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Self-directed learning, teamwork, holistic view and oral health
Malmö högskola, Faculty of Odontology (OD).
2014 (English)Doctoral thesis, comprehensive summary (Other academic)
Abstract [en]

The dental program at the Malmö dental school, the so called Malmö-model, is guided by four linked principles: self-directed learning, teamwork, a holistic view of patient care, and oral health (Fig.1). Figure 1. The four guiding principles of problem based learning at TVH, Malmö.Self-assessment ability is a critical competence for healthcare professionals, necessary for the successful adaptation to the modern life-long learning environment. Educational research seems to point out two critical factors for the development of such skills, continuous practice of self-assessment (1) and constructive feedback (2). The first study (3) presented in this publication assessed students’ self-assessment ability by means of the Interactive Examination in a cohort of senior dental students, who had gone through an identical assessment procedure during their second year of studies (4). The results indicated that self-assessment ability was not directly relevant to subject knowledge. Upon graduation, there were a number of students (10%) with significant self-assessment difficulties. Early detection of students with weak self-assessment abilities appears possible to achieve. The aim of the second study, concerning teamwork and holistic view (5), was to investigate if highlighting teamwork between dental and dental hygienist students could improve the students’ holistic view on patients, as well as their knowledge of, and insight into, each other's future professions. Thus, this project showed that by initiating teamwork between dental and dental hygienist students, it was possible to increase students’ knowledge on dental hygienists competence, develop students’ perceived holistic view on patients, and prepare students for teamwork. The third study explored findings clinicians use when diagnosing chronic periodontitis. A questionnaire was distributed to students, dental teachers and clinical supervisors in the Public Dental Services. Within all categories of clinicians, the majority of the clinicians used deepened pocket, bone loss on x-rays, and bleeding. There were differences in the use of findings between the categories of clinicians. None of the supervisors used attachment loss as a finding, while 13% to 27% of the other categories of clinicians used this finding. A higher frequency of dental hygienist students used plaque, calculus and pus, compared to the other categories.Dental hygienist students used more findings as compared to the other categories of clinicians. Fifty-eight of the 76 clinicians used each finding solitarily, i.e. one at a time, and not in combination to diagnose chronic periodontitis. However, about a third of the dental students and the supervisors only used findings either from the soft tissue inflammation subgroup or the loss of supporting tissue subgroup. With the exception of the dental teachers, the majority of clinicians within each category used irrelevant findings. The third study (6) gave valuable information when designing the fourth study (7). The In the fourth study, a questionnaire was distributed to 2,440 professional clinicians, i.e. dentists and dental hygienists in public and private activity, and dental students at the Dental school in Malmö. The results showed that two groups, representing dentists and dental hygienists delivering basic periodontal care in Sweden, were to a significant degree not sharing the knowledge basis for diagnosis and treatment planning. This may result in a less optimal utilization of resources in Swedish dentistry. The delivery of basic periodontal care was not in line with the severity of disease and too much attention was paid to the needs of relatively healthy persons. To change this pattern, the incentives in, and structure of, the national assurance system need to be adapted in order to stimulate a better inter-collegial cooperation between dentists and dental hygienists in basic periodontal care.

Place, publisher, year, edition, pages
Malmö University, Faculty of Odontology , 2014. , p. 65
Series
Swedish Dental Journal : Supplement, ISSN 0348-6672 ; 235
Keywords [en]
Livslångt lärande, Munhälsa, Tandläkarutbildning, Problembaserat lärande, Oral health, Education, Dental, Diagnosis, Patient Care Team
National Category
Dentistry
Identifiers
URN: urn:nbn:se:mau:diva-7726Local ID: 17710ISBN: 9789171046055 (print)ISBN: 9789171046062 (print)OAI: oai:DiVA.org:mau-7726DiVA, id: diva2:1404666
Note

Paper IV is not included in the fulltext online.

