Development and Validation of an Interprofessional Dental Ergonomics Educational Module for Implementation into Dental Curriculum

Face Validity

BackgroundWork-related musculoskeletal disorders are one of the main occupational health hazards affecting dental practitioners. This study was conducted to assess the prevalence of Work-related Musculoskeletal Disorder (WMSD) amongst dental students. Possible correlations with the working environment and ergonomics taught in Malaysian dental schools were also sought.MethodsFive dental schools in Malaysia participated in this cross-sectional study. A validated self-administered questionnaire was used to establish the point prevalence of WMSD in the dental students based on various body regions. The questionnaire also collected data regarding the working environment, clinical practice and the taught ergonomics of the students during their training years.ResultsOut of five hundred and sixty eight dental students who participated in the study, 410 were in their clinical years whilst 158 were students in their non- clinical years. Ninety three percent of the clinical year students reported symptoms of WMSD in one or more body regions. Female students reported a significantly higher numbers of symptoms compared to male students. The neck (82%) and lower back (64%) were reported to have the highest prevalence of WMSD. Discomfort in the neck region was found to be associated with self-reported frequency of bending of the neck. A majority of students (92%) reported minimum participation in workshops related to ergonomics in dentistry and 77% were unfamiliar with treatment and remedies available in the case of WMSD.ConclusionsThere was more WMSD seen in dental students who had started their clinical years. Neck and lower back are more injury prone areas and are at increased risk of developing musculoskeletal disorders. Theory and practice of ergonomics should be incorporated into the dental undergraduate curriculum.

Background: The present study was conducted to assess knowledge, attitude, and practice of dental ergonomics among dental undergraduates (UGs), interns, and postgraduate students (PGs) in a teaching hospital in the Koshi province. Methods: A cross-sectional questionnaire-based study was conducted in a tertiary care center. The questionnaire was distributed to 228 dental students to assess their knowledge, attitude, and practice related to dental ergonomics. The responses obtained were presented in terms of frequency and percentage. Results: In the surveyed population, 211 (92.54%) students were aware of musculoskeletal disorders related to dental practice, while 175 (76.75%) students knew about dental ergonomics. The study highlights a notable prevalence (77 students; 33.8%) of musculoskeletal disorders (MSDs) among dental students, which they believed were related to their profession. Regarding habits, 144 (63.16%) students practiced both sitting and standing dentistry, while 83 (36.40%) students performed only sitting dentistry. Only 59 (25.88%) participants practiced 4-handed dentistry and 88 (52.07%) students of those who did not practice it swiveled to better access the area. The majority, 217 (95.18%) students, suggested integrating dental ergonomics into their academic curriculum, while 212 (93%) students expressed interest in participating in workshops focused on dental ergonomics. Conclusions: The study highlights the awareness among dental students about musculoskeletal disorders and dental ergonomics. However, the notable prevalence of musculoskeletal disorders during dental practice emphasizes the importance of addressing ergonomic practices within the profession and the importance of incorporating dental ergonomics into the academic curriculum.

IntroductionAs work-stress, is associated with Non Communicable Diseases, and decreased work productivity, health and economic benefits are expected from periodic work-stress screening among employees using valid and reliable tools. Tool to Assess and classify Work Stress (TAWS– 16) was developed to overcome limitations in existing work-stress assessment tools in India. This study aims to test face, content, criterion and construct validity of TAWS– 16 in a sample of managerial-supervisory employees.MethodsNine domain experts rated face and content validity of TAWS– 16. Content validity was measured by Content Validity Indices (I-CVI, S-CVI) and Modified Kappa statistics. Empirical validity was tested by analysing data reported from 356 Information Technology (IT) professionals wherein Exploratory Factor Analysis was conducted for the assessment of Construct Validity. Self-reported data was collected in an unlinked and anonymous manner using a web-link, which was emailed to the study subjects, after initial introductory telephone or personal conversation. Criterion Validity was tested against stress sub-scale of DASS– 21. This study was approved by NIMHANS ethics committee.ResultsFindings revealed that TAWS– 16 has good face validity. The content validity is acceptable (CVI = 0.829). Construct Validity is appropriate as 60.8% of the total variance was explained by the factors identified in our study. Criterion Validity was moderate (Kappa Value 0.208) due to inappropriate work-stress instrument for comparison with TAWS– 16.ConclusionsOverall, TAWS– 16 demonstrated good face, content and construct validity. It measures work-stressors, coping abilities and psycho-somatic symptoms associated with work-stress. We recommend use of TAWS– 16 for periodic screening and classification of work-stress among employees.

