Using theory-informed data science methods to trace the quality of dental student reflections over time.

This study describes a theory-informed application of data science methods to analyze the quality of reflections made in a health professions education program over time. One thousand five hundred reflections written by a cohort of 369 dental students over 4 years of academic study were evaluated for an overall measure of reflection depth (No, Shallow, Deep) and the presence of six theoretically-indicated elements of reflection quality (Description, Analysis, Feeling, Perspective, Evaluation, Outcome). Machine learning models were then built to automatically detect these qualities based on linguistic features in the reflections. Results showed a dramatic increase from No to Shallow reflections from the start to end of year one (20% → 66%), but only a limited gradual rise in Deep reflections across all four years (2% → 26%). The presence of all six reflection elements increased over time, but inclusion of Feelings and Analysis remained relatively low even at the end of year four (found in 44% and 60% of reflections respectively). Models were able to reliably detect the presence of Description (κTEST = 0.70) and Evaluation (κTEST = 0.65) in reflections; models to detect the presence of Analysis (κTEST = 0.50), Feelings (κTEST = 0.54), and Perspectives (κTEST = 0.53) showed moderate performance; the model to detect Outcomes suffered from overfitting (κTRAIN = 0.90, κTEST = 0.53). A classifier for overall depth built on the reflection elements showed moderate performance across all time periods (κTEST > 0.60) but relied almost exclusively on the presence of Description. Implications for the conceptualization of reflection quality and providing personalized learning support to help students develop reflective skills are discussed.

The inconspicuous nature of COVID-19 and its impact to dentistry.

To state that the new coronavirus SARS-CoV-2 has broadly and deeply impacted our lives is an understatement. Since it first showed up on our radar in December 2019, the new coronavirus has wreaked havoc on virtually all businesses and industries across the globe. The impact is equally felt in developing, developed, industrialized, rural, rich, and poor countries and communities, irrespective of how well-prepared those countries and communities felt they were 9 months ago. To this day we are still learning to prepare for, respond to, and adapt to the broad and deep impact of this virus. This essay presents different perspectives on the impact of the novel coronavirus to dentistry, through the lenses of a private practice-based general dentist, a nursing home-based public health dentist, and a school of dentistry clinical director. The goal of the essay is to share our experiences and challenges, as well as highlight our capacity to respond to a crisis with resilience, determination, creativity, inventivity, and, most importantly, humility and altruism.

Delivering the evidence--skill mix and education for elder care.

OBJECTIVES: To review the current status of dental curricula on elder care, and the current curricula regarding elder care, and it's effect on altering practitioner behaviors while addressing the needs of a growing North American elder population. BACKGROUND: An impending crisis is looming over the oral healthcare of our aging population. At the same moment that life expectancy is being extended through increasingly complex healthcare improvements, the numbers of trained dental providers capable and interested in delivering the needed care is failing to grow at an adequate rate. DISCUSSION: The skills necessary to manage these increasingly complex patients require an interprofessional approach capable of delivering care to sicker patients, in a variety of living accommodations, while managing a variety of care givers. The dental skills necessary to treat these elderly are modifications of skills students routinely learn in dental school. As a matter of fact, the skills students acquire to treat an adult patient population may be contrary to the basic skills necessary to manage the elderly dependent adult patient. Teaching students the nuance differences needed to properly diagnose and care for this population is a difficult task that must be taught in a contextual environment. CONCLUSION: Significant changes in the teaching of dental management of the elderly are critical within much of the education community. Just as teaching students to care for the pediatric population as general dentists, the clinical education must involve a sufficient number of quality experiences to address issues of both competency, that of the graduate to perform care independently, and attitudes, the actually willingness to treat the elderly.

Evaluation of CDs and chewing gum in teaching dental anatomy.

The purposes of this pilot study were: 1. to compare two methods of teaching dental anatomy-CD + lab vs. standard lecture + lab; and 2. to determine whether actively chewing gum during lecture, lab and studying would have an effect on learning. Only the written examination average scores for the gum vs. no gum chewing groups showed differences that appear to be educationally meaningful, though not statistically significant because of the limited number of subjects in this pilot study. This pilot study suggests that: 1. the cost-effective method of using a self-study CD is as educationally effective as a standard lecture; 2. gum chewing resulted in higher scores in the written examination; and 3. future, full-sized studies should be conducted to confirm these findings.

Removing carious dentin using a polymer instrument without anesthesia versus a carbide bur with anesthesia.

