Hesham F. Marei

Medical litigation in oral surgery practice: Lessons learned from 20 lawsuits

The aim of this study was to investigate all the lawsuits related to oral surgery practice over a period of three years, and to analyze the different causes of litigation. Inclusion criteria involved all the closed cases that proved malpractice against an oral and maxillofacial surgeon or involved a dentist who performed an oral and maxillofacial surgical procedure. The most common causes of litigation were oro-antral communication, neurological deficit, and bleeding. The study presented the lessons learned from 20 cases, and concluded that most of the lawsuits in oral surgery practice can be prevented either through preoperative measures or by dealing with the impact of the surgical error through good patient rapport and communication.

A fresh look at Miller's pyramid: assessment at the ‘Is’ and ‘Do’ levels

In its silver jubilee, we celebrate the ground‐breaking pyramid of George Miller by submitting a fresh look at it. We discuss two questions. (i) Does the classical pyramidal structure perfectly portray the relationships of the four levels that were described by Miller? (ii) Can the model of Miller fulfill the unmet needs of assessors to measure evolving essential constructs and accommodate the increasingly sophisticated practice of assessment of health professionals? In response to the first question, Millers pyramid is revisited in view of two assumptions for pyramidal structures, namely: hierarchy and tapering. Then we suggest different configurations for the same classical four levels and indicate when to use each one. With regard to the second question, we provide a rationale for amending the pyramid with two further dimensions to assess personal qualities of students at the ‘Is’ level and their performance in teams at the ‘Do’ (together) level. At the end of the article, we yearn to think outside the pyramid and suggest the Assessment Orbits framework to assess students as individuals and in teams. The five Assessment Orbits alert educators to assess the emerging cognitive and non‐cognitive constructs, without implying features such as hierarchy or tapering that are ingrained in pyramidal structures. The ‘Is’ orbit attends to the personal qualities of graduates ‘who’ we may (or may not) trust to be our physicians. Assessment of teams at the ‘Do’ level (together) offers a paradigm shift in assessment from competitive ranking (storming) among students toward norming and performing as teams.

Alveolar bone density and its clinical implication in the placement of dental implants and orthodontic mini-implants

Objectives: To assess the bone density in maxilla and mandible in dentate and edentulous patients in Saudi population. Methods: This study involved a retrospective analysis of cone beam CT images of 100 patients (50 male and 50 female) who have come to College of Dentistry, University of Dammam, Dammam, Kingdom of Saudi Arabia between January 2014 and 2015. Using the bone density option in the Simplant software, the Hounsfield unit (HU) was calculated at the edentulous sites. While for dentate sites, a region of interest was selected coronally at 3-5 mm to the root apex using I-CAT vision software. The densities of the buccal bone and cancellous bone were measured at interradicular areas of a specific teeth. Results: The highest bone density at the edentulous sites was at the mandibular anterior region (776.5 ± 65.7 HU), followed by the mandibular posterior region (502.2 ± 224.2 HU). Regarding the dentate sites, the highest bone density was at the buccal cortical plate of the lower incisor teeth (937.56 ± 176.92 HU) and the lowest bone density was at the cancellous bone around the posterior maxillary teeth (247.12 ± 46.75 HU). Conclusion: The alveolar bone density at dentate and edentulous sites in our population is generally lower than the norm reference density of other populations, which dictates the need for quantitative assessment of bone density before implants and mini-implants placement.

Medical professionalism: When in Rome,… Romans should help visitors

Cook DA, Triola MM. 2014. What is the role of e-learning? Looking past the hype. Med Educ 48(9):930–937. Pearson D, Walpole S, Barna S. 2015. Challenges to professionalism: Social accountability and global environmental change. Med Teach. [Epub ahead of print]. doi:10.3109/0142159X.2015.1044955. Sandars J, Walsh K, Homer M. 2010. High users of online continuing medical education: A questionnaire survey of choice and approach to learning. Med Teach 32:83–85.

Patterns, trends and thinking 'inside' the box in medical education.

In order to apply ideas from design and planning to medical education we suggest two key strategies. First, we should consider not only the tools of medical education (problem-based learning, competency-based education, longitudinal integrated clerkships) but the problems that they were produced to solve. Second, we should use case narratives when we engage in cross-national and crosscultural exchanges, so as to limit the risk that knowledge developed in one context may be applied in another without adequate adaptation. By bringing ideas from architecture and environmental design to the field of medical education, Ellaway and Bates have provided us with new insights for analysing and refining the application of medical education products and practices across cultures.

Assessment of dental students' psychomotor skills using oral surgery simulation models

Aim: The aim of this study was to determine the validity of using oral surgery simulation models as a tool to assess the psychomotor skills of dental students. Materials and Methods: All students in the 4 th year of a 6 years dental program were enrolled in the study. 23 dental students were asked to display their competency in the injection of local anesthesia and dental extraction in two summative testing environments namely; in the simulation and in the outpatient clinic. A panel of four experts assessed the students′ performance during the injection of local anesthesia and tooth extraction on patients and simulation using a pre-validated checklist. Students′ scores were compared in both settings. Results: The results showed no significant correlation between the scores on patients and simulation in the two settings (P = 0.759). Conclusion: The study revealed that the real patient remains the gold standard in summative assessment of dental students′ psychomotor skills.

Would Interactive Textbooks take Dental Education to a New Level of Learning

Abstract Objective: To evaluate the educational need for interactive textbooks designed by IBook Author application, and to assess the feasibility of their implementation as a learning tool. Materials and methods: This study involved the participation of 42 dental students, and 28 faculty members working in one dental college. The study involved training on the creation of interactive textbooks using IBook Author application. A questioner was used to get participants’ feedback about the value, educational need, and feasibility of their implementation. Results: All faculty members agreed that the application would solve some of the existing educational problems, and it will help them in preparing their handouts. All the students agreed that they would be more attracted to learn from an interactive textbook than from printed or non-interactive electronic textbook. The college administration reported that the implementation of interactive textbooks is within its capabilities, and resources. Conclusion: There is an educational need for interactive textbooks that are designed by IBook Author as they can be regarded as a highly motivating environment for students’ learning, and can be easily implemented by the medical teacher in dental education.

Would Printed Textbook Survive in the Digital Age

The need for a high quality medical service challenged the medical educationists to come with new learning tools, and strategies that can be adapted by the current generation of learners, and on the same side based on scientific learning theories. The new learning theories and technology had an impact on the style, content, and organization of modern textbook, which highlights the need for medical teachers who can renovate their role as a resource developer in the digital age.