from the same cohort of students and were audited. The audit of the initial prescriptions showed that 85 percent (n=33) did not comply with the recommended conventions. After the intervention, the prescriptions that did not meet the guidelines had fallen to 30 percent (n=12) of the total. Improvements in prosthetic prescriptions submitted by these dental students to the commercial dental laboratory suggest there is an advantage to including a prosthetic prescription-writing module in dental school curricula.

Smiles for success: restoring functional dentition one mouth at a time.

Edentulism is the outcome of a multifactorial process involving biological factors and patient-related factors. Prosthodontics serves as a solution. Tooth replacement through prosthetic devices may be prohibitive for the underserved population due to barriers such as cost and lack of transportation. A community service project was developed as a response strategy to address these concerns in Fort Wayne, Indiana. With the help of Indiana University Purdue University (IPFW) Dental Laboratory Technology students and local dental professionals, the Smiles for Success: Restoring Functional Dentition One Mouth at a Time project assisted the underserved of Fort Wayne. Success was accomplished through the repair or reline of existing dentures, as well as the creation of new partial and complete oral prosthetic appliances. Working within the existing healthcare framework of an inner city clinic and local health fair for the underserved, the project completed work on 29 dentures and restored 22 patients to functioning dentitions. While the prosthetic appliances bring about new and restored smiles, it leads to a lifetime of new opportunities and improved health.

Evaluating the ability of dental technician students and graduate dentists to match tooth color.

STATEMENT OF PROBLEM: The ability of dental technician students to match tooth shade with the Vita 3D-Master shade guide and Toothguide Training Box has not been investigated. PURPOSE: The purpose of this study was to evaluate and compare the shade-matching ability of dental technician students and graduate dentists using the Vita 3D-Master shade guide. MATERIAL AND METHODS: Twenty-nine dental technician students (DTS group) and 30 graduate dentists (GD group) participated in this study. The Toothguide Training Box (TTB) was used to train the participants and test their shade-matching abilities. Shade-matching ability was evaluated with 3 exercises and a final test, all of which are components of the TTB. The number of mistakes for each participant for value (L), chroma (c), and hue (h) were recorded during the exercises and the final test, and the mistake ratios were calculated. Color difference (ΔE) values for each shade were calculated from the L*, a*, and b* values of the Vita 3D-Master shade guide for each participant in both groups. The Mann-Whitney U test was used to determine statistically significant differences between the L, c, and h mistake ratios of the 2 groups, and the Student t test was used to determine statistically significant differences between the final test scores and the ΔE values of the groups (α=.05). RESULTS: The mistake ratio for L in the GD group was significantly higher than that of the DTS group (P<.05), whereas the mistake ratio for h in the DTS group was higher (P<.001). No significant differences were observed between the groups regarding the mistake ratios for c (P>.05). With regard to the final test scores and the ΔE values, no significant differences were found between the groups (P<.001), and the DTS group received higher scores than the GD group (912 and 851). The mean ΔE values for the DTS and GD groups were 1.72 and 2.92. CONCLUSIONS: DTSs made more mistakes in the h parameter than GDs, and GDs made more mistakes in the L parameter than DTSs. With regard to the final test scores and the ΔE values, DTSs were more successful in shade matching than GDs.

Audit to assess the quality of communication between operators and technicians in a fixed prosthodontic laboratory: educational and training implications.

OBJECTIVE: This audit aimed to assess the quality of communication between dental students/qualified dentists and dental technicians, increase the percentage of satisfactorily completed laboratory prescriptions and reduce the number of errors that can result from poor communication. A subsidiary aim was to educate students and staff in this respect. METHOD: An audit of laboratory prescription completion was conducted within Dundee Dental Hospital. Four hundred and eighteen prescriptions for indirect fixed restorations completed by dental undergraduates and qualified staff were audited over a three month period (first audit cycle). Educational reminders on laboratory prescriptions were then provided to undergraduates and qualified staff, a further three hundred and twenty-two prescriptions were audited (second audit cycle) and compared with the first cycle. RESULTS: Satisfactorily completed prescriptions increased from 28% to 43% following basic educational intervention. However, this percentage still signifies a poor level of completion and the need for improvement. Some aspects of the prescription were completed better than others, but overall the standard remained poor with a significant number failing to comply with guidelines set by the UK General Dental Council, the European Union's Medical Devices Directive and the British Society for Restorative Dentistry (BSRD). CONCLUSION: Further undergraduate and staff training on laboratory prescription writing will be necessary through staff training events and developments in the undergraduate curriculum.

A survey of the sociodemographic and educational characteristics of oral health technicians in public primary health care teams in Minas Gerais, Brazil.

BACKGROUND: To describe some sociodemographic and educational characteristics of oral health technicians (OHTs) in public primary health care teams in the state of Minas Gerais, Brazil. METHODS: A cross-sectional descriptive study was performed based on the telephone survey of a representative sample comprising 231 individuals. A pre-tested instrument was used for the data collection, including questions on gender, age in years, years of work as an OHT, years since graduation as an OHT, formal schooling, individual income in a month, and participation in continuing educational programmes. The descriptive statistic was developed and the formation of clusters, by the agglomerative hierarchy technique based on the furthest neighbour, was based on the age, years of work as an OHT, time since graduation as an OHT, formal schooling, individual income in a month, and participation in continuing educational programmes. RESULTS: Most interviewees (97.1%) were female. A monthly income of USD 300.00 to 600.00 was reported by 77.5% of the sample. Having educational qualifications in excess of their role was reported by approximately 20% of the participants. The median time since graduation was six years, and half of the sample had worked for four years as an OHT. Most interviewees (67.6%) reported having participated in professional continuing educational programmes. Two different clusters were identified based on the sociodemographic and educational characteristics of the sample. CONCLUSIONS: The Brazilian OHTs in public primary health care teams in the state of Minas Gerais are mostly female who have had little time since graduation, working experience, and formal schooling sufficient for professional practice.

