Sains Malaysiana 50(7)(2021): 2123-2134

http://doi.org/10.17576/jsm-2021-5007-25

 

Resuming Clinical Teaching in the Era of COVID-19: Experiences and Protocols from a Dental School in Malaysia

(Menyambung Semula Pengajaran Klinikal di Era COVID-19: Pengalaman dan Protokol daripada Institusi Pergigian di Malaysia)

 

MOHD ZAMRI HUSSIN1, MOHIDEEN SALIHU FAROOK1, NOR AZLIDA MOHD NOR2, FIRDAUS HARIRI3, KATHREENA KADIR3, NOR NADIA ZAKARIA4, MUHAMMAD KAMIL HASSAN3 & WAN NURAZREENA WAN HASSAN4* 

 

1Department of Restorative Dentistry, Faculty of Dentistry, University of Malaya, 50603 Kuala Lumpur, Federal Territory, Malaysia

 

2Department of Community Oral Health & Clinical Prevention, Faculty of Dentistry, University of Malaya, 50603 Kuala Lumpur, Federal Territory, Malaysia

 

3Department of Oral and Maxillofacial Clinical Science, Faculty of Dentistry, University of Malaya, 50603 Kuala Lumpur, Federal Territory, Malaysia

 

4Department of Paediatric Dentistry and Orthodontics, Faculty of Dentistry, University of Malaya, 50603 Kuala Lumpur, Federal Territory, Malaysia

 

Diserahkan: 5 Februari 2021/Diterima: 17 Mei 2021

 

ABSTRACT

The rapid spread of the global pandemic COVID-19 had challenged the Malaysian Healthcare and Education Systems. Teaching and learning at dental schools across the country were drastically changed to online approach as the nation enforced Movement Control Order (MCO). However, translation of psychomotor skills still require hands-on approach to produce competent dentists upon graduation, but most dental schools were not prepared for the prevention of COVID-19 transmission that require more strict cross infection protocol. The aim of this paper was to describe the response by a dental school in Malaysia to COVID-19 in modifying the clinical teaching and learning, infrastructure, facilities, and clinical services, and enhancing the infection control protocol through risk assessment of COVID-19 transmission and prevention strategies. The paper also discusses the limitations of our approach, challenges in providing clinical services and supervision as well as implications of changes to our practice. In conclusion, COVID-19 has modified the delivery and implementation of clinical teaching and learning in Malaysia. However, within the limited fund and resources, dental teaching institutions need to adapt to the new normal clinical environment in order to ensure that dentals students graduate on time with sufficient clinical training.

 

Keywords: COVID-19; Dental Teaching Institutions; new norm; teaching and learning

 

ABSTRAK

Penularan wabak COVID-19 secara global telah menggugat sistem kesihatan dan pendidikan di Malaysia. Pengajaran dan pembelajaran di semua institusi pergigian di seluruh negara diubah secara mendadak dengan pendekatan dalam talian setelah penguatkuasaan Perintah Kawalan Pergerakan (PKP). Walau bagaimanapun, latihan kemahiran psikomotor masih memerlukan pendekatan langsung untuk melahirkan pengamal pergigian yang kompeten setelah tamat pengajian tetapi kebanyakan institusi pendidikan pergigian tidak mempunyai kesediaan untuk menghadapi pencegahan transmisi COVID-19 yang memerlukan protokol kawalan jangkitan silang yang lebih ketat. Tujuan kertas ini adalah untuk membincangkan respons institusi pengajaran pergigian terhadap pandemik COVID-19 dalam pengubahsuaian pengajaran dan pembelajaran klinikal, infrastruktur, kemudahan dan perkhidmatan klinikal, serta protokol kawalan jangkitan silang melalui strategi penilaian risiko untuk mencegah penularan wabak COVID-19. Kertas ini juga membincangkan limitasi, cabaran dalam perkhidmatan dan penyeliaan klinikal serta implikasi pengubahsuaian yang telah dilakukan terhadap amalan pergigian. Kesimpulannya, COVID-19 telah mencetus pengubahsuaian cara penyampaian dan pelaksanaan pengajaran dan pembelajaran klinikal untuk program pergigian di Malaysia. Namun begitu, dengan bekalan dana dan sumber tenaga yang terhad, institusi pendidikan pergigian perlu mengadaptasi dengan persekitaran klinikal normal baru untuk memastikan para pelajar lulus pengajian dalam tempoh yang ditetapkan dengan latihan klinikal yang mencukupi.

 

Kata kunci: COVID-19; Institusi Pendidikan Pergigian; norma baharu; pengajaran dan pembelajaran

 

RUJUKAN

Ahmed, F., Nicole, Z. & Amra, U. 2018. Effectiveness of workplace social distancing measures in reducing influenza transmission: A systematic review. BMC Public Health 18(1): 1-13.

