Impact of simulation in local anesthesia training of dental students. A three-year program evaluation
Kyriaki MARTI, Vidya RAMASWAMY, Mark FITZGERALD
Department of Periodontics and Oral Medicine, School of Dentistry, University of Michigan, Ann Arbor, MI, USA (Interim Chair: Assoc. Professor Rogerio Castilho, DDS, MS, PhD)
SUMMARY: An interdepartmental intervention was im- plemented to determine how the addition of simulation training in local anesthesia to a clinical course could im- prove students' perception of knowledge, experience, confidence, preparedness and stress. The program was evaluated after a 3-years implementation (2013-2015). Group 1B of second-year students (2013) received sim- ulation before and Group 1A received simulation after their clinical exercise. Both Groups completed a survey immediately post-simulation. Group 2 (2014-2015) stu- dents received simulation before clinical experience and completed the surveys both pre-and post- clinical expe- rience. Students self-assessed their knowledge, experi- ence and confidence concerning four local anesthesia competencies. Faculty members compared students’ clin- ical performance with those of students’ 4 years prior who had no simulation experience.
Students experiencing a combined simulation and clinical experience perceived themselves statistically significantly more knowledgeable, confident and experienced versus simulation experience only. There was no statistical dif- ference between the Group receiving simulation pre- and the Group receiving simulation post- clinical experi- ence. Faculty perceptions of students’ clinical perform- ance showed mild improvement in all groups experienc- ing simulation.
KEY WORDS: simulation, dental education, local anesthe- sia, program evaluation, predoctoral education.
Hellenic Archives of Oral & Maxillofacial Surgery (2020) 3, 143-159
REFERENCES
Bradley P, Postlethwaite K: Setting up a clinical skills learning facility.
Medical Education Nov 1; 37(s1): 6-13, 2003
Brand HS, Baart JA, Maas NE, Bachet I: Effect of a training model in local anesthesia training. J Dent Educ 74(8): 876-9, 2010
Brand HS, Tan LLS, van der Spek SJ, Baart JA: European dental stu- dents' opinions on their local anaesthesia education. Eur J Dent Educ 15: 47–52, 2011
Buchanan JA: The use of simulation technology in dental education. J Dent Educ 65(11): 1225-31, 2001
Chandrasekaran B, Cugati N, Kumaresan R: Dental students’ perception and anxiety levels during their first local anesthetic injection. The Malaysian journal of medical sciences (MJMS) Nov; 21(6): 45. 2014 Cleveland JL, Barker L, Gooch BF, Beltrami EM, Cardo D: Use of HIV post-exposure prophylaxis by dental health care personnel: an overview and updated recommendations. J Am Dent Assoc
133(12): 1619-1626, 2002
Commission on Dental Accreditation (CODA): Accreditation Stan- dards for Dental Education Programs, American Dental Associa- tion, ada.org, 2010 (revision 2013)
Daublander M, Muller R, Lipp MDW: The incidence of complications associated with local anesthesia in dentistry. Anesth Prog 44:132- 41, 1997
Ericsson KA: Deliberate practice and the acquisition and maintenance of expert performance in medicine and related domains. Acad Med 79:S70–81, 2004
Hossaini M: Teaching Local Anesthesia in Dental Schools: Opinions About the Student-to- Student Administration Model. J Dent Educ 75(9): 1263- 1269, 2011
Jaber MA: A survey of needle sticks and other sharp injuries among dental undergraduate students. International Journal of Infection Control. Jan 25; 7(3), 2011
Jasinevicius TR, Landers M, Nelson S, Urbankova A: An evaluation of two dental simulation systems: virtual reality versus contemporary non-computer-assisted. J Dent Educ 68: 1151–1162, 2004
Knipfer C, Rohde M, Oetter N, Muench T, Kesting MR, Stelzle F: Local anaesthesia training for undergraduate students–how big is the step from model to man? BMC medical education. Dec; 18(1): 1- 8, 2018
Kolb DA: Experiential learning: experience as the source of learning and development. J Organ Behav 8:19-38, 1984
Lee JS, Graham R, Bassiur JP, Lichtenthal RM: Evaluation of a Local Anesthesia Simulation Model with Dental Students as Novice Cli- nicians. J Dent Educ Dec; 79(12): 1411-7, 2015
Lo López-Cabrera C, Hernández-Rivas EJ, Komabayashi T, Galindo- Reyes EL, Tallabs-López D, Cerda-Cristerna BI: Positive influence of a dental anaesthesia simulation model on the perception of learning by Mexican dental students. Eur J Dent Educ Nov; 21(4): e142-7, 2017
Malamed SF: Handbook of Dental Anesthesia. 6th Ed, Elsevier, Mosby, 2014.
