A Randomized Controlled Trial of Outreach Placement's Effect on Dental Students’ Clinical Confidence

Abstract

This randomized controlled trial compared the effects of outreach placement with traditional, exclusively dental schoolbased clinical experience on students' confidence in providing treatment for patients presenting with common dental problems. Senior dental students (n=49) were allocated at random to existing dental school-based clinics or placement in primary care clinics to work supervised by local dentists. At baseline, students self-rated their global confidence on a five-point scale. These measures were repeated at follow-up, augmented by a transition judgment and a then-test of confidence (asking students to look back and re-rate their pre-placement confidence). Groups were comparable at baseline. Follow-up scores for global confidence were similar between groups. The outreach group scored higher in the transition judgment (mean 3.7, SD 0.9) than the control group (mean 3.1, SD 1.1, P=0.05). In the then-test, on reflection, the outreach group considered their baseline ratings of confidence were overoptimistic (mean then-test scores 3.2, SD 0.9 and baseline 3.7, SD 0.5) while the control group thought theirs were accurate (mean then-test scores 3.8, SD 0.7 and baseline 3.6, SD 0.8, P=0.01). The findings suggest dental outreach training in primary care settings is more effective than dental school training alone in improving students' confidence in tackling clinical situations. The measurement of change in confidence is complicated by shifts in students' internal scales arising from insights gained on outreach.

Undergraduates' self-reported clinical experience, confidence and perspectives of hospital and outreach paediatric dentistry: a three-year multi-centre evaluation

“…Outreach placements were seen as essential for students to gain satisfactory clinical experience, and this was evidenced by both the quantitative and qualitative data. This finding is supported by previous studies 18 that also reported that students perceived time spent within outreach primary care centres as enhancing their confidence levels in treating children 23,24 and leaving them feeling better prepared for dental practice. 25 Interestingly, this study revealed that Manchester students, who had the longest periods of time within an outreach setting, did not necessarily have the highest levels of confidence.…”

“…The qualitative data suggested that some students were confused by disparity in clinical opinions between different trainers, which is consistent with previous research. 23,26 Similarly, the COPDEND report expressed concerns over new graduates being guided by DF1 trainers with differing clinical opinions to their hospital-based tutors. 5 It is therefore important that outreach placements are selected carefully and that emphasis is placed on the continuity of teaching between dental school and outreach providers.…”

A city‐wide survey of dental students’ opinions on undergraduate oral surgery teaching

“…There is no outreach programme for the undergraduate oral surgery curriculum in Turkey. The role of outreach and vocational training programmes should be considered in primary care settings to improve and secure students’ confidence in handling clinical procedures …”

O agir em competência para o cuidado especializado na saúde bucal

“…Segundo esses estudos, os estudantes que participaram de processos de formação em que se enfatizam a integração ensino-serviço, demonstram maior consciência da importância dos determinantes sociais no processo saúde-doença 29 e da importância de se compreender o histórico sócioodontológico 30 . Além de adquirirem maior confiança na realização dos mais diversos procedimentos da cínica odontológica 31,32 . Currículos com programas de integração ensino serviço permitem aos estudantes um melhor entendimento das necessidades da comunidade 33 .…”