As work-stress, is associated with Non Communicable Diseases, and decreased work productivity, health and economic benefits are expected from periodic work-stress screening among employees using valid and reliable tools. Tool to Assess and classify Work Stress (TAWS- 16) was developed to overcome limitations in existing work-stress assessment tools in India. This study aims to test face, content, criterion and construct validity of TAWS- 16 in a sample of managerial-supervisory employees. Nine domain experts rated face and content validity of TAWS- 16. Content validity was measured by Content Validity Indices (I-CVI, S-CVI) and Modified Kappa statistics. Empirical validity was tested by analysing data reported from 356 Information Technology (IT) professionals wherein Exploratory Factor Analysis was conducted for the assessment of Construct Validity. Self-reported data was collected in an unlinked and anonymous manner using a web-link, which was emailed to the study subjects, after initial introductory telephone or personal conversation. Criterion Validity was tested against stress sub-scale of DASS- 21. This study was approved by NIMHANS ethics committee. Findings revealed that TAWS- 16 has good face validity. The content validity is acceptable (CVI = 0.829). Construct Validity is appropriate as 60.8% of the total variance was explained by the factors identified in our study. Criterion Validity was moderate (Kappa Value 0.208) due to inappropriate work-stress instrument for comparison with TAWS- 16. Overall, TAWS- 16 demonstrated good face, content and construct validity. It measures work-stressors, coping abilities and psycho-somatic symptoms associated with work-stress. We recommend use of TAWS- 16 for periodic screening and classification of work-stress among employees.

Objectives: Work-related musculoskeletal disorders are one of the main occupational health hazards affecting dental practitioners. This study was conducted to assess the prevalence of Work- related Musculoskeletal Disorder (WMSD) amongst dental students. Possible correlations with the working environment and ergonomics taught among dental students in Collage of Dentistry of King Saud University in Riyadh (KSA) in their clinical and non-clinical years. Subjects & Methods: Randomly chosen dental students in King Saud University participated in this cross-sectional study. A validated self-administered questionnaire was used to establish the point prevalence of WMSD in the dental students based on various body regions. The questionnaire also collected data regarding the working environment, clinical practice and the taught ergonomics of the students during their training years. Results: Out of two hundred forty two (242) of dental students who participated in the study, 200 were in their clinical years while 42 were students in their non- clinical years. (68.2%) of the clinical year students reported symptoms of WMSDs in one or more body regions. Female students reported a significantly higher numbers of symptoms compared to male students. The neck (83.1%) and lower back (84.7%) were reported to have the highest prevalence of WMSD. Discomfort in the neck region was found to be associated with self-reported frequency of bending of the neck. A majority of students (94.2%) reported minimum participation in workshops related to ergonomics in dentistry and (86.8%) were unfamiliar with treatment and remedies available in the case of WMSDs. Conclusion: There was more WMSDs seen in dental students who had started their clinical years. Neck and lower back are more injury prone areas and are at increased risk of developing WMSDs. Theory and practice of ergonomics should be incorporated into the dental undergraduate curriculum.

PurposeTo investigate the concurrent, face and content validity of an evaluation tool for Myofascial Adhesions in Patients after Breast Cancer (MAP-BC evaluation tool).Methods1) Concurrent validity of the MAP-BC evaluation tool was investigated by exploring correlations (Spearman’s rank Correlation Coefficient) between the subjective scores (0 –no adhesions to 3 –very strong adhesions) of the skin level using the MAP-BC evaluation tool and objective elasticity parameters (maximal skin extension and gross elasticity) generated by the Cutometer Dual MPA 580. Nine different examination points on and around the mastectomy scar were evaluated. 2) Face and content validity were explored by questioning therapists experienced with myofascial therapy in breast cancer patients about the comprehensibility and comprehensiveness of the MAP-BC evaluation tool.Results1) Only three meaningful correlations were found on the mastectomy scar. For the most lateral examination point on the mastectomy scar a moderate negative correlation (-0.44, p = 0.01) with the maximal skin extension and a moderate positive correlation with the resistance versus ability of returning or ‘gross elasticity’ (0.42, p = 0.02) were found. For the middle point on the mastectomy scar an almost moderate positive correlation with gross elasticity was found as well (0.38, p = 0.04) 2) Content and face validity have been found to be good. Eighty-nine percent of the respondent found the instructions understandable and 98% found the scoring system obvious. Thirty-seven percent of the therapists suggested to add the possibility to evaluate additional anatomical locations in case of reconstructive and/or bilateral surgery.ConclusionsThe MAP-BC evaluation tool for myofascial adhesions in breast cancer patients has good face and content validity. Evidence for good concurrent validity of the skin level was found only on the mastectomy scar itself.

