Determining competence in prosthodontics in undergraduate dental school programmes: an international study
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Date
2022-12-09
Authors
Al Khalaf, Khaleel
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University College Cork
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Abstract
Background and aims: In an era of increased attention on patient safety, as well as
increased student mobility between many countries, it is of interest to investigate
contemporary international trends in the teaching and assessment of prosthodontics.
The aims of this PhD project were to investigate the teaching and assessment methods
of the prosthodontics domains and to determine if it is possible to agree on competency
standards in prosthodontics.
Structure and methods: This thesis includes an introductory chapter (Chapter 1), a
narrative review of relevant educational and prosthodontic literature (Chapter 2), four
original quantitative (questionnaire-base) studies to assess the contemporary teaching
and assessment methods of prosthodontics on international basis (Chapters 3-6), and
a mixed-method Delphi approach among prosthodontic/restorative dentistry experts
to obtain a consensus on the most suitable undergraduate teaching and assessment
methods (Chapter 7). Chapter 8 includes a qualitative study using one-to-one interview
to explore the perspectives and opinions of senior dental academics that did not reach
consensus using the Delphi method. Chapter 9 contains a systematic review
synthesising the response rates in dental literature of questionnaire-base studies.
Finally, a brief conclusion of the thesis was presented (Chapter 10).
Results: Narrative review: there was significant divergence among prosthodontic
curricula in dental schools in terms of teaching methods, assessment criteria and how
student competence is determined.
Quantitative studies: Our findings from the quantitative studies reinforced the findings
of the narrative review; there was a significant international divergence of undergraduate teaching and assessment trends among dental schools, including the preclinical and clinical course, of the prosthodontics divisions (complete denture, removable partial denture, fixed prosthodontics and dental implants). Divergence was evident in dental schools even within the same country.
Mixed-method Delphi and qualitative studies: A total of 23 senior academic experts
from 11 countries participated in the Delphi study. There was a high level (92.6%, 175
statements out of 189) of consensus agreement over three iterative rounds, whereas 14
statements (7.4%) did not achieve a consensus. A total of 12 senior dental academics
from seven countries participated in semi-structured interviews, it was agreed that
academic professors, consultants, or specialists were the most suitable staff members
to supervise students during preclinical hands-on sessions in removable and fixed
prosthodontics. In addition, participants mentioned the availability of suitable patients
for treatment, dental schools’ curriculum and the level of students’ skills as factors
influencing the starting point of clinical sessions in fixed prosthodontics. We also found differences among the participating schools in regard to course contents and extent of teaching on dental implants. The experts suggested tailoring the curriculum according to what is expected from the graduating dentists and allowing students to observe dental implant cases before treating simple cases.
Systematic review of response rate: Overall, 133 studies with 149 response rates were
included. The median response rate across the included studies was 77%, a significant
negative correlation was observed between the response rate and the actual number of
distributed questionnaires (sample size) (r = -0.4127; P<0.001). there was an association between the response rate and the area of distribution (e.g., national or international, P= 0.0012). Yet, it was unclear whether if there are correlations between
the response rate and other variables (e.g., piloting, number of questions and the journal impact factor).
Conclusions: This thesis highlighted the current divergence in teaching and assessment methods of undergraduate prosthodontics. However, this divergence can be minimized, and the international harmonization of the dental curricula is highly possible by reassessing and tailoring the dental curricula. We presented a list of senior academics’ consensus statements on the teaching and assessment methods of prosthodontics. In addition, multiple recommendations and challenge resolutions were suggested and introduced. Thus, our findings can be considered as guidelines and references to develop recommendations for stakeholders involved in undergraduate curricula among dental schools worldwide and in consistence with the local dental council recommendations, which will ensure dentists with the same level of competence at graduation.
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Keywords
Prosthodontics , Dental undergraduate teaching and assessment , Dental education , Removable partial denture , Fixed prosthodontics , Dental implants , Complete denture
Citation
Al Khalaf, K. I. 2022. Determining competence in prosthodontics in undergraduate dental school programmes: an international study. PhD Thesis, University College Cork.