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The SARS-CoV-2 pandemic shuttered dental colleges for months and students are concerned about leaving the education environment without enough clinical experience. (Image: Photographee.eu/Shutterstock)
Jeremy Booth, Dental Tribune International

Jeremy Booth, Dental Tribune International

Thu. 5. November 2020

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LEIPZIG, Germany: Many dental students returning for the winter semester in the northern hemisphere have had little or no clinical practice since the SARS-CoV-2 outbreak began in earnest in March. Dental Tribune International (DTI) spoke with dental students and young key opinion leaders from around the world and found that students are concerned about their professional development and possible changes in the dental industry.

Dental students across Asia, the Middle East, Europe and North America have returned to clinical settings for in-person training. But many of them face uncertainty as to whether the winter programme will take place as planned. Those in the Indian city of Bangalore, for example, were at the time of writing still waiting on a decision from the state government before in-person classes could resume. Dr Silvi Domnori, vice president of public relations at the International Association of Dental Students (IADS), told DTI that those who are returning to in-person training have reported mixed emotions. A lack of hands-on clinical experience has left many students worrying that they will not receive the optimal amount of clinical practice before graduating and leaving the dental education environment.

Domnori explained: “One would think that the return to the clinic after such a break—being highly anticipated—would come as a relief. However, from what I’ve seen among the students in our organisation, it has come with a series of other concerns, such as the lower patient influx because of the need to work with proper protection measures, and the exposure to a smaller range of case diversity.”

She said that there was also a fear among some students that a return to the clinical setting could result in furthering the spread of the virus. But she added: “After the break, it appears that students are very eager to take in more practical knowledge and new cases, and to develop their skills in a timely fashion.”

Students need more than video and virtual platforms

Dr Huthaifa Abdul Qader, vice president of science and research at IADS, commented that providing the necessary clinical skills to dental students this year had been a daunting task for all dental faculties worldwide. One of the few options that faculties had was to engage video and virtual platforms, and Qader said that dental schools were quick to include these platforms as part of their curricula in order to familiarise students with the clinical procedures that are normally executed in a non-virtual framework.

Dr Beste Özgür from the Department of Pediatric Dentistry at Hacettepe University in Ankara in Turkey told DTI that video and synchronous training opportunities had been engaged at the faculty in order to make up for a shortfall in on-site training. “The [pandemic] situation has led to senior students losing their motivation,” she said. “But we have initiated patient-oriented training videos, conducted face to face under the supervision of the academic faculty member, while the students show their cavity preparations live to pass through the step-by-step checkpoints in a visual consultation session.”

“[It] appears that students are very eager to take in more practical knowledge and new cases” – Dr Silvi Domnori, vice president of public relations, IADS

As expected, the adoption of new digital platforms was a process of trial and error. “Dental colleges were quick to transition to online lectures, which had a positive impact in terms of the students not missing out on their academic year,” Domnori said. She pointed out that IADS has experienced greater interest in its online content—such as webinars and virtual soft skills workshops—since the beginning of the pandemic, which could signal a change in the focus and attitudes of dental students regarding digital content.

Is it a sustainable method in the long run?” Domnori asked. “For dentistry, in particular, it could prove difficult. We have seen students get creative with trying to keep their practical skills fresh while being taught online, so whereas virtual lectures can be incorporated as a part of the education, it is crucial that the face-to-face and hands-on training is provided simultaneously.”

A new future for dental professionals?

Qader told DTI that unless a vaccine or similarly effective solution can be found to expedite the end of the pandemic, he presumes that the result will be a drop in clinical competency among the next generation of dental graduates.

Jana—an IADS-affiliated dental student—told DTI that her fears of missing out on clinical experience have so far not been allayed. “My concerns have risen regarding not being qualified enough as a graduate,” Jana said. She added that she predicts that the pandemic will “impact finances and employment rates owing to the decrease in patient encounters per day, and patients potentially viewing their dental problems as less significant matters that can be postponed”.

With the broad array of changes that SARS-CoV-2 has necessitated in dental curricula, it stands to reason that some of them will be positive.

According to Dr Mariana Morgado, junior researcher at the Interdisciplinary Investigation Center at Egas Moniz Higher Education School in Almada in Portugal, academic and scientific research may now be given a greater focus at dental schools. “Most dental colleges have a duty regarding scientific research, and the pandemic may have provided a great opportunity for conducting academic research, mainly through systematic or umbrella reviews. Time will tell whether this has been an area of activity, based on the publications in indexed journals,” she said.

Morgado added that one additional effect of the pandemic could be a greater knowledge of infectious diseases—the measures to control them—and a heightened interest in prevention, minimally invasive interventions and reduced aerosol environments.

“[The] pandemic may have provided a great opportunity for conducting academic research” – Dr Mariana Morgado, junior researcher, Egas Moniz Higher Education School

Domnori said that she expects that the new health measures that have been adopted to stop the spread of SARS-CoV-2 will have a lasting effect on dental practice.

She explained: “As dentistry is a profession in which close contact with the patient is unavoidable, I believe that the impact of the health measures being taken at this time are here to stay. Clinic settings are changing. Safety distances are being incorporated into waiting rooms; surgeries are separated; there is increased emphasis on ventilation and sterilisation of the air to mitigate the risk of transmission. Will these changes be reflected by treatment costs? Considering the feedback that I have had from other dental professionals around me, I believe they will.”

Last but not least, working under pressure during the pandemic—the constant concerns regarding work safety, patient safety and everything else in between—could have a lingering impact on the mental health of dental professionals, and this ought not to be overlooked.”

Clinical skills COVID 19 Dental education

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