Graduates' characteristics and professional situation : a follow-up of five classes graduated from the Malmö model

Syftet med denna studie var att beskriva de examinerade från de fem första kurserna av den problembaserade tandläkarutbildningen i Malmö, deras generella syn på utbildningen och deras professionella situation. Av totalt 166 examinerade (examinerade åren 1995-1999) svarade 128 på den utskickade enkäten. Frågeformuläret inkluderade frågor av demografisk karaktär, de examinerades syn på utbildningen och deras professionella situation. De svarandes medianålder när de examinerades var 26 år (24-43 år) och andelen kvinnor var 56 %. Cirka en fjärdedel var födda utanför Sverige. Två tredjedelar av de svarande angav att de valde tandläkarutbildningen för att de ville bli tandläkare. Nästan samtliga (97 %) arbetade som tandläkare och cirka en tredjedel arbetade utanför Sverige. De som arbetade utanför Sverige var i högre utsträckning också födda utanför Sverige. De svarande menade att utbildningen gav en god förberedelse för deras professionella situation. Deras tillfredsställelse med sin professionella situation, som var hög överlag, korrelerade till deras möjligheter att påverka sin arbetssituation. Cirka en fjärdedel uttryckte intresse för specialistutbildning. När det gällde forskarutbildning uttryckte 64 % av kvinnliga svarande intresse jämfört med 42 % av männen. Vår slutsats är att de svarande överlag var nöjda med sin professionella situation och majoriteten av dem var intresserade av efter- och vidareutbildning.This study describes some characteristics of graduates of the five first classes from the Malmö dental programme, their overall experience of the programme, and their professional situation. Of 166 graduates (graduated 1995-1999) who were invited to participate, 128 responded (response rate 77%). The questionnaire queried participant characteristics, undergraduate education, and professional situation. The median age of the respondents at graduation was 26 years (range: 24-43 years, female: 56%). One-fourth of the respondents were born outside Sweden.Two-thirds of the respondents answered that they enrolled in the dental education because they wanted to become a dentist. Most respondents (97%) were working as a dentist, and a majority (82%) worked full-time. The respondents thought their dental education had prepared them well for their profession. About one-third of the respondents worked outside Sweden; the majority had been born outside of Sweden. The respondents' satisfaction with their professional situation, which was high overall, correlated to how much they were able to influence their work situation. About one-fourth expressed interest in specialist training. Respondents differed on the topic of research education: 64% of the female graduates and 42% of the male graduates were interested. We conclude that the respondents were satisfied with their professional situation as a dentist and that most were interested in postgraduate education

The Solo Taxonomi : a Tool to Empower Student Learning

In the “Learning Society” in which we live , the capacity for ‘learning to learn’ is important. With PBL as an educational approach we try to design learning environments, which facilitate and support students in their learning to learn and use of tools for meaning making and reality construction as well as making them eager to understand. But how do we assess students’ ability to adopt active strategies and how do we evaluate our programme on these issues

Evidensbaserad vård - vad är det och vad är det inte?

Evidensbaserad vård är att på ett medvetet sätt använda bästa sammantagna vetenskapliga bevis – evidens – i kliniska beslut. Men evidensbaserad vård innebär inte att man mekaniskt kan följa en "kokbok". I stället måste man samtidigt ta hänsyn till varje patients unika förutsättningar och sin kliniska erfarenhet. Det kan vara svårt att vid sidan av patientarbetet hålla sig à jour med den ständigt växande vetenskapliga litteraturen, följa nya rön och värdera resultatens tillförlitlighet och tillämpbarhet. Tandläkarna måste hitta sätt att hantera den växande kunskapsmassan, sätt att sovra och sammanställa informationen så att den blir kliniskt användbar. Evidensbaserad vård innebär en sådan strävan efter vård på säkrare vetenskaplig grund och är en logisk följd av vårdens ledstjärnor – vetenskap och beprövad erfarenhet.Evidence is the collection of results that have been systematically collected and scrutinized to fulfil well-established criteria on validity. Evidence-based health care is often defined as the careful, precise and systematic implementation of evidence in clinical decision-making. However, evidence alone is never enough. A more appropriate description of evidence-based health care includes a combination of the implementation of the best available clinical evidence, the consideration of the patient’s circumstances, values and preferences and the clinician's experience. The goal of evidence-based health care is to improve people’s health through the explicit use of scientific findings, which is in contrast to the concept that relies on intuition and the use of unsystematic clinical experience, as well as authoritative statements by experts. During decision-making, the clinician must combine evidence together with different preferences, such as weighing what our patients and society will gain or lose. This includes the question “Should health care resources be reserved primarily for procedures that are proven to be effective?” Evidence-based health care tries to address this question by analysing the efficacy and cost-effectiveness of heath services. A number of myths are applied to evidence based health care. Firstly discarding evidence that has not been scientifically assessed, although lack of evidence does not mean lack of effect, the benefits may not yet have been assessed. Analysis of the scientific literature always reveals clinical issues that require further research. Second, is that randomised trials always generate the best evidence, this is incorrect. The research question determines which type of study design will yield the most valid answer. Third, evidence-based health care is said to be incompatible with trusting patient-clinician relationships, again false. If clinicians ignore information, patients can be misinformed and will have difficulty in actively participating in decisions that affect their health. A continuing challenge to evidence-based health care and education is the integration of new clinical research with the time-honoured craft of caring for patients and their health

