OBJECTIVES: This thesis adopts a multivariate approach to examine perceptions and practices regarding routine dentist-patient interactions in initial consultations. METHODS: A 16-item Dental Patient Feedback on Consultation skills (DPFC) questionnaire was adapted for use in the dental setting through face, content, and construct validity. A cross-sectional survey (n=389) of patients’ perceptions of their dentist’s clinical performances was conducted in a teaching hospital. Test-retest reliability (n=42) was assessed. Variations in DPFC responses (scale and item level) were examined in relation to socio-demographics and dental attendance patterns in bivariate and regression analyses. Second tier data was collected in the form of 70 audio-visual recordings (~15 hours) which were transcribed and sequentially analyzed to identify internal structures. Corpus-based discourse and sociolinguistic analysis drawing on traditions of Conversation Analysis, was used to identify dental consultation stages and sequential patterns across turn-taking systems. Transcribed recordings from the top quartile of survey results (n=18) were examined to reveal how dentists and their patients co-accomplished ‘successful’ consultations. RESULTS: Face validity of the DPFC questionnaire ranged 81.1-100%. Content Validity Index ranged 0.73-1.00. Variations across DPFC scores regarding global ratings of satisfaction were apparent (p<0.001). Cronbach’s alpha value was 0.94 and Intraclass Coefficient Correlation value was 0.89. Results identified that dental attendance pattern was a factor associated with DPFC (p<0.05); but no significant differences were observed regarding socio-demographics. Corpus-based discourse and sociolinguistic analysis indicated seven specific consultation stages across the 70 recordings. This was divided into two parts by radiographic imaging, namely Part A: Opening, Oral Problem Presentation, Medical History Taking, Oral Examination, Post-examination; and Part B: Diagnosis and Explanation, and Closing. Sequential analysis of Turn-Constructional Units in the Oral Problem Presentation Stage across the 70 recordings indicated patterns for dentists’ soliciting and patients’ presenting. Dentists solicited patient problems through open-ended questions (n=68) and closed-ended questions (n=2). Patients adopted two oral problem presentation types either using talk with gestures (n=61) or without gestures (n=9). Sequential analysis of the top quartile of recordings (n=18) revealed that patients perceived higher satisfaction with clinical communication if dentists re-visited their oral problems in the Diagnosis and Explanation Stage through a stepwise formulation. This presented as re-visiting patients’ oral problems through either repeating patients’ own terms or repairing patients’ prior talk. Finally, a case is analyzed to examine how a patient perceived effective dentist communication despite receiving a less-than-satisfactory admission outcome. CONCLUSIONS: The lack of socio-demographic variations in DPFC indicates similar treatment across groups and standardized communication practices by dentists in this public hospital context. Patients with prior dental visits within one year require greater attention in first encounters, possibly due to their recently unresolved oral problems. To enhance the quality of dentist-patient communication, dentists need to attend to patients’ non-verbal signals during talk when presenting oral problems. In identifying how patients and dentists co-accomplish ‘successful’ communication, a clear topical thread connecting patients’ oral problem presentation with the final dentist explanation stages emerged. Empirical findings suggest re-visiting of patients’ oral problems before delivering diagnosis may enhance patient perceptions of ‘successful’ communication in initial consultations. / published_or_final_version / Dentistry / Doctoral / Doctor of Philosophy

Thesis (PhD Dentistry)--University of Pretoria, 2006. / Includes bibliographical references.

Thesis (PhD(Dentistry))--University of Pretoria, 2006. / Includes bibliographical references.

This paper describes a case study of a non-native speaking (NNS) dental hygienist in her work environment. The subject learned English by learning to become a dental hygienist rather than through formal language education. Participant observation and discourse, event/network, and componential analyses were the methods used to analyze the subject's communication in her work setting. The philosophical question as to how ESP differs from ESL is raised and elements of the work setting and the NNS workers' communication with interlocutors in that setting are identified to aid educators in teaching ESP courses. Questions ESP educators might address in designing and teaching ESP courses are given as well as suggestions for future research.

Thesis (M.S.)--University of Michigan, 1997. / Includes bibliographical references.

Thesis (Ph. D.)--Oregon State University, 2007. / Printout. Includes bibliographical references (leaves 142-151). Also available on the World Wide Web.

The purposes of this investigation were (1) to determine if a systematic training program in communication skills could be used to improve written response levels of dental hygiene students, and (2) to determine if a systematic training program in communication skills could yield improved dental hygiene student-patient rapport. The experiment involved two groups of dental hygiene students that had previously been randomly selected and consisted of twelve junior and twelve senior students in each group. The entire population of dental hygiene students at Texas Woman's University participated in the study. Analysis of the data provided statistically significant findings on seven of the eight hypotheses. Those subjects in the systematic training program were able to demonstrate increased ability to write responses and, in addition, had higher patient rapport scores. The results were also statistically significant two weeks following the training period. It was, therefore, concluded that the systematic training program in communication skills was an effective teaching device for improving dental hygiene responses. The systematic training program also seemed to be an effective strategy for improving dental hygiene student-patient rapport formation.

Indiana University-Purdue University Indianapolis (IUPUI) / Purpose: Patient-provider communication has been studied extensively in the last two decades, and many researchers have confirmed the importance of communication between patient and provider in medical contexts. In spite of increased research in patient-provider communication in dentistry, dental care providers still report that patients often do not accurately follow oral health recommendations. Thus, there is the need for additional study on how patients make sense of the oral health information they receive and how they translate that information into action. This study aimed to obtain insight into how dental care patients perceive and make sense of the information they receive from their dentist and how they translate that information into action. Methods: 16 patients and 8 dentists from Indiana School of Dentistry’s (IUSD) Graduate Prosthodontic Clinic in Indianapolis, Indiana were included. Two in-depth interviews, one immediately following the dental visit and one 7-10 days later, were conducted with the patients, and one short interview was conducted with each patient’s dental care provider. Interviews were audio taped and transcribed. Results: The results show both patients and providers perceived the interaction during consultation positively. The majority of patients were able to accurately recall information they received from their dentists and made sense of new information through the lens of their previous experiences. Four additional factors that explain patients’ adherence with health advice were also found in addition to the previous studies. Conclusions: Successful dentist-patient interaction could be thought of as a match between what dentists think patients need to know, what patients think they want/need to know, and what patients actually know. Thus, some barriers that can keep dentists and patients from reaching information equilibrium are discussed. The study concludes by offering practical and theoretical implications.