Student-Dentist (SD) Factors Predict Concordance Between Patient/SD Pain Ratings

OBJECTIVES: Clinician assessment of patient's pain is an important determinant in treatment and clinical outcome. The assessment of clinical pain is related to patient characteristics (e.g., symptoms, radiographic findings, verbal and non-verbal communication) as well as clinician characteristics (e.g., clinical experience). The purpose of the present study was to assess the relationship between independent student dentists (SD) and patient assessments of clinical pain in emergency dental patients (EDP) and whether SD knowledge of patient pain level predicts SD and patient outcomes (effectiveness).

METHODS: Study subjects were 79 EDP requiring dental extractions and the SD providing dental care (45 junior students, 34 senior students, 40.5% females). Patient data included sex (49.4% female), race (55.7% white (W), 38.0% Black (B), 6.3% other (O)), and clinical findings and visual analog scale (VAS) ratings of pain, anxiety and post-operative assessments of effectiveness. SD data included year in training, sex and VAS ratings of patient pain, anxiety, pretreatment confidence in achieving pain control and post-treatment effectiveness in achieving pain control during treatment. Thirty-nine of the SD were shown patient VAS ratings of pain and anxiety prior to the initiation of treatment.

RESULTS: A 2-way ANOVA (sex of student X year of training) was conducted on students' ratings of patients' pain. Results indicated a significant sex effect (F(1,75)=4.4, p=.038) suggesting that female students rated patient pain higher than males. The main effect for year of training and the interaction of training and sex were both non-significant (p >.1). Senior SD more accurately rated patient pain than junior. There were no differences in between the knowledge group outcomes.

CONCLUSIONS: SD ratings of patient pain were related to EDP ratings. SD characteristics (junior vs. senior and sex) were significant contributors to EDP rating variance.