MP01-15 FACE, CONTENT, AND CONSTRUCT VALIDATION OF ENDOSCOPIC NEEDLE INJECTION (ENI) SIMULATOR FOR TRANSURETHRAL BULKING AGENT IN TREATMENT OF STRESS URINARY INCONTINENCE

PurposeWe evaluate the face, content, and construct validity of a portable hip arthroscopy module in a regional orthopaedic unit.MethodsParticipants were recruited from a regional orthopaedic centre, and categorized into novice (0 arthroscopies), intermediate (1-29 arthroscopies), and expert (>50 arthroscopies) groups based on reported experience in arthroscopy. Face and content validity was evaluated by feedback from users immediately following completion of modules. Objective measurements, including time taken and subjective measurements consisting of simulation software metrics including, cam lesion locations attempts, scope strikes on bone, healthy bone burred, and cam lesion burred. Scores achieved by experts were recorded, and the median score was set at the level at which proficiency was demonstrated. Participant feedback on perceived educational use was collected following completion.ResultsIn total, 20 participant results were included for analysis. Good face and content validity was expressed by participants with previous arthroscopic experience. Number of scope strikes within the simulator-derived metrics accurately discerned between levels of experience. Novices had a mean of 5 strikes per attempt (SD a mean of 5.8 strikes (SD 4.1). There was a significant difference between expert and novice groups (P = .01), and expert and intermediate groups (P = .002). No significant difference between overall performance scores achieved by participants in expert, intermediate, and novice groups (62% vs 55% vs 50% P = .15). This demonstrates incomplete construct validity of the simulator software-derived metrics.ConclusionsThis hip arthroscopy simulator demonstrated acceptable face and content validity, with incomplete construct validity of simulator software metrics. Participants reported high levels of satisfaction with the module, highlighting that the addition of haptic feedback would be beneficial to improve procedural steps. Incorporation of tactile feedback to the modulator components would likely enable the software to accurately delineate between levels of experience.Clinical RelevanceThis study demonstrates good face and content validity. The addition of haptic feedback in a hip arthroscopy simulator may improve learning.

To assess the face and content validity of artificial temporal bone dissection in surgical training in the UK. Expert and non-expert groups participated in artificial temporal bone dissection at the Queen Elizabeth Hospital, Birmingham, UK. Face and content validity were assessed by a validated post-dissection questionnaire. The median content validity score was 34 out of 35 (interquartile range 32.00-35.00). Mean face validity score compared to human was 45.76 out of 65 (95 per cent CI 42.57-48.94). Face validity compared to cadaveric models demonstrated equivalence (95 per cent CI 25.30-30.70, crossing equivalence value 27.00). Experts rated face validity less favourably than non-experts (p = 0.012 and 0.042, respectively). Content validity was equivalent between experts and non-experts (p = 0.052). There were no significant differences in total content (p = 0.606) and face validity (p = 0.133, p = 0.105) scores between different artificial bones. The high content and face validity suggests ENT training programs should consider formally incorporating artificial models into mastoid surgery training pathways.

MP23-09 A NOVEL TECHNIQUE FOR SIMULATED SURGICAL PROCEDURES USING 3D PRINTING TECHNOLOGY

BackgroundInformation on the HIV and AIDS-related knowledge among dental students provides a crucial foundation for efforts aimed at developing an appropriate dental curriculum on HIV and AIDS, and for attracting the attention of dental school educators towards the subject.PurposesFocusing on a census of dental students attending their 3rd, 4th and 5th study year at publicly – and privately funded dental faculties in Khartoum, this study aimed to assess the prevalence and socio-economic correlates of dental students' knowledge, sources of information and reported need for further education related to HIV and AIDS.MethodsAt the time of the survey (March–May 2007), the total number of dental students registered was 782 of which 642 (response rate 82%, mean age 21.7 year, 72% girls) completed anonymous self-administered questionnaires in supervised class room settings.ResultsA total of 49% and 86% had correct sum scores with respect to knowledge of transmission through contamination and through shaking hands and eating, respectively. About half the dental students recognized a need for further education across HIV related issues, varying from 75% (basic HIV/AIDS related issues) to 84% (patient management). Only 38% of the students had correct sum scores regarding various occupational groups at risk for contacting HIV and AIDS. Multiple logistic regression analysis revealed that compared to privately funded dental school students, publicly funded dental school students were less likely to have correct knowledge about modes of HIV transmission (OR = 0.6) and occupational risk groups (OR = 0.6) and to have received information from lectures/health care workers (OR = 0.5).ConclusionStudents attending privately funded schools were more knowledgeable about various HIV related issues than students from publicly funded schools. About half of the students investigated had received HIV/AIDS information from various sources and reported need for further education. This suggests that students are not adequately prepared for treating patients with HIV infection and AIDS and that the dental school curriculum needs improvements. Differences between public and private dental schools should be considered when planning such improvements.

