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Mandatory attendance, particularly in didactic settings, is a highly debated topic in higher education, including dental education. Within dental education, a large portion of education occurs in preclinical laboratories and clinical environments. There is little to no research on attendance in these settings in dental schools. This point/counterpoint paper examines the pros and cons of mandatory attendance in these highly specialized educational settings. With the backdrop of the COVID‐19 pandemic that began in March 2020 and continues to impact dental education at the time of publication, this topic has become even more relevant. Viewpoint 1 claims that attendance should be mandatory because a greater exposure to preclinical and clinical environments helps foster better clinical hand skills, critical thinking, decision‐making, problem‐solving skills, and an overall sense of professional identity. It goes on further to suggest that there may be a link between attendance and performance in exams and that attendance is part of the dental school's responsibility. Viewpoint 2 argues that the rationale for attendance is complex, and that creating learning environments that are psychologically safe will incentivize students to attend, even without mandatory attendance policies. Furthermore, it explains that technological advances have allowed dental schools to think creatively about asynchronous learning, which by its very nature does not require attendance at a given time. The authors of both viewpoints conclude that the preclinical and clinical education and experience are critical dental education and that dental school leaders should focus on improving the quality of these experiences. [ABSTRACT FROM AUTHOR]

Purpose/objectives: Clinical teaching in dentistry has cycled through specialty‐based "departmental" teaching to group practice scenarios. The aims of this study were to ascertain third‐year dental students' perceptions of a specialty‐based rotation supplemented by online educational tools and to compare their Objective Structured Clinical Exam (OSCE) scores to those of the students in the previous year. Methods: This retrospective research design included the analysis of OSCE scores, and student responses to survey questions regarding their perceptions of the clinical oral pathology (COP) rotation. This study was completed in 2022. It included data from 2020 to 2021 and 2021 to 2022 corresponding to input from the Classes of 2022 and 2023, respectively. The response rate was 100%. Results: The students evaluated the focused COP rotation and the online teaching modules as a positive experience. The results of the OSCE were similar to those of the previous class and showed a high average score. Conclusions: This study shows that students had a positive perception to specialty‐based learning with online educational tools and that it enhanced the education they received in the comprehensive care clinic. The OSCE scores were similar to those of the previous class. These findings suggest a method of maintaining high‐quality dental education through challenges as it continues evolving. [ABSTRACT FROM AUTHOR]

Introduction: Harassment is an issue that occurs in all workplaces and institutions. Due to increased exposure to patients, higher rates of harassment are experienced in health care systems. Health care workers need to form a professional relationship with patients to attend to their health care needs; however, harassment by patients can disrupt this relationship and have detrimental physical, mental, and emotional impacts on the health practitioner. Objective: The purpose of this study was to examine the prevalence and impact of harassment by patients toward clinical students at a prominent Australasian dental school. Methods: A 14‐item survey was distributed to clinical students. The survey collected basic demographic information and contained Likert‐scale closed questions on harassment prevalence and experience and a free text question asking for details of a significant harassment experience. Descriptive statistics and analysis of free text data were performed. Results: The response rate was 67%. About 20% of respondents reported experiencing at least one incident of harassment. Verbal harassment was most commonly reported, followed by sexual and racial harassment. All incidences of sexual harassment were reported by female students, while racial harassment was most frequently reported by students of Asian ethnicity. Most students indicated they were unsure of how to respond to harassment by patients. Conclusion: Dental students were exposed to harassment by patients. Implications: Appropriate policies and education on responding to harassment, alongside support for the same, could help ensure the safety and wellbeing of students. [ABSTRACT FROM AUTHOR]

The aim of this study was to evaluate teeth prepared for computer-aided design/computer-aided manufacturing (CAD/CAM) restorations by senior dental students using recently developed rubrics. The rubrics used evaluation criteria based on four factors: retention or resistance form; marginal or internal adaption or manufacturing process; biology, esthetics, or durability of restorative material; and intraoral scanner impression. In academic year 2018-19, four faculty members used the rubrics to assess 111 first maxillary right premolars (tooth no. 4) prepared for lithium disilicate crowns and 223 second maxillary right premolars (tooth no. 5) and first maxillary right molars (tooth no. 3) prepared for monolithic zirconia partial fixed dental prostheses. The preparations had been performed on typodont teeth. The most common errors identified for tooth preparations were in the finish line quality (136 errors in 223 prostheses), a criterion that is crucial for quality CAD/CAM restorations. To prevent poorly fit CAD/CAM restoration preparations that result from an unacceptable finish line quality, students need to understand the rationale used to develop detailed rubrics and adhere to the defined critera. [ABSTRACT FROM AUTHOR]

