Contrasting student and staff perceptions of preclinical-to-clinical transition at a Chilean dental school

J. Tricio-Pesce, Gonzalo Garcés, Cesar Orsini

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Dental education is a challenging and demanding field of study as students are expected to acquire various competencies to fulfil their professional requirements after graduation. The curricular integration of these skills has been advocated to allow future dental professionals to independently
solve a series of clinical conditions and deliver high-quality care. During the last few decades, dental education has moved from a traditional siloed curriculum to a more integrated multidisciplinary learning environment where basic science together with clinically relevant preclinical training provide
knowledge continuity. However, the transition from preclinical-to-clinical training remains a challenge for students, teachers, and dental schools.
Thus, a preclinical-to-clinical transition barrier to integration remains, hindering students from applying their knowledge to real clinical practice; this has been called 'the shock of practice'. This transition implies a great challenge for students, as within a few weeks they change their roles from
being taught to being responsible for patient care. In addition, students must convert the practical skills learnt during preclinical training to work successfully in real situations with the associated
complexities of actual patient care, such us performing irreversible procedures and additional
challenges related to professional behaviour, ethics, self-confidence and motivation.
At this stage of their training, psychological distress, emotional exhaustion and burnout-related symptoms can occur in dental students. Hence, students report an abrupt transition from preclinic-to- clinical training because of increased clinical sessions and patient loads.
Students also become confused because different tutors have different treatment approaches. They also report being hesitant and uncomfortable because of the patients' lack of trust, not showing up for their appointments and high expectations, as well as because of hygiene guidelines and the
documentation of patient records. These issues are exacerbated by a lack of sleep, health issues, financial concerns, time taken to pursue hobbies and issues with friends.
Aims & objectives:
The aim of this exploratory cross-sectional study was to investigate and compare dental students' and clinical staff instructors' perceptions of the preclinical-to-clinical transition training at the University of the Andes Dental School in Santiago, Chile.
Materials and methods:
Two questionnaires containing 11 quantitative and one qualitative item were developed to assess our year three, four and five (n = 244) dental undergraduate students' challenges when they begin treating
patients, and clinical staff (n = 78) perceptions of the preparedness to treat patients of the same students. Both questionnaires were voluntarily and anonymously implemented eight weeks after the beginning of the 2019 academic year. Responses were analysed using a Chi-squared test for each
quantitative question, while qualitative comments were studied to form themes and dimensions.

A total of 234 (96%) students and 60 (77%) tutors completed their respective questionnaire. There were considerable variations between students in the different years of the programme, as well as between students and staff members. Students and tutors felt the former had enough knowledge to treat patients though it was difficult for them to apply it in clinical practice. Again, both believed they could communicate with patients, but third year students asked for more training on this. Regarding practical skills, fourth and fifth year students felt prepared but not third year students, who preferred
to work in pairs with senior students, a preference that was shared by the tutors. All student groups asked tutors to provide more frequent, constructive and consistent feedback and felt that the difference between simulation and clinical environments and the amount of clinical work to fulfil
clinical requirements made them feel stressed. Other mentioned stressor was students’ low self-confidence when working with patients. Among the requested improvements, students requested better training on how the dental clinic works in order to save time.

The preclinical-to-clinical transition training at our school presents several challenges. Some of the problems highlighted by both students and clinical staff members persist along with the transition from third to fourth and even to fifth year training and need to be addressed in order to improve the clinical
environment student experience. Areas of improvement include the integration of knowledge to clinical practice, the gap between simulation and clinical practice, inconsistent feedback on student work among different tutors, the amount of clinical work to fulfil clinical requirements, and the students’
low self-confidence when working with patients.
Original languageEnglish
StatePublished - 2021
EventAssociation for Dental Education in Europe: Annual Conference - Strasbourg, France
Duration: 1 May 202127 Aug 2021


ConferenceAssociation for Dental Education in Europe
Abbreviated titleADEE
Internet address

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