Senior Dental Hygiene Students Research Articles

Using Motivational Interviewing to Increase Confidence in Nutritional Counseling Among Dental Hygienists: A Pilot Study

Purpose: Dental hygienists have the unique opportunity to educate patients on connections between nutrition and oral health. Dental hygiene students are introduced to these concepts but struggle to gain confidence to share this knowledge with patients. This pilot study looked at an educational module on motivational interviewing (MI) and an assessment and counseling tool to build student confidence with nutritional counseling. Methods: Dental hygiene students participated in an educational module to review MI and introduce a nutritional risk assessment and counseling tool. Prior to the module, participants completed a pretest about confidence levels regarding MI and nutritional counseling. After three weeks of clinical practice, participants completed a posttest. Data was compared for quantitative changes and qualitative themes from responses. Results: Twenty-two senior dental hygiene students (n = 22) participated in both the pretest and posttest. There were statistically significant changes in participants’ confidence (p = 0.007) and comfort (p = 0.020) discussing nutrition with patients. Participants struggled to become more confident in MI as demonstrated by no significant change in their feelings surrounding MI (p = 0.150). Students reporting increased nutritional counseling sessions showed improvement in their confidence. Conclusion: Introducing MI with an assessment and counseling tool to aid students can improve confidence with nutritional counseling. This type of education may translate into more chairside discussions about nutrition, improving overall patient care.

Dental hygiene students' matching accuracy when comparing antemortem dental radiographs and oral photographs to simulated postmortem WinID3® odontograms.

Matching dental antemortem (AM) and postmortem (PM) data for human identification is especially challenging when the workforce is limited. Dental hygienists have served mass fatality incidents (MFIs) due to dental-related expertise. However, forensics within dental hygiene education and research on transferable skills is limited. This qualitative balance design study assessed senior dental hygiene students' match accuracy of simulated cases varying in dental identifiers based on AM full mouth series (FMS) radiographs and oral photographs to PM WinID3® odontograms to demonstrate possible disaster victim identification (DVI) transferable skills gained during formal education. A convenience sample of senior dental hygiene students (n=31) was presented information on WinID3® interpretation, then presented with 5 mismatched cases and asked to visually interpret each to make 10 total matches; five based on AM FMS with simulated PM WinID3® odontograms and five based on AM photographs with PM WinID3® odontograms. Match accuracy scores ranged from 41.9% to 58.1% for cases with 1-10 identifiers, and 77.4% to 93.5% for cases with 11-40 identifiers. Accuracy when matching AM radiographs to PM odontograms versus AM photographs to PM odontograms was compared and revealed no statistical differences in match accuracy depending on image type (p=0.388 to 1.000). Results of this pilot study suggests transferable match accuracy skills resulted from the participants' dental hygiene formal education. These baseline skills with additional specialized training support the rationale for dental hygienists serving on DVI teams. More research is needed in education and practice when preparing dental hygienists for forensic-based service.

CLASSIFYING FEATURES FOR AN ORAL LESION IMAGE LEARNING TOOL

<h3>Objectives</h3> A web-based image classification tool (DiLearn) was developed to facilitate active learning in the oral health profession. Students engage with oral lesion images using swipe gestures to classify each image into predetermined categories (e.g., Left - refer; Right - no intervention). To assemble the training modules and to provide feedback to students, DiLearn requires each oral lesion image to be classified with various features displayed in the image. Collection of accurate meta information is a crucial step for enabling the self-directed active learning approach taken in DiLearn. The purpose of this study is to evaluate the classification consistency of features in oral lesion images by experts and students for use of the learning tool. <h3>Study Design</h3> Twenty oral lesion images from DiLearn's image bank were classified by 3 oral lesion experts and 2 senior dental hygiene students using the same rubric containing 8 features. Fleiss's κ was used to evaluate the classification agreement among oral lesion experts and to evaluate the overall agreement. Cohen's κ was used to compare agreement between student raters. <h3>Results</h3> Classification agreement between the 3 experts ranged from identical (Fleiss's κ = 1) for clinical action to slight agreement for border: regularity (Fleiss's κ = 0.136), with most categories having fair to moderate agreement (Fleiss's κ = 0.332-545). With the exception of morphology, inclusion of the 2 student raters with the experts yielded fair to moderate overall classification agreement (Fleiss's κ = 0.224-0.554). In sum, the feature clinical action can be accurately classified, whereas other anatomic features indirectly related to diagnosis have lower classification consistency. <h3>Conclusions</h3> Findings suggest 1 oral lesion expert or 2 student raters can provide fairly consistent meta information for select features implicated in the creation of image classification tasks in DiLearn.

