Development and evaluation of learning module on clinical decision-making in Prosthodontics (original) (raw)
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Advances in Medical Education and Practice, 2014
Successful prosthodontic rehabilitation involves making many interrelated clinical decisions which have an impact on each other. Self-directed computer-based training has been shown to be a very useful tool to develop synthetic and analytical problem-solving skills among students. Thus, a computer-based case study and treatment planning (CSTP) software program was developed which would allow students to work through the process of comprehensive, multidisciplinary treatment planning for patients in a structured and logical manner. The present study was aimed at assessing the effect of this CSTP software on the clinical judgment of dental students while planning prosthodontic rehabilitation and to assess the students' perceptions about using the program for its intended use. Methods: A CSTP software program was developed and validated. The impact of this program on the clinical decision making skills of dental graduates was evaluated by real life patient encounters, using a modified and validated mini-CEX. Students' perceptions about the program were obtained by a pre-validated feedback questionnaire. Results: The faculty assessment scores of clinical judgment improved significantly after the use of this program. The majority of students felt it was an informative, useful, and innovative way of learning and they strongly felt that they had learnt the logical progression of planning, the insight into decision making, and the need for flexibility in treatment planning after using this program. Conclusion: CSTP software was well received by the students. There was significant improvement in students' clinical judgment after using this program. It should thus be envisaged fundamentally as an adjunct to conventional teaching techniques to improve students' decision making skills and confidence.
2014
Problem-solving and integration of knowledge are key objectives of the undergraduate dental curriculum of the School of Dentistry, University of Pretoria, which aims to develop the clinical reasoning skills of students. For practical reasons the School provides discipline-based teaching and learning, which, according to the literature, might limit a student's ability to integrate knowledge during clinical reasoning processes. The literature suggests that problem-solving by means of case studiesan active teaching and learning strategy-might be a useful method to develop and integrate knowledge at undergraduate level, and that earlier exposure to clinical cases might assist in the attainment of clinical reasoning skills at an earlier stage. Hence, this action research study describes the planning, design, implementation and evaluation of a "new" Comprehensive Patient Care curriculum over a three-year period (2009-2011) based on Kern's "six-step approach to curriculum development". The new curriculum employs an adjunctive integrated case-based approach according to the principles described in the "Four Component Instructional Design Model" and a new variant of the so-called "progress test", starting already in the preclinical (third) year of study, to develop and test students' clinical reasoning skills over time. The exit-level progress test results of dental students who had been taught by following an adjunctive integrated case-based approach were statistically analysed, using mixed model statistics, and were compared with the clinical decision-making skills of cohorts who had been taught by following the traditional discipline-based approach. These analyses were complemented by bivariate and multivariate quantitative analyses and qualitative student feedback (mixed methods). The validity of the progress test results was also examined by comparing the results of different cohorts. The fifth-year cohort who had been exposed to integrated case-based teaching and learning from their preclinical year performed significantly better in the progress test at exit level than the cohorts who had received only discipline-© © U Un ni iv ve er rs si it ty y o of f P Pr re et to or ri ia a (iii) based teaching and learning, even when controlling for previous academic performance. These findings were supported by the quantitative and qualitative feedback that students gave about the educational processes that were followed. The progress test performed reasonably well as a measurement tool and all the differences that were measured between the different cohorts could be explained logically. Case specificity posed the biggest threat to the reliability of the test. The results suggest that integrated case-based teaching and learning, commencing in the preclinical study years, might be a useful intervention to improve clinical reasoning ability at exit level in dental schools such as the School of Dentistry, University of Pretoria that follow a discipline-based approach. The results of this action research study provided particularly useful information, which will allow further improvements to the educational intervention. The results of this study require further research to substantiate the findings beyond doubt.
European Journal of Dental Education, 2015
Introduction: This study provides empirical evidence of the development of integrated clinical reasoning in the discipline-based School of Dentistry, University of Pretoria, South Africa. Students were exposed to case-based learning in comprehensive patient care (CPC) in the preclinical year of study, scaffolded by means of the fourcomponent instructional design model for complex learning. Methods: Progress test scores of third-to fifth-year dental students, who received case-based teaching and learning in the third year (2009-2011), were compared to the scores of preceding fourth-and fifth-year cohorts. These fourth-and fifth-year cohorts received content-based teaching concurrently with their clinical training in CPC. The progress test consisted of a complex case study and 32 MCQs on tracer conditions. Students had to gather the necessary information and had to make diagnostic and treatment-planning decisions. Results: Preclinical students who participated in the case-based teaching and learning achieved similar scores compared to final-year students who received lecture-based teaching and learning. Final-year students who participated in the case-based learning made three more correct clinical decisions per student, compared to those who received content-based teaching. Students struggled more with treatment-planning than with diagnostic decisions. Conclusion: The scaffolded case-based learning appears to contribute to accurate clinical decisions when compared to lecture-based teaching. It is suggested that the development of integrated reasoning competencies starts as early as possible in a dental curriculum, perhaps even in the preclinical year of study. Treatment-planning should receive particular attention.