Marei HF, Al-Jandan BA: Simulation-based local anesthesia teaching enhances learning outcomes. Eur J Dent Educ 17(1): e44-48, 2013
Marti K, Sandhu G, Aljadeff L, Greene R, Lesch AB, Le JM, Pinsky HM, Rooney DM: Simulation-Based Medical Emergencies Education for Dental Students: A Three-Year Evaluation. J Dental Educ Aug 1; 83(8): 973-80, 2019
Martis C, Karabouta-Voulgaropoulou E, Marti K: Aspiration in inferior alveolar nerve block. Stomatologia (Bucur) 43: 273-8, 1986 McGaghie WC, Issenberg SB, Petrusa ER, Scalese RJ: A critical review
of simulation-based medical education research: 2003-2009. Med Educ Jan; 44(1): 50-63. Review, 2010
McGaghie WC, Issenberg SB, Cohen ER, Barsuk JH, Wayne DB: Med- ical education featuring mastery learning with deliberate practice can lead to better health for individuals and populations. Acad Med. 86(11): e8-9, 2011
MERLOT - Website: https://www.merlot.org/merlot/viewMaterial.htm? Id=80037. Accessed March 2, 2016 Nunez DW, Taleghani M, Wathen WF, et al: Typodont versus live patient: predicting dental students' clinical performance. J Dent Educ 76:407-13, 2012
Park CS: Simulation and quality improvement in anesthesiology. Anes- thesiol Clin. Mar 29(1): 13-28, 2011
Polyzois I, Claffey N, McDonald A, Hussey D, Quinn F: Can evaluation of a dental procedure at the outset of learning predict later per- formance at the preclinical level? A pilot study. Eur J Dent Educ May 1; 15(2): 104-9, 2011
Quinn F, Keogh P, McDonald A, Hussey D: A pilot study comparing the effectiveness of conventional training and virtual reality simu- lation in the skills acquisition of junior dental students. Eur J Dent Educ 7: 13–19, 2003
Reed T, Pirotte M, McHugh M, Oh L, Lovett S, Hoyt AE, Quinones D, Adams W, Gruener G, McGaghie WC: Simulation-Based Mastery Learning Improves Medical Student Performance and Retention of Core Clinical Skills. Simul Healthc 11(3): 173-80, 2016
Rosenberg M: Simulation technology in Anesthesiology. Anesth Prog 47(1): 8-11, 2000
Rosenberg M, Orr DL, Starley ED, Jensen DR: Student-to-student local anesthesia injections in dental education: moral, ethical, and legal issues. J Dent Educ Jan 1; 73(1): 127-32, 2009
Rosenberg AD, Popovic J, Albert DB, et al: Three partial-task simulators for teaching ultrasound-guided regional anesthesia. Reg Anesth Pain Med 37:106-10, 2012
Sánchez-Garcés MÁ, Arnabat-Domínguez J, Camps-Font O, Toledano- Serrabona J, Guijarro-Baude A, Gay-Escoda C: Evaluation of stu- dent-to-student local anaesthesia administration at the University of Barcelona: A cross-sectional study. Eur J Dent Educ May; 24(2): 328-34, 2020
Stufflebeam DL: The CIPP model for evaluation. In Kellaghan T, Stuffle- beam DL: International Handbook of Educational Evaluation. Part
1. Perspectives. Kluwer Academic Publishers Ed, 2003
Sukotjo C, Thammasitboon K, Howell H, Karimbux N: The impact of targeted shortened preclinical exercises on student perceptions and outcomes. J Dent Educ 71(8): 1070-79, 2007
Tomruk CÖ, Oktay I, Şençift K: A survey of local anesthesia education in Turkish dental schools. J Dent Educ. 77(3): 348-50, 2013
Udani AD, Kim TE, Howard SK, Mariano ER: Simulation in teaching re- gional anesthesia: current perspectives. Local Reg Anesth. Aug 11; 8:33-43, 2015. doi: 10.2147/LRA.S68223. eCollection 2015
Wong G, Apthorpe HC, Ruiz K, Nanayakkara S: A Tale of Two Teach- ing Methods: Students' Clinical Perspectives on Administering Dental Local Anesthetics. J Dent Educ Feb 1; 84(2): 166-75, 2020 Yekta SS, Lampert F, Kazemi S, et al: Evaluation of new injection and cavity preparation model in local anesthesia teaching. J Dent Educ
77(1): 51–7, 2013
Ziv A, Small SD, Wolpe PR: Patient safety and simulation-based med- ical education. Medical Teacher, Jan 1; 22(5): 489-95, 2000
Kyriaki MARTI, Vidya RAMASWAMY, Mark FITZGERALD
Department of Periodontics and Oral Medicine, School of Dentistry, University of Michigan, Ann Arbor, MI, USA (Interim Chair: Assoc. Professor Rogerio Castilho, DDS, MS, PhD)
SUMMARY: An interdepartmental intervention was im- plemented to determine how the addition of simulation training in local anesthesia to a clinical course could im- prove students' perception of knowledge, experience, confidence, preparedness and stress. The program was evaluated after a 3-years implementation (2013-2015). Group 1B of second-year students (2013) received sim- ulation before and Group 1A received simulation after their clinical exercise. Both Groups completed a survey immediately post-simulation. Group 2 (2014-2015) stu- dents received simulation before clinical experience and completed the surveys both pre-and post- clinical expe- rience. Students self-assessed their knowledge, experi- ence and confidence concerning four local anesthesia competencies. Faculty members compared students’ clin- ical performance with those of students’ 4 years prior who had no simulation experience.