Al Kawas, S., Natheer, A.R., Wael, T., Zaid, H., Basheer, S., Saad, A.B., Waseem, J. & Samsudin, A.B.R. 2020. Post COVID-19 lockdown: Measures and practices for dental institutes. BMC Oral Health 20(1): 1-7.

American Dental Association. 2020. What Constitutes a Dental Emergency? http://www.ada.org/~/media/CPS/Files/Open%20Files/ADA_COVID19_Dental_Emergency_DDS.pdf.

Amity Limited. 2020. VIRUSOLVE®+ Sproricidal Disinfection & Cleaning for Medical Devices and Any Surface. https://www.amityinternational.com/wp-content/uploads/2013/02/Virusolve.pdf

Anderson, V., Alison, R. & Gregory, S. 2011. Undergraduate dental education in New Zealand: 2007-2009 final-year student feedback on clinical learning environments. New Zealand Dental Journal 107(3): 85.

Bartoszko, J.J., Mohammed, A.M.F., Waleed, A. & Mark, L. 2020. Medical masks vs N95 respirators for preventing COVID‐19 in healthcare workers: A systematic review and meta‐analysis of randomized trials. Influenza and Other Respiratory Viruses 14(4): 365-373.

California Department of Public Health. 2021. Resuming Califonia's Deferred and Preventive Health Care. https://www.cdph.ca.gov/Programs/CID/DCDC/Pages/COVID-19/ResumingCalifornia%E2%80%99sDeferredandPreventiveHealthCare.aspx.

Centers for Disease Control and Prevention. 2020. Guidance for Dental Setttings During the Coronavirus Disease (COVID-19) Pandemic. https://www.cdc.gov/coronavirus/2019-ncov/hcp/dental-settings.html.

Chang, T.Y., Guang, H., Corrado, P., Prathip, P., Wei-Jen, C., Yi-Shing, S. & Ming-Lun, H. 2021. Innovation of dental education during COVID-19 pandemic. Journal of Dental Sciences 16(1): 15-20.

Chu, D.K., Elie, A.A., Stephanie, D., Karla, S., Sally, Y., Holger, J.S., Amena, E.H., Antonio, B., Tamara, L. & Mark, L. 2020. Physical distancing, face masks, and eye protection to prevent person-to-person transmission of SARS-CoV-2 and COVID-19: A systematic review and meta-analysis. The Lancet 395(10242): 1973-1987.

Cochrane Oral Health. 2020. Recommendations for the Re-Opening of Dental Services: A Rapid Review of International Sources.  oralhealth.cochrane.org/sites/oralhealth.cochrane.org/files/public/uploads/covid19_dental_review_16_may_2020_update.pdf.

Coia, J.E., Ritchie, L., Adisesh, A., Makison Booth, C., Bradley, C., Bunyan, D., Carson, G., Fry, C., Hoffman, P. & Jenkins, D. 2013. Guidance on the use of respiratory and facial protection equipment. Journal of Hospital Infection 85(3): 170-182.

Dental Dean Council. 2020. Minimum Clinical Experience/Competency (MCE) [Sp. Edition - COVID-19 Situation]. Online Google Meet.

Dental Dean Council. 2018. Minimum Clinical Experience/Competency. Port Dickson. 25-27 March.

Dental Fallow Time Calculator launched. 2020. British Dental Journal 229(8): 511-511.

Dickens, B.L., Koo, J.R., Lim, J.T., Park, M., Quaye, S., Sun, H., Sun, Y., Pung, R., Wilder-Smith, A. & Chai, L.Y.A. 2020. Modelling lockdown and exit strategies for COVID-19 in Singapore. The Lancet Regional Health-Western Pacific 1: 100004.

Faculty of General Dental Practice. 2020a. COVID-19: Joint Statement on the Impact on Students and Graduates. https://www.fgdp.org.uk/news/covid-19-joint-statement-impact-students-and-graduates.

Faculty of General Dental Practice. 2020b. Implication of COVID-19 for the Safe Management of General Dental Practice: A Practical Guide. https://www.fgdp.org.uk/implications-covid-19-safe-management-general-dental-practice-practical-guide.

Glick, A., Kookal, K.K., Walji, M.F. & Saeed, S.G. 2020. Prioritizing patient care during the COVID‐19 pandemic: A data‐driven approach. Journal of Dental Education. DOI: 10.1002/jdd.12361.

Han, E., Tan, M.M.J., Turk, E., Sridhar, D., Leung, G.M., Shibuya, K., Asgari, N., Oh, J., García-Basteiro, A.L. & Hanefeld, J. 2020. Lessons learnt from easing COVID-19 restrictions: An analysis of countries and regions in Asia Pacific and Europe. The Lancet 396(10261): 1525-1534.