Technology has revolutionized the field of dentistry, and digital workflow has become commonplace in everyday dental practices. However, are future practitioners prepared to enter into an increasingly digitized world? The aim of this study was to determine the extent to which digital modalities were being taught to predoctoral dental students and used for patient care in dental schools throughout North America. A 35-question survey was sent in February 2019 to all 76 dental schools in the U.S. and Canada. After 90 days, 54 recorded responses were received, for a 71% response rate. Students were reported to be using CAD/CAM technology in 50 (93%) of the 54 responding schools. While almost all schools responding to the survey were using digital scanning, there was disparity among them in terms of the types and frequency of procedures for which digital impressions were utilized. This study found that the incorporation of CAD/CAM technology in predoctoral dental curricula varied widely. However, it was clear that the relative dearth of well-trained faculty members and the number of CAD/CAM units available to students limited its use. It is imperative that more emphasis is placed on the utilization of digital workflow in North American dental schools for future practitioners to practice contemporary restorative dentistry. [ABSTRACT FROM AUTHOR]

The aim of this study was to assess the relationship between personality preferences of incoming fourth-year dental students at the University of Texas Health Science Center at San Antonio as measured by the Keirsey Temperament Sorter II and their third-year clinical productivity and percentage of broken appointments. All 105 incoming fourth-year dental students in 2016 were invited to participate in the study, and 92 students completed the temperament questionnaire, for a response rate of 87.5%. Those students' clinical activity during their third year was measured by production points and percentage of broken appointments extracted from the electronic health record. The results showed that the majority of the respondents were extroverts rather than introverts and that the extroverts had significantly higher production points and significantly fewer broken appointments than the introverts. The most common personality preferences were sensing and judging. More than two-thirds of the respondents represented the Guardian temperament, one of four categories on the temperament measure. These findings help highlight the traits that may contribute to success in clinical training during dental school and support the notion that clinical success may be influenced by certain personality characteristics as well as the technical and specialized skills of dentistry. [ABSTRACT FROM AUTHOR]

The aims of this study were to determine the trend of senior dental students' rate of production of clinical procedures performed in the comprehensive care clinic at one U.S. dental school and to compare that trend to what was reported immediately following inception of that clinic. In addition, total clinic revenues collected were recorded and compared. The periods used for comparisons were 2005 and 2006 combined, the last years before introduction of comprehensive care (called "pre-comp care"); 2007 and 2008 combined, the first two years of comprehensive care (called "post-comp care"); and subsequent years through 2014. The number of procedures and total charges were tracked in the electronic health record, and the total number of student-hours was calculated by multiplying the number of students in the class by the total number of available clinic hours. The rate calculated in this way was then multiplied by a factor of 1,000 for ease of interpretation. The results showed a generally upward trend and a significant increase from post-comp care to 2014 for all procedures combined and for indirect restorations. There was a generally downward trend and a significant decrease from post-comp care to 2014 for direct restorations, extractions, and root planing. There was some up and down fluctuation but no significant change from post-comp care to 2014 for exams. In terms of all procedures, the rate per student/1,000 clinic hours increased from approximately 227 to 419, an 85% increase over seven years. These results show that implementation of the comprehensive care clinic model of clinical education has increased the total clinical productivity of senior dental students at this dental school. Additional studies are indicated to determine the proper balance between a quality education and the financial capabilities of the institution. [ABSTRACT FROM AUTHOR]

A traditional summative grading structure, used at Indiana University School of Dentistry (IUSD) for more than 30 years, was identified by faculty as outdated for assessing students' clinical performance. In an effort to change the status quo, a feedback-driven assessment was implemented in 2012 to provide a constructive assessment tool acceptable to both faculty and students. Building on the successful non-graded clinical evaluation employed at Baylor College of Dentistry, IUSD implemented a streamlined electronic formative feedback model (FFM) to assess students' daily clinical performance. An important addition to this evaluation tool was the inclusion of routine student self-assessment opportunities. The aim of this study was to determine faculty and student response to the new assessment instrument. Following training sessions, anonymous satisfaction surveys were examined for the three user groups: clinical faculty (60% response rate), third-year (D3) students (72% response rate), and fourth-year (D4) students (57% response rate). In the results, 70% of the responding faculty members preferred the FFM over the summative model; however, 61.8% of the D4 respondents preferred the summative model, reporting insufficient assessment time and low faculty participation. The two groups of students had different responses to the self-assessment component: 70.2% of the D4 respondents appreciated clinical self-assessment compared to 46% of the D3 respondents. Overall, while some components of the FFM assessment were well received, a phased approach to implementation may have facilitated a transition more acceptable to both faculty and students. Improvements are being made in an attempt to increase overall satisfaction. [ABSTRACT FROM AUTHOR]

