Susanne Gerhardt-Szép

An Introduction to the Inverted/Flipped Classroom Model in Education and Advanced Training in Medicine and in the Healthcare Professions

In describing the inverted classroom model (ICM), the following paper is meant to provide an introduction to the subject matter and to serve as a practical guide for those wishing to employ its methods in basic and advanced medical training and education. The ICM is a blended-learning method in which a self-directed learning phase (individual phase) precedes the classroom-instruction phase. During the online phase, factual knowledge is imparted that serves as a basis for the classroom phase. The classroom phase should subsequently be used to assimilate and implement the previously gained knowledge. In contrast, traditional course concepts impart factual knowledge in lectures, for example, or in other face-to-face teaching formats and are followed by the students’ self-instruction in order to assimilate this knowledge. The goal of the ICM is the shift from passive learning to accelerated learning in order to foster learning at cognitively demanding levels such as analysis, synthesis and evaluation. The concurrent increase in production and use of screencasts and educational videos, the Open Educational Resources “movement” and the widespread use of Massive Open Online Courses (MOOCS) have contributed to the increased dissemination of the inverted-classroom method. The intention of the present paper is to provide an introduction to the subject matter and simultaneously to offer a short overview of important projects and research results in the field of medical education and other health professions. Furthermore, an outline is given of the advantages and disadvantages of the model as well as its potential benefit to the future of medical education and training.

Evaluating differently tutored groups in problem-based learning in a German dental curriculum: a mixed methods study

BackgroundIt is still unclear to what extent the PBL tutor affects learning in PBL-sessions. This mixed-methods study (Part 1 and 2) evaluated the effects of facilitative (f) versus non-facilitative (nf) tutoring roles on knowledge-gain and group functioning in the field of endodontics.MethodsPart 1 was a quantitative assessment of tutor effectiveness within a prospective, experimental, single-blind, stratified, randomized, two-group intervention study. Participants attended PBL in the context of a hybrid curriculum. A validated questionnaire was used and knowledge assessments were conducted before and after the intervention. External observers rated tutor performance. Part 2 was a qualitative assessment of tutor effectiveness and consisted of semi-structured expert interviews with tutors and focus group discussions with students.ResultsPart 1: f tutors obtained significantly higher scores than nf tutors with respect to learning motivation and tutor effectiveness (p ≤ 0.05). nf tuition resulted in a slightly larger knowledge gain (p = 0.08). External observers documented a significantly higher activity among facilitative tutors compared to non-facilitative tutors.Part 2: Tutors found the f role easier although this led to a less autonomous working climate. The students rated f tutoring as positive in all cases.ConclusionsWith respect to PBL-group performance, students felt that groups guided in a non-facilitative fashion exhibited a higher level of independence and autonomy, especially with increasing PBL experience. In addition, students reported that more preparation was necessary for sessions guided by a non-facilitative tutor. Tutors were able to modify their role and influence group processes in a controlled manner. Results are useful for future “Train-the-Teacher” sessions.

Influence of femtosecond laser treatment on shear bond strength of composite resin bonding to human dentin under simulated pulpal pressure.

This in vitro study evaluated the influence of femtosecond laser (fs-laser)-generated patterns on shear bond strength (SBS) of composite resin bonded to human dentin under simulated pulpal pressure. Laser treatment was used to produce two different patterns on dentin surfaces. Three test groups and a control group without laser treatment under pulpal pressure were investigated. Dentin discs of 800 nm thickness were cut from 60 extracted caries-free human molars. Using a perfusion machine, the discs were exposed to Ringer solution on their basal surfaces. Clearfil SE Bond/Herculite XRV system was used. The samples were stored in distilled water and thermocycled. Bonding failures caused by a test set-up to challenge SBS were analyzed by scanning electron microscope (SEM). An 80 μm-sized cube-shaped pattern caused more cohesive failures in dentin or resin compared with the 160 μm-sized cube-shaped pattern. Weibull statistics demonstrated a significant difference between the two laser patterns, but only the test group with small-sized laser pattern was significantly different from the control group. The Weibull moduli ranged from 4.3 to 9.6 (control group). The 160 μm-sized pattern enhanced the bonding quality and avoided dentin weakening. It was concluded that fs-laser treatment in a 160 μm-sized cube-shaped pattern enabled a simplified bonding procedure by dispensing the primer without affecting SBS, compared with the control group.

Gold nanoparticle-mediated delivery of molecules into primary human gingival fibroblasts using ns-laser pulses: A pilot study

Interaction of gold nanoparticles (AuNPs) in the vicinity of cells’ membrane with a pulsed laser (λ = 532 nm, τ = 1 ns) leads to perforation of the cell membrane, thereby allowing extracellular molecules to diffuse into the cell. The objective of this study was to develop an experimental setting to deliver molecules into primary human gingival fibroblasts (pHFIB-G) by using ns-laser pulses interacting with AuNPs (study group). To compare the parameters required for manipulation of pHFIB-G with those needed for cell lines, a canine pleomorphic adenoma cell line (ZMTH3) was used (control group). Non-laser-treated cells incubated with AuNPs and the delivery molecules served as negative control. Laser irradiation (up to 35 mJ/cm2) resulted in a significant proportion of manipulated fibroblasts (up to 85%, compared to non-irradiated cells: p < 0.05), while cell viability (97%) was not reduced significantly. pHFIB-G were perforated as efficiently as ZMTH3. No significant decrease of metabolic cell activity was observed up to 72 h after laser treatment. The fibroblasts took up dextrans with molecular weights up to 500 kDa. Interaction of AuNPs and a pulsed laser beam yields a spatially selective technique for manipulation of even primary cells such as pHFIB-G in high throughput.