Paper IV  published in dissertation as manuscript with title "A comparison of proposals for diagnosis and treatment of periodontal conditions by dentists, dental hygienists and undergraduate students: An analysis based on the recommendations from the Swedish National Guidelines"

Available from: 2020-02-28 Created: 2020-02-28 Last updated: 2024-03-08Bibliographically approved
List of papers
1. The interactive examination in a comprehensive oral care clinic: a three-year follow up of students' self-assessment ability
Open this publication in new window or tab >>The interactive examination in a comprehensive oral care clinic: a three-year follow up of students' self-assessment ability
2006 (English)In: Medical teacher, ISSN 0142-159X, E-ISSN 1466-187X, Vol. 28, no 6, p. 544-548Article in journal (Refereed) Published
Abstract [en]

Little is known of how students' self-assessment ability evolves throughout the curriculum. The Interactive Examination aims to assess students' self-assessment ability, in parallel with their knowledge and competences. The method utilizes a written task and subsequent comparison of own performance with that of a qualified clinician. One cohort of dental students (n = 48) underwent assessment through Interactive Examination at three instances in 2004, during their final year of studies. Forty-two of them were assessed with the same methodology in 2001. Students' individual performance, self-assessment ability scores and attitudes in 2004 were correlated with their respective data from 2001. Students' acceptance of the methodology was high. The written performance in 2004 was positively correlated with this of 2001 in one of the three cases, while the comparison document scores in two out of three cases. Five students presented unacceptable self-assessment ability in 2004, four of whom were also unacceptable in 2001 in the same field. Unacceptable students of 2001 (n = 9) presented significantly lower results than their colleagues in 2004. These observations indicate that the self-assessment ability is not directly relevant to subject knowledge. On graduation, there exist students with significant self-assessment difficulties, the majority of whom could be detected earlier in their studies.

National Category
Dentistry
Identifiers
urn:nbn:se:mau:diva-6833 (URN)10.1080/01421590600878184 (DOI)000242451600005 ()17074702 (PubMedID)2-s2.0-33750510070 (Scopus ID)3498 (Local ID)3498 (Archive number)3498 (OAI)
Available from: 2020-02-28 Created: 2020-02-28 Last updated: 2024-02-05Bibliographically approved
2. Improving teamwork between students from two professional programmes in dental education
Open this publication in new window or tab >>Improving teamwork between students from two professional programmes in dental education
Show others...
2012 (English)In: European journal of dental education, ISSN 1396-5883, E-ISSN 1600-0579, Vol. 16, no 1, p. 17-26Article in journal (Refereed)
Abstract [en]

In Sweden, the National Board of Health and Welfare forecasts a decrease in dentists with 26% and an increase in dental hygienists with 47% until the year of 2023. This, together with changes in both epidemiology, especially of dental caries, and political priorities, calls for an effective and well-developed cooperation between dentists and dental hygienists in future dentistry. Hence, the aim of this project was to investigate whether highlighting teamwork during the undergraduate studies of dental students and dental hygiene students could improve the students' holistic view on patients as well as their knowledge of and insight into each other's future professions. Thirty-four dental students and 24 dental hygiene students participated in the study. At the beginning of their final year in undergraduate education, a questionnaire testing the level of knowledge of the dental hygienists' clinical competences was completed by both groups of students. In addition, activities intending to improve teamwork quality included the following: (i) a seminar with a dentist representing the Public Dental Health Services in Sweden, (ii) dental students as supervisors for dental hygiene students, (iii) planning and treatment for shared patients and (iv) students' presentations of the treatments and their outcomes at a final seminar. The project was ended by the students answering the above-mentioned questionnaire for the second time, followed by an evaluation of the different activities included in the study. The knowledge of dental hygienists' competences showed higher scores in almost all questions. Both groups of students considered the following aspects important: seminars with external participants, dental students acting as supervisors and planning and treating shared patients. By initiating and encouraging teamwork between dental students and dental hygiene students, it is possible to increase knowledge on dental hygienists' competence and also to develop and strengthen a holistic view on patients and dental work, thereby preparing both groups of students for their professional life.