The aim of this study was to determine the degree to which dental schools in the United States have policies and procedures in place that facilitate the implementation of evidence-based clinical guidelines. The authors sent surveys to all 65 U.S. dental schools in 2014; responses were obtained from 38 (58%). The results showed that, of the nine policies and procedures examined, only two were fully implemented by 50% or more of the responding schools: guidelines supported through clinical faculty education or available chairside (50%), and students informed of guidelines in both the classroom and clinic (65.8%). Although 92% of the respondents reported having an electronic health record, 80% of those were not using it to track compliance with guidelines. Five schools reported implementing more policies than the rest of the schools. The study found that the approach to implementing guidelines at most of the responding schools did not follow best practices although five schools had an exemplary set of policies and procedures to support guideline implementation. These results suggest that most dental schools are currently not implementing guidelines effectively and efficiently, but that the goal of schools' having a comprehensive implementation program for clinical guidelines is achievable since some are doing so. Future studies should determine whether interventions to improve implementation in dental schools are needed. [ABSTRACT FROM AUTHOR]

Although the importance of empathy, rapport, and anxiety/pain awareness in dentist-patient relations has been well documented, these factors continue to be an issue with patients in many dental school clinics. The aim of this study was to develop an in-depth understanding of how patients at an urban, university-affiliated medical center and its dental school's clinic experienced oral health care and to generate ideas for improving the dental school's clinical curriculum and management of the clinic. Although patient satisfaction surveys are common, in-depth patient narratives are an underutilized resource for improving dental education. In-depth qualitative interviews were conducted with 20 uninsured or underinsured dental patients at these sites, and the results were analyzed using content analysis. Major phenomena that participants discussed were the importance of empathy and good rapport with their oral health providers and provider awareness of dental pain and anxiety. Many patients also discussed feeling dehumanized during dental visits. Based on their positive and negative experiences, the participants made suggestions for how oral health professionals can successfully engage patients in treatment. [ABSTRACT FROM AUTHOR]

The Consortium for Oral Health Research and Informatics (COHRI) is leading the way in use of the Dental Diagnostic System (DDS) terminology in the axiUm electronic health record (EHR). This collaborative pilot study had two aims: 1) to investigate whether use of the DDS terms positively impacted predoctoral dental students' critical thinking skills measured by the Health Sciences Reasoning Test (HSRT), and 2) to refine study protocols. The study design was a natural experiment with cross-sectional data collection using the HSRT for 15 classes (2013-17) of students at three dental schools. Characteristics of students who had been exposed to the DDS terms were compared with students who had not, and the differences were tested by t-tests or chi-square tests. Generalized linear models were used to evaluate the relationship between exposure and outcome on the overall critical thinking score. The results showed that exposure was significantly related to overall score (p=0.01), with not-exposed students having lower mean overall scores. This study thus demonstrated a positive impact of using the DDS terminology in an EHR on the critical thinking skills of predoctoral dental students in three COHRI schools as measured by their overall score on the HSRT. These preliminary findings support future research to further evaluate a proposed model of critical thinking in clinical dentistry. [ABSTRACT FROM AUTHOR]

The aim of this study was to evaluate the long-term adoption of a risk-based caries management program at a university dental clinic. The authors extracted data from electronic records of adult non-edentulous patients who underwent a comprehensive oral evaluation in the university predoctoral clinic from July 2007 through June 2014 (N=21,984). Consistency with caries management guidelines was measured as the percentage of patients with caries risk designation (low, moderate, high, or extreme) and the percentage of patients provided non-operative anti-caries agents within each designated caries risk category. Additionally, patient and provider characteristics associated with risk assessment completion and with provision of anti-caries therapy were identified. Results showed that the percentage of patients with documented caries risk grew steadily from 62.3% in 2007-08 to 92.8% in 2013-14. Overall, receipt of non-operative anti-caries agents increased with rising caries risk, from low (6.9%), moderate (14.1%), high (36.4%), to extreme (51.4%), but percentages were stable over the study period. Younger patients were more likely to have a completed risk assessment, and among high- and extreme-risk patients, delivery of anti-caries therapy was more common among patients who were younger, identified as Asian or Caucasian, received public dental benefits, or were seen by a student in the four-year DDS program or in the final year of training. These results demonstrate that extensive compliance in documenting caries risk was achieved within a decade of implementing risk-based clinical guidelines at this dental school clinic. Caries risk was the most strongly associated of several factors related to delivery of non-operative therapy. The eventual success of this program suggests that, in dental education, transition to a risk-based, prevention-focused curriculum may require a longterm commitment. [ABSTRACT FROM AUTHOR]