Quality management of eLearning for medical education: current situation and outlook.

Introduction: In 2008, the German Council of Science had advised universities to establish a quality management system (QMS) that conforms to international standards. The system was to be implemented within 5 years, i.e., until 2014 at the latest. The aim of the present study was to determine whether a QMS suitable for electronic learning (eLearning) domain of medical education to be used across Germany has meanwhile been identified. Methods: We approached all medical universities in Germany (n=35), using an anonymous questionnaire (8 domains, 50 items). Results: Our results (response rate 46.3%) indicated very reluctant application of QMS in eLearning and a major information deficit at the various institutions. Conclusions: Authors conclude that under the limitations of this study there seems to be a considerable need to improve the current knowledge on QMS for eLearning, and that clear guidelines and standards for their implementation should be further defined.

Work shadowing in dental teaching practices: evaluation results of a collaborative study between university and general dental practices

BackgroundThe aim of this study was to investigate the acceptance and assessment of work shadowing carried out by students and dentists in dental practices. Furthermore, the extent to which students perceive an improvement in their specialised, communication and social competencies, was to be examined.Methods61 dental students in their clinical semesters at a German university participated in work shadowing placements at 27 different general dental practices. Before beginning, they received checklists of various competencies that they self-assessed using school grades (from 1 = ‘very good’, to 6 = ‘failed’), which they also repeated after completion. The dentists supplemented this with their external assessments. In addition, the students were requested to fill out a 54-item questionnaire and compose a freely-structured report after the work shadowing; the dentists filled out a questionnaire containing 16 items. The statistical analysis was carried out by means of the Friedman Test, including a post-hoc test (Bonferroni-Holm correction).ResultsThe analysis showed a significant overall improvement in the students’ self-assessed competencies by 0.71* ± 0.43 grades. With an average of 0.33* ± 0.36, the dentists’ external assessment proved significantly higher than the self-assessment. The greatest improvements were perceived by the students in the areas of accounting (1.17* ± 0.77), practice organisation (1.05* ± 0.61) and dentist’s discussions (0.94* ±0.80) [*p < 0.05]. The students confirmed experiencing an expansion of knowledge, an improvement in their communication skills and indicated a high degree of satisfaction in regard to the dentists (school grade 1.58 ± 0.93). A maximum amount of satisfaction towards the work shadow students was demonstrated by the dentists, and this form of teaching was assessed with a school grade of 1.69 ± 0.89.ConclusionBoth students and dental practitioners demonstrated a high level of satisfaction in regard to the work shadowing. The students felt their knowledge had increased, viewed the dentists as motivating role models and acknowledged a significant improvement in their specialised, communication and social competencies. Work shadowing in dental teaching practices presents a sensible addition to academic teaching at a university.

Dental training in evidence-based dentistry : a replication study

In the area of education research, it is well-known that studies of a defined question are seldom replicated. Furthermore, e-learning resources with evidence-based content in dentistry have received relatively little attention from researchers.

Problems with a Cordless Endodontic Hand Piece when Preparing Severely Curved Root Canals

The aim of this study was to describe the shaping ability of a rotary nickel-titanium instrument in combination with different torque-controlled endodontic devices in severely curved root canals of extracted human teeth.

Problems of Direct Composite Posterior Restorations: A Clinical Study

The aim of this clinical study was to describe the quality of posterior composite restorations (n = 329) performed on a group of patients (n=219) during an observation period of three years at various intervals (6, 12, 18, 24 and 36 months) after application.

Comparison of the shaping ability of RaCe, FlexMaster, and ProFile nickel-titanium instruments in severely curved root canals

Background This in vitro study compared the shaping ability of RaCe, FlexMaster, and ProFile rotary nickel-titanium instruments in severely curved root canals of extracted teeth. Material and Methods Sixty maxillary molars with curvatures ranging from 25° to 65° were embedded in a muffle system and portioned into five horizontal sections (thickness 1.2 mm), starting from the apex. Canals were divided into three groups (n = 20, each) and were prepared with RaCe, FlexMaster, or ProFile rotary nickel-titanium instruments and the TriAuto ZX handpiece using a crown-down preparation technique. We evaluated the difference between pre- and postoperative root canal cross-sections, loss of working length, instrument failure, and preparation time. The root canal area before and after the intervention was determined using an area-measuring software. The data were analyzed statistically using a one-way ANOVA followed by a Kruskal-Wallis multiple-comparison Z-value test. Results Specimens treated with FlexMaster showed the greatest change from preoperative cross-sections, followed by RaCe and ProFile. The cross-sectional changes induced by RaCe and FlexMaster preparation differed significantly from those produced by ProFile. Loss of working length, instrument failure, and preparation time did not differ significantly between the groups. Conclusions Root canal preparation with the three instruments did not lead to any significant alteration of the original root anatomy or working length. Thus, we conclude that RaCe, FlexMaster, and ProFile instruments are of comparable efficiency and usefulness in the preparation of severely curved root canals. Key words:Endodontics, root canal preparation, rotary, extracted teeth, nickel-titanium.