What factors influence learning of psychomotor skills by dental students?

Abstract

Several key factors have been identified that relate to skill acquisition: a) ability, b) motivation, c) thinking processes and d) learning environments. Other health professions have used learning theories to inform study designs when investigating skill acquisition but this approach has not been adopted routinely in dentistry. Previous studies in dentistry have focused mainly on the predictive value of assessments used in dental admissions, eg ability tests, rather than trying to clarify how factors such as motivation and ability influence skill learning. This dissertation explores the influence of the above key factors on dental performance and outlines theoretical-based implications for practice in operative technical courses. To clarify how motivation, ability, thinking processes and learning environments influence the acquisition of psychomotor skills in operative dentistry, two cohorts of dental students were studied from different years of the Bachelor of Dental Surgery program at The University of Adelaide. To determine the nature of the relationship between individual differences in ability, motivational determinants and performance on routine operative dentistry tasks, a cross-sectional study (Phase I) was conducted of third-year students. Phase I also investigated the use of motor learning parameters by students during completion of a routine operative task. The second phase of the study investigated individual differences in ability of a different cohort of students and was carried out during the second year. This was achieved by exploring the contribution of ability and motivation determinants to changes in motor performance throughout the operative technique course. The study also explored external factors that were related to performance, ie learning experiences that students reported had influenced their skill learning, as well as motor learning parameters they used during the activities. Both quantitative and qualitative approaches were used to explore the previously noted key factors using a range of instruments, eg psychometric tests, a motivation survey, a retrospective think-aloud technique and critical incident reports. Significant positive associations were found between cognitive, psychomotor and motivation scores and performance in operative dentistry. This relationship varied across different stages of learning in the dental program. Students tended to focus on evaluating their outcome rather than evaluating their processes to achieve a task. Three themes related to learning environments were derived from critical incident reports and follow-up interviews: roles of tutors in providing a positive learning environment; perceptions about the quality of cavity preparations, ie “learning from errors”; and roles of peers in self-assessment of outcomes. This study has provided insights into individual differences in the learning of psychomotor skills by dental students as a result of inherited factors, eg ability, as well as the roles of the learning environment in enhancing learning. This dissertation presents the implications of these findings for the design of quality learning activities in operative technique courses.