| Abstract|| |
Context: Medical emergencies can happen at any time; dentists and dental students as the members of the health-care system are expected to play an effective role in these situations. All dental schools in Iran provide dental students with the dental emergency management course, but the course is theoretical, and students do not find the opportunity to practice different maneuvers, especially airway management maneuvers, injection, and cardiopulmonary resuscitation (CPR).
Aims: In this study, we investigated the necessity of learning medical skills, including injection, establishing intravenous line access, practical CPR, and first aid, on undergraduate dental students using a questionnaire.
Settings and Design: In this cross-sectional study, 84 dental students were enrolled to fill out a questionnaire about the necessity of learning certain clinical skills; they subsequently participated in a 1-day-long practical medical skills training workshop.
Materials and Methods: We enrolled 84 dental students in our study to fill out a questionnaire, and then we held a 1-day-long practical medical skills training workshop for 2 days to study if workshops are effective to achieve the desired educational goals or not.
Statistical Analysis Used: SPSS software version 20 (Chicago, IL, USA) was used to analyze the data. Descriptive measures were used for the assessment of the categorical data.
Results: Almost all students agreed on the necessity of learning mentioned skills, including blood pressure measurement, injection, CPR, and first aid. Most of them believed that medical skills training for students would enhance their knowledge.
Conclusions: Our results showed that most of the students believed that learning mentioned skills in the dentistry educational curriculum is necessary and should be included in the educational program. We suggest that dental students be introduced to these educations throughout their professional curriculum. Our pilot evaluation suggests that workshops would be effective to achieve the desired goals.
Keywords: Airway management maneuvers, cardiopulmonary resuscitation, dental students, first aid, injection, intravenous line access, medical emergencies
|How to cite this article:|
Nikaein M, Dadgostarnia M, Parnia A. Medical skills training for undergraduate dental students. J Educ Ethics Dent 2018;8:13-6
|How to cite this URL:|
Nikaein M, Dadgostarnia M, Parnia A. Medical skills training for undergraduate dental students. J Educ Ethics Dent [serial online] 2018 [cited 2021 Apr 18];8:13-6. Available from: https://www.jeed.in/text.asp?2018/8/1/13/309669
| Introduction|| |
Medical emergencies are unpredictable situations that can happen at any time. Dental offices are no exceptions. These situations are unavoidable and need immediate action as delay may result in loss of life or severe complications., Dentists are expected to be familiar with emergency interventions which include basic life support and other advanced methods including administration of specific medications.,,
Dentists should be prepared and well equipped for emergency management. These include severe situations such as cardiopulmonary resuscitation (CPR) following a cardiac arrest or pulmonary compromise. Nearly 37.2% of the patients visiting dentists have medical disorders such as cardiopulmonary diseases, brain disorders, and seizures. In addition, dental procedures have become more invasive and more painful, leading to the use of anesthetics and sedative procedures that will increase the chance of emergency situations in the dental offices.
Syncope is the most common emergency with a rate of 0.07%, while the total risk of emergencies in a dental office is about 0.08%. Other emergencies including seizures, hyperventilation syndrome, hypoglycemia, postural hypotension and allergic reactions, angina, and asthma may also happen with a total risk of 0.01%.
Dental schools in Iran provide students with emergency management courses, but these courses are theoretical, and students never have hands-on experience to practice maneuvers, such as airway management maneuvers, injection, and CPR.
The aim of this study was to investigate the need of dental school students for practical medical emergency management courses along with the need of assessment for medical skills training programs during their education.
| Materials and Methods|| |
We enrolled 84 dental students in this cross-sectional study. Participants were recruited consecutively to the study. Participants' opinions were asked using a questionnaire about the necessity of learning certain clinical skills, including injection and establishing intravenous (IV) line access, blood pressure measurement, CPR, and first-aid skills (five questions); in addition, there were three questions about the necessity of mandatory training of the mentioned skills in the dentistry educational curriculum [Figure 1].
After primary collection of the data, a 1-day practical medical skills training workshop was held for 2 consecutive days. From the enrolled students, 64 participated (32 students each day). Workshops were on blood pressure measurement; IV, intramuscular (IM), and subcutaneous (SC) injection; IV therapy; and venipuncture training workshop. The workshop included hands-on experiences; all students were provided with required equipment such as angiocath, syringes, several practice models, and blood pressure measurement cuffs.
Following the workshops, Likert questionnaires were used to assess the workshop quality and efficacy [Figure 2].
IBM SPSS Statistics (version 20, IBM SPSS, Chicago, IL, USA) was used to analyze the data. Descriptive measures were used for the assessment of the categorical data.
| Results|| |
Thirty-two male and 52 female dental students participated in this study. Participants spanned 2nd-year to last-year dental students.
The results of the analysis of the questionnaires are presented in [Figure 3].
Forty female and 24 male dental students participated in the workshops.
The results are presented in [Figure 4].
Based on the first questionnaire, 98.8% of the students agreed on the necessity of teaching blood pressure measurement to dental students and 94% believed that practical injection training is necessary for them. Nearly 87.8% of the students believed that teaching mentioned skills in the dental curriculum should be mandatory for students, and 41.7% preferred extra-curricular workshops for learning these skills. Majority opined that they should know how to inject and also measure the blood pressure in the dental clinic. Almost 90.4% of the students wanted to practically learn CPR and first-aid skills and believed that holding medical practical workshops would be useful for dental students.
