Local anaesthesia training for undergraduate students – how big is the step from model to man?

Abstract

BackgroundLocal anesthesia is an important skill and a prerequisite for most dental treatments. However, the step from theory to application on the patient is huge for the novice. Hence, a mannequin training model course was developed and implemented into the existing local anesthesia curriculum in undergraduate dental students. It was the aim of this study to evaluate the relation between training-model and real-life anesthesia performance and to measure whether a gain in skill on the model translates to the actual patient situation.MethodsThirty-six third-year students (14 males, 22 females, age 24 years±2.98) attended the four-day course comprising each 4 h of lectures and practical training. The student cohort gave subjective ratings about the didactical components of the course after attendance by using the TRIL questionnaire (TRIL-mod; University of Trier). At the end of the course the performance of each student in administering an inferior alveolar nerve (IAN) block on the training model as well as on a fellow dental student was investigated using a standardized checklist. To evaluate the successful performance, the in vivo IAN-block was assessed using subjective patient-feeling, the sharp-blunt test and an objective pain- and thermal sensitivity tester (PATH).ResultsThe course was rated with an average score of 5.25 ± 0.44 (range 1–6; 6 = best). On the training model, 69.4% of the students successfully performed an IAN-block. The in vivo assessment, objectified by the PATH test, showed a successful anesthesia in 36.9% of the cases. The assessment of local anesthesia by using the sharp blunt test and the subjective patient feeling significantly correlated with these findings (k = 0.453–0.751, p < 0.05). The model performance did not correlate with the performance on the patient (k = 0.137, p = 0.198).ConclusionsAlthough subjective ratings of the course were high, the anesthesia success rate on mannequin models did not imply an equal performance on the in vivo setting. As local anesthesia training models are a valuable didactic complement, the focus of the training should be on to the actual real life situation. Chair side feedback should be offered to the students using one of the presented evaluation methods.

A Tale of Two Teaching Methods: Students' Clinical Perspectives on Administering Dental Local Anesthetics

“…These findings were consistent with the results of studies by Hossaini and Kuscu et al 9,21 The manikin simulation models are static, which are far from being realistic. The major limitation of the manikin simulation models noted by the students was the unrealistic replication of anatomical structures; this concern was congruent with the findings of studies by Brand et al and Knipfer et al 22,23 This limitation may have affected students' responses to questions about finding the correct landmark and insertion points for injections. Although Knipfer et al found that an anesthesia success rate on manikin models did not imply an equal performance on patients, there were confounding factors in their study that would have affected the robustness of those findings, such as variations in anatomy, patients' behavioral reaction, and student inexperience in the procedure.…”

“…However, the perceived confidence and anxiety in administering LA between the two did not differ significantly. 23 A dental robot patient has been developed in Japan that can perform specific movements and will help to reduce the effects of such confounders. Theme 1 emphasized this finding, which provided us with a deeper understanding of how students perceived the value of being on the receiving end of LA and that the sensation of feeling numbed could have made their transition to clinical practice easier.…”

“…Although Knipfer et al found that an anesthesia success rate on manikin models did not imply an equal performance on patients, there were confounding factors in their study that would have affected the robustness of those findings, such as variations in anatomy, patients' behavioral reaction, and student inexperience in the procedure. 23 A dental robot patient has been developed in Japan that can perform specific movements and will help to reduce the effects of such confounders. 16 With advances in technology, haptic-based simulations in virtual reality, augmented reality, and artificial intelligence may potentially be embedded in manikins in the future to mimic human behavior.…”

Evaluation of student‐to‐student local anaesthesia administration at the University of Barcelona: A cross‐sectional study

“…This practicum can generate great anxiety and stress for the recipient and the surgeon but in our study, most of the student samples were calm or slightly nervous before and during administration of LA and only one participant out of the 71 was terrified. Instead, after the local anaesthetic was injected, the majority of the participants were calm and relaxed.…”

The importance of using mannequin-training models in first aid learning: Case of avulsed tooth

“…First aid education programmes, public health campaigns and formal first aid training are recommended in order to improve prevention, recognition and management of different injuries and illnesses [9]. A step from theory to application on patients is huge [10]. The traditional teaching methods are not always the most appropriate and effective [11].…”