An evaluation of outreach dental education

Introduction: Dental schools are developing new curricula, with primary care
outreach training placements complementing hospital-based training.
Objective: To evaluate undergraduate dental outreach training.
Design: A mixed-method study phased to match a developing programme of
outreach training. The first phase used qualitative methods to identify key
educational outcomes for use as principal variables in the second phase, a
randomised controlled trial.
Intervention: Block placements of 5-6 weeks in existing primary care clinics for
undergraduate students to work supervised by local dentists while providing care to
patients. The intervention took place within a traditional dental curriculum.
Methods: Qualitative methods included semi-structured interviews, content
analysis and respondent validation. Parallel studies gathered placement staff and
student perceptions and interpretations of their recent outreach training
experiences. The randomised controlled trial (n=49) used a hospital-based control,
had two primary variables: confidence in providing everyday care and competence
in treatment planning. Confidence was self-assessed. Competence was assessed
using a standard simulated patient and viva.
Results: Key benefits of the programme identified qualitatively by stakeholders
included: the workplace setting; increased clinical experience; nursing support; and
a broader view of dentistry. Effective communication was identified as a critical
success factor. Both stakeholder groups found unanticipated benefits. In the trial
the groups were similar at baseline. The outreach group perceived their confidence
to be increased more than the control group (P=0.05). Treatment planning scores
were also greater for the outreach group for capturing a social history (P=0.01) and
the appropriateness of treatment planning (P=0.01).
Conclusions: Dental outreach training in primary care settings is positively
regarded by students and placement staff. A five-week block placement within a
traditional curriculum is more effective than dental hospital training alone in
improving students' confidence in clinical situations and their competence in
treatment planning.