Students experiencing a combined simulation and clinical experience perceived themselves statistically significantly more knowledgeable, confident and experienced versus simulation experience only. There was no statistical dif- ference between the Group receiving simulation pre- and the Group receiving simulation post- clinical experi- ence. Faculty perceptions of students’ clinical perform- ance showed mild improvement in all groups experienc- ing simulation.
KEY WORDS: simulation, dental education, local anesthe- sia, program evaluation, predoctoral education.
Hellenic Archives of Oral & Maxillofacial Surgery (2020) 3, 143-159
REFERENCES
Bradley P, Postlethwaite K: Setting up a clinical skills learning facility.
Medical Education Nov 1; 37(s1): 6-13, 2003
Brand HS, Baart JA, Maas NE, Bachet I: Effect of a training model in local anesthesia training. J Dent Educ 74(8): 876-9, 2010
Brand HS, Tan LLS, van der Spek SJ, Baart JA: European dental stu- dents' opinions on their local anaesthesia education. Eur J Dent Educ 15: 47–52, 2011
Buchanan JA: The use of simulation technology in dental education. J Dent Educ 65(11): 1225-31, 2001
Chandrasekaran B, Cugati N, Kumaresan R: Dental students’ perception and anxiety levels during their first local anesthetic injection. The Malaysian journal of medical sciences (MJMS) Nov; 21(6): 45. 2014 Cleveland JL, Barker L, Gooch BF, Beltrami EM, Cardo D: Use of HIV post-exposure prophylaxis by dental health care personnel: an overview and updated recommendations. J Am Dent Assoc
133(12): 1619-1626, 2002
Commission on Dental Accreditation (CODA): Accreditation Stan- dards for Dental Education Programs, American Dental Associa- tion, ada.org, 2010 (revision 2013)
Daublander M, Muller R, Lipp MDW: The incidence of complications associated with local anesthesia in dentistry. Anesth Prog 44:132- 41, 1997
Ericsson KA: Deliberate practice and the acquisition and maintenance of expert performance in medicine and related domains. Acad Med 79:S70–81, 2004
Hossaini M: Teaching Local Anesthesia in Dental Schools: Opinions About the Student-to- Student Administration Model. J Dent Educ 75(9): 1263- 1269, 2011
Jaber MA: A survey of needle sticks and other sharp injuries among dental undergraduate students. International Journal of Infection Control. Jan 25; 7(3), 2011
Jasinevicius TR, Landers M, Nelson S, Urbankova A: An evaluation of two dental simulation systems: virtual reality versus contemporary non-computer-assisted. J Dent Educ 68: 1151–1162, 2004
Knipfer C, Rohde M, Oetter N, Muench T, Kesting MR, Stelzle F: Local anaesthesia training for undergraduate students–how big is the step from model to man? BMC medical education. Dec; 18(1): 1- 8, 2018
Kolb DA: Experiential learning: experience as the source of learning and development. J Organ Behav 8:19-38, 1984
Lee JS, Graham R, Bassiur JP, Lichtenthal RM: Evaluation of a Local Anesthesia Simulation Model with Dental Students as Novice Cli- nicians. J Dent Educ Dec; 79(12): 1411-7, 2015
Lo López-Cabrera C, Hernández-Rivas EJ, Komabayashi T, Galindo- Reyes EL, Tallabs-López D, Cerda-Cristerna BI: Positive influence of a dental anaesthesia simulation model on the perception of learning by Mexican dental students. Eur J Dent Educ Nov; 21(4): e142-7, 2017
Malamed SF: Handbook of Dental Anesthesia. 6th Ed, Elsevier, Mosby, 2014.