Grand Rounds are widely used in medicine for educating students comprehensively about clinical issues. The aim of this study was to explore the value of Grand Rounds for introducing first-(D1) and second-year (D2) dental students to an interdisciplinary approach to dental care. The objectives were to explore how interested students were in various topics, which topics they would like to see addressed in future sessions, which aspects they liked/disliked, how they evaluated the program components, and how they evaluated the outcomes. Data were collected from Dls at the end of the Year 1 fall term and from Dls and D2s at the beginning and end of the Year 1 winter term and at the end of Year 2. Response rates for most of the groups ranged from 88% to 100%, but response rates for surveys at the end of the study period fell to 40% and 32%. The results showed that the students were most interested in clinical topics that were presented in an interdisciplinary way. Their suggested topics ranged from specialty-specific issues to treatment-related topics such as implants and cosmetic dentistry. The open-ended responses showed that students liked learning differing perspectives on these topics, but disliked the course-related assignments and the preparation work in small groups. The closed-ended responses showed that the students appreciated the in-class presentations by experts and evaluated the course as helpful in informing them about the complexity of issues and the importance of the interplay between basic and clinical sciences. Educating future dentists in a way in which they embrace interdisciplinary approaches is challenging. Using the Grand Rounds concept could be one approach to increasing students' awareness of the importance of interdisciplinary work. [ABSTRACT FROM AUTHOR]

Dental clinicians have an expanding range of biomaterial choices for restoring tooth structure. Scientific developments in cariology, advances in dental biomaterials, and patients' esthetic concerns have led to a reduction in amalgam restorations and an increase in composite restorations. The aim of this study was to compare teaching time with students' clinical procedures in amalgam and composite posterior restorations in dental schools across the United States. Academic deans in 60 schools were invited to complete a survey that asked for the amount of instructional time for amalgam and composite posterior restorations and the number of clinical restorations performed by their Classes of 2009, 2010, and 2011. Of these 60, 12 returned surveys with complete data, for a 20% response rate. Responses from these schools showed little change in lecture and preclinical laboratory instruction from 2009 to 2011. There was a slight increase in two-surface restorations for both amalgam and composites; however, the total number of reported composite and amalgam restorations remained the same. Of 204,864 restorations reported, 53% were composite, and 47% were amalgam. There were twice as many multisurface large or complex amalgam restorations as composites. One-surface composite restorations exceeded amalgams. Among the participating schools, there was little to no change between curriculum time and clinical procedures. Findings from this preliminary study reflect a modest increase in twosurface resin-based restorations placed by dental students from 2009 to 2011 and little change in curricular time devoted to teaching amalgam restorations. The total number of posterior composite restorations placed by students in these schools was slightly higher than amalgams. [ABSTRACT FROM AUTHOR]

Research has demonstrated the validation of specific caries risk assessment (CRA) systems, but little is known about how dental practitioners assign a caries risk level to their patients. The aim of this study was to explore dental students' decision making in caries risk assignment when using the Caries Management By Risk Assessment (CAMBRA) system. Multiple correspondence analysis and chi-squared automated interaction detector analysis were performed on data collected retrospectively for a period of six years (2003-09) at the University of California, San Francisco predoctoral dental clinic. The study population consisted of 12,952 patients from six years of age through adult who received a baseline CRA during the period, were new to CAMBRA, and had not received any prior CAMBRA recommendations. The results showed variation in decision making and risk level assignment, illustrated by the range of percentages for the three scores (low, moderate, and high/extreme caries risk) when CRA was assigned for the first time. For those first-time CRAs, decision making was mainly based on four factors: cavities or caries lesions into dentin on radiograph, restorations during the last three years due to caries, visible heavy plaque, and interproximal lesions into enamel (by radiographs). This study's findings provide important data regarding one group of CAMBRA users and thus contribute to the development of knowledge about the implementation of caries risk assessment in contemporary dental practice. [ABSTRACT FROM AUTHOR]