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 Lesson Title:  Dental Shade Selection.

Target Learner Audience:  2nd year dental students.

 

1.     Teacher Goals

During this lesson I aim to:

 

  • Motivate the student to learn the skill of shade selection through my enthusiasm for its exciting cosmetic applications and the prospect of patient satisfaction.
  • Model awareness of the patient’s emotional state to encourage reflection of this awareness in the student being taught.
  • Provide a simple and memorable system that can be used by the student incorporating familiar concepts of colour and brightness to come to a correct dental shade decision.
  • Ensure that the student feels comfortable enough to take progressive control of the shade selection process at their own discretion and raise any questions and concerns.

 

2.     Assumed learner background (prior) knowledge and experience

 

This skills lesson has been tailored to the needs of dental students at the beginning of their second year of undergraduate study. These students have already received lectures about dental materials and restoration processes. Students are aware that different shade selection methods exist but are unlikely to have had experience in using these clinically. Students have had previous interactions with patients through examination procedures and are familiar with infection control principles.

3.     Resources (equipment list, teaching aids, environment configuration, teacher/learner positioning)

 

2 x VITA classic shade guides. 2 patients, Photographs, and colour photocopy of VITA shade guide.

 

  • 1 true Vitapan Classic shade guide.
  • 1 Vitapan Classic shade guide copy for the student to take home and use for practice.

* Cut slits between individual tabs so the student can fold down tabs to simulate use of one or two tabs at a time.

  • 2 de-identified photographs of patient dentition.
  • 1 volunteer patient.
  • Access to a whiteboard or pen and paper is desirable to prepare for possible trouble-shooting or more detailed descriptions that may be required as part of the lesson.

 

Teacher positioned beside the learner at a table (facing in the same direction) with the shade guide and de-identified patient photographs on the table. The demonstration patient is positioned in a chair across the table from the teacher and student within reaching distance.

4.     Key questions.

 

–  Can the student identify a poor versus sound shade match?

–  What innate methods does the student use to select a shade use?

–  Has the student had the opportunity to see or use a shade guide in the clinic before?

–  Does the student understand the concept of colour as it relates to the Vitapan shade guide?

–  Does the student understand the concept of brightness as it relates to the Vitapan shade guide?

–  Can the student relate steps taken to select a shade?

–  Can the student perform the steps associated with shade selection?

–  Can the student arrive at a shade that is accurate using the technique described?

5.     Major difficulties anticipated (conceptual and procedural)

 

– Unpredictable prior experience and innate capacity in shade selection.

– Limited time to ensure the student can apply the skill.

– Limited resources. Cannot provide entire class with their own real Vitapan guide.

– Positioning of teacher, student and patient in a way that is non-threatening, practical and efficient for lesson delivery.

– Patient response to learning environment.

– Student-patient ‘dynamic’.

6.     Learning objectives.

 

By the end of this lesson, the learner will be able to:

1. Describe the colour and brightness trends represented on a Vitapan shade guide.

2. Demonstrate and describe a systematic approach to shade selection using knowledge of colour and brightness concepts.

3. Identify the correct shade of a patient’s central incisor tooth.

 

7.     Evaluation of learning (how you plan to determine if the learning objectives have been achieved)

 

Evaluation of learning objective achievement will be formative in nature and will be assessed through use of specific questions and ‘mini-challenges’ during the course of the skills session. The student will be asked to demonstrate their understanding of each important concept introduced in this session through targeted questioning. The synthesis of this knowledge into successful application of the clinical skill will be tested with increasing complexity using the ATLS system. The student will eventually be asked to describe and perform the skill to arrive at a correct shade decision as ultimate evidence that they have met the stated lesson objectives.

 

The specific questions that the teacher will seek to answer throughout the lesson are:

 

– Do students accurately identify problems with shade selection in the photographs shown?

– Do students abandon a haphazard shade selection approach for the systematic process recommended?

– Can the student describe the different base colours of brown, yellow and grey as they relate to the Vitapan guide?

– Can the student relate the effect of increasing number on the brightness of a shade within the Vitapan system?

– Can the student talk the demonstrator through the process of shade selection using the sequence described to them?

– Does the student demonstrate their understanding of colour and brightness when asked to perform shade selection?

– Can the student describe a systematic approach to shade selection whilst performing this?

– Does the student select the correct shade?

 

SET (MMOPO)
Lesson components Learner activities Teacher activities Timeframe
Mood Listen or respond Establish Mood

– Encourage students as soon as possible to offer their opinion on shade selections made by other dentists in clinical photographs.

– Set an interactive mood where students are allowed to make mistakes and offer their subjective view.

– Make formal introductions between the student, the patient and myself to establish a respectful tone.

– Frame my introduction with a commitment to help the student achieve the desired skill.

– Encourage the student to move around, raise concerns and ask questions as needed in order to grasp the procedure.

2 minutes

60 seconds

Motivate Listen or respond Motivate learner to learn the skill.

– Encourage students to commit to learning this skill by sharing the positive rewards it can bring in the form of patient and clinician satisfaction.

30 seconds
Orientate: (including a linking back to prior lesson) Listen and recall prior lesson

Respond to questions

Introduce content

During the session the student will learn:

– How a Vitapan shade guide works.

– When and how to use a shade guide.

Introduce process

Describe the steps associated with ATLS in terms of what the STUDENT needs to do (rather than the teaching steps).

1) Watch only as I give a silent demonstration.

2) Watch and listen as I describe and perform the steps.

3) Talk me through the steps as I perform the skill.

4) Demonstrate the skill while narrating the steps.

