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Developing Consensus over Course Contents of Undergraduate Oral and Maxillofacial Surgery Curriculum. Dr S Gulzar Ali Bukhari Assoc. Prof. Oral & Maxillofacial Surgery

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Defining an anaesthetic curriculum for medical undergraduates. A Delphi study

Developing Consensus over Course Contents of Undergraduate Oral and Maxillofacial Surgery Curriculum. Dr S Gulzar Ali BukhariAssoc. Prof. Oral & Maxillofacial Surgery

Oral & Maxillofacial Surgery:

Introduction The branch of dentistry that deals with the diagnosis and treatment of dental and oro-maxillofacial injury, deformity, and disease by manual and instrumental means.

Services AvailableMaxillofacial Trauma SurgeryMaxillofacial OncologyMaxillofacial Congenital SurgeryMaxillofacial Esthetic SurgeryMinor Oral Surgery

Gulono Pa Veena Rang

Rhinoplasty

Distraction OsteogenesisMonoblock Technique

Gunshot wound

Blast Injury

Cleft Lip & Palate

Cleft Palate

Immediate Implant Surgery

Objective of the studyTo develop consensus over the optimal oral & maxillofacial course contents for Pakistani dental undergraduates.

Rationale Present PMDC website display three different BDS Curricular document namely;Revised BDS Curriculum (A meeting of NCRC B.D.S. was held on 19.8.2003)Draft Curriculum 2011 ( A meeting of NCRC B.D.S. was held in 2009)Regulations for the Degree of Bachelor of Dental Surgery (B.D.S) Requirements for BDS Degree.

RationaleThere is disparity as well as repetitions and ambiguities. For example it is not clear whether the implant dentistry is a part of undergraduate oral and maxillofacial curriculum or a separate subject. Likewise the importance of topic of oral oncology has been, keeping in view the high prevalence of oral cancer in our society, under rated in the 2011 draft curriculum.

Rationale More over the present BDS curriculum draft document is a 2nd stage document which needs extensive review by the expertise in the field of oral and maxillofacial surgery before culmination into final stage document and implementation

Research QuestionWhat topics in the areas of oral & maxillofacial surgery needs to be included in the undergraduate curriculum?

Study settingIslamic Republic of Pakistan (IRP)Oral & Maxillofacial Faculty of dental colleges

DurationSix Months

Research TechniqueQualitative study (Delphi technique), three iterative rounds with feedback given at the start of each successive round in the form of the results of the previous round

Sampling technique & sizePseudo-anonymous: The respondents will be known to the authors, but anonymous to each other.More than thirty consultant oral & maxillofacial surgeon will be requested to participate in the study.

Selection criteriaInclusion criteriaWilling consultant oral & maxillofacial surgeon, in the Islamic Republic of Pakistan, experts in undergraduate medical education with 03 years of teaching experience.Exclusion criteriaNon-faculty members oral & maxillofacial surgeons

Data collection instrumentVia a questionnaireFive point Likert scale

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QuestionnaireQ. 1. What topics in the areas of oral and maxillofacial surgery do you feel should be included in the curriculum?Please give your preference for each one of them on the scale. You can also add any new topic in the space provided below, which you might consider important in our local context. Instructions: Please Circle/color/tick the choice after each statement that indicates your opinion.Please also give number for order of sequence for each of your choice. Theory topicsPrinciples of surgery, incisions, flaps, sutures, biopsies, MOS techniques, bone cutting and removal.Strongly agree Agree Undecided Disagree strongly disagree (5) (4) (3) (2) (1)Clerking & Consent, History taking, Examination, Investigations, Role of ConsentStrongly agree Agree Undecided Disagree strongly disagree (5) (4) (3) (2) (1)Routine Investigations Interpretation of Routine of Hematological, Chemical and Radiological InvestigationsStrongly agree Agree Undecided Disagree strongly disagree

(5) (4) (3) (2) (1)

Statistical analysisKappa statistics for measuring agreementThe agreement between observers (inter observer agreement) is often reported as kappa statistics . It gives quantitative measure of the magnitude of agreement between observers and cater for the element of by chance agreement.

ResultsThe response rate of the first round.New individual items included in the second questionnaire based on first response.The % age consultants responded to the second questionnaire. The response rate of the second round and consensus levelThe %age consultants responded to the third questionnaire and consensus level. The number of Items achieved consensus level on completion of the study

Present StatusKhyber Pukhtoon KhawaKCDKIDSDental Section AMCDental Section Bacha Khan Medical CollegePunjabArmy Medical College Dental SectionMragala Dental collegeFauji Foundation Dental SectionIMDCFatima Memorial Dental CollegeLMDCPMC Dental SectionSindLiaqat MDC Dental SectionBaqai Dental SectionQuettaBolan Medical College Dental Section

Conclusion Instead of readily confirming to the Western medical perspective, we should endeavor to produce our own curriculum for our societal needs . This will help us to avoid a new wave of imperialism as warned by some education scholars 2 and build our indigenous capacity.

ReferencesPakistan Medical and Dental Council. PM & DC: Criteria/ Accreditation Standards, Rules and Regulations : http://www.pmdc.org.pk/Home/tabid/36/Default.aspx (accessed 18 October 2014)SHIH-LI TSAI, MING-JUNG HO, DAVID HIRSH & DAVID E. KERN.. Defiance, compliance, or alliance? How we developed a medical professionalism curriculum that deliberately connects to cultural context. Med Teach. 2012; 34: 614617