Assessment of undergraduate students in tooth extraction competence- A cohort study

The aim of the study was to determine the value of the number of patient encounters and tooth extractions on the competence of final-year Bachelor of Dental Surgery (BDS) students.

Following ethics approval, the study employed purposive sampling to enrol final-year BDS students and assess their competence longitudinally over a full academic year. Students were assessed periodically on four separate occasions after they had gained experience in performing 15, 40, 70 and 100 patient encounters involving tooth extractions.

There were 177 students with complete profiles completing the tooth extraction assessments including 31 males (18%) and 146 females (82%). The age range of participants was 22 to 24 years (mean = 21.92; median = 22). The total number of assessment data points available for the four assessments was 1062. A chi-squared test was carried out to test the hypothesis that competence in tooth extraction increases with increasing exposure to patients. Students in Group 100 were most likely to pass the competency, whilst students in Group 15 were most likely to fail. There was a statistically significant variation in the proportion of "Below Standard," "Meets Standard" and "Exceeds Standard" judgements awarded to students with differing levels of prior experience (p < .001). Therefore, the hypothesis was accepted. Analysis of assessment results for differential performance of students by gender did not show significant differences.

The results of this study show a positive relationship between the number of tooth extractions performed and competence of final-year dental students. Over 90% students achieved competence after performing 100 patient encounters. Although competence in tooth extractions showed a linear relationship with experience of the participants in this study, the data were collected from a single cohort of students at one institution. Further multi-institution studies involving several cohorts are required to further explore the value of increased experience.