Place, publisher, year, edition, pages
Wiley-Blackwell, 2012
Keywords
teamwork, undergraduate dental education, intervention
National Category
Dentistry
Identifiers
urn:nbn:se:mau:diva-5843 (URN)10.1111/j.1600-0579.2011.00702.x (DOI)000299202600036 ()22251323 (PubMedID)2-s2.0-84855993117 (Scopus ID)14260 (Local ID)14260 (Archive number)14260 (OAI)
Available from: 2020-02-28 Created: 2020-02-28 Last updated: 2024-02-05Bibliographically approved
3. What findings do clinicians use to diagnose chronic periodontitis?
Open this publication in new window or tab >>What findings do clinicians use to diagnose chronic periodontitis?
2008 (English)In: Swedish Dental Journal, ISSN 0347-9994, Vol. 32, no 3, p. 115-123Article in journal (Refereed) Published
Abstract [sv]

Kronisk sjukdom har ett eller flera av följande karakteristika: sjukdomen är varaktig, lämnar kvarvarande invaliditet, orsakar irreversibla patologiska förändringar och fordrar återkommande stöd i form av någon slags intervention eller instruktion. Detta innebär att diagnosen kronisk parodontit med stor sannolikhet medför personella och ekonomiska insatser från patient och tandvård. Majoriteten av alla patienter med parodontit har kronisk parodontit. Vilka fynd som används för att diagnostisera sjukdomen kan vara av central betydelse för val av behandling. Tidigare forskningsresultat visar att det finns stora variationer inom hälso- och sjukvård avseende vilka fynd som används för att ställa diagnos och hur man omhändertar patienter med likartade diagnoser/symptom. Målet med studien var att undersöka vilka fynd olika kategorier av kliniker använder för att ställa diagnosen kronisk parodontit och om det finns skillnader mellan de olika kategorierna. En enkät distribuerades som innehöll frågan: "Vilka fynd eller kombinationer av fynd använder du för att ställa diagnosen kronisk parodontit?". De undersökta kategorierna av kliniker utgjordes av sista terminens tandläkarstuderande och tandhygieniststuderande, kliniska lärare på Tandvårdshögskolan i Malmö och VFU (verksamhetsförlagd utbildning) -handledare i folktandvården dvs. tandläkare som är ansvariga för tandläkarstuderande när de fullgör sin obligatoriska tjänstgöring i folktandvården. Sjuttiosex kliniker, som representerade de olika kategorierna, angav tjugofem olika fynd för att ställa diagnosen kronisk parodontit. De fynd som angavs mest frekvent av samtliga kategorier var blödning, fördjupad tandköttsficka och förlust av marginal benvävnad. Tandhygieniststuderande angav signifikant fler fynd (P<0.05) än övriga kategorier och var mer benägna att använda irrelevanta fynd, dvs. fynd som inte per definition beskriver själva sjukdomen, t.ex. tandsten, plack och rökning, jämfört med övriga kategorier (P<0.05). Stor variation inom en och samma kategori av kliniker sågs också avseende vilka fynd som användes för att ställa diagnosen kronisk parodontit, dvs. om man angav fynd som påvisar inflammation i tandens stödjevävnad, förlust av tandens stödjevävnad eller om fynden var irrelevanta. Anmärkningsvärt var att de flesta deltagarna använde fynden solitärt, dvs. de angav antingen ett fynd som påvisade inflammation i tandens stödjevävnad eller ett fynd som påvisade förlust av tandens stödjevävnad eller ett fynd som var irrelevant. Endast 12 av de 76 deltagarna angav att de kombinerade fynden för att ställa diagnosen, dvs. en kombination av fynd som beskrev både förlust och inflammation av tandens stödjevävnad. Variationerna i vilka fynd man använde för att ställa diagnosen kronisk parodontit medför kanske att patienter med samma diagnos och sjukdomsbild får olika behandling av olika kliniker, om fyndet som användes för att ställa diagnos också ligger till grund för behandlingen. Detta kan i sin tur leda till icke kostnadseffektiv behandling. Vi avser att belysa detta i framtida studier.

