1Department of Pediatric Dentistry, School of Detistry, Shiraz University of Medical Sciences, Shiraz, IRAN
2Student of Committee Research, Shiraz, IRAN
3Department of Dermatology, Birjand University of Medical Sciences, Birjand, IRAN
Background: The graduated dentists who are working for the community health services are considered to be better judges to comment on the educational needs in accordance with the society prerequisites. The aim of this study was to investigate the educational provisions of the department of pediatric dentistry from the viewpoints of the graduated dentists of Shiraz dental school. Methods: A total of 100 questionnaires, were distributed among 100 graduates composed of three sections. The main part assessed the quality of the proposed process (clinical, theoretical or none) that they had learnt in their study years. In the final part they were posed a key question to evaluated their ability to perform pediatric treatments in the current practice Results: A small percentage of them (%31.7) were able to perform pediatric treatments in their current practice despite the high score they have reported for their skills in routine dental procedure in their study years. There was no significant difference between acquired skill of students and their ability to perform pediatric treatments after graduation. Conclusions: Since performing pediatric treatment is somewhat obstinate, student tends to treat adult patients with more enthusiasm. Therefore, they gradually forget their skills in pediatric dentistry “Slippery slope of clinical competence”, it is named. Recommend the ministry of health and human resources to give exclusive bonus, such as increasing salary and better facilities to the dentists practicing pediatrics.
Students’ suggestions have always been the focus of attention in higher education centers since they could impart and resolve many current problems by their valuable ideas (1, 2) .Many rational changes have been made in the curricula of medical schools owing to the students’ cooperation to educate clinicians who are aware of the needs of the society and are capable of re solving the current health problems of their community (3, 4). Moreover, we need to recognize what the students expectations are, how effective the curricula have been in providing their professional skills, what revisions should be relevant to their educational system, and what explicit skills have to be emphasized (5,6) . Marsh et al believe that the importance of student evaluation has been confirmed to a great extent (7). Besides, many studies have been conducted in different countries and cities around the world in order to weigh up the curricula of their colleges(1, 8, and 9). Birmingham University investigated the capability of the dentists in root canal therapy in 2003 (10). They believed that their problems generally resulted from inadequate exposé to the techniques and the equipment of the related department(10). In Iran, a study was conducted in the School of Dentistry of Qazvin University of Medical Sciences to investigate the viewpoints of the professors as well as the students regarding clinical edification of dental school. The results of this study revealed a necessity for appraising the clinical trainings of their dental school and increasing the requisite amenities for both academic and students (11).
Recent graduated dentists who are working for community services can comment more precisely on the educational requirements of both society and dentistry departments (11). Therefore, the present study aims to investigate the educational provisions of the department of pediatric dentistry from the viewpoints of the graduated dentists from the school of dentistry, Shiraz University of Medical Sciences, Shiraz, Iran in 2009-2010. Consequently, the findings of the study could be of great value in reviewing the curriculum and improving the quality of the future services provided for the society.
The present descriptive-analytical study was conducted in 2011 in order to investigate the educational needs of the department of pediatric dentistry from the viewpoints of the individuals graduated from the Shiraz dental School (2009-2010), who working for the community health services (2009-2010).
In this study, a total of 100 questionnaires, which had been designed according to both theoretical and practical curricula of the department, were distributed among 100 graduates. It should be noted that the questionnaires were distributed in person or by email. Moreover, the study subjects were assured about the secrecy of their names and characteristics.
The main section of the questionnaire was, a table adopted from the study conducted by Seale et al was presented to the participants and they were required to determine how they had learnt the intended process (clinical, theoretical, both, none) (7) . Then, based on having or not having acquired the knowledge and necessary skills according to the pediatric curriculum, the study subjects were assigned to either less than sufficient or sufficient groups. Finally, closed-ended questions were posed asking adequate number of academic trainers, efficacy of dental units which were available in pediatric department and mostly concerning their capability of performing the pediatric treatments in their current practice. It should be mentioned that the reliability and validity of the questionnaire were confirmed by a statistical specialist and the data were analyzed by a statistical software (SPSS, version) using Chi-square statistical test.
Out of 100 questionnaires, 76 were replied back and collected from the former dental students who had entered the university in 2003-2004.
According to the findings of the present study, 87% of the graduates confirmed the adequacy of the number of the imposed units, while 6% considered the number of the units as being not enough. Moreover, 75% of the dentists believed that the number of academic in the pediatric department of school was adequate, while 19% evaluated it as inadequate.
A small percentage of these former students (%31.7) were able to perform pediatric treatments in their current practice.
