Students’ perspectives of early and gradual transitioning between simulation and clinical training in dentistry and their suggestions for future course improvements

Abstract

Introduction:Students' perspectives on their learning environment are essential for course development and to enhance the educational experience. In dentistry, there is limited understanding of how students perceive their early clinical training. This study presents students' views on their gradual progression from simulation to patient care and describes the approaches they followed to adapt during this transitioning phase.Methods: A qualitative study design was employed, drawing on focus group discussions conducted with students from the Division of Dentistry at the University of Manchester. The discussions were transcribed verbatim. Data collection and coding process followed the principles of thematic analysis and the inductive approach. Findings:The sample was comprised of 28 undergraduate students, across four focus groups. Thematic analysis generated three key categories: students' immediate perspectives of early clinical training, students' approaches to adapting to the transitioning period and students' suggestions for future improvement. Further, subthemes emerged describing the positive gains which students recognised from their early and gradual clinical involvement and training. Despite experiencing stress and uncertainty, related to insufficient knowledge and immature multitasking skills in the early years of dental training, students were motivated by the clinical environment and identified several ways to adapt to it and enhance their learning. These included additional self-learning resources and simulation opportunities; inter-year group learning activities and further peer support and mentoring. Conclusion:The current study provided insights into students' experiences of learning through early clinical involvement and gradual transitioning between simulation and clinical environments in dentistry. The findings revealed that whilst students appreciated being involved in the clinic at an early stage, they had to adopt a variety of approaches to link their knowledge, learning and skills between the simulation and clinical environments. Students' suggested additional activities to link the learning gap between the two environments and to enrich their learning. K E Y W O R D Sclinical learning, focus group, qualitative research, simulation, students experiences, students learning This study was conducted during 2018 in the Division of Dentistry at the University of Manchester, UK. The teaching philosophy at the Division of Dentistry is based on an Enquiry-Based Learning (EBL) curriculum and student-centreed teaching. This approach integrates theory, skills and clinical teaching vertically and horizontally to achieve the intended learning outcomes defined by the General Dental Council, UK. 10 Students start their clinical learning from early course stage one in parallel with learning using simulation. During the first year, although students are not directly involved in patient care, they are gradually introduced to the complex clinical environment. Students must learn to undertake different competen...

Frightened of the pulp? A qualitative analysis of undergraduate student confidence and stress during the management of deep caries and the exposed pulp

“…This approach is contrary to advice encouraging selected referral for VPT to a specialist environment (Komabayashi & Zhu 2010), but that may depend on a number of country-specific factors. In a deviation from students surveyed in other studies (Botelho et al 2018, Kashbour et al 2019, this cohort did not report a lack of knowledge, perhaps as they were more advanced in their studies, or alternatively because they did not wish to admit a lack of knowledge in front of their peers. In the same way, none of them mentioned personal alternative strategies to deal specifically with the stress of deep caries treatment or stress management in general.…”

“…In these circumstances, students within this study reported coping by enlisting the initial support or the help of their peers and colleagues, who they are more comfortable with, rather than engaging with the supervisor. Although this peer support is recognized as a factor of confidence, and peer mentoring is developed in some dental universities (Kashbour et al 2019), it is arguably not sufficient within undergraduate clinical teaching and the students would prefer more feedback directly from their supervisors, rather than just a grade or a short comment. It was previously shown that the quantity and quality of feedback were positive predictors of students' autonomous motivation (Orsini et al 2018).…”

“…Essentially the students’ propositions of more practical training are in common with other studies to reduce dental students transitioning stress, which have highlighted that more pre‐clinical laboratory training on extracted teeth is important (Kashbour et al . 2019). Students also described their personal approaches to dealing with stress and suggested some potential improvements for each category of this study (Table 3).…”

“…The current study highlights the importance to student confidence of supportive staff and positive feedback, and conversely the negative effect of conflict and uncertainty over tutor’s advice (Kashbour et al . 2019). A problem identified within this study is that much of the chairside teaching is carried out by part‐time GDPs, a group which may have a disparate training or established ideas from years in dental practice.…”

“…To reduce stress, the students mentioned the importance of extensive pre‐clinical preparation, including watching videos, reading guidelines, anticipating equipment requirements as part of a professional personal organizational strategy, which concurs others (Kashbour et al . 2019). Time pressure seems to be a stressor during the treatment of deep caries and especially in case of pulp exposure, when the students often have to leave the patient and find their supervisor or an endodontist, who may then be busy with other students.…”