Abstract [en]

The prevalence of chronic periodontitis is around 40% in the adult population and most patients visiting a dental clinic experience an intervention related to this disease, either as prophylaxis, e.g. disease information, oral hygiene instruction and polishing, or as treatment of the disease, per se. Hence, chronic periodontitis is a diagnosis that initiates time and costs consuming interventions. The findings clinicians use to diagnose chronic periodontitis are probably also the base for their choice of treatment. The aim of this study was to examine: - What findings dental students, dental hygienist students, dental teachers, and supervisors in Public Dental Health use to diagnose patients with chronic periodontitis. - If different categories of clinicians use different findings to diagnose chronic periodontitis. A questionnaire was distributed. Seventy-six clinicians representing the four categories answered the question: "What findings, or combinations of findings, do you use when you diagnose chronic periodontitis?" Twenty-five different findings were identified as findings the clinicians use when they diagnosed chronic periodontitis. The most frequently reported findings were bleeding, deepened pockets and loss of marginal bone tissue. Variations between different categories of clinicians were identified. For example, dental hygienist students used more findings (P<0.05), and were also more inclined to use irrelevant findings like calculus, plaque, smoking, compared to the other categories of clinicians (P<0.05). The majority of clinicians used only one finding at a time to diagnose chronic periodontitis, and more seldom combined findings. Only 12 out of 76 clinicians used a finding that provided soft tissue inflammation, e.g. bleeding, in combination with a finding that provided loss of supporting tissue, e.g. marginal bone loss. Few clinicians commented that there should be a progressive loss of supporting tissue over time. Further research is needed to investigate if these variations in findings used to diagnose chronic periodontitis indicate variations in treatment of these patients.

Place, publisher, year, edition, pages
Swedish Dental Association, 2008
Keywords
periodontitis, diagnosis, chronic disease, decision-making
National Category
Dentistry
Identifiers
urn:nbn:se:mau:diva-6111 (URN)000260200100002 ()18973082 (PubMedID)2-s2.0-53949109599 (Scopus ID)6887 (Local ID)6887 (Archive number)6887 (OAI)
Available from: 2020-02-28 Created: 2020-02-28 Last updated: 2024-05-31Bibliographically approved
4. Diagnoses and treatment proposals in periodontal treatment: A comparison between dentists, dental hygienists and undergraduate students
Open this publication in new window or tab >>Diagnoses and treatment proposals in periodontal treatment: A comparison between dentists, dental hygienists and undergraduate students
2015 (English)In: Swedish Dental Journal, ISSN 0347-9994, Vol. 39, no 2, p. 87-97Article in journal (Refereed)
Abstract [en]

The aim of this study is to find out how professionals in Swedish dental care perform diagnostic procedures in general. Is there a common ground between dentists and dental hygienists concerning sharing different job assignments in an effective way? Are the methods of treatment used in accordance with degree of severity of the disease and to what extent is proposed treatment in accordance with the National Guidelines? A questionnaire consisting of three different patient cases with periodontal disease was sent to 804 private practitioners, 809 dentists in Dental Public Service, 802 dental hygienists and 40 dental students on their final semester at the Dental School in Malmo.The questionnaire was completed by 1,103 respondents (47%). A majority of all practitioner groups (94%) found that a relatively healthy patient had disease, the risk for developing further disease was deemed none too low by 97%, but 91% wanted to give preventive care. A vast majority suggested more dental care to healthy patients as compared to patients with severe periodontal disease. In Conclusion the two groups, i.e. dentists and dental hygienists, did not to a sufficiently high degree share views on diagnosis and treatment, in order to optimize the resources in dentistry. The delivery of dental care was not in line with the severity of disease and too much attention was paid to the needs of relatively healthy persons.To change this pattern, the incentives in and structure of the national assurance system could be adapted. Furthermore, the knowledge basis for periodontal diagnosis and treatment needs, with special reference to the National Guidelines, should to a higher degree be shared by all caregivers.

Place, publisher, year, edition, pages
Swedish Dental Journal, 2015
Keywords
Periodontal treatment, undergraduate students, professional performers, evidence based treatment, National Guidelines
National Category
Dentistry
Identifiers
urn:nbn:se:mau:diva-6273 (URN)000377057900004 ()26529834 (PubMedID)27376 (Local ID)27376 (Archive number)27376 (OAI)
Available from: 2020-02-28 Created: 2020-02-28 Last updated: 2022-07-27Bibliographically approved

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