Development, implementation, and evaluation of a standardized patient-based training program in oral cancer prevention and early detection for dental students

Introduction. Oral cancer is a significant public health issue in the United States. However, few studies have examined the relation between oral cancer education and the oral cancer prevention and detection skills of dental students. This dissertation reports the utilization of the PRECEDE-PROCEED framework to develop, implement, and evaluate a randomized pretest/posttest controlled study to examine the association between specific oral cancer education and oral cancer prevention and detection skills among first and second year predoctoral dental students enrolled at the Medical University of South Carolina. Methods. Three outcomes were evaluated: competency in oral cancer prevention and detection skills, oral cancer/tobacco cessation knowledge, opinions, and behaviors, and communication skills with patients. Baseline assessment occurred in September 2005, and posttesting was in March 2006. Dental students (n=104) were randomized to either an intervention or control group. The intervention group received faculty-facilitated standardized patient-based training in oral cancer prevention and early detection in addition to usual course instruction. Data were analyzed using ANOVA and ANCOVA to compare changes from baseline to posttest. Results. Second year students significantly improved in oral cancer knowledge (p=0.01), and those in the intervention group were more competent at posttest than second year students in the control group (p=0.02). All students had positive opinions toward their role in tobacco intervention. Although baseline interpersonal communication skills were higher for second year students in the control group than first year control group students (p=0.02), there were no significant group differences in communicating about tobacco use cessation. Conclusion. Results from this study demonstrate the effectiveness of faculty-facilitated standardized patient-based training on the oral cancer prevention and early detection skills of dental students. Although results suggest that a comprehensive communications training course may be more beneficial than brief training in improving dental students' communication skills, the use of PRECEDE-PROCEED provides a framework for designing a standardized oral cancer curriculum for a wide range of health professions disciplines. Health professional schools can utilize this approach to incorporate faculty-facilitated standardized patient-based training and required competency measurement into existing early clinical experiences to train students in oral cancer prevention and detection.