MedEdPORTAL (Jun 2015)
A Collection of Clinical Scenario Videos: Using Physiology to Understand Medical Emergencies in the Dental Office
Abstract
Abstract Introduction First-year DMD students are exposed to a variety of basic science courses, including gross anatomy, physiology, histology, and microbiology. While these courses are important for success on Part I of the National Board Dental Examination (NBDE), many students have difficulty seeing the courses' relevance to their own success as practicing dentists. The goal of this resource is to improve student perceptions of the importance of physiology to clinical dentistry by showcasing medical emergencies with a physiological basis. Methods The resource consists of three videos. In the first video, Patient C, a 35-year-old female, experiences an episode of acute respiratory and cardiovascular distress during a routine restoration, illustrating the impact of a severe anaphylactic reaction on the cardiovascular system. In the second video, Patient D, a 66-year-old male with a history of cardiovascular disease, experiences an adverse reaction during a dental procedure, highlighting the role of epinephrine on heart rate, the diastolic cardiac cycle period, and coronary perfusion. In the third video, Patient M, a 30-year-old female, experiences an episode of near-syncope following a dental procedure, illustrating the role of positional changes. Several multiple-choice questions interspersed throughout the videos formatively assess viewers' knowledge. The resource also includes transcripts and relevant PowerPoint slides for student notes. These video modules were implemented in Dental Physiology, a general science course for first-year DMD students with an enrollment of 120 students, at the University of Louisville School of Dentistry. The videos were played during class, and students were asked to respond to all embedded questions using a personal response clicker. No outside discussion of the video content was conducted during the lecture series. Results A survey was administered to gather information about students' perceptions of the physiology course and importance of the basic sciences to clinical dentistry. Freshmen students were asked to evaluate the effectiveness of the clinical scenario videos and identify areas for improvement. They anonymously completed a survey containing 11 Likert-scale questions (Likert scale: 1 = Strongly Disagree, 2 = Disagree, 3 = Neither Agree nor Disagree, 4 = Agree, and 5 = Strongly Agree) and three open-response questions. Senior DMD students were also asked to complete a survey containing the 11 Likert-scale questions and one open-response question. When the senior students had taken the physiology course, there was little incorporation of clinical content into the lecture material or assessments and no video modules were utilized. The response rate for freshmen dental students was 96% (115 out of 120) and for senior dental students was 57% (68 out of 120). The Likert-scale questions indicated that the freshman dental students had more positive perceptions of the physiology course. Freshmen reported that the faculty in the physiology course were more aware of the needs of dental clinicians (4.25 on the 5-point Likert scale) and used more content that related to dentistry (4.41) as compared to the senior dental students' impressions (3.00 and 2.85, respectively; p < .05). Discussion These video modules may have positively influenced student perceptions of the importance of physiology in the dental curriculum. Both freshmen and senior students reported that physiology was important for success on the NBDE Part I, with averages of 4.69 and 4.04, respectively, on the 5-point Likert scale. However, the freshmen students rated importance of physiology for NBDE Part I performance and the daily practice of dentistry statistically higher. They also indicated that there should be more emphasis on physiology in the curriculum, with a mean response of 3.54, compared to the senior dental students, who largely disagreed with the statement, for a mean response of 2.53. A longitudinal study will be conducted to examine whether the freshman students maintain this positive perception over the duration of their dental education.
Keywords
