Aims To develop a measure of dentists' anxiety in clinical situations; to establish if dentists' anxiety in clinical situations affected their self-reported clinical decision-making; to establish if ...occupational stress, as demonstrated by burnout, is associated with anxiety in clinical situations and clinical decision-making; and to explore the relationship between decision-making style and the clinical decisions which are influenced by anxiety.Design Cross-sectional study.Setting Primary Dental Care.Subjects and methods A questionnaire battery Maslach Burnout Inventory, measuring burnout; Melbourne Decision Making Questionnaire, measuring decision-making style; Dealing with Uncertainty Questionnaire (DUQ), measuring coping with diagnostic uncertainty; and a newly designed Dentists' Anxieties in Clinical Situations Scale, measuring dentists' anxiety (DACSS-R) and change of treatment (DACSS-C) was distributed to dentists practicing in Nottinghamshire and Lincolnshire. Demographic data were collected and dentists gave examples of anxiety-provoking situations and their responses to them.Main outcome measure Respondents' self-reported anxiety in various clinical situations on a 11-point Likert Scale (DACSS-R) and self-reported changes in clinical procedures (Yes/No; DACSS-C). The DACSS was validated using multiple t-tests and a principal component analysis. Differences in DACSS-R ratings and burnout, decision-making and dealing with uncertainty were explored using Pearson correlations and multiple regression analysis. Qualitative data was subject to a thematic analysis.Results The DACSS-R revealed a four-factor structure and had high internal reliability (Cronbach's α = 0.94). Those with higher DACSS-R scores of anxiety were more likely to report changes in clinical procedures (DACSS-C scores). DACSS-R scores were associated with decision-making self-esteem and style as measured by the MDMQ and all burnout subscales, though not with scores on the DUQ scale.Conclusion Dentists' anxiety in clinical situations does affect the way that dentists work clinically, as assessed using the newly designed and validated DACSS. This anxiety is associated with measures of burnout and decision-making style with implications for training packages for dentists.
Introduction Stress and burnout are widely accepted as a problem for primary care dental practitioners. Previous programmes to address this issue have met with some success. Burnout is associated ...with poor coping skills and emotion regulation, and increased rates of clinical errors. Anxiety is associated with poor decision-making and is thought to be associated with poor clinical decision-making. Attempts to improve decision-making use increasing meta-awareness and review of thinking processes. Bibliotherapy is an effective method of delivering cognitive behavioural therapy as self-help or guided self-help (with some therapist input) formats.Objective To evaluate the efficacy of a specially designed CPD package which was designed to improve coping skills, build resilience and reduce the impact of anxiety on dentists' clinical decision-making.Design A multi-centred quasi-experiment.Setting Lincolnshire and Nottinghamshire (England) 2014.Materials and methods Thirty-five volunteer primary care dentists used two versions (self-help SH and guided self-help GSH, which included a 3 hour workshop) of a specially written cognitive behavioural therapy bibliotherapy programme designed to improve well-being and decision-making.Main Outcome Measures The main outcome measures were dentists' burnout, depression, anxiety, stress and decision-making style. Data were also collected on use and evaluation of the programme.Results At 6 weeks there was a clinically and statistically significant reduction in depression, anxiety and stress levels, a statistically significant reduction in burnout (emotional exhaustion) and hypervigilant decision-making, and an increase in personal achievement. The improvements in depression, stress, emotional exhaustion and hypervigilant decision-making were maintained at 6 months. Dentists were overwhelmingly positive in their evaluation of the project and used most of its contents.Conclusion With the caveat of small numbers and the lack of a no-treatment control, this project demonstrated that a self-help package can be highly acceptable to dentists and, in the short-to-medium term, improve dentists' well-being and decision-making with implications for patient safety.
BACKGROUNDHigher education learning abroad programs provide many benefits to healthcare students. However, inadequate preparation prior to their international travel, and misdirected motivations for ...their participation, can jeopardise the benefits and increase the risks. While it is pivotal to objectively evaluate pre-departure student preparation and the impact the programs have on students, existing assessment questionnaires fail to inform these aspects.OBJECTIVESTo develop an assessment tool (two surveys) to holistically evaluate learning abroad programs for higher education healthcare students.DESIGNA qualitative Delphi technique.PARTICIPANTSA total of 24 experts who had designed, managed, participated in, hosted, funded, and/or researched Australian learning abroad programs for higher education students.METHODSThe study was conducted over a 4-month period. An initial set of pre-departure and post-program questions was developed through a review of the existing literature and from a post-program survey previously used at an Australian higher education institution. Subsequently, experts provided constructive and practical feedback on the questions to be included in the two surveys.RESULTSThe experts reached consensus on the 26 questions to be included in the pre-departure survey and the 16 questions in the post-program survey after three Delphi rounds. Key areas of interest to the experts were mitigating student risk, improving effectiveness of pre-departure briefings, gaining a better insight into student motivations for participation, and understanding the impact the programs have on students.CONCLUSIONSThe development of this valid assessment tool (two surveys) will provide higher education institutions and program leaders with the ability to better evaluate the effectiveness of the pre-departure preparation they provide to students, understand the motivations of students who participate, as well as assessing the impact these programs have on students. The insights gathered can be used to improve future program offerings and maximise the benefits to healthcare students while reducing the risks.