Hinds, W.C. 1999. Aerosol Technology: Properties, Behavior and Measurement of Airborne Particles. 2nd ed. New York: John Wiley & Sons.

Holliday, R., Allison, J.R., Currie, C.C., Edwards, D.C., Bowes, C., Pickering, K., Reay, S., Durham, J., Lumb, J. & Rostami, N. 2021. Evaluating contaminated dental aerosol and splatter in an open plan clinic environment: Implications for the COVID-19 pandemic. Journal of Dentistry 105: 103565.

Iyer, P., Aziz, K. & Ojcius, D.M. 2020. Impact of COVID‐19 on dental education in the United States. Journal of Dental Education 84(6): 718-722.

Izzetti, R., Nisi, M., Gabriele, M. & Graziani, F. 2020. COVID-19 transmission in dental practice: Brief review of preventive measures in Italy. Journal of Dental Research 99(9): 1030-1038.

Machado, R.A., Bonan, P.R.F., Perez, D.E.D.C. & Martelli Júnior, H. 2020. COVID-19 pandemic and the impact on dental education: Discussing current and future perspectives. Brazilian Oral Research 29(34): e083. doi: 10.1590/1807-3107bor-2020.vol34.0083.

Malaysian Qualification Agency. 2016. Programme Standards: Medical and Health Science. https://www2.mqa.gov.my/qad/PS/SP%20Medical%20and%20Health%20Sciences%201.11.2016.pdf.

Ministry of Health Malaysia. 2020a. Delivery of Dental Health Services by the Ministry of Health Malaysia Following the Latest Situation COVID-19. Putrajaya: Oral Health Program.

Ministry of Health Malaysia. 2020b. Guidelines for the Control of Issues Related to COVID-19 Disease and Infection in Dental Health. Putrajaya: Oral Health Program.

National Services Scotland. 2020. Ventilation, Water and Environmental Cleaning in Dental Surgeries Relating to COVID-19. https://www.scottishdental.org/ventilation-water-and-environmental-cleaning-in-dentalsurgeries-relating-to-covid-19/.

Ogden, R.S. 2020. The passage of time during the UK COVID-19 lockdown. PloS ONE 15(7): e0235871.

Patil, N.G. & Yan, Y.C.H. 2003. SARS and its effect on medical education in Hong Kong. Medical Education 37(12): 1127.

Ren, X. 2020. Pandemic and lockdown: A territorial approach to COVID-19 in China, Italy and the United States. Eurasian Geography and Economics 61(4-5): 423-434.

Scottish Dental Clinical Effectiveness Programme. 2020. Management of Acute Dental Problems During COVID-19 Pandemic. https://www.sdcep.org.uk/wp-content/uploads/2020/03/SDCEP-MADP-COVID-19-guide-300320.pdf.

Scottish Dental Clinical Effectiveness Programme.  2021. Rapid Review of Aerosol Generating Procedures in Dentistry. https://www.sdcep.org.uk/published-guidance/covid-19-practice-recovery/rapid-review-of-agps/.

Sukumar, S., Dracopoulos, S.A. & Martin, F.E. 2020. Dental education in the time of SARS‐CoV‐2. European Journal of Dental Education https://doi.org/10.1111/eje.12608.

Tillett, R.L., Sevinsky, J.R., Hartley, P.D., Kerwin, H., Crawford, N., Gorzalski, A., Laverdure, C., Verma, S.C., Rossetto, C.C. & Jackson, D. 2021. Genomic evidence for reinfection with SARS-CoV-2: a case study. The Lancet Infectious Diseases 21(1): 52-58.

University of Malaya. 2020. Standard operating procedure (SOP) of COVID-19 transmission control and prevention measures at the University of Malaya (current and post-conditional movement control order). Kuala Lumpur: Occupational Safety & Health and Environment Division (OSHE) University of Malaya.

World Health Organisation. 2020a. Clinical Management of COVID-19. https://www.who.int/publications/i/item/clinical-management-of-covid-19.

World Health Organisation.  2020b. Coronavirus Disease (COVID-19): Herd Immunity, Lockdowns and COVID-19. https://www.who.int/news-room/q-a-detail/herd-immunity-lockdowns-and-covid-19.

World Health Organisation.  2020c. Listings of WHO's Response to COVID-19. https://www.who.int/news/item/29-06-2020-covidtimeline.

World Health Organisation. 2020d. Public Health Surveillance for COVID-19: Interim Guidance. https://www.who.int/publications/i/item/who-2019-nCoV-surveillanceguidance-2020.8.

Wu, Z. & McGoogan, J.M. 2020. Asymptomatic and pre-symptomatic COVID-19 in China. Infectious Diseases of Poverty 9: 72.

 

*Pengarang untuk surat-menyurat; email: wannurazreena@um.edu.my

 

 

sebelumnya