Interactions in the dental team: understanding theoretical complexities and practical challenges.

BACKGROUND: Interdisciplinary collaboration and communication during dental training has become an increasingly influential idea within dental schools, both in the United Kingdom and European contexts. Research into this curriculum innovation has provided evidence to argue that benefits accrue both in terms of professional understanding and the development of dental professional learning dispositions. OBJECTIVE: This study investigates the interactions within a trainee dental team. In particular, the paper reports the professional experiences and development of trainee dental technicians and undergraduate dental students during a prolonged shared learning exercise in a combined UK university dental school and hospital. METHODS: Using a qualitative approach with a phenomenological framework, data sources included reflective diaries, focus group interviews and participant feedback. RESULTS: Eleven major domains were identified that accurately characterised the participants' beliefs, thoughts and practices. The results indicate that both trainee dental technicians and undergraduate dental students were pragmatic but positive in terms of their expectations of shared learning. In particular, they regarded the exercise as useful in terms of communication and understanding each other's role. Evidence also indicated the presence of original elements such as crisis of confidence and feelings of awkwardness that do not arise in other studies. CONCLUSIONS: The implications for dental education are that for effective professional collaboration during training to take place a merger of interests among educators and policy developers in dental education must occur, and the challenges encountered within practice cultures must somehow be overcome. Therefore, more investment in evaluating research into interprofessional learning in dentistry would contribute to our knowledge about the place and role of interprofessional education in the professional dental curriculum and beyond.

Traditional and interprofessional curricula for dental technology: perceptions of students in two programs in Australia.

Collaboration between dental technicians and other members of the dental care team is essential to achieve optimal outcomes for patients in prosthetic care. Interprofessional education can be effective in improving attitudes, communication, and practices within such teams. This study compared and contrasted the perceptions of role, responsibilities, communication, and teamworking of dental technology students in a traditional curriculum with those in an interprofessional curriculum, both in Australia. A social demographic questionnaire and two standard self-report measures were used to collect data from each year group of the two programs. Thirty to thirty-two of the thirty-nine students enrolled in a traditional dental technology program and nineteen to twenty-two of twenty-five students enrolled in an interprofessional curriculum completed surveys. Statistical analysis of self-report measures identified a significant difference in professional identity, development of roles, and perception of enhanced opportunities for collaboration of dental technologists with the wider oral health professions in those undertaking the interprofessional curriculum. This study suggests that interprofessional learning can shift traditional attitudes and, potentially, improve opportunities for collaboration between dentists and dental technicians. It also supports the idea that adoption of an interprofessional curriculum can significantly enhance communication and teamwork skills essential for readiness in the workplace.

Dental laboratory technology education in China: current situation and challenges.

Modern dentistry and dental education in China were first introduced from abroad by Dr. Lindsay in 1907. However, advancements in the field of dental laboratory technology did not occur to the same degree in specialties such as prosthodontics and orthodontics. Since the 1990s, orders from abroad demanding dental appliances surged as the image of China as the "world's factory" strengthened. The assembly line model, in which technicians work like simple procedure workers, was rapidly applied to denture production, while the traditional education system and apprenticeship systems demonstrated little progress in these years. The lack of advancement in dental laboratory technology education caused insufficient development in China's dental technology industry. In order to alter the situation, a four-year dental laboratory technology undergraduate educational program was established in 2005 by West China School of Stomatology, Sichuan University (WCSS, SCU). This program was based on SCU's undergraduate education and WCSS's junior college education systems. The program introduced scientific methods in relevant subjects into laboratory technicians' training and made many improvements in the availability of trained faculty, textbooks, laboratory facilities, and curriculum.

Developing professional status: an investigation into the working patterns, working relationships and vision for the future of UK clinical dental technicians.

AIMS: To investigate the working patterns and patient base of registered clinical dental technicians (CDTs); their relationships with dentists and other professionals in the dental team; their willingness to work within the NHS and their expectations for the future as a new professional group. METHODS: Face-to-face qualitative interviews of registered CDTs, selected because of their geographic representation and mode of working, informed the development of a postal questionnaire survey of all early registrants with the General Dental Council (GDC). RESULTS: The majority of CDTs reported working part-time, often combining clinical practice with their role as a dental technician. They reported both positive and negative working relationships with dentists and dental technicians, demonstrating collaboration and/or competition depending on whether the scope of CDTs was respected and patient care was shared or lost. CDTs role in the NHS was limited because they did not have the status of becoming a recognised provider of dental care. There was a desire to expand their scope of practice in future. CONCLUSION: CDTs are embracing their new status as an occupational group within dentistry. Core features of becoming a professional group were exhibited including the importance of social and financial status and the need to negotiate their current and future roles in the healthcare system.