Evaluating Classification Consistency of Oral Lesion Images for Use in an Image Classification Teaching Tool.

A web-based image classification tool (DiLearn) was developed to facilitate active learning in the oral health profession. Students engage with oral lesion images using swipe gestures to classify each image into pre-determined categories (e.g., left for refer and right for no intervention). To assemble the training modules and to provide feedback to students, DiLearn requires each oral lesion image to be classified, with various features displayed in the image. The collection of accurate meta-information is a crucial step for enabling the self-directed active learning approach taken in DiLearn. The purpose of this study is to evaluate the classification consistency of features in oral lesion images by experts and students for use in the learning tool. Twenty oral lesion images from DiLearn’s image bank were classified by three oral lesion experts and two senior dental hygiene students using the same rubric containing eight features. Classification agreement among and between raters were evaluated using Fleiss’ and Cohen’s Kappa. Classification agreement among the three experts ranged from identical (Fleiss’ Kappa = 1) for “clinical action”, to slight agreement for “border regularity” (Fleiss’ Kappa = 0.136), with the majority of categories having fair to moderate agreement (Fleiss’ Kappa = 0.332–0.545). Inclusion of the two student raters with the experts yielded fair to moderate overall classification agreement (Fleiss’ Kappa = 0.224–0.554), with the exception of “morphology”. The feature of clinical action could be accurately classified, while other anatomical features indirectly related to diagnosis had a lower classification consistency. The findings suggest that one oral lesion expert or two student raters can provide fairly consistent meta-information for selected categories of features implicated in the creation of image classification tasks in DiLearn.

A pilot virtual project for advising senior dental hygiene students on work readiness skills.

A pilot virtual project for advising senior dental hygiene students on work readiness skills.

Evaluating the Impact of an Educational Program on Stigmatizing Attitudes in Dental Hygiene Students

ABSTRACT: People living with serious mental illness (SMI) are at high risk for poor dentition, poor oral health, and increased tooth loss. This mixed methods research study assessed the impact of an interdisciplinary education program on dental hygiene student attitudes toward people with SMI. Senior dental hygiene students ( n = 38) from a large northeastern university participated in 3 hours of didactic learning, followed by experiential service learning. Quantitative surveys and qualitative questions were administered at three time points. Results showed a decrease in stigmatizing attitudes from before to after the didactic learning, which was maintained following experiential learning for two of the three scales. Thematic analysis indicated students' willingness to work with the population after service learning. Interdisciplinary education programs combining didactic and experiential service learning offer promise to improve attitudes of dental hygiene students. Future work is needed to explore the most critical and impactful components of this type of educational program.

Reflective Learning Outcomes of Community-Based Experiences: A Qualitative Study.

The aim of this study was to explore the meaning of community-based experiences for senior dental and dental hygiene students through the use of critical incident essays. A total of 108 senior dental students and 22 senior dental hygiene students were invited to participate in the study. Each student was required to write about one critical incident that occurred at one of four community clinic rotation sites during the 2012-13 school year. The participation rate was 78% of the students. Professional responsibility, a willingness to volunteer, and an understanding of the importance of oral health education were the main themes that emerged from analysis of the essays. These results suggest that community-based learning, with reflection, challenged how these students perceived oral health disparities and expanded the meaning of professional responsibility for them.

