|Year : 2015 | Volume
| Issue : 2 | Page : 47-50
|Ergonomic work posture in undergraduate dentistry students: Correlation between theory and practice
Patricia Petromilli Nordi Sasso Garcia1, Ana Carolina de Araujo Gottardello2, Cristina Dupim Presoto3, Juliana Alvares Duarte Bonini Campos1
1 Department of Social Dentistry, Araraquara Dental School, UNESP, Univ Estadual Paulista, Araraquara, São Paulo, Brazil
2 Department of Restorative Dentistry, Araraquara Dental School, UNESP, Univ Estadual Paulista, Araraquara, São Paulo, Brazil
3 Department of Social Dentistry, Araraquara Dental School, UNESP, Univ Estadual Paulista, Araraquara, SãoDepartment of Restorative Dentistry, Araraquara Dental School, UNESP, Univ Estadual Paulista, Araraquara, São Paulo Paulo, Brazil
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|Date of Web Publication||17-Aug-2016|
| Abstract|| |
Context: The presence of theoretical knowledge on ergonomics, as well as its practical application, is very important to prevent musculoskeletal disorders.
Aims: Correlating between the theoretical knowledge of ergonomic posture and its practical application among dentistry students, as well as between the students' theoretical knowledge and their practical self-assessment.
Settings and Design: Sixty second-year graduate students of Araraquara Dental School, UNESP were evaluated.
Subjects and Methods: Each student responded to a multiple-choice questionnaire on the requirements of ergonomic posture and received a score (0-10 points). To analyze the practical implementation of work posture and the self-assessment, photographs were taken of students performing laboratory procedures. To assess the practical application, each procedure was assessed by a calibrated researcher (ρ =0.78) and received a score (0-10 points). For the self-assessment, each student analyzed the photographs of their own posture and received a score (0-10 points). The theoretical knowledge and the self-assessment practice were corrected by the researcher.
Statistical Analysis: A descriptive statistical analysis was performed. The correlation between theoretical knowledge and practical application and between theoretical knowledge and self-assessment were estimated using Pearson's correlation coefficient (r), and the significance was tested using Student's t-test. The level of significance was set at 5%.
Results: There was no correlation between theoretical knowledge and practical application (r = 0.100, P = 0.450) nor between theoretical knowledge and the practical self-assessment score (r = 0.067, P = 0.623).
Conclusions: The theoretical knowledge of students on ergonomics was greater than its practical application and their self-assessment, and there was no correlation between them.
Keywords: Dentistry, ergonomics, musculoskeletal disorders, occupational health, students
|How to cite this article:|
Sasso Garcia PP, de Araujo Gottardello AC, Presoto CD, Bonini Campos JA. Ergonomic work posture in undergraduate dentistry students: Correlation between theory and practice. J Educ Ethics Dent 2015;5:47-50
|How to cite this URL:|
Sasso Garcia PP, de Araujo Gottardello AC, Presoto CD, Bonini Campos JA. Ergonomic work posture in undergraduate dentistry students: Correlation between theory and practice. J Educ Ethics Dent [serial online] 2015 [cited 2017 Aug 22];5:47-50. Available from: http://www.jeed.in/text.asp?2015/5/2/47/188568
| Introduction|| |
Musculoskeletal disorders of the upper limbs are one of the most frequent occupational problems among dental health-care workers, and have psychological and social, in addition to physical consequences. When they reach a certain level of severity, they directly affect a person's ability to work, causing absenteeism, and even early retirements. ,,, Dental students are also at a high risk of developing these disorders, ,,,,,, mainly owing to the deleterious postural habits they acquired during professional training. As a result, educational institutions need to develop strategies to prevent the appearance of these disorders in dental students.
At Araraquara Dental School, UNESP, Brazil, undergraduate students receive the first notions about the requirements for the adoption of ergonomic postures and occupational health through the ergonomics discipline in dentistry, which is offered through theoretical and practical classes. Nevertheless, Garcia et al.  perceived a high risk for the development of musculoskeletal disorders in students in their final year of graduation.
Thus, research is needed to better understand the influence of teaching ergonomics on the postural habits of dental students, and consequently, on their risk of developing musculoskeletal disorders. In this sense, verification of the presence of theoretical knowledge on ergonomics in dentistry, as well as its practical application, is of great importance. The identification of the causes of postural imbalance is the first step in the development of strategies to prevent the development of musculoskeletal disorders.
This study investigated the correlation between the theoretical knowledge of dental students on the requirements of ergonomic posture and the practical application of these principles during the execution of preclinical activities. We also estimated the correlation between the students' theoretical knowledge and their practical self-assessment.
| Subjects and Methods|| |
This was an observational cross-sectional study.
A digital camera was used to take photographs of the students during the execution of their laboratory activities, allowing the analysis of the implementation of the requirements of ergonomic posture by the students.
The photographs were taken at least 10 min after the students started their laboratory activities, thus allowing them to be comfortable in their working position, and were carried out by a researcher, who was not a professor in the area of ergonomics so that there would be no influence on the students' attitudes.
