Browsing by Author "Schrader, Stuart"

Now showing 1 - 4 of 4
  • Thumbnail Image
    Item
    Clinician-Patient Small Talk: Comparing Fourth-Year Dental Students and Practicing Dentists in a Standardized Patient Encounter
    (2016) Maupome, Gerardo; Holcomb, Christopher; Schrader, Stuart; Cariology, Operative Dentistry and Dental Public Health, School of Dentistry
    The aim of this study was to establish whether frequency of non-diagnostic, non-management exchanges between clinicians and patient (called “socioemotional communication,” SC) during a consultation differed between fourth-year dental students and dentists, controlling for clinically driven exchanges of information. Fifteen dentists and 17 fourth-year dental students were recorded in 2006 while undergoing a consultation with a live standardized patient and were subsequently interviewed by investigators in a separate room with the recording present for analysis. Their shared interpretations of cognitive strategies were recorded and compared for differences in the presence of SC. The results showed that most of the students and dentists engaged in SC throughout the consultation with a few exceptions. There were no significant differences between student and dentist cohorts for overall SC presence (p=0.62), time to first instance of SC from overall start of the consultation (p=0.73), and time to first instance of SC after first intraoral examination had taken place (p=0.76). Nonsignificant differences were also recorded for overall frequency at which SC occurred from overall start of the consultation (p=0.89) and after the first intraoral examination had taken place (p=0.12). The patterns showed SC interaction occurring throughout the consultation, not concentrated at the beginning or end. SC did not appear to differ between practitioners and students in terms of prevalence, frequency, or timing. Future research should examine the detailed association between SC and diagnostic thinking processes to further delineate the relationship and characterize possible pedagogical applications.
  • Thumbnail Image
    Item
    A Collaborative Assessment of Barriers to Oral Health Care: Are Social Workers Needed?
    (IUPUI, 2021-06-14) Lyons, Stephanie; Schrader, Stuart; Galyean, Erika; Romito, Laura; Everidge, Caroline; Smith, Margaret; Mandapati, Surendra Reddy; School of Social Work
    Oral health disparities are pervasive. Interprofessional education and collaborative practice experiences may be a means to address this problem in oral healthcare settings. This project aimed to determine: (1) barriers involved in patients’ access to oral health care at an academic dental school clinic, (2) dental students’ perceived ability to address patients’ needs and/or care barriers, (3) the ability of current clinical operations’ to address access to care issues, and (4) the potential role of a licensed health care social worker integrated into the clinic. Investigators conducted three focus groups –one student group (n=5), one clinical staff group (n=7), and one clinical faculty group (n=5). Further, investigators administered two needs assessment surveys in the dental school – one with students, staff, and faculty (n=144) and the second with the school’s dental patients (n=150). Investigators employed descriptive and inferential statistical analyses to evaluate the survey data. Five principal barriers to oral health care for dental patients were identified from focus group and survey data, inclusive of patients, students, staff and faculty perspectives: (1) lack of financial means, (2) lack of/inadequate insurance, (3) limited/no transportation, (4) general health problems, and (5) language barriers. More female patients (38.7%) than male patients (8.1%) reported financial barriers to accessing oral care. Including licensed social workers in an academic dental clinic may help address patient barriers to care and support interprofessional collaborative practice.