Dental and Dental Hygiene Intraprofessional Education: A Pilot Program and Assessment of Students' and Patients' Satisfaction.

Interprofessional and intraprofessional education (when students from two or more professions or within the same profession, respectively, learn about, from, and/or with each other) is crucial for effective interdisciplinary collaboration. The aims of this study were to assess the effectiveness of a clinical intraprofessional education program for dental and dental hygiene students, based on students' expectations and satisfaction with the program and patients' satisfaction with the team-based care. The pilot program was developed at the University of Tennessee Health Science Center College of Dentistry, where dental hygiene students were paired randomly with dental students scheduled for prophylaxis, scaling and root planing, or periodontal maintenance. Surveys with questions about the students' expectations and satisfaction were distributed to 89 senior dental students and 27 senior dental hygiene students before and after team-based procedures. Another survey was distributed to 17 patients asking about their satisfaction with the team-based care. All 27 dental hygiene students (100% response rate), 51 dental students (57.3% response rate), and all 17 patients (100% response rate) participated in the surveys. The results showed that both the dental and dental hygiene students had high expectations and were overall satisfied with the intraprofessional education. The students' expectations and perceived educational gap (difference between expectations and satisfaction) differed for the dental and dental hygiene students (p<0.001). The male dental students were also more satisfied than the female dental students (p<0.01). Overall, the program met or exceeded the students' expectations, and the patients were overwhelmingly satisfied with the team-based care. These results suggest that this intraprofessional practice model provided an effective educational experience for both dental and dental hygiene students and patients. The differences between the dental hygiene and dental students' expectations will help in the design of more effective training that promotes intraprofessional and interprofessional teamwork.

Assessing Critical Thinking Outcomes of Dental Hygiene Students Utilizing Virtual Patient Simulation: A Mixed Methods Study

Dental hygiene educators must determine which educational practices best promote critical thinking, a quality necessary to translate knowledge into sound clinical decision making. The aim of this small pilot study was to determine whether virtual patient simulation had an effect on the critical thinking of dental hygiene students. A pretest-posttest design using the Health Science Reasoning Test was used to evaluate the critical thinking skills of senior dental hygiene students at The University of Texas School of Dentistry at Houston Dental Hygiene Program before and after their experience with computer-based patient simulation cases. Additional survey questions sought to identify the students' perceptions of whether the experience had helped develop their critical thinking skills and improved their ability to provide competent patient care. A convenience sample of 31 senior dental hygiene students completed both the pretest and posttest (81.5% of total students in that class); 30 senior dental hygiene students completed the survey on perceptions of the simulation (78.9% response rate). Although the results did not show a significant increase in mean scores, the students reported feeling that the use of virtual patients was an effective teaching method to promote critical thinking, problem-solving, and confidence in the clinical realm. The results of this pilot study may have implications to support the use of virtual patient simulations in dental hygiene education. Future research could include a larger controlled study to validate findings from this study.

Dental and Allied Dental Students’ Attitudes Towards and Perceptions of Intraprofessional Education

Interprofessional and intraprofessional learning opportunities in health professions education are vital to emphasize evidence-based practice, quality improvement, and cost-effectiveness in patients' oral health care. The aim of this study was to assess dental, dental hygiene, and dental assisting students' readiness for intraprofessional education and to evaluate their attitudes towards and perceptions of intraprofessional teamwork, communication, respect, and understanding of professional roles. In 2013, students at one dental school (N=247) were surveyed, and focus groups were conducted for this convergent parallel mixed-methods study. Survey response rates were as follows: senior dental students 54.4% (N=43), senior dental hygiene students 100% (N=32), dental assisting students 95% (N=19), junior dental students 51.8% (N=42), and junior dental hygiene students 100% (N=33). The results showed that the dental hygiene students had more positive responses about intraprofessional education than the dental and dental assisting students (p<0.05). Most (94%, N=160) of the respondents in the combined groups agreed that intraprofessional learning would help them become more effective members of the oral health care team. The three focus group sessions (N=17) revealed consistency among the groups regarding the value of an integrated clinical design and intraprofessional education. These students were eager and positive about intraprofessional learning and agreed that a shared learning model can improve communication and respect among team members, provide a better understanding of roles, and ultimately enhance patient care.

