Evaluating a medical emergency training program for dentists in SSWAHS-OHS

Introduction: Medical emergencies occur in general dental practice but are more likely to occur in the public system due to high numbers of medically compromised and elderly patients being treated. Recognition of potential dangers, use of precautions and early interventions to prevent escalation of medical emergencies are essential skills for a dentist. This project aims to provide an assessment of a theoretical and hands-on training program in terms of increasing the competence and confidence amongst dental officers. Methods: A hands-on medical emergency training program was developed by the Oral Surgery Department, Sydney Dental Hospital. The methodology used was pre-training/post-training questionnaires and focus group interviews. Pre-training questionnaires were given to 15 participants and focussed on specific issues such as knowledge of medicine as applicable to dental practice and identifying and managing patients with a potential medical emergency. Post-training questionnaires included additional questions on improved confidence. To achieve a deeper understanding of the outcomes and assess possible other issues, five senior dental officers were selected for focus group interviews. Results: The pre-training questionnaires showed that 14 participants were ‘unsure' or ‘not confident' in identifying and managing medical emergencies. The post-training questionnaires found that all participants had become ‘confident'. The focus group interviews pointed to certain specific aspects of medical emergency training specific to dentistry. Comments included “Medical emergency training programs need be run in an actual dental surgery in a simulated environment” and “Existing programs place too much emphasis on CPR and not enough on why/how the patient ended up in an arrested state”. Conclusions: A hands-on simulated medical emergency program improves both the competence and confidence of dentists. Further improvements may be gained through high-fidelity simulations, once a good theoretical understanding of basic emergency medicine is achieved. Evaluations of these types of programs must consider both qualitative and quantitative outcomes.