Musculoskeletal (MSK) disorders account for 11%-98% of occupational health issues for dental professionals, with an onset as early as in dental school. Dental ergonomics is among the risk factors; thus, a prompt assessment is crucial in preventing future MSK pain. The aim of this study was to retrospectively assess dental ergonomics of second-year dental students after dedicated lectures were introduced in the predoctoral curriculum. Three cohorts of second-year dental students were evaluated during preclinical activity in July 2019, January 2022, and December 2022 by an Occupational Therapy (OT) faculty and calibrated OT students. Dental ergonomics was assessed with the Rapid Upper Limb Assessment (RULA). Dental student cohorts were compared with one-way analysis of variance (ANOVA). The average RULA final score of 409 participants was 5.1±0.9, with no difference between the three cohorts (p=0.676). The January 2022 cohort scored significantly lower in wrist-arm score than that of 2019 (p=0.001) and December 2022 (p=0.046). Neck and lower limb posture were significantly higher in January 2022 cohort than in 2019 (p=0.001 and 0.013) and December 2022 (p=0.001 and 0.005) cohorts. The December 2022 cohort revealed a medium, high and extremely high risk of developing MSK of 40.2%, 37.1%, and 21.6%, respectively, with no difference between sexes. The risk of developing MSK pain was medium-high in predoctoral dental students and was not related to sex. The overall dental ergonomics required attention and rapid change. Further implementation of varied forms of teaching and monitoring of dental ergonomics from the early years of education is recommended to prevent development of MSK pain at young age and foster better postural habits.

BackgroundThe Oral Health Impact Profile-14 (OHIP-14) questionnaire assesses quality of life related to people’s perception of oral disorders on their well-being. However, a translated and validated Danish version of OHIP-14 is not yet available.The purpose of this pilot study was to translate and cross-culturally adapt the English version of the OHIP-14 into Danish (OHIP-14-DK). In addition, to assess its content and face validity, internal consistency and test-retest reliability.MethodsThe English version of OHIP-14 was translated into Danish following a standard protocol of cross-cultural adaptation. Stages I-IV: translation phase to generate a pre-final version “OHIP-14-DK”. Stage V: pre-testing phase. A random sample of 22 orthodontic patients (mean age 24.7 years, SD ±14.8; 14 females, 8 males) were selected at the Section of Orthodontics, Aarhus University, Denmark. All patients self-completed the OHIP-14-DK and were then interviewed to assess its content and face validity. Internal consistency was assessed with Cronbach’s alpha coefficients. All patients completed the same questionnaire again at a one-week interval. Test-retest reliability was assessed using Spearman’s correlation coefficient and intra-class correlation coefficient (ICC).ResultsThe initial and back translations were very similar: the OHIP-14-DK proved to have a good level of equivalence with no translation errors or deviations. Furthermore, the OHIP-14-DK seemed well-adapted to Danish culture and was understood by individuals down to 12 years of age. Pre-testing demonstrated good face and content validity; interviews had a response rate of 100% and confirmed that each item was understandable without inducing reluctance or hesitation. Thus, responses were related to their corresponding item. Therefore, no final adjustments were required for the pre-tested version. Cronbach’s alpha for the OHIP-14-DK subscales fell in the 0.75–0.84 range, indicating an adequate-to-good internal consistency. Spearman’s correlation coefficient for the OHIP-14-DK total score was 0.77. The ICC for the OHIP-14-DK total score was 0.91.ConclusionsThe OHIP-14-DK seems well adapted to Danish culture, proved to be face and content valid and also showed good internal consistency and excellent reliability. However, its psychometric properties still need to be tested.Study registrationNot applicable

BackgroundThe reliability and validity of instruments used to survey health-care providers' views about and experiences with research evidence have seldom been examined.MethodsCountry teams from ten low- and middle-income countries (China, Ghana, India, Iran, Kazakhstan, Laos, Mexico, Pakistan, Senegal and Tanzania) participated in the development, translation, pilot-testing and administration of a questionnaire designed to measure health-care providers' views and activities related to improving their clinical practice and their awareness of, access to and use of research evidence, as well as changes in their clinical practice that they attribute to particular sources of research evidence that they have used. We use internal consistency as a measure of the questionnaire's reliability and, whenever possible, we use explanatory factor analyses to assess the degree to which questions that pertain to a single domain actually address common themes. We assess the questionnaire's face validity and content validity and, to a lesser extent, we also explore its criterion validity.ResultsThe questionnaire has high internal consistency, with Cronbach's alphas between 0.7 and 0.9 for 16 of 20 domains and sub-domains (identified by factor analyses). Cronbach's alphas are greater than 0.9 for two domains, suggesting some item redundancy. Pre- and post-field work assessments indicate the questionnaire has good face validity and content validity. Our limited assessment of criterion validity shows weak but statistically significant associations between the general influence of research evidence among providers and more specific measures of providers' change in approach to preventing or treating a clinical condition.ConclusionOur analysis points to a number of strengths of the questionnaire - high internal consistency (reliability) and good face and content validity - but also to areas where it can be shortened without losing important conceptual domains.