BackgroundYearly surveys among the undergraduate students in oral and maxillofacial surgery at Karolinska Institutet have conveyed a wish for increased clinical training, and in particular, in surgical removal of mandibular third molars. Due to lack of resources, this kind of clinical supervision has so far not been possible to implement. One possible solution to this problem might be to introduce simulation into the curriculum. The purpose of this study was to investigate undergraduate students' perception of two different simulation methods for practicing clinical reasoning skills and technical skills in oral and maxillofacial surgery.MethodsForty-seven students participating in the oral and maxillofacial surgery course at Karolinska Institutet during their final year were included. Three different oral surgery patient cases were created in a Virtual Patient (VP) Simulation system (Web-SP) and used for training clinical reasoning. A mandibular third molar surgery simulator with tactile feedback, providing hands on training in the bone removal and tooth sectioning in third molar surgery, was also tested. A seminar was performed using the combination of these two simulators where students' perception of the two different simulation methods was assessed by means of a questionnaire.ResultsThe response rate was 91.5% (43/47). The students were positive to the VP cases, although they rated their possible improvement of clinical reasoning skills as moderate. The students' perception of improved technical skills after training in the mandibular third molar surgery simulator was rated high. The majority of the students agreed that both simulation techniques should be included in the curriculum and strongly agreed that it was a good idea to use the two simulators in concert. The importance of feedback from the senior experts during simulator training was emphasised.ConclusionsThe two tested simulation methods were well accepted and most students agreed that the future curriculum would benefit from permanent inclusion of these exercises, especially when used in combination. The results also stress the importance of teaching technical skills and clinical reasoning in concert.

To improve teaching quality and student satisfaction, a new curriculum in Oral Surgery was implemented at Karolinska Institutet in 2007. This paper describes the curriculum change as well as the results regarding quality, satisfaction, cost-effectiveness and workload for teachers and staff. To design the new curriculum, all members of the teaching staff participated in a series of group discussions where problems with the previous curriculum were identified and ideas on how to improve the curriculum were discussed. Cost-effectiveness was evaluated by comparing the number of teaching sessions between the new and the old curriculum. A questionnaire was used to investigate the staffs' perceived change in workload and teaching quality. The students' satisfaction and attitudes to learning was screened for by on-line questionnaires. The large amount of passive observational teaching was considered as the main problem with the old curriculum. Half of these sessions were replaced by either clinical seminars or demonstrations performed in an interactive form. Students rated the new curriculum as a clear improvement. Analyses of time and cost-effectiveness showed a decrease in teaching sessions by almost 50%. Generally, the teachers were more positive towards the changes compared to the non-teaching staff. The students rated the new type of learning activities relatively high, whilst the traditional observational teaching was seen as less satisfactory. They preferred to learn in a practical way and few indicated analytic or emotional preferences. The majority of the students reported a good alignment between the new course curriculum and the final exam.

The purpose of the study was to investigate which supervisory approach afforded the most efficient learning method for undergraduate students in oral and maxillofacial surgery (OMS) using a computerised third molar surgery simulator. Fifth year dental students participated voluntarily in a randomised experimental study using the simulator. The amount of time required and the number of trials used by each student were evaluated as a measure of skills development. Students had the opportunity to practise the procedure until no further visible improvements were achieved. The study assessed four different types of supervision to guide the students. The first group was where they were supported by a teacher/specialist in OMS, the second by a teaching assistant, the third group practised without any supervision and the fourth received help from a simulator technician/engineer. A protocol describing assessment criteria was designed for this purpose, and a questionnaire was completed by all participating students after the study. The average number of attempts required to virtually remove a third molar tooth in the simulator was 1.44 times for the group supervised by an OMS teacher; 1.5 times for those supervised by a teaching assistant; 2.8 times for those who had no supervision; and 3.6 times when support was provided only by a simulator technician. The results showed that the most efficient experience of the students was when they were helped by an OMS teacher or a teaching assistant. In a time and cost-effective perspective, supervision by a teaching assistant for a third molar surgery simulator would be the optimal choice.

Background: High stake assessments are an important component in all stages of healthcare education that validate learners’ clinical performance but may also inform and promote the learning process. Informatics has been a driver to transform paper examinations to digital examinations (e-examinations) but knowledge about their efficient and effective application in the context of healthcare assessment is still limited. Objective: The aim of this study is therefore to investigate the main aspects of the examination process and information that may become more effective and efficient with the application of informatics. Method: With the use of a deductive approach, we wish to study four cases of e-assessment and develop a conceptual model to standardize the e-examination process. Results: Based on the four e-examination cases studied, we developed a common information model. To visualize the e-examination ecosystem we outlined different types of e-examination, the aspects composed in it, illustration of its processes, contextual components and stakeholders incorporated in it.

Background: High stake assessments are an important component in all stages of healthcare