Comparison of case-based and lecture-based learning in dental education using the SOLO taxonomy
Journal of dental education, 2014
The aim of this study was to compare the impact of case-based learning (CBL) and lecture-based learning (LBL) on fourth-year dental students' clinical decision making by using the Structure of Observed Learning Outcome (SOLO) taxonomy. Participants in the study were fourth-year dental students (n=55) in academic year 2012-13 taught in a large-group LBL context and fourth-year dental students (n=54) in academic year 2013-14 taught with the CBL methodology; both took place in the oral diseases course at Yeditepe University Faculty of Dentistry, Istanbul, Turkey. All eligible students participated, for a 100 percent response rate. A real case was presented to the students in both groups to assess their clinical decision making on the topic of oral diseases. Their performance was evaluated with the SOLO taxonomy. Student t-test was used for statistical evaluation, and significance was set at the p<0.05 level. A statistically significant difference was found between the mean score...
PURPOSE: This cross-sectional study aimed to assess teaching staff and their students' perceptions regarding the students' competency for clinical performance following the preclinical fixed prosthodontics course and their suggestion regarding alternative methods to improve the preclinical training. METHODS: Fourth-and fifth-year dental students and their teaching staff participated in a survey about the difficulty that faced the student during transitional period from preclinical fixed prosthodontic training to clinical context at Taibah Dental School. A well-constructed Questionnaire, designed to evaluate the students' perceptions regarding the students' competency for clinical performance following the preclinical fixed prosthodontics course and their suggestion regarding alternative methods to improve the preclinical training. The response to the questionnaire was based on the five-point Likert scale. Medians, frequencies were used to assess their perception on preclinical training and suggestion. RESULTS: A total of 78 students from 90 respond .The survey response was 87%; and 100% for the staff members (9 participants). 46% of the students thought that the four-handed dentistry system is not improving their quality of work and 46% felt that the academic staff were cooperative in helping them.56% of the academic staff members believed that the duration of the preclinical training is sufficient. 78% thought that the theoretical part is closely related to the preclinical training sessions. CONCLUSIONS: The feeling of confidence to start clinical phase felt students and their teaching staff members should be kept and reinforced by improving the positives aspects of the results and to resolve the negativities assigned.
Journal of Dental Education, 2015
Previous research regarding dental students has found modest predictive value in preclinical didactic course grades in predicting clinical performance, but systematic assessment of students' feedback on their perceived preparedness has received little attention as a preclinical assessment methodology. The aim of this study was to assess the perceptions of the dental students at one U.S. academic dental institution regarding their preparedness for clinical performance following the preclinical fixed prosthodontics course. Third-and fourth-year dental students participated in a survey about their perceived preparedness to diagnose and treat patients with fixed prosthodontics needs in the school's dental clinics. The respondents (79 out of 161 students, for a response rate of 49%) rated each item on a five-point Likert scale. Responses about which preclinical procedures of the course prepared students the least and the best were consistent for the third-and fourth-year students. Less than 60% of all responding students felt prepared for planning complex cases and performing laboratory-related procedures. The findings of this study indicate that improvement is required in teaching students about laboratory procedures and problem-solving to adequately prepare them for clinical treatment of patients with fixed prosthodontics needs.
Journal of Dental Education, 2019
The aim of this study was to evaluate the effects of dental faculty‐student interactions, virtual assessment software, and associated rubrics on student performance by assessing tooth preparations generated during the students' final practical exam. The study, conducted in 2017 and 2018, compared teeth prepared for preclinical fixed prosthodontics competency exams by two subsequent classes of second‐year dental students trained using different methods. Class A was trained for nine months prior to the exam using feedback via student‐faculty interactions and conventional rubrics. Class B was trained for five and half months prior to the exam via contemporary rubrics that incorporated feedback from both faculty and virtual assessment software. Two blinded, independent, and calibrated faculty members randomly evaluated the tooth preparations and graded them as excellent, standard, or standard not met for occlusal reduction, axial/lingual reduction, contour/long axis/axial wall heigh...
2020
Introduction: Video-based teaching (VBT) method was introduced in prosthodontics to supplement the conventional method of power point lecture (PPL) to effectively deliver preclinical knowledge prior to hands-on-simulation. Aim: To identify learning effectiveness and preferences between the PPL and VBT methods in a fixed prosthodontics classes amongst first-year clinical dental students (Year-3) at International Islamic University of Malaysia (IIUM). Method: A cross-over study design comprising teaching sessions (PPL and VBT methods), test assessment and questionnaire on onlay-subjects were conducted amongst third-year dental students (n=57) at IIUM in 2019. They were divided into 2 groups; exposed by different method of teaching; followed by other method. They were tested twice for teaching effectiveness in each session and survey preference post-combined methods. Data were analysed using SPSS v25, includes pre and post-tests. Results: All 57 students participated. The test score fo...
Evolution of Clinical Reasoning in Dental Education
Journal of Dental Education, 2011
The approach to care in dentistry has evolved over the past couple of decades from a narrow focus on oral disease to addressing the psychosocial determinants of oral health. Subsequently, there have been many attempts to reform dental curricula through alternative models of education, such as competency-based and community-based educational models and problem-based learning. These efforts aim to improve the abilities of dental students in problem-solving, critical thinking, professionalism, and social and cultural competence to help them cope with the complexity of dealing with oral health-related issues and the constantly changing evidence underlying the practice of dentistry. However, it is not yet clear how well these educational initiatives meet their objectives or how they influence the reasoning skills of dental students. There is now a need to develop a conceptual framework for clinical reasoning in dentistry grounded on empirical evidence to direct the future evolution of dental education.