Undergraduate teaching in an oral surgery day case unit

Abstract

Objective: To examine the immediate post-operative morbidity experienced by patients following dento-alveolar procedures on a day-case basis when student operators are involved. Design: Single centre prospective study. Setting: Oral Surgery Day Case Unit. Subjects: One hundred and six patients underwent surgical removal of third molar teeth. Under supervision of an experienced operator, 55 undergraduate dental students removed a unilateral lower-third molar tooth and the contra lateral third molar teeth were excised by the experienced operator (student/staff operators). A comparative group of 51 patients were operated on entirely by experienced operators. There was no significant difference between the levels of tooth eruption and types of impacted teeth removed in either group. Results: The median operating time for the student/staff operator group was 30.0 (range 10–60) min, compared with 20.0 (range 5–55) min for experienced operators. Four patients experienced post-operative nausea and vomiting in the student/staff operator group compared with one in the experienced operator group. Post-operative analgesia was requested in the student/staff operator group at 23.0 (range 0–100) min and in the experienced operator group, 30.0 (range 0–80) min. Seventy-eight percent of patients in the student/staff operator group suffered moderate/severe pain immediately after surgery compared with 59% of patients treated by experienced operators. Six patients in the student/staff operator group suffered temporary lingual nerve anaesthesia, which resolved within 2 weeks after surgery compared with none in the experienced operator group. Conclusions: The concept of monitoring clinical outcomes in relation to under-graduate teaching is important. In the immediate post-operative period, student operators increase post-operative morbidity experienced by patients undergoing oral surgical procedures. Four patients in the student operator group suffered greater post-operative morbidity compared with one in the experienced operator group. In the day case setting, with careful case selection of patients, an environment can be created where patient throughput can be valuable for one-to-one teaching.