Amaç: Bu çalışmanın amacı, klinik eğitim almakta olan diş hekimliği öğrencilerinin ağız lezyonlarının karakterini tanıma becerilerini değerlendirmek ve ilave bir eğitimin gerekli olup olmadığını incelemektir. Gereç ve Yöntemler: Yetmiş iki gönüllü katılımcıya (4. sınıftan 36 öğrenci ve 5. sınıftan 36 öğrenci) benign, prekanseröz ve malign lezyonlardan oluşan 20 olgu, ağız içi görüntü, hasta hikâyesi ve ağız lezyonunun klinik özelliklerine ait bilgiler eşliğinde sunuldu ve lezyonların karakterini sınıflandırmaları istendi. Grupların tanı skorları student t-testi ve grupların her bir olgu için tanı performansı ki-kare testi ile analiz edildi. Bulgular: Beşinci sınıf öğrencilerinin tanı skorları [ortalama 15,58, %95 güven aralığı (GA) 15,03-16,13] 4. sınıf öğrencilerinden (ortalama 13,44, %95 GA 12,53-14,35) daha yüksekti (p<0,05). Benign, prekanseröz ve malign lezyonlar için 4. sınıf öğrencilerinin tanı performansları sırayla %77,78 (%95 GA, 73,73-81,47), %40,28 (32,20-48,77) ve %57,41 (47,53-66,78); 5. sınıf öğrencilerinin ise %87,49 (84,04-90,26), %53,47 (44,98-61,82) ve %64,81 (55,04- 73,76) olarak belirlendi. Ağızda en sık rastlanan malignite olan skuamöz hücreli karsinomu 4. sınıf öğrencileri %75-77,7; 5 sınıf öğrencileri ise %83,3-91,7 doğrulukla sınıflandırdı. Sonuç: Öğrencilerin klinik deneyimi arttıkça ağız lezyonlarını tanıma becerileri gelişmekle birlikte, prekanseröz ve az rastlanan malign lezyonları ayırt etmekte güçlük çekmektedirler. Bu nedenle, klinik eğitim sırasında tanı becerilerinin geliştirilmesine katkı sağlayabilecek vaka tabanlı öğrenme çalışmalarının daha geniş bir yelpazede olacak şekilde yeniden düzenlenmesine karar verilmiştir.
Anahtar Kelimeler: Eğitim, diş hekimliği; tanı, oral; ağız hastalıkları
Objective: The purpose of this study was to assess the ability of dentistry students undergoing clinical education identifying nature of oral lesions and to examine whether an additional training is required. Material and Methods: Twenty cases consisting of benign, precancerous and malignant lesions were presented to 72 volunteer participants (4th-year; 36 students and 5th-year; 36 students) accompanied by intraoral images, patient's history, and clinical findings of the oral lesions and they were asked to classify the nature of the lesions. The diagnostic scores of the groups were analysed by student t-test and the diagnostic performance of the groups for each case were analysed by chi-square test. Results: Diagnostic scores of 5thyear students [mean 15.58, 95% confidence interval (CI) 15.03-16.13] were higher than those of 4th-year students (mean 13.44, 95% CI 12.53-14.35) (p<0.05). For benign, precancerous and malignant lesions, diagnostic performances of 4th-year students were 77.78% (95% CI, 73.73-81.47), 40.28% (32.20-48.77) and 57.41% (47.53- 66.78), respectively; the diagnostic performances of 5th-year students were 87.49% (84.04-90.26), 53.47% (44.98-61.82) and 64.81% (55.04-73.76), respectively. 4th-year students identified squamous cell carcinoma, the most common malignancy of oral cavity, with an accuracy of 75-77.7% and 5th-year students with an accuracy of 83.3- 91.7%. Conclusion: The students' ability to distinguish nature of oral lesions improves with clinical experience, however, they have difficulties in identifying precancerous and rare malignant oral lesions. Therefore, it was decided to reorganize the case-based learning studies that would contribute to the development of diagnostic skills during the clinical education, in a broader spectrum.
Keywords: Education, dental; diagnosis, oral; mouth diseases
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