Preclinical Dental Simulation: Cord Packing Protocol

To teach the exercise, we created the cord packing model fabrication video (Appendix A) along with the step-by-step instructional guide (Appendix B). The target audience for this activity was second-year preclinical dental students; the activity itself was an exercise in the simulation laboratory, course number 1636L. The students were just beginning the spring session and preparing for transition to clinic. They had previously received 2 hours of classroom presentations describing measures to facilitate tissue management and fluid control during impression procedures. The video reviewed tissue retraction techniques, when they should be used, and how those results would lead to an acceptable impression.
We created a 20-slide PowerPoint (Appendix E) to use at the commencement of the activity for review. The first portion of the presentation provided background information regarding the use of lasers, cord, and electrosurgery for GD. The second half reviewed cord placement technique. Faculty could determine the appropriate use of the PowerPoint presentation based on student need. We also created a short video of the students’ instructional guide (Appendix F) for faculty and/or student reference as needed. The implementation guide (Appendix G) provided overall guidance in facilitating the simulation exercise.
We asked instructors to distribute the instructional guide to the students and verbally review the goals for the exercise. The faculty-to-student ratio was 1:5. Instructors demonstrated the retraction cord placement technique to small groups. Following the demonstration, students received one-on-one opportunities to practice the technique for 10–15 minutes with verbal feedback from faculty. As this session was included as part of a larger daily simulation activity, no formal assessment was provided. The session was a completion exercise supported by verbal faculty feedback. We developed the cord packing assessment (Appendix H) to evaluate students’ skill at completion of the exercise.
To gain further understanding of the students’ experience, we expanded the activity to a convenience sample of third- and fourth-year students (n = 71) the following year. Verbal informed consent that described the purpose of participation was given by the students. The groups surveyed were D3s (formerly D2s) and D4s who had not previously experienced the exercise. The D4s (n = 34) were 3 months from completion of their clinical education. A survey for D3s (Appendix I) and a separate survey for D4s (Appendix J) were used to assess their perception of the exercise. This student cohort had the opportunity to review the instructional guide and practice on the cord placement technique model. The goal of involving the D4 students was to retrospectively determine if they felt it would have been helpful to have had the exercise during their preclinical education.