Background and aims It is widely acknowledged that dentists experience occupational stress. This qualitative study aimed to explore previously identified specific stressors in more detail in order to ...inform the development of a future stress management programme.Method Two focus groups of dentists (N: 7 &6) were conducted to explore, in more detail, nine specific stressors and concepts; being out of one's comfort zone, zoning out from the patient, celebrating the positive aspects of work, thinking aloud, the effect of hurting patients, the impact of perfectionism, responsibility for patient's self-care, the emotional impact of difficult situations as a foundation dentist. Participants were also asked for their views on the structure and contents of the proposed stress management package. Verbatim transcripts were subjected to thematic analysis.Results and discussion Dentists described the impact of these stressors and their current coping methods; thematic analysis revealed nine themes which covered the above concepts and a further overall theme of need for control. The findings are elaborated in connection to their relevant stress, coping and emotion psychological theory. Their implications for personal well-being and clinical outcomes are discussed.Conclusion Dentists' stressful and coping experiences are complex and it is essential that any stress management programme reflects this and that the skills are easily accessible and sustainable within the context of a busy dental practice.
Higher education institutions offer in-country learning abroad programs to provide healthcare students with the opportunity to gain the intercultural and global competencies they need to work in a ...globally interconnected world. During the Covid-19 pandemic, institutions offered virtual learning abroad programs as an alternative to the in-country programs, however, little is known about whether they provide comparable benefits to students.
The purpose of this study was to investigate, and identify, the benefits gained by higher education healthcare students through their participation in a virtual learning abroad program.
This research implemented a qualitative approach, conducting semi-structured interviews with four higher education students enrolled in the final year of their healthcare studies. Data were analyzed using interpretative phenomenological analysis.
The results revealed that virtual programs provide a range of benefits students can use in their future careers. They also provide students with a positive learning experience and an opportunity for personal growth. However, although the benefits students gain from virtual learning abroad programs are similar to those they gain from in-country programs, they are not identical. While virtual learning abroad programs are a viable alternative for in-country programs and offer many benefits, they fail to replicate the intercultural and global competencies that in-country programs offer to students.
This study focusses on virtual learning abroad programs and whether the benefits healthcare students gain from them are comparable to the traditional in-country programs. Students gain personal and professional benefits from these programs without the risks and costs associated with international travel. However, the identified lack of increased global awareness has implications for how the benefits of virtual learning abroad programs should be promoted to students.
•Virtual learning abroad programs provide positive benefits to healthcare students.•Benefits from virtual programs differ to those gained through in-country programs.•Differences include development of student's intercultural or global competencies.•Virtual programs are not direct replacements for in-country programs.
Dentistry is widely reported to be a stressful profession. There is a limited body of research relating to the coping strategies used by dentists whilst in clinical situations. This study aims to use ...qualitative methods to explore the full extent of the coping strategies associated with stressful events in primary dental practice.
Semi-structured interviews were conducted with 20 dentists within a 50 mile radius of Lincoln. A thematic analysis was conducted on verbatim transcriptions thereby identifying six themes and 35 codes.
Participants described both problem-focussed and emotion-focussed strategies. The strategies used had a variety of outcomes in the context of use. Most dentists denied that their emotions affected their decision-making, but then proceeded to describe how they were influential.
Dentists use a wide variety of coping strategies some of which are maladaptive. Training in the development and recognition of appropriate coping decisions would be appropriate as they would, potentially, improve practitioner decision-making and well-being.
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•Male crickets exposed to 0 °C for 6 h were less likely to carry a spermatophore.•Female contact could induce cold stressed males to produce a spermatophore.•Cold stressed males had ...difficulty transferring the spermatophore to a female.•Cold stressed males that successfully mated sired as many offspring as controls.
Cold stress is an important abiotic factor that can impact insect physiology, behavior, and overall fitness. Upon exposure to cold temperature, many insects enter a reversible state of immobility called chill coma. If the cold stress is brief and mild enough, insects can recover and regain full mobility upon return to warmer temperatures. However, the long-term impact of sublethal cold stress on insect behavior has been understudied. Here, sexually naïve adult male Acheta domesticus crickets were exposed to a single 0 °C cold stress for 6 h. One week later, the ability of these males to mate with a female was examined. For mating trials, a cold stressed male cricket was paired with a non-cold stressed, control female. Control pairs were comprised of a non-cold stressed control male and control female. Cold exposed males were less successful at mating than control males because most did not carry a spermatophore at the time of their mating trials. However, when these cold stressed males were allowed 1 h of chemosensory contact with a female, most produced a spermatophore. Males that produced spermatophores were given the opportunity to mate once with a female, and stressed males that successfully mated sired as many offspring as did control males. However, our results support that a single cold stress exposure can negatively impact the reproductive fitness of male crickets since it reduced their capacity to carry spermatophores and, as a consequence, to attract females.
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