Dental students' perception of their approaches to learning in a PBL programme

AIM: To compare dental students' perceptions of their learning approaches between different years of a problem-based learning (PBL) programme. The hypothesis was that in a comparison between senior and junior students, the senior students would perceive themselves as having a higher level of deep learning approach and a lower level of surface learning approach than junior students would. This hypothesis was based on the fact that senior students have longer experience of a student-centred educational context, which is supposed to underpin student learning. PARTICIPANTS AND METHODS: Students of three cohorts (first year, third year and fifth year) of a PBL-based dental programme were asked to respond to a questionnaire (R-SPQ-2F) developed to analyse students' learning approaches, that is deep approach and surface approach, using four subscales including deep strategy, surface strategy, deep motive and surface motive. The results of the three cohorts were compared using a one-way analysis of variance (ANOVA). A P-value was set at <0.05 for statistical significance. RESULTS: The fifth-year students demonstrated a lower surface approach than the first-year students (P = 0.020). There was a significant decrease in surface strategy from the first to the fifth year (P = 0.003). No differences were found concerning deep approach or its subscales (deep strategy and deep motive) between the mean scores of the three cohorts. CONCLUSIONS: The results did not show the expected increased depth in learning approaches over the programme years

Dentists reflect on their problem-based education and professional satisfaction

AIM: To determine the way in which Malmö University dental graduates perceive their problem-based dental education and evaluate their professional satisfaction. METHOD: The first five cohorts (graduating in years 1995-1999) of the problem-based curriculum were invited to participate. Of 166 graduates, 77% responded to a questionnaire comprising 20 questions on aspects of their dental education, professional situations and interest in postgraduate education. They were asked to rank their perception of their dental education and satisfaction with their professional situation on a visual analogue scale (VAS) with endpoints ranging from 'Not at all' (1) to 'Very well' (10). For other statements, the markings were made on a Likert scale from 1 (not important/not satisfied) to 5 (very important/very satisfied). There were also open-ended questions. RESULTS: Most respondents perceived their education to prepare them well for a career in dentistry (median score VAS 8), and 90% rated above six on a VAS for their professional satisfaction as dentists. Importance and satisfaction were highly correlated with principles of the curriculum: holistic view, oral health, lifelong learning, integration between theory and clinic, and clinical competence. Forty-five per cent of the graduates noted the problem-based learning approach as the most valuable asset of their education, and 19% cited training in oral surgery as a deficit. Of the respondents, 77% expressed interest in specialist training and 55% in research educatio

Från evidens till bättre praxis : tillämpning av evidens

Om vården ska göra största möjliga nytta måste bästa tillgängliga vetenskapliga kunskap – evidens – tillämpas systematiskt. Ineffektiva kliniska rutiner måste förändras och bevisat effektiva behandlingar spridas. Men forskningen ger inget enkelt svar på hur sådana förändringar ska åstadkommas. Studier av praxispåverkan visar dels att åtgärder som syftar till att förändra praxis bör skräddarsys efter budskap, målgrupp och nuläge, dels att enskilda insatser oftast endast har liten eller måttlig effekt. En effektiv praxispåverkan kräver ofta ett paket av samordnade åtgärder som är anpassade till sammanhanget. Dessutom krävs en strategi för att hantera tänkbara hinder för en evidensbaserad tandvård.Is it reasonable to disregard effective methods or to use methods that result in more harm than benefits for the patients and their health? The answer is of course no! However, effective methods do not auto¬matically win out over alternatives, which might be ineffective or unproven. Surveys of practice show gaps between the evidence of what clinicians should be doing, and what is actually being done. How should these gaps be dealt with? To date, no single strategy is available. Diffe¬rent approaches to changing clinical practice are used and most are more based on belief rather than scientific evidence. Evidence relating to the implementation of changes in health care demonstrates that changing practice seldom entails a single action. Good plan¬ning is usually demanded, which requires a multi-fa¬ceted approach with different interventions at differ¬rent organisational levels. Evidence also emphasises the importance of developing good understanding of the barriers to change. Thus, approaches to changing to best practice should be evidence-based. To illustrate the complexity of achieving changes in health care, the case of hand hygiene is cited from a review article [7]. Despite well-established evidence on the benefits of hand washing, compli¬ance by health-care workers is known to be poor. From the literature on changing clinical practice, we present some obstacles and strategies on how to improve hand hygiene in patient care. An example on notation of periodontal status in the patient record is also presented

Formation of a hard tissue barrier after pulp cappings in gumans. A systematic review

Aim To evaluate the evidence on the formation of a hard tissue barrier after pulp capping in humans. Methodology A PubMed and CENTRAL literature search with specific indexing terms and a hand search were made. The authors assessed the level of evidence of each publication as high, moderate or low. Based on this, the evidence grade of the conclusions was rated as strong, moderately strong, limited or insufficient. Results The initial search process resulted in a total of 171 publications. After reading the abstracts and hand searching the reference lists of the retrieved publications, 107 studies were retrieved in full-text and interpreted. After the interpretation, 21 studies remained and were included in the systematic review and given a level of evidence. No study had a high level of evidence, one study had moderate and 20 studies had a low level of evidence. There was heterogeneity between the studies; therefore, no meta-analysis was performed. The majority of studies on pulp capping using calcium hydroxide based materials reported formation of hard tissue bridging, studies on other pulp capping materials such as bonding agents presented inferior results. The evidence grade was insufficient. Conclusions Insufficient evidence grade does not necessarily imply that there is no effect of a pulp capping procedure or that it should not be used. Rather, the insufficient evidence underpins the need for high-quality studies