AbstractAim: To test the feasibility of undergraduate dental outreach clinics as an environment in which to support the conduction of clinical research studies.
Methods: In order to test the ability to carry out clinical research in dental outreach clinics, a simple trial was set up to be conducted in outreach clinics. The Dental Outreach Oral Hygiene Study (DOOHS) was a prospective randomised controlled cluster trial investigating the effectiveness of oral hygiene instruction. This trial was based on a previously used clinical study but was conducted in dental outreach clinics. It involved the six dental outreach clinics attended by University of Dundee dental students at the time and two year groups of final year dental students. For the purposes of the study, dental students were trained as clinical researchers. Students underwent Good Clinical Practice and study protocol training. The intervention students were additionally trained to deliver the intervention oral hygiene instruction which was enhanced with a psychological framework of Tell-Show-Do-Plan. All dental students under the supervision of outreach clinicians were considered collaborators in the clinical research.The post study views of supervisors, patients and final year dental students involved with DOOHS were collected by questionnaire and focus groups. These together with the results of the study were used to assess the feasibility of the environment for clinical research.
DOOHS Results:Two year groups of final year dental students underwent training and subsequently collaborated with the clinical research study ‘DOOHS’. All dental outreach clinics associated with the University of Dundee at that time were involved.DOOHS recruited 165 participants across 6 outreach clinics. Sixty-four percent of participants return for clinical (plaque and bleeding) measures at three months and 75% of questionnaire returns at three months. At six months this dropped to 55% of the original number of participants returning for clinical measures and 63% of questionnaire returns.Both the intervention and control groups saw a reduction in plaque scores at three months. This was statistically significant for the intervention group (Related samples Friedman’s Two-Way Analysis of Variance by Ranks, Significance 0.002).
Overall Results:The clinical study approvals were granted without problem. NHS R&D approval took a long time and this held up the start date of DOOHS.By their final year, dental students are not particularly interested in carrying out clinical research studies investigating something as simple as oral hygiene instruction. Clinical research needs to be ‘sold’ well to dental students and properly integrated into the undergraduate curriculum if students are to consider it part of ‘normal’ dentistry. Training dental students for collaboration in clinical research studies needs to be carried out by clinicians who are used to teaching students, not researchers if the students are to maintain interest in the topic. Dental outreach clinics require additional support for clinical research studies, especially the paperwork which was considered arduous. Dental nurses prove to be essential to organisation of the students during the research period and to the tracking of participants during the study and therefore to the clinical research process.
Conclusions: It is feasible to conduct clinical research studies in undergraduate dental outreach clinics however close attention needs to be paid to the timing within the curriculum, the design of the study and training of dental students. Clinics require additional administrative support. Dental nurses are essential to clinical research in dental outreach.
|Date of Award||2018|
|Supervisor||Andrew Hall (Supervisor) & Janet Clarkson (Supervisor)|
- Dental outreach