The sample was composed of undergraduate students enrolled in the 2 nd year of the Araraquara Dental School, UNESP, of both sexes (n = 60), who agreed to participate voluntarily in the study.
The study variable was the knowledge about the requirements of ergonomic work posture  [Table 1], assessed in three ways: Theoretical knowledge, practical implementation in the dental laboratory, and each student's self-assessment of their own posture.
|Table 1: Requirements of ergonomic posture, adapted to the work on a dental mannequin|
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To assess the theoretical knowledge, each student was asked to answer a questionnaire containing items related to the requirements of ergonomic posture [Table 1]. The questionnaire was composed of 10 multiple-choice questions, with only one of the responses being correct. After its completion, a theoretical score ranging from 0 to 10 points was assigned. This evaluation was done prior the students self-assessment.
To assess the practical implementation of the requirements of ergonomic work posture in the dental laboratory, the photos of the students executing the different activities in the dental laboratory were analyzed by the researcher (Ana Carolina de Araujo Gottardello) after his calibration (ρ = 0.78). The photographs were analyzed by means of visual inspection. Each laboratorial activity performed by the student received a practical implementation score ranging from 0 to 10 points. The same requirements [Table 1] were used, and each item was assessed as "appropriate" (1 point) or "inappropriate" (0 point). At the end of the rating, all items were added, totaling a maximum of 10 points. Each student was photographed during the execution of more than one laboratory procedure and therefore received a rating for each procedure. To obtain a final practical score, the arithmetic average of each student's scores was calculated.
For the self-assessment of their own posture, each student received their photographs. They were instructed to analyze them using the same criteria adopted by the researcher. The correction of the students' self-assessment was carried out by the researcher (Ana Carolina de Araujo Gottardello). Each item was classified as correct, receiving 1 point, or incorrect, receiving 0 points. At the end of the correction, the procedure evaluated received a self-assessment score ranging from 0 to 10 points. To obtain the final self-assessment score, the arithmetic average of each student's self-assessment scores was calculated.
The procedures followed were in accordance with the Ethics Committee in Research - Araraquara Dental School registration number 229,786 and with the Helsinki Declaration of 1975.
A descriptive statistics analysis was performed. The correlation between theoretical knowledge and practical application, as well as the correlation between theoretical knowledge and practical self-assessment were estimated using Pearson's correlation coefficient (r), and the significance was assessed using Student's t-test. The level of significance was set at 5%.
| Results|| |
Altogether, 316 laboratory procedures were observed, of which 75.0% were carried out by female students. The students' average theoretical score was 7.98 (±0.73) points; the practical implementation score was 5.33 (±1.25) points; and the self-assessment score 5.20 (±1.40) points.
[Figure 1] presents the correlation between the theoretical knowledge of students on ergonomic principles (theoretical rating) and its practical implementation.
|Figure 1: Study of the correlation between the theoretical knowledge and the practical application of ergonomic requirements - Araraquara, Brazil, 2013|
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No correlation was observed between theoretical knowledge and its practical implementation (r = 0.100, P = 0.450).
[Figure 2] presents the correlation between the theoretical knowledge of students on ergonomic principles (theoretical rating) and the corrected practical self-assessment.
|Figure 2: Study of the correlation between the theoretical knowledge and the self-assessment practice - Araraquara, Brazil, 2013|
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Again, no correlation was observed between the theoretical knowledge of students and their practical self-assessment (r = 0.067, P = 0.623).
| Discussion|| |
The adoption of an ergonomic work posture during professional training should be encouraged  because it can reduce the risk of the development of musculoskeletal disorders. Nevertheless, dental students frequently neglect to adopt this posture. 
Thus, the identification of the causes that lead to postural imbalance is important in preventing the establishment of harmful habits during the students' academic training. ,
In the present study, the students displayed good theoretical knowledge, with a mean theoretical score of 7.98 (±0.73) points; yet, the application of the requirements of ergonomic posture was fair, with a mean score of 5.33 (±1.25) points.
No correlation was observed between the theoretical knowledge of ergonomics and its practical application [Figure 1] (r = 0.100, P = 0.450). It must be pointed out that the photographs used in the evaluation of the practical implementation of ergonomics were taken in the third semester of the undergraduate course, a period when the students have only theoretical classes in the discipline of ergonomics in dentistry but are already executing preclinical laboratory activities in the discipline of dentistry, performing cavity preparations, and restorations in dental mannequins; therefore, these results suggest that although the students have acquired and retained the theoretical knowledge about the requirements of ergonomic posture, this knowledge alone was not sufficient to facilitate its practical application without the aid of a professor in the area of ergonomics. This means that good theoretical knowledge is not reflected in good practical implementation, showing that the students, when not accompanied by a professor of ergonomics, have difficulty in practicing the theoretical knowledge they have acquired.