Post workshop questionnaire assessments indicated that, 84.1% of the students mentioned that after the workshop, they could precisely measure the blood pressure, 38.1% of the participants believed that after the workshop they could inject a patient with required medication successfully, and 75.9% said that they would participate in similar workshops in future.
| Discussion|| |
Dentists and dental students can benefit from learning some of the medical practical skills, including IV and IM injection, blood pressure measurement, CPR, airway maintenance maneuvers, and first-aid skills.
We found that students believed that they need to learn medical practical skills.
Blood pressure measurement and intravenous, intramuscular, and subcutaneous injection
Blood pressure measurement and injection are some necessary skills that according to our results almost all students agreed on the necessity of learning them during their education in a dental school as in some emergency situations, dentists should be able to inject special drugs or even establish IV line access. Similar surveys have been conducted in other countries, for instance, the results of a study performed in India demonstrated that less than half of the Indian dentists have received practical emergency management courses during their undergraduate and postgraduate education.
Cardiopulmonary resuscitation and first-aid skills
About all students were willing to learn practical CPR and first-aid skills. Dentists should be prepared to manage emergencies requiring CPR as nearly 37.2% of the patients visiting dentists have medical disorders such as cardiopulmonary diseases, brain disorders, and seizures and also dental procedures are becoming more complicated., The results of a study in Brazil also showed that Brazilian dentists are not fully prepared to handle emergencies and their training and experience about CPR is insufficient. Evaluating dental students at Paris Descartes University showed that final-year students were not capable of competently handling cardiac arrest. The results of a survey in Northern England demonstrated that 96.3% of the dentists believed that they could perform CPR, 81.4% believed that they could give IM injection, 76.4% believed that they could give SC injection, 60.5% believed that they could take blood pressure, and 47.3% believed that they could inject an IV drug. Another study in Australia showed that 55% of the graduates could properly perform CPR. International studies prove that about half of the dentists all over the world cannot perform CPR appropriately., The results of the study by Birang et al. showed that dentists' awareness about emergency situations in Isfahan city was 5.42 out of 10, which is suboptimal.
Similar to previous studies, the results of our study indicate that students need to learn some practical medical skills, including IV, IM, and SC injection; blood pressure measurement; practical CPR; and first–aid skills, and there might be a gap in this part of dental education.
| Conclusions|| |
Our results showed that most of the students believed that learning basic skills for handling medical emergencies is necessary and should be included in the educational program. We suggest that dental students be introduced to hands-on experiences in this field during their education curriculum to include practical medical skill training courses. Our pilot evaluation suggests that workshops would be an effective method to achieve the desired goals.
We would like to thank Dr. Navid Manouchehri for his comments that greatly improved the manuscript.
Financial support and sponsorship
Conflicts of interest
There are no conflicts of interest.
| References|| |
Mutzbauer TS, Rossi R, Ahnefeld FW, Sitzmann F. Emergency medical training for dental students. Anesth Prog 1996;43:37-40.
Stafuzza TC, Carrara CF, Oliveira FV, Santos CF, Oliveira TM. Evaluation of the dentists? knowledge on medical urgency and emergency. Braz Oral Res 2014;28:1-5.
Burdick WP, Jouriles NJ, D'Onofrio G, Kass LE, Mahoney JF, Restifo KM. Emergency medicine in undergraduate education. SAEM education committee, undergraduate subcommittee, society for academic emergency medicine. Acad Emerg Med 1998;5:1105-10.
Sopka S, Biermann H, Druener S, Skorning M, Knops A, Fitzner C, et al.
Practical skills training influences knowledge and attitude of dental students towards emergency medical care. Eur J Dent Educ 2012;16:179-86.
Birang R, Kaviani N, Behnia M, Mirghaderi M. Isfahan dentists' readiness for medical emergencies: Their knowledge and access to necessary equipments. Iran J Med Educ 2005;5:47-54.
Gupta T, Aradhya MR, Nagaraj A. Preparedness for management of medical emergencies among dentists in Udupi and Mangalore, India. J Contemp Dent Pract 2008;9:92-9.
Arsati F, Montalli VA, Flório FM, Ramacciato JC, da Cunha FL, Cecanho R, et al.
Brazilian dentists' attitudes about medical emergencies during dental treatment. J Dent Educ 2010;74:661-6.
Laurent F, Augustin P, Nabet C, Ackers S, Zamaroczy D, Maman L. Managing a cardiac arrest: Evaluation of final-year predoctoral dental students. J Dent Educ 2009;73:211-7.
Girdler NM, Smith DG. Prevalence of emergency events in British dental practice and emergency management skills of British dentists. Resuscitation 1999;41:159-67.
Chapman PJ. Medical emergencies in dental practice and choice of emergency drugs and equipment: A survey of Australian dentists. Aust Dent J 1997;42:103-8.
Dr. Mahsa Nikaein
Post Graduate Student, Department of Operative Dentistry, School of Dentistry, Shahid Beheshti University of Medical Sciences, Tehran
Source of Support: None, Conflict of Interest: None
[Figure 1], [Figure 2], [Figure 3], [Figure 4]