@2024 Afarand., IRAN

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ISSN: 2228-5468    Education Strategies in Medical Sciences 2014;7(5):279-285

Background
Early familiarity with the clinical skills facilitates the integration of basic and clinical sciences and understating the relation between the courses and clinical issues [1-4]. … [5-10] In England, assessment of the medicine faculties shows the implementation of early clinical encounter programs, while educational changes has been aimed at providing more such programs [11].
Previous Studies
Early encounter with the patient reduces the shock of presence in the clinics and enhances the student’s capabilities to attend at the clinical sector [5]. Early clinical encounter leads to facilitate self-retrieve, as well as sympathy with the patients, in the medicine students. In addition, it leads to motivation, more satisfaction in education, and strengthen the professional personality of the medicine students. Implementation of the program leads to more recruitment of doctors in the network to provide medical services in outlying areas [8]. A new field is the effects of the early encounter program on students’ understanding of the concept of health and disease in two levels (person and society) and students’ adaptation with the concept. Main items include enhancement of motivation and learning quality, job selection, professional role, communication skills, and understanding the patient’s view [6]. An early encounter program, including first-year medicine students’ attendance at the patients’ bedside in the company of third-year students, has been evaluated useful by most of the students and their attitudes towards education in Medicine Discipline have been enhanced according to their viewpoints. In addition, the students’ understanding of the relation between basic sciences and the patients’ problems in the clinics has been enhanced [9]. Introducing clinical skills during early years of education has been evaluated useful by 87% of the students. The students’ interests in education have been enhanced [12]. After implementation of an educational course including the students’ attendance at the hospital environment, 86% of the students has demanded the course for all students. 96% of the students have said that the course has enhanced their motivations and interests in medical education [13]. The specified goals of an early encounter with the clinical environment have been evaluated proper by the students, considering accessibility and importance of the goals. However, based on the students’ viewpoints, there should be more attempts to integrate basic and clinical sciences [14]. … [15-18]
Aim(s)
The aim of this study was to evaluate the early clinical experience program for the 1st year dental students of Tehran University of Medical Sciences.
Research type
This is a descriptive-analytical study.
Research society, place and time
All 1st semester dental students (155 persons) of Faculty of Dentistry of Tehran University of Medical Sciences, Iran, were studied. The students were studying for two successive 2011-12 and 2012-13 academic years, including 87 persons registered at September 2011 and 68 persons registered at September 2012.
Sampling method and number
140 persons, including 74 students registered at September 2011 (1st group) and 66 students registered at September 2012 (2nd group), were selected using census method.
Used devices&materials
Data were collected, using a self-administered researcher-made questionnaire, which included demographic information (age, sex, and study experience in the university) and two main parts. 2 questions of the questionnaire were about the first awareness of the field and clarifying the motivations of selecting dentistry field of study caused by visiting the health sectors. A 13-part question of the questionnaire was about the usefulness of visiting every educational-treatment sectors of Dentistry Faculty, which had been scored from “completely useless” (1 score) to “completely useful” (5 scores) based on Likert’s scale. One question of the questionnaire was about the time allocated to visit. 2 open questions were about the most interesting and the most important issues raised during the visit. Formal validity of the questionnaire was evaluated by two specialists in oral health and one public health expert (PhD). Internal consistency of the questionnaire was determined by Cronbach’s Alpha 0.82. The curriculum included theoretical sessions in lecture method and practical training consisting of visiting educational-treatment sectors, small-group discussion, and playing a role. Divided into 7-person groups, the students visited educational-health sectors and research centers of Dentistry Faculty, in circulation and for 6 two-hour sessions. The students were accompanied by one faculty member of Oral Health and Social Dentistry Department at every visit, receiving required comments. In addition, theoretical comments about educational-treatment duties and general explanations about the field of work of each sector were provided by one faculty member of that sector. In addition, to be present at the patient’s bedside, observing the treatment, being familiar with the used equipment, way of completing the files and recording the patient’s records, and way to communicate with the patient had been included in the program. At the end of the first semester, the annual monitoring of the program was done for two successive years to gain feedback and enhance the program. At the last session of the semester, the first-semester students registered at September 2011 and September 2012 were asked to complete the questionnaire voluntarily and without recording their names. The health sectors were divided into 2 types, in order to make comparisons. Type one included the health sectors with the patients being observed on the dentistry units during treatment. Other types were considered type two. The given scores were computed from 100 scores as standard based on Likert’s scale. Comparison between the mean scores was done in two groups for two successive years. Data were analyzed, using SPSS 18 software, descriptive statistic, Chi Square Test (to compare the relation), and Independent T Test (to compare the mean values).
