IADR Abstract Archives
Pediatric Dental Pain Assessment Training: Current Practices, Barriers, and Facilitators
Objectives: Published clinical guidelines in pediatric dentistry recommend the consistent use of evidence-based pain assessment tools, but it is unclear how widespread use is. This study aimed to: (1) determine which approaches and tools for pediatric acute pain assessment are being taught to dental students and pediatric dentistry residents; and (2) identify barriers to and facilitators of training in the use of evidence-based tools.
Methods: All U.S. pediatric dentistry department chairs and residency program directors were invited to participate in this mixed-methods study. Participants (41 chairs, 62.1% of predoctoral programs; 61 directors, 64.2% of residency programs) completed an online questionnaire. Quantitative data were analyzed using descriptive statistics. Written responses to open-ended questions were coded and synthesized using inductive qualitative analytic methods.
Results: Clinical judgment is the most commonly taught pain assessment approach (predoctoral=95.1%, residency=100%). Behavioral coding is taught at 41.5% of predoctoral and 47.5% of residency programs. The Wong-Baker Faces Pain Rating Scale is the most frequently taught evidence-based pain assessment tool, but at only 56.1% of predoctoral programs (residency=80.3%). At 26.8% of predoctoral programs, no standardized pain assessment tool is taught as part of the pediatric dentistry curriculum. Lack of curriculum time, few clinical opportunities for practice, and lack of faculty expertise and calibration are barriers to predoctoral pain assessment training; facilitators are student clinical experience, availability of scripts and demonstration materials, and interdepartmental collaboration. In residency programs, lack of time for instruction and clinical use, limited faculty observation/enforcement, and lack of faculty calibration are barriers, while clinical experience, direct observation by faculty, and clear institutional guidelines are facilitators.
Conclusions: Though pediatric pain assessment via clinical judgment is commonly taught to dental students and pediatric dentistry residents, less emphasis is placed on use of evidence-based tools. Future implementation research should address barriers to and leverage facilitators of evidence-based pain assessment training. (K23DE028906)
Methods: All U.S. pediatric dentistry department chairs and residency program directors were invited to participate in this mixed-methods study. Participants (41 chairs, 62.1% of predoctoral programs; 61 directors, 64.2% of residency programs) completed an online questionnaire. Quantitative data were analyzed using descriptive statistics. Written responses to open-ended questions were coded and synthesized using inductive qualitative analytic methods.
Results: Clinical judgment is the most commonly taught pain assessment approach (predoctoral=95.1%, residency=100%). Behavioral coding is taught at 41.5% of predoctoral and 47.5% of residency programs. The Wong-Baker Faces Pain Rating Scale is the most frequently taught evidence-based pain assessment tool, but at only 56.1% of predoctoral programs (residency=80.3%). At 26.8% of predoctoral programs, no standardized pain assessment tool is taught as part of the pediatric dentistry curriculum. Lack of curriculum time, few clinical opportunities for practice, and lack of faculty expertise and calibration are barriers to predoctoral pain assessment training; facilitators are student clinical experience, availability of scripts and demonstration materials, and interdepartmental collaboration. In residency programs, lack of time for instruction and clinical use, limited faculty observation/enforcement, and lack of faculty calibration are barriers, while clinical experience, direct observation by faculty, and clear institutional guidelines are facilitators.
Conclusions: Though pediatric pain assessment via clinical judgment is commonly taught to dental students and pediatric dentistry residents, less emphasis is placed on use of evidence-based tools. Future implementation research should address barriers to and leverage facilitators of evidence-based pain assessment training. (K23DE028906)