Manas Dave discusses a topic featured in our sister journal Evidence-Based Dentistry.

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©SEAN GLADWELL/Moment/Getty Images Plus

‘Effectiveness of educational strategies to teach evidence-based dentistry to undergraduate dental students: a systematic review' was published in Evidence-Based Dentistry this year.1

Background

Evidence-based dentistry (EBD) is a systematic approach that involves clinical decision-making by using high quality and the most updated scientific evidence. There are five steps of evidence-based practice which include: ask (formulating questions), acquire (searching for the best evidence), appraise (critically appraising the evidence), apply (using the evidence in clinical practice) and assess (evaluating this).1 These steps intersect with knowledge, skills, attitudes and behaviours demonstrating competence in evidence-based practice. There is a need for all healthcare practitioners to understand the principles of evidence-based practice however its most effective teaching methods are unclear.2

The aim of this systematic review was to determine the most effective strategies for teaching EBD to undergraduate dental students.

Methods

An electronic database search of PubMed, Embase, Scopus, Cochrane Central Register of Controlled Trials and Eric were conducted for studies until November 2022. The grey literature was searched including theses and conference papers. In addition, the reference lists of included studies were manually searched. Primary research from cross-sectional, cohort, before-after and randomised or non-randomised control trials were included. Studies were excluded if they included postgraduate students or students from other health disciplines. Quality assessment of studies was assessed using the Joanna Briggs Institute (JBI) tool.

Results

  • Twenty-four studies comprising quasi-experiments, cross-sectional studies and a randomised control trials were included in this review.

  • The JBI appraisal showed 12 studies met more than half of the quality criteria

  • The following teaching methods for EBD were discussed:

    • Community of learners: students presented and discussed patient cases in a community of learners. Students became more positive (attitude assessment) on the adopted procedure, content, learning outcomes and course appreciation

    • Problem based learning: students had a facilitator who provided feedback on cases. There was a significant increase in EBD skills. In another study, students had their EBD skills assessed on first and final exercises and showed a non-significant improvement in assessment of a manuscript

    • Educational programme of EBD: to evaluate the effectiveness of an educational program in EBD, a course was constructed for small groups of students. The results showed a significant increase in knowledge and attitudes. Another study provided EBD teaching in lectures and small groups. Students showed a significant improvement in use of statistical tests and critical appraisal

    • EBD workshop: one study undertook a two-day workshop in a classroom and reported a significant improvement in knowledge, attitudes and skills in accessing evidence

    • EBD courses: a four-day interactive course included six hours on theory and ten hours on teamwork. The results showed a significant increase in awareness, attitudes and self-assessed knowledge. Another study undertook critical appraisal exercises on tooth preparation skills which showed no significant improvement in tooth preparations. Another study provided courses on critical thinking and showed a significant difference in skills in assessing professional literature following the course.

    • Journal club: six journal club sessions resulted in a significant improvement in knowledge and skills in accessing evidence but a non-significant change in attitude

    • Online tools: one study used an online tool (VoiceThread) to assess self-reported preparedness in EBD. This was significantly higher in the VoiceThread group compared to the class average across three years.

      The results of this systematic review show that EBD is a topic that can be taught using different teaching methods as each showed a significant improvement in knowledge, attitude and/or skills.

Conclusions

The authors stated:

‘…this review provides consistent evidence of how EBD teaching strategies impact learning outcomes.'

Commentary

The results of this systematic review show that EBD is a topic that can be taught using different teaching methods as each showed a significant improvement in knowledge, attitude and/or skills. This is in keeping with other systematic reviews on this topic.2 The studies included used different techniques and the results could not be pooled together for a meta-analysis. Therefore, it is not clear which teaching method is the most effective for teaching EBD to undergraduate dental students; however, this review does highlight some of the key techniques used which show positive responses from learners. Moreover, the principles of evidence-based practice remain the same regardless of the health profession. Future reviews should aim to pool studies from beyond any single healthcare discipline to inform the evidence-base. More research is needed in this field to determine the most effective EBD teaching strategy.