Preclinical Competency Testing in North American Dental Schools and Opinions About Possible Standardization.

In the U.S., the Commission on Dental Accreditation (CODA) requires that dental schools use competency-based assessments and standardized levels of proficiency to ensure that students are prepared for patient care after graduation. No such comprehensive standardized preclinical testing is required in the CODA standards. The aim of this study was to determine the use of preclinical competency assessments for students transitioning from preclinical to clinical education in North American dental schools and respondents' perceptions of the need for standardization in preclinical testing. An electronic survey was sent to the academic deans of all 76 U.S. and Canadian dental schools in July 2018 asking if the school used competency exams to assess preclinical students prior to entering patient care and, if so, about the type of tests and disciplines tested, student remediation, and reasons for revisions. The survey also asked for the respondents' perspectives on potential preclinical assessment standardization. Respondents from 28 U.S. and two Canadian schools participated in the survey, for a 39.5% response rate. The majority (92.3%) of respondents said their school considered preclinical competency assessments to be good indicators of students' readiness for transitioning into patient care, yet 40.0% reported their schools had no comprehensive preclinical testing, and 13.8% had no preclinical testing in endodontics, periodontics, prosthetics, or restorative dentistry. Regarding type of comprehensive preclinical assessment used, 71.4% reported using typodont-based exams, 46.4% used written comprehensive exams, and 42.9% used objective structured clinical examinations (OSCEs); respondents could select all that applied on this item. Of the respondents whose schools had preclinical competency assessments, 72.4% had a review mechanism in place to evaluate its effectiveness. Overall, this study found that 60% of the participating schools had some form of preclinical testing, but there were no agreed-upon competencies to determine preclinical dental students' readiness for safe patient care in their clinical education.

Prep-Along Facilitated Posterior Crown Preparation in the Preclinical Dental Setting: A Multimedia Approach.

Introduction: Dental students often seek visual aids and demonstrations when attempting to perform new procedures. This video resource provides an adjunctive teaching tool for a crown preparation on an ivorine molar using the "prep-along" method. This method teaches crown preparation in a uniform, step-by-step manner while providing feedback to students after each step. Methods: Prior to the daily simulation clinic session, a calibration session was held for faculty. Following didactic instruction-including principles, criteria, and grading rubric-students participated in the laboratory portion of the course. During this laboratory portion, students viewed a segment of the video, the video was paused, and students attempted that portion of the preparation. The project continued in stages until it was completed. Upon completion, using an electronic grading system, each student performed a self-evaluation, the instructor then performed a blind evaluation, and both student and instructor compared assessments. Results: To obtain feedback, an electronic survey was sent to 285 third- and fourth-year dental students. Ninety-four students completed the survey; 94% responded favorably to this method of instruction. Individual comments were also predominantly positive. Discussion: Preclinical faculty at the Midwestern University College of Dental Medicine-Arizona use this prep-along for instruction of direct and indirect tooth preparations and restorations. Students participate in this step-by-step process while receiving feedback. Faculty are allowed a structured environment in which to give feedback and instruction at each segment of the preparation. The faculty found that this method of instruction created efficiency and excellence in training surgical hand skills.

Implementation of new technologies in U.S. dental school curricula.

With dentistry rapidly evolving as new technologies are developed, this study aimed to identify the penetration of emerging dental technologies into the curricula of U.S. dental schools and to explore whether certain school characteristics affected adoption of these technologies. A 19-question survey was sent to the academic deans of all 62 U.S. dental schools. In addition to questions about characteristics of the school, the survey asked respondents to indicate where in their curricula the technology was incorporated: preclinical didactic, preclinical laboratory, clinical didactic, and/or clinical patient experience. Of 62 eligible schools, 33 useable responses were received, for a 52% response rate. The results showed that the greatest overall penetration of dental technologies was in preclinical didactic courses and the lowest was in the preclinical laboratory. Specific technologies implemented in the largest percentage of responding schools were digital radiography and rotary endodontics. The technologies with the lowest penetration were CAD/CAM denture fabrication and hard tissue lasers. These results suggest that the incorporation of technology into dental schools is following that of private practice as the most widely adopted technologies were those with the greatest acceptance and use in private practice. Among the respondents, factors such as class size and age of the school had greater impact on incorporation of technology than funding source and geographic location.