This suggests the need for a discipline that provides lectures on ergonomics in dentistry, both in theory and from the beginning, in practice of the students' manual skills in the dental laboratory. This practical training must be performed to prevent the adoption of postural vices in the preclinical stage, as the earlier the establishment of poor posture, the more difficult it is to eliminate them. ,
Garbin et al.  also found that theoretical knowledge is not fully reflected in an appropriate posture during clinical procedures and stated that the reasons for these deficiencies should be investigated. The authors suggested that the existence of a gap between the theoretical discipline and its practical application can interfere with learning and the application of ergonomic principles.
In addition to the investigation of the correlation between theoretical knowledge and practical application, the correlation between the theoretical knowledge and self-assessment of students was also estimated. No correlation was observed between them (r = 0.067, P = 0.623), and this reflects a gap between the theoretical knowledge and the perception of working posture of the assessed students. Therefore, the students, besides not properly applying their theoretical knowledge in practice, also cannot understand where their postural errors lie. This generates a great deal of concern, especially after their graduation, and suggests the need for the implementation of new teaching methods of ergonomics to facilitate this self-perception.
The data obtained in this study show that early and constant ergonomic monitoring of dental students is essential and should be used as a tool for the prevention of occupational diseases. This follow-up is important to allow students to develop, in addition to the skills necessary for the implementation of suitable dental treatments, an understanding that appropriate work postures are important for their own health and the maintenance of their quality of life.
The results obtained in this study show that the discussions on ergonomics and their interactions and applicability in academia are necessary so that educational and preventive ergonomic practices are used regularly, thus decreasing the deficiency of the applicability of ergonomic principles, as currently observed in university clinics. The sooner this awareness and the adoption of preventive measures occur; the better will be the results of the assimilation and incorporation of concepts, skills, and ergonomic attitudes.
| Conclusions|| |
We conclude that the theoretical knowledge of students on ergonomics was greater than its practical application and their self-assessment and that there was no correlation between the theoretical knowledge and practical application nor between the theoretical knowledge and the self-assessment of the students.
The authors would like to thank the students of Araraquara Dental School, volunteers of this study.
Financial support and sponsorship
The authors would like to thank the PIBIC/Prope, UNESP for the scientific initiation scholarship (number 27226/2013-2014).
Conflicts of interest
There are no conflicts of interest.
| References|| |
Oberg T, Oberg U. Musculoskeletal complaints in dental hygiene: A survey study from a Swedish county. J Dent Hyg 1993;67:257-61.
Morse TF, Michalak-Turcotte C, Atwood-Sanders M, Warren N, Peterson DR, Bruneau H, et al.
A pilot study of hand and arm musculoskeletal disorders in dental hygiene students. J Dent Hyg 2003;77:173-9.
de Carvalho MV, Soriano EP, de França Caldas A Jr., Campello RI, de Miranda HF, Cavalcanti FI. Work-related musculoskeletal disorders among Brazilian dental students. J Dent Educ 2009;73:624-30.
Ding H, Solovieva S, Vehmas T, Takala EP, Leino-Arjas P. Hand osteoarthritis and pinch grip strength among middle-aged female dentists and teachers. Scand J Rheumatol 2010;39:84-7.
Rising DW, Bennett BC, Hursh K, Plesh O. Reports of body pain in a dental student population. J Am Dent Assoc 2005;136:81-6.
Lindfors P, von Thiele U, Lundberg U. Work characteristics and upper extremity disorders in female dental health workers. J Occup Health 2006;48:192-7.
Thornton LJ, Barr AE, Stuart-Buttle C, Gaughan JP, Wilson ER, Jackson AD, et al.
Perceived musculoskeletal symptoms among dental students in the clinic work environment. Ergonomics 2008;51:573-86.
Horton SJ, Johnstone CL, Hutchinson CM, Taylor PA, Wade KJ. Clinical working postures of bachelor of oral health students. N Z Dent J 2011;107:74-8.
Garcia PP, Pinelli C, Derceli JR, Campos JA. Musculoskeletal disorders in upper limbs in dental students: Exposure level to risk factors. Braz J Oral Sci 2012;11:148-53.
Corrocher PA, Presoto CD, Campos JA, Garcia PP. The association between restorative pre-clinical activities and musculoskeletal disorders. Eur J Dent Educ 2014;18:142-6.
Porto FA. O Consultório Odontológico. 1 st
ed. São Carlos: Scritti; 1994.
Barry RM, Woodall WR, Mahan JM. Postural changes in dental hygienists. Four-year longitudinal study. J Dent Hyg 1992;66:147-50.
Garcia PP, Wajngarten D, Gottardello AC, Campos JA. Occupational ergonomics: Work posture among Brazilian dental students. Occup Saf Hyg 2013:303-6.
Garbin AJ, Garbin CA, Diniz DG, Yarid SD. Dental students′ knowledge of ergonomic postural requirements and their application during clinical care. Eur J Dent Educ 2011;15:31-5.
Patricia Petromilli Nordi Sasso Garcia
Rua Humaitá, 1680 Centro, Araraquara, São Paulo 14801-903
Source of Support: None, Conflict of Interest: None
[Figure 1], [Figure 2]
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