Easing Clinical Nerves

Paediatric dentistry can be stressful for both patient and dentist – many children experience dental fear and anxiety, and providing dental care for youngsters can be particularly nerve-wracking for undergraduate students.

To help students cope with the extra pressure of paediatric care, Professor Phoebe Lam and her team from the Faculty of Dentistry have developed e-learning and vicarious learning methods. “Our students, who are part of Generation Z, prefer to learn using e-learning methods,” she explained. “Vicarious learning through dialogue videos is an ideal approach for them as it allows for self-paced learning in a comfortable environment.”

The method involves observing and imitating the behaviours, actions and outcomes of others, such as teachers and peers, to enhance decision-making and psychomotor skills, consolidate knowledge, and make exploratory efforts. It enables students to develop and master clinical skills, helps prepare them for their own clinical practice, and increases their confidence in treating children.

“To develop the VLDV database, we recorded clinical videos of BDS [Bachelor of Dental Surgery] students as they first started treating paediatric patients. Consent was obtained from the students and the parents,” said Professor Lam. “The VLDV record authentic treatment situations of undergraduates with their paediatric patients, focussing on chairside one-to-one learning dialogues when a teacher probes students’ understanding and leads them to solutions for problems and builds their clinical decision-making process.”

Common treatments

The content of the videos was based on the dentistry course syllabus, focussing on common operative treatments students will be performing. The videos were then uploaded to an online platform for them to watch before simulation classes and to discuss in group sessions. A crucial element is the inclusion of novel key decision point moments that require students watching to engage with important questions.

The programme also uses a flipped classroom approach – a teaching method where students watch pre-recorded lectures or videos before attending class. Then the in-class time can be used for higher-order levels of thinking, like discussions, problem-solving, and hands-on preparation on typodonts – the oral cavity model, upon which dentistry students practise.

“This approach allows students to learn at their own pace and better prepare themselves for the learning activities coming up,” said Professor Lam. “In the past, we used one-third of the time as didactic lecture and found students did not have enough time to process what they had to learn, which often led to confusion during tooth preparation on typodonts.

“However, with the flipped classroom approach, we move all didactic lectures to pre-course learning and start every class with a quiz. We discuss the answers and scenarios with students before moving on to tooth preparation. This way, they already have a greater understanding of the hands-on practice, are more engaged during class discussions and are better prepared for the hands-on activities.”

Since introducing the VLDV, the teachers have already seen an improvement in the quality of work students produce and a reduction in the time taken to complete tasks. Out of 13 videos uploaded on the online video platform – which is called Video Vox – 92.1 per cent (70 out of 76) of BDS students new to the clinic watched at least one video. The most viewed videos are about basic techniques, such as rubber dam isolation and cavity preparation.

Students have said they are utilising the VLDV for revision, skill refinement and preparation for assessments, often studying them prior to performing procedures in the clinic. They have found that vicarious learning through VLDV stimulates critical thinking, helps prevent errors and enhances self-confidence.

Realistic situation

“More than 30 students further participated in focus group interviews to reflect on the VLDV and evaluate their usefulness in learning,” said Professor Lam. The students described how the videos provided a more realistic clinical situation and helped them visualise what could not be simulated in the laboratory. They also shared that the VLDV helped supplement content that was not covered during their simulation laboratory. For example, when learning about pulpotomy, there was no blood in the simulation laboratory, but the VLDV taught them how to handle bleeding.

Additionally, some students noted that the VLDV helped them reduce mistakes by allowing them to see and learn from the errors made by the student operator in the video. “It’s a good lesson to learn from this happening,” one student remarked, and another said: “It’s a common mistake that I try to avoid in my own clinical practice.” Overall, the students felt that the VLDV were a valuable resource for enhancing their learning and improving their clinical skills.

“The platform has helped us create a more effective learning environment for our students,” said Professor Lam. “Vicarious learning is particularly valuable in medical and dental education, where mistakes can have severe consequences for patients. This approach enables students to learn from the experiences of others and avoid potential errors – ultimately benefitting patient care.”