Dental Hygiene Students’ Perceptions of Older Adults

Geriatric education is an important component of the dental hygiene curriculum because, in it, students acquire skills and attitudes to help provide quality care to older adults. The purpose of this study was to determine if off-site exposure to nursing home residents with supervised oversight had the potential to improve dental hygiene students' attitudes toward older adults. Senior dental hygiene students at one school completed a pre-nursing home experience questionnaire. A series of geriatric lectures and discussions, which included discussions about students' anxieties of working with institutionalized older adults, were held prior to the nursing home experience. The students then participated in two supervised four-hour nursing home experiences, were debriefed after the experiences, and completed a second questionnaire. Of thirty-nine potential participants in the study, thirty-two took part in the pre-nursing home experience questionnaire (82.1 percent). They had a mean split Fabroni score of 34.2 (95 percent confidence interval: 32.2, 36.3). The thirty participants in the post-experience questionnaire (76.9 percent of total) had a mean split score of 32.7 (95 percent confidence interval: 30.1, 35.3). This study failed to reject the null hypothesis of no mean difference between the pre- and post-nursing home experience; however, the post-experience mean score was lower than the pre-nursing home experience mean score, indicating a more positive attitude toward older adults after the experience.

Dental hygienists’ knowledge of HIV, attitudes towards people with HIV and willingness to conduct rapid HIV testing

To normalize rapid human immunodeficiency virus (HIV) testing in the United States, expanded rapid HIV testing initiatives are needed outside the routine medical setting. The dental setting is a logical choice as almost two-thirds of Americans regularly see a dental provider each year. This study was aimed to determine the dental hygienists' knowledge of HIV, attitudes towards people living with HIV and willingness to conduct rapid HIV testing. A national cross-sectional survey of practicing dental hygienists and senior dental hygiene students were recruited using state dental hygiene associations, email LISTSERVS, dental hygiene programmes and continuing education conferences (n = 634). The mean knowledge score was 10.5/13. High versus low test-scorers (75% of test questions or more answered correctly versus less than 75% answered correctly) did differ in their comfort level in counselling about sexual HIV prevention methods (P = 0.03) and comfort level in working with medically compromised patients (P = 0.04). Dental hygienists, with additional training in HIV prevention counseling and diagnostic testing, may be an appropriate profession to conduct rapid HIV testing.

M‐OSCE as a Method to Measure Dental Hygiene Students’ Critical Thinking: A Pilot Study

Educators in all academic disciplines have been encouraged to utilize assessment strategies to evaluate students' critical thinking. The purpose of this study was to assess the viability of the modified objective structured clinical examination (m-OSCE) to evaluate critical thinking in dental hygiene education. This evaluation utilized a convenience sample of senior dental hygiene students. Students participated in the m-OSCE in which portions of a patient case were revealed at four stations. The exam consisted of multiple-choice questions intended to measure students' ability to utilize critical thinking skills. Additionally, there was one fill-in-the-blank question and a treatment plan that was completed at the fifth station. The results of this study revealed that the m-OSCE did not reliably measure dental hygiene students' critical thinking. Statistical analysis found no satisfactory reliability within the multiple-choice questions and moderately reliable results within the treatment planning portion of the examination. In addition, the item analysis found gaps in students' abilities to transfer clinical evidence/data to basic biomedical knowledge as demonstrated through the multiple-choice questioning results. This outcome warrants further investigation of the utility of the m-OSCE, with a focus on modifications to the evaluation questions, grading rubric, and patient case.

