Title: Evaluating the Way Local Anesthesia is Taught: A Systematic Review
Andrew Kary (Presenter)
New York University
Juliana Gomez, New York University
Samuel Raffaellli, New York University
Marci Levine, New York University
Objectives: Despite the frequent application and significant risk of complications during local anesthesia (LA) administration, there are few studies evaluating the outcomes of LA education. The purpose of this study is to evaluate current educational techniques used to teach LA administration within dental schools in order to determine the methods by which potential complications may be minimized and LA efficacy may be maximized.
Methods: In this review, a PubMed search was performed on the following terms: (local anesthesia, education, dental) AND (Humans[Mesh]). Thirteen articles studying LA educational outcomes were included for review. After adaptation of a quality assessment tool for our purposes, the quality of all articles was assessed independently by two authors.
Results: Three main pedagogies were identified: didactic instruction based on textbooks and lectures, student-to-student injections, and the use of anatomic models. However, their effects on LA administration efficacy, patient satisfaction, and student confidence administering LA are largely unknown. Quality assessment of reviewed articles yielded a mean score of 64% with a range of 42-83% among observational studies, and a mean score of 52% with a range of 50-57% among interventional studies. Overall, the Joint-Probability of Agreement and Cohen’s Kappa (κ) of the quality assessment were found to be 83% and 0.66, respectively, indicating good inter-rater agreement. None of the included studies use the same educational methods, and the outcome measures varied widely. Due to the heterogeneity of the studies assessed, no meta-analysis could be performed.
Conclusions: While the experimental and observational studies reviewed provide some insight into the efficacy of current educational techniques, they have numerous methodological inconsistencies. The inconsistency of the available evidence makes it difficult to make fully informed curriculum recommendations based upon existing literature. Further research is needed in order to ensure student confidence and patient satisfaction.