BACKGROUND: The authors describe a new rotary polymer instrument that selectively removes infected dentin. This instrument has the potential to prepare selected cavities without the need for local anesthesia (LA). Patient acceptance has not been investigated in a clinical trial. METHODS: In this open-label clinical study, the authors enrolled 20 subjects with two Class I carious lesions and randomly assigned them to receive one restoration with the polymer instrument and no LA and the second restoration with a carbide bur and LA. Both procedures were completed in one appointment. Subjects completed dental history, dental anxiety and situational pain questionnaires. At specific points during the procedure, subjects rated their perception of the intensity of cold, heat, pain, pressure, vibration, fear and anxiety. On completion of the restorative procedures and at 48-hour and one-week telephone contacts, subjects indicated which procedure they preferred. RESULTS: During treatment with the polymer instrument, subjects indicated that they experienced slightly more pain, pressure, vibration and anxiety, but not more heat, cold or fear. Immediately after the procedure, 14 (70 percent) of 20 respondents (binomial test; P = .11) said that they would prefer having no LA and use of the polymer instrument for future dental work. The number of subjects indicating this preference increased to 15 (P < .05) at both the 48-hour and one-week contacts. One subject requested rescue LA during the polymer instrument treatment. CONCLUSIONS: A significant number of subjects preferred the rotary polymer instrumentation with no LA to the carbide bur instrumentation with LA. They held this preference despite experiencing slightly, but reliably, more pain and pressure when treated with the polymer instrument. CLINICAL IMPLICATIONS: A polymer (bur-like) rotary instrument with cutting ability limited to infected dentin can be used in Class I cavity preparations without the need for LA.

Clinical simulation and foundation skills: an integrated multidisciplinary approach to teaching.

Faced with the challenge of restructuring a preclinical curriculum to provide a stronger background in general dentistry, a clinical simulation program that emphasizes critical thinking in clinical decision-making was developed and implemented at New York University College of Dentistry. The program offers an integrated program in clinical sciences focused on the faculty-defined outcomes for a general dentist. The curriculum was developed using outcomes that must be met before full patient care privileges are extended. The curriculum is centered around a series of patients with differing profiles of risk, disease, and treatment needs. Students are required to think globally, collect data that leads to an accurate assessment of the patient's risk, plan prevention and health promotion, and define a treatment plan. The student then demonstrates proficiency in executing treatment, evaluates the results, and speculates about the long-term impact of the treatment provided. Student and faculty evaluations are discussed as well as the strengths and shortcomings of the curriculum.

Integrating dental anatomy and biomaterials: an innovative use of composite resin.

As part of the new integrated curriculum at the New York University College of Dentistry, a pilot program uses composite resins to teach dental anatomy. The Department of Biomaterials and Biomimetics, in conjunction with the Department of Cariology and Operative Dentistry, has created a teaching module to replicate the morphology of a central incisor through the manipulation and placement of a composite resin.

An overview of the CEREC 3D CAD/CAM system.

Computer-aided design/computer-aided manufacture (CAD/CAM) technology has made steady inroads into the practice of dentistry. The CEREC CAD/CAM system can be used chairside to fabricate porcelain and composite inlays, onlays, and crowns and porcelain veneers. The latest incarnation of the CEREC system is the CEREC 3D, which provides a versatile, relatively simple, user-friendly method for fabricating esthetic restorations chairside without involving a dental laboratory. CEREC 3D may be the system that allows the average general dentist to provide chairside porcelain restorations during single-visit appointments, eliminating the need for an elastomeric impression or an interim restoration as well as the expense of a laboratory fee.

Comparative use of podcasts vs. lecture transcripts as learning aids for dental students.

The purpose of this project was to describe dental students' use of lecture podcasts versus written lecture transcripts as learning aids under three different circumstances: studying for an exam, reviewing an attended lecture, and reviewing a missed lecture. Additional analyses were performed to see whether demographic differences (e.g., age, gender, language skills, and computer skills) or grade differences were associated with preferences for using podcast versus written lecture transcripts of class notes. Fifty-one percent (n=171) of the second-year dental students at the New York University College of Dentistry voluntarily participated in this survey. The major findings were that 1) a high percentage of students (70-92 percent) used one or both aids in all three utilization circumstances with a consistent preference for podcast use, especially when reviewing a missed lecture; 2) course grades were not associated with the preferred use of either lecture aid; and 3) over half the students listened to the podcasts at speeds that were one and one-half or two times faster than normal speech, especially younger students. Further studies are warranted to delve into the current student generation's preferred learning styles and the resultant learning outcomes associated with those preferences.