Findings by Text
In the first group, 53 persons (71.6%) and 21 persons (28.4%) were female and male, respectively. In the second group, 37 persons (56.1%) and 29 persons (43.9%) were female and male, respectively. 3 persons had been educated in one university discipline. In primary awareness of the dentistry discipline, primary familiarity with the patients and ways of treatment in the dentistry sectors were evaluated useful by 59 persons (79.7%) of the first group and completely useful by 60 persons (90.9%) of the second group. In clarifying the motivation to select the dentistry discipline, the program was evaluated useful by 58 persons (78.4%) of the first group and completely useful by 55 persons (83.3%) of the second group. There was no significant statistical difference between females and males in responding two questions. Among 13 educational-health and research sectors, visiting the children’ dentistry sector was evaluated useful by 55 persons (74.3%) of the first group. In addition, visiting the dental prosthesis sector was evaluated useful by 56 persons (84.8%) of the second group. These were the highest rates among educational-health sectors. Satisfaction levels of visiting other sectors were 40 to 70% and 50 to 80% in the first and the second groups, respectively. In the first group, the mean standard usefulness score of primary awareness with the patients and way of dentistry treatment in health sectors, in which the treatment was being done at the same time (type 1), was 73.53±15.70. There was a significant statistical difference between the mean score and the mean score of other sectors (69.94±14.50). In the second group, in the health sectors, in which the treatment was being done (type 1), the mean score was 80.77±12.30. There was a significant statistical difference between the mean score and the mean score in other sectors (74.68±13.50), in the second group. Visiting time of the health sectors was evaluated improper by 36 persons (48.6%) of the students of the first group and 16 persons (24.2%) of the second group. The quality of the presented course materials in the sectors at the presence of the students were evaluated easy and understandable by 68 persons (91.9%) of the students of the first group and 65 persons (98.5%) of the students of the second group. 67 persons (90.5%) of the students of the first group and 63 persons (95.4%) of the second group stated that the students’ questions formed in attendance at the sector were answered excellently. The open question was answered by 14 persons of the first group and 21 persons of the second group. From their viewpoints, professional dealing with the patient and observing medical ethics, familiarity with different oral diseases and prevention, to describe the general duties of each sector, following up the patients’ records, better comprehension of the relation between the basic sciences courses and the clinical courses, familiarity with the prevention principles, and foundations of oral and dental health were the most important materials during the visit. In addition, familiarity with the teachers and the patients, familiarity with the principles of oral and dental health, and attendance at the practical sectors were evaluated interesting during the visit.
Main comparison to the similar studies
Implementation of the early encounter with the patient in Dentistry Discipline was welcomed by the dentistry students. Especially, considering quality and content of the course, professional dealing with the patient, familiarity with the duties of the educational-health sectors, general prevention, and oral and dental health were evaluated important and interesting. In other educational centers of the universities around the world, the programs of early encounter with the patients have been welcomed by the students. The general course students have given positive feedback of participating in the early encounter program, assessing encountering with the patients a way to facilitate understanding the relation between basic sciences and clinical courses [19]. Visiting the educational-health clinical sectors, in which the patient received dentistry treatment at the same time, was evaluated more useful by the students than visiting other sectors. Opportunity to gain early experiences leads to facilitate the students’ understanding of their professional duties and roles [8].
Suggestions
Utilization of the learning theories, especially about opportunities for the learner to gain experiences in the educational environments, ought to be considered [20]. Designing standard questionnaires for such studies ought to be considered. Based on the evaluation models, a comprehensive program ought to be designed for periodic assessment of the early encounter programs.
Limitations
Self-reported evaluation method was one of the limitations for the present study.
Conclusions
The courses of early encounter with the clinical environment affect the students’ primary awareness of Dentistry Discipline and clarification of their motivation. Especially, from the students’ viewpoints, attendance at the clinical sectors, in which the patient is being observed while receiving treatment, is more useful than other sectors.
Acknowledgments
The researchers feel grateful to Educational Deputy of Dentistry Faculty of Tehran University of Medical Sciences and all the colleagues in Oral Health Department of Dentistry Faculty.
Conflict of interest
Non-declared
Ethical Permissions
Non-declared
Funding Sources
Non-declared