In the present study, based on the subjects’ point of view, no statistically significant relationship was found between the acquired skills during study years and the capability to perform pediatric treatments during practice (Table 1).
Table1.Fequency and percent of acquired skills in different procedure from point of student and the ability to perform pediatric treatments during the project period
Acquired skills in different procedure from point of student
Nevertheless, a significant relationship was found between the behavioral control skills and the ability to perform pediatric treatments (Table 2).
Table 2.Fequency and percent of acquired capacity in behavioral control from point of student and the ability to perform pediatric treatments during the project period
Acquired capacity in behavioral control from point of student
The recent graduated dentists who are working for the community health services are considered to be the best judges to comment on the educational needs of both the society and the department of dentistry since they have valuable information about their educational condition and , at the same time they are aware of their patients’ needs in the society (12).
In 2000, ADA conducted a research to discover a strategy to advance pediatric dental care in their own community (8). They scrutinized the pediatric dentistry curriculum, the number of pediatric dentists needed for the society, and complexity of the dental problems of the individuals referred to the pediatric departments. To do so, some questionnaires were sent to 55 American dentistry schools in 2001. The Study also showed that the number academic trainers of pediatric dentistry were not enough and student’s training was mostly performed by clinical teachers. In addition, most patients did not have many orodental problems to be treated to advance practical experience of the students (8).
Moreover, each clinical instructor supervised 6 students; hence, students believed that number of trainers were not enough. On the contrary, in our study, the subjects considered the number of trainers to be sufficient.
The results of the present study revealed that a large percent of recent graduated dentists have reported their professional ability in routine treatments, such as fissure sealant (%82) and pulpotomy (%80). However, the graduates believed in the insufficiency of skills provided for treating the patients with special needs and space maintainer SM (%9/9) and (%12), respectively. Forty nine percent of the American students had acquired the essential skill of treating the patients with special diseases. This difference might result from different participants taking part in the two studies. In fact, most of the patients referring to the department of pediatric dentistry of American dentistry schools did not have sufficient dental problems for enhancing the students’ capability in treating the complex problems; therefore, the students had to focus on simple routine dental problems. Quite the opposite, the patients with special diseases referring to the department of pediatric dentistry of Shiraz dentistry school mostly suffered from complex oral-dental problems in very lower ages (13). This might be due to the nature of their disease or to the low socio-economic status of their parents; treatment of the children suffering from special diseases was not possible for the undergraduate students.
Many of these dentists believed that they couldn’t practice SM application in the pediatric department. In fact, clinical training of SM is not completely covered since it is presented in other departments as well. Note worthily, SM is completely taught in the department of orthodontics of Shiraz dental faculty. The study carried out in the U.S, shows %90 of the students theoretically and %82 of them practically had acquired the knowledge and skills in SM treatment (8).
In the present study, although these dentists had acquired high levels of skills in various clinical treatments such as pulpotomy (%87) and fissure sealant (%89) in their undergraduate studies they were not able to perform pediatric treatments in their current practice. Moreover, no significant relationship was found between the acquired knowledge and capability from the students' points of view and the ability to perform pediatric treatments. Nevertheless, a significant relationship was observed between the acquired capability in behavioral control and performing pediatric treatments. Overall, a small percentage of the students were able to perform pediatric treatments during their early dental carrier.
The results showed that if community-based-education improves students' skills, it will result in more positive attitudes in them. So this education method could increase tendency of dentists to visit children for dental treatment (14).
Saghravanian et al reported the periodic examination is the best method to improve educational quality from dental students’ point of view (15).
The present study only investigated the graduates' ability to perform pediatric treatments. In general, newly graduated dentists can perform many dental treatments; however, since performing pediatric treatments is somewhat obstinate, they tend to accept the adult patients. Therefore, they gradually forget their skills in pediatric dentistry which, consequently, leads to deteriorate their expertise and effectiveness in performing pediatric treatments. This phenomenon has been named “Slippery slope of clinical competence”(16). This did not include the behavioral management skill which might link up to their personal charisma and their inborn personality and not necessarily the behavioral skills which were taught at department.
To solve this dilemma, authors would like to recommend the ministry of health and human resources to give exclusive bonus, such as increasing salary and better facilities to the dentists who wish to practice pediatric dentistry. This will definitely increase graduates' propensity for performing pediatric treatments in their future carrier.
Authors would like to acknowledge Research Deputy of Shiraz Dental School for their excellent choose of Dr. Shahram Hamedani who graciously helped us in editing and enhancing the English structure of the manuscript.
Research committee approval and financial support: The manuscript was prepared from an undergraduate dissertation for a doctoral degree in dentistry with the Code of 1392.
Conflict of Interest: The authors declare that they have no conflict of interests.
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