A Service-Learning Project to Eliminate Barriers to Oral Care for Children With Special Health Care Needs

Children with special health care needs face many barriers to oral care and are at high risk for oral disease. School nurses are in a unique position to promote oral wellness in this vulnerable population. Collaboration between school nurses and dental hygiene faculty resulted in the formation of a partnership between a university-based dental hygiene program and two special education districts in rural southern Illinois. Senior dental hygiene students participated in a school-based service-learning project that provided dental examinations, preventive services, and education to children with special health care needs. Evidence-based behavioral interventions were used to teach children to comply with oral procedures. School nurses mentored dental hygiene students in behavior management of children. Dental exams were provided to 234 children from four special education schools with the majority receiving cleanings and fluoride.

Evaluation of Outcomes for Tobacco Cessation Counseling in the Dalhousie University Dental Hygiene Curriculum

As part of their curriculum, senior dental hygiene students at Dalhousie University Faculty of Dentistry provide tobacco cessation counseling (TCC). This study was conducted to evaluate the effectiveness of the TCC didactic curriculum and its clinical extensions. Research methods included a comprehensive literature search, an assessment of available resources related to TCC, and a structured telephone interview. The interview, consisting of ten summative questions, was conducted to determine the current tobacco use status of clients who had been counseled by a dental hygiene student for tobacco cessation. A target population of 132 subjects was extracted from axiUm, Dalhousie University dental clinic's patient database. The population represented clients who had TCC from 2001 to 2008. The investigators wanted to know if the client was 1) advised to quit tobacco use; 2) informed of the health risks of using tobacco; 3) still using tobacco; 4) taught self-examination techniques for oral cancer; and 5) if any post-counseling follow-up was initiated. A convenience size of fifty-one subjects was obtained. Survey results, along with the assessment of resources, revealed that the current TCC program needed improvement. As a result of the research, changes were implemented aimed at improving the effectiveness of the TCC program, and recommendations were made for further changes to enhance the overall program effectiveness.

Effect of Magnification Lenses on Student Operator Posture

A distinct body of literature supports the association between clinical postures of the dental practitioner and work-related musculoskeletal disorders (WRMD). Several aids or devices have been tested to improve clinical posture in the interest of decreasing WRMD. The use of magnification lenses while performing dental procedures may increase the quality of work and decrease the likelihood of musculoskeletal problems. To date, only anecdotal and personal opinions had existed regarding the benefits of using magnification lenses, and no empirical evidence had authenticated the contention that use of magnification lenses exerts a positive change in operator posture. The objective of this study was to assess the effect magnification lenses had on the posture of dental hygiene students. Using a randomized crossover design, researchers videotaped nineteen senior dental hygiene students performing an intra-oral procedure with and without the use of magnification lenses. The tapes were then evaluated by a panel of five dental hygiene educators calibrated in the use of Branson's Posture Assessment Instrument (PAI). Results of a paired t-test indicate that the posture of the students while wearing magnification lenses was more acceptable (p=.019) than when wearing traditional safety glasses. Results of this study indicate a quantifiable change in acceptability of posture for clinicians wearing magnification lenses and suggest that the use of such lenses in dental education may be warranted.

Catastrophizing, anxiety and pain during dental hygiene treatment.

This study examined the relations between catastrophizing, dental anxiety, and pain during dental hygiene treatment. Participants were 78 (32 men, 46 women) consecutive referrals to the Dalhousie University Dental Clinic. All patients were scheduled for a scaling procedure performed by senior dental hygiene students. Following treatment, patients completed the Pain Catastrophizing Scale and the Dental Anxiety Scale - Revised, and were asked to rate the degree of pain they experienced during the scaling procedure. Regression analyses revealed that age and the rumination subscale of the Pain Catastrophizing Scale were significant predictors of pain, even when controlling for gender, and oral hygiene status. The findings suggest that excessive focus on pain sensations may be one of the mechanisms by which catastrophizing leads to increased pain. The clinical challenges will be to develop cost- and time-effective means of identifying individuals who catastrophize and to implement interventions to reduce their level of distress.