A Randomized Controlled Trial of the Effect of Standardized Patient Scenarios on Dental Hygiene Students' Confidence in Providing Tobacco Dependence Counseling

Abstract

Purpose: Dental hygienists report a lack of confidence in initiating Tobacco Dependence Counseling (TDC) with their patients who smoke. The purpose of this study was to determine if the confidence of dental hygiene students in providing TDC can be increased by Standardized Patient (SP) training, and if that confidence can be sustained over time.

Methods: This 2-parallel group randomized design was used to compare the confidence of students receiving SP training to students with no SP training. After a classroom lecture, all subjects (n=27) received a baseline test of knowledge and confidence. Subjects were randomly assigned to test and control groups with equivalent mean knowledge scores. The test group subjects participated in a SP TDC session. Both groups gained parallel experience to treating patients who were smokers and giving TDC in clinical scenarios during the 6 month time period. One week end-training and 6 month post-training assessments were administered to both groups. ANCOVA compared mean confidence scores.

Results: End-training scores at 1 week showed a statistically significant increase (p=0.002) in overall mean confidence following SP training for individuals in the test group. The 6 month follow-up test results showed a slight decline in confidence scores among subjects in the test group and an overall gain in confidence for control group participants. However, overall confidence scores were comparable for the groups.

Conclusion: SP training improved dental hygiene students' initial confidence in providing TDC and was sustained, but not to a significant degree. Clinical experience alone increased confidence. Further studies may help determine how the initial confidence gained by SP training can be sustained and what the role of clinical experience plays in overall confidence in providing TDC.

This study supports the NDHRA priority area, Clinical Dental Hygiene Care: Develop and test interventions to reduce the incidence of oral disease in special at-risk populations (diabetics, tobacco users, cardiac patients and genetically susceptible).