LA緊急事態における自己評価と文書化の強化：ピアロールプレイと双方向フィードバックを通じたOSCEコンピテンシーの習得

This study investigated the effect of instructor-supervised, digitally supported peer role-play on dental students' competence in managing local anesthetic systemic emergencies (LASEs). It specifically examined how being assigned to either a feedback-giving patient role or a feedback-receiving dentist role influenced self-assessment accuracy, clinical performance, and documentation quality.

Ninety-nine dental students received standardized training on LASEs-including LAST, methemoglobinemia, and anaphylaxis-comprising 7 h of theory and 10 h of practical simulation using ResusMonitor. Participants were randomly assigned to feedback-receiving dentist (DRP) or feedbackgiving patient role-play (PRP) groups. Competency was evaluated via a 3-station OSCE using faculty assessment, self-assessment, and medicolegal documentation. Reflective feedback was also collected.

Both groups demonstrated high clinical competence (PRP: 88%; DRP: 83.6%). The PRP group outperformed the DRP group in treatment management and documentation quality (p < 0.05). Overall, students tended to overestimate their performance, with the exception of treatment scores in the PRP group, where self-assessments closely matched faculty evaluations. Reflective responses indicated increased confidence, perceived competence, and strong appreciation for the training's realism and instructional quality.

Instructor-supervised, digitally enhanced peer role-play significantly improved dental students' clinical competence and documentation in managing LASEs. Notably, students in the feedback-giving patient role outperformed peers in treatment management and medicolegal documentation. Acting as a feedback provider promoted evaluative judgment and cognitive engagement at least as effectively as receiving feedback. Embedding structured, feedback-rich simulations into dental curricula fosters reflective learning and may strengthen students' preparedness for managing clinical emergencies. Multicenter, longitudinal research is recommended to confirm and extend these findings.