J Dent Educ. 2020 Feb;84(2):166-175. doi: 10.21815/JDE.019.171.
Various preclinical methodologies have been adopted by dental and oral health programs to develop student competence in administering dental local anesthetics (LA). Student-to-student practice is the most common preclinical training method. However, manikin simulation models have been introduced to avoid possible complications and ethical concerns with student-to-student injections. In 2017, the methodology was changed in the Bachelor of Oral Health program at The University of Sydney School of Dentistry in Australia from student-to-student practice to manikin simulation models. The aim of this study was to compare the students' learning experience, perceived confidence, and anxiety in giving their first injections to patients in these two preclinical training methods. A mixed-methods cohort design was used to compare the 2016 (n = 42) and 2017 (n = 32) oral health students' experiences and perceptions and evaluate students' clinical experience after commencing LA practice on patients. Students completed a questionnaire about their perceived level of confidence and anxiety before and after their first LA to a child and an adult for both infiltration and inferior alveolar nerve b lock (IANB) injections. Focus groups were conducted to further investigate the students' experience. The results showed that the perceived confidence and anxiety of the two cohorts did not differ significantly from each other. Although students found it difficult to transition into clinical practice without having experienced LA themselves, the manikin simulation practice provided a safe learning platform that avoided ethical and legal concerns. These findings support the use of manikin simulation models as an alte rnative method for dental local anesthetic preclinical training.
各种口腔健康项目已采用多种临床前方法来培养学生实施牙科局部麻醉(LA)的能力。学生间实践是最常见的临床前培训方法。然而,为了避免学生间注射可能产生的并发症和伦理问题,引入了人体模拟模型。2017 年,澳大利亚悉尼大学牙科学院的口腔健康学士课程将教学方法从学生间实践改为人体模拟模型。本研究旨在比较这两种临床前培训方法中学生在给患者第一次注射时的学习体验、自信心和焦虑感。采用混合方法队列设计来比较 2016 年(n=42)和 2017 年(n=32)口腔健康专业学生的经历和看法,并评估学生在开始给患者实施 LA 后的临床经验。学生在第一次给儿童和成人进行浸润麻醉和下齿槽神经阻滞(IANB)注射之前和之后,都要完成一份关于他们对自身注射局部麻醉剂的自信和焦虑程度的问卷。还进行了焦点小组讨论,以进一步调查学生的经历。结果表明,两个队列的学生的自信心和焦虑感没有显著差异。尽管学生发现没有自身经历过 LA 很难过渡到临床实践,但人体模拟实践提供了一个安全的学习平台,避免了伦理和法律问题。这些发现支持将人体模拟模型作为牙科局部麻醉临床前培训的替代方法。