  • Thumbnail Image
    Item
    Comparing Brief Relaxation Period to Virtual Reality Period in Reducing Dental Anxiety Prior to Root Canal Treatment: A Randomized Control Trial
    (2023-06) Mintz, Caley Faith; Spolnik, Kenneth; Ehrlich, Ygal; Schrader, Stuart; Flowers, Leslie; Warner, Ned
    Introduction: Anxiety is a debilitating and difficult sensation many people face on a daily basis. Up to 20% of American adults experience dental anxiety2. Dental anxiety can present both psychologically and physiologically as a barrier to starting, completing and/or finishing dental treatment.2,4 Catastrophizing the procedure, which is common practice in anxious patients, will alter and increase the perception of pain66. Approaching and understanding dental anxiety has shown to produce more positive treatment outcomes and overall increased patient satisfaction2, 4, 6. Non-pharmacological approaches to reducing dental anxiety can be a quick, non-invasive, method to put patients at ease and can save chair time for both practitioner and patient, as well as a more pleasant experience for the patient. Objectives: The goal of this study is to investigate non-pharmacologic approaches to reducing dental anxiety prior to non-surgical root canal treatment. This will be done by comparing an Auditory Alone Brief Relaxation period (ABR) to a Relaxation Virtual Reality period (RVR). Materials and Methods: 60 subjects who need non-surgical root canal treatment was randomly allocated into 2 groups. One group received earphones to listen to a guided brief relaxation recording, focusing on breathing and a body scan. The other group received virtual reality goggles and choose a scene of their liking to experience. State Trait Anxiety Indicator (STAI), Visual Analog Scale (VAS), and vitals were measured to objectively determine baseline anxiety score followed by the same metrics after brief relaxation or virtual reality experience. A student will perform root canal treatment, and VAS and vitals were again be recorded at the end of the appointment. Results: Both RVR and ABR showed a statistically significant decrease in anxiety in STAI-S (p value <.001 for both), STAI-T (p value 0.025 ABR; <.001 RVR). VAS scores also significantly reduced from T1 to T2 to T3 time frame. Discussion: Our study investigated and compared two different interventions in reducing anxiety prior to endodontic therapy. The results showed that both ABR and RVR reduced anxiety prior to endodontic therapy and had an effect even after the endodontic therapy was completed. Additionally, when comparing the time points T1, T2, and T3, heart rate decreased throughout the procedure and more importantly, after the intervention (ABR or RVR) was delivered. Both anxiety scales, STAI and VAS showed a statistical significant decrease in anxiety throughout the appointment. Conclusion: Non-pharmacological techniques like guided meditation and virtual reality are a valid and unique approach to reducing anxiety prior to endodontic therapy. Both ABR and RVR interventions reduced the feelings of anxiety throughout the entire endodontic appointment. This study displays the ease of incorporating both interventions to reduce anxiety in an economical and noninvasive fashion.
  • Thumbnail Image
    Item
    Diagnostic thinking and information used in clinical decision-making: a qualitative study of expert and student dental clinicians
    (BMC, 2010-05-13) Maupomé, Gerardo; Schrader, Stuart; Mannan, Saurabh; Garetto, Lawrence; Eggertsson, Hafsteinn; Cariology, Operative Dentistry and Dental Public Health, School of Dentistry
    Background It is uncertain whether the range and frequency of Diagnostic Thinking Processes (DTP) and pieces of information (concepts) involved in dental restorative treatment planning are different between students and expert clinicians. Methods We video-recorded dental visits with one standardized patient. Clinicians were subsequently interviewed and their cognitive strategies explored using guide questions; interviews were also recorded. Both visit and interview were content-analyzed, following the Gale and Marsden model for clinical decision-making. Limited tests used to contrast data were t, χ2, and Fisher's. Scott's π was used to determine inter-coder reliability. Results Fifteen dentists and 17 senior dental students participated in visits lasting 32.0 minutes (± 12.9) among experts, and 29.9 ± 7.1 among students; contact time with patient was 26.4 ± 13.9 minutes (experts), and 22.2 ± 7.5 (students). The time elapsed between the first and the last instances of the clinician looking in the mouth was similar between experts and students. Ninety eight types of pieces of information were used in combinations with 12 DTPs. The main differences found in DTP utilization had dentists conducting diagnostic interpretations of findings with sufficient certainty to be considered definitive twice as often as students. Students resorted more often to more general or clarifying enquiry in their search for information than dentists. Conclusions Differences in diagnostic strategies and concepts existed within clearly delimited types of cognitive processes; such processes were largely compatible with the analytic and (in particular) non-analytic approaches to clinical decision-making identified in the medical field. Because we were focused on a clinical presentation primarily made up of non-emergency treatment needs, use of other DTPs and concepts might occur when clinicians evaluate emergency treatment needs, complex rehabilitative cases, and/or medically compromised patients.