Marei HF, Al-Jandan BA: Simulation-based local anesthesia teaching enhances learning outcomes. Eur J Dent Educ 17(1): e44-48, 2013
Marti K, Sandhu G, Aljadeff L, Greene R, Lesch AB, Le JM, Pinsky HM, Rooney DM: Simulation-Based Medical Emergencies Education for Dental Students: A Three-Year Evaluation. J Dental Educ Aug 1; 83(8): 973-80, 2019
Martis C, Karabouta-Voulgaropoulou E, Marti K: Aspiration in inferior alveolar nerve block. Stomatologia (Bucur) 43: 273-8, 1986 McGaghie WC, Issenberg SB, Petrusa ER, Scalese RJ: A critical review
of simulation-based medical education research: 2003-2009. Med Educ Jan; 44(1): 50-63. Review, 2010
McGaghie WC, Issenberg SB, Cohen ER, Barsuk JH, Wayne DB: Med- ical education featuring mastery learning with deliberate practice can lead to better health for individuals and populations. Acad Med. 86(11): e8-9, 2011
MERLOT - Website: https://www.merlot.org/merlot/viewMaterial.htm? Id=80037. Accessed March 2, 2016 Nunez DW, Taleghani M, Wathen WF, et al: Typodont versus live patient: predicting dental students' clinical performance. J Dent Educ 76:407-13, 2012
Park CS: Simulation and quality improvement in anesthesiology. Anes- thesiol Clin. Mar 29(1): 13-28, 2011
Polyzois I, Claffey N, McDonald A, Hussey D, Quinn F: Can evaluation of a dental procedure at the outset of learning predict later per- formance at the preclinical level? A pilot study. Eur J Dent Educ May 1; 15(2): 104-9, 2011
Quinn F, Keogh P, McDonald A, Hussey D: A pilot study comparing the effectiveness of conventional training and virtual reality simu- lation in the skills acquisition of junior dental students. Eur J Dent Educ 7: 13–19, 2003
Reed T, Pirotte M, McHugh M, Oh L, Lovett S, Hoyt AE, Quinones D, Adams W, Gruener G, McGaghie WC: Simulation-Based Mastery Learning Improves Medical Student Performance and Retention of Core Clinical Skills. Simul Healthc 11(3): 173-80, 2016
Rosenberg M: Simulation technology in Anesthesiology. Anesth Prog 47(1): 8-11, 2000
Rosenberg M, Orr DL, Starley ED, Jensen DR: Student-to-student local anesthesia injections in dental education: moral, ethical, and legal issues. J Dent Educ Jan 1; 73(1): 127-32, 2009
Rosenberg AD, Popovic J, Albert DB, et al: Three partial-task simulators for teaching ultrasound-guided regional anesthesia. Reg Anesth Pain Med 37:106-10, 2012
Sánchez-Garcés MÁ, Arnabat-Domínguez J, Camps-Font O, Toledano- Serrabona J, Guijarro-Baude A, Gay-Escoda C: Evaluation of stu- dent-to-student local anaesthesia administration at the University of Barcelona: A cross-sectional study. Eur J Dent Educ May; 24(2): 328-34, 2020
Stufflebeam DL: The CIPP model for evaluation. In Kellaghan T, Stuffle- beam DL: International Handbook of Educational Evaluation. Part
1. Perspectives. Kluwer Academic Publishers Ed, 2003
Sukotjo C, Thammasitboon K, Howell H, Karimbux N: The impact of targeted shortened preclinical exercises on student perceptions and outcomes. J Dent Educ 71(8): 1070-79, 2007
Tomruk CÖ, Oktay I, Şençift K: A survey of local anesthesia education in Turkish dental schools. J Dent Educ. 77(3): 348-50, 2013
Udani AD, Kim TE, Howard SK, Mariano ER: Simulation in teaching re- gional anesthesia: current perspectives. Local Reg Anesth. Aug 11; 8:33-43, 2015. doi: 10.2147/LRA.S68223. eCollection 2015
Wong G, Apthorpe HC, Ruiz K, Nanayakkara S: A Tale of Two Teach- ing Methods: Students' Clinical Perspectives on Administering Dental Local Anesthetics. J Dent Educ Feb 1; 84(2): 166-75, 2020 Yekta SS, Lampert F, Kazemi S, et al: Evaluation of new injection and cavity preparation model in local anesthesia teaching. J Dent Educ
77(1): 51–7, 2013
Ziv A, Small SD, Wolpe PR: Patient safety and simulation-based med- ical education. Medical Teacher, Jan 1; 22(5): 489-95, 2000
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