Link back to:

Learning about different shade guide options as part of theory lessons.

Ask or state why this skill is needed in clinical practice?

Explain that this skill can be used to match the shade of the patient’s natural teeth or make a controlled shade change.

Ask or state how it is used in the delivery of care?

Ask student to suggest a time when they may need to use a shade guide. Briefly cover options such as composite resin restorations, bleaching, and dentures.

Describe the appropriate timing of shade selection at the beginning of treatment before teeth dehydrate.

75 seconds
Probe prior learning (knowledge, skill) Respond to questions Is the learner familiar with the equipment?

– Has the student seen a shade guide before?

Has the learner seen this skill being performed before?

– Has the student ever seen a shade guide being used or had the opportunity to use one?

What does the learner know about this skill?

– Has anyone described how to use a shade guide before to the student?

15 seconds
Objectives Listen to objectives State the learning objectives

By the end of this lesson, the learner will be able to:

1. Describe the colour and brightness trends represented on a Vitapan shade guide.

2. Demonstrate and describe a systematic approach to shade selection using knowledge of colour and brightness concepts.

3. Identify the correct shade of a patient’s central incisor tooth.

 

30 seconds
BODY
Lesson components Learner activities Teacher activities Timeframe
Usually list learning objectives to ensure that the learner and teaching activities match.

 

Key aspects to consider:

Provide a clear structure

Use appropriate amount of content (less is more)

Manage time

Explain equipment well

Clarify technical terminology

Emphasise safety points

Involve learner

Emphasise major points

Demonstrate process

Give learner opportunity to practice

Pitch teaching at the appropriate level

Check for understanding

Encourage learner questions

Talk to learner, not equipment

Maintain unobstructed view

Maintain eye contact

Exhibit enthusiasm

 

Listen and ask clarifying questions Explain equipment

– Vitapan shade selection system.

(A, B, C – disregard D at first. 1, 2, 3, 4.)

A= Brown

B= Yellow

C= Grey

1= Bright, 4= Dark (spectrum in between the two)

– Removable tabs.

Explain technical terminology

Shade = base colour (represented by letter) plus brightness (represented by number).

Explain safety precautions

– No contact with oral tissues while practicing to ensure infection control.

Ask the student to describe the base colours represented by A, B and C letters.

Ask the student if they have selected a B2 shade and want ato change to a BRIGHTER shade, what shade would they select?

90 seconds
Observe demonstration Silent demonstration

** Removed silent demonstration as peer and formal reviewers did not feel that it added much to the lesson.

 
Observe and listen to demonstration Teacher narrative demonstration

Demonstrate shade selection on the live patient. Talk the student through the four steps of shade selection:

– Select base colour

– Select brightness

– Select and appraise your best guess

– Refine selection (colour and brightness)

60 seconds
Narrate teacher through the skill steps Learner narrative

Ask the learner to talk you through the skill.

Is the learner confident enough to talk through the skill yet?

Does the learner require clarification of any aspect of the skill before attempting narration?

Demonstrate shade selection on the photograph with the student narrating.

– Specifically seek out the use of terms “base colour,” “brightness,” “best guess,” “refine” (or synonyms).

– Ensure that decisions are made using the recommended sequence.

60 seconds
Demonstrate skill

Ask clarifying questions

 

Learner performance

Ask learner to perform the skill

Give the learner the opportunity to demonstrate the skill on either the patient OR photograph at first.

If the learner elects to select a shade on the photograph first, give the option of selecting the shade on the patient next if time permits.

Is the learner confident enough to perform and narrate this skill yet?

Does the learner require clarification of any aspect of the skill before attempting demonstration with narration?

Observe and evaluate performance

– Specifically seek out the use of terms “base colour,” “brightness,” “best guess,” “refine” (or synonyms).

– Ensure that decisions are made using the systematic sequence.

– Point out specific actions that are correct to reinforce use of the approach advocated.

Provide corrective feedback and coaching as necessary

– Refer student back to the 4-step basic sequence when necessary.

– Reinforce basic concepts of colour and brightness as needed.

Praise efforts

Be specific about what was done well.

Ask learner if they have any questions

60 seconds

 

  How will you address any of the anticipated difficulties?

– Find the point in the process where the student becomes disorientated by watching actions closely and listening to their description and tone.

– Try to address gaps in knowledge early on by providing ample opportunities for questions, and allowing the student to dictate the pace and progress of the lesson.

How will you check for understanding?

Ensure the student meets the expectations set at each stage of the lesson.  

– Can first show their understanding of colour and brightness through simple questions based on this understanding.

– Feels able to narrate the teacher demonstration and then perform the skill with narration.

– Accurately describes the systematic process used to come to a shade selection.

– Correctly selects a dental shade by the end of the lesson.

How will you encourage learner questions?

Be specific and encourage questions frequently, for example:

 – So what are the base colours of A, B and C?

– What is the brightest, 1 or 4?

– What would you do if the shade you selected was not bright enough?

– Can you describe how the colours change as I go across the shade tab?

Be positive and encouraging. Do not reprimand students for gaps in knowledge; instead address these problems pragmatically. Praise inquiry and attainment of new knowledge.

30 seconds
BODY
Lesson components Learner activities Teacher activities Timeframe
Usually list learning objectives to ensure that the learner and teaching activities match.

 

Key aspects to consider:

Provide a clear structure

Use appropriate amount of content (less is more)

Manage time

Explain equipment well

Clarify technical terminology

Emphasise safety points

Involve learner

Emphasise major points

Demonstrate process

Give learner opportunity to practice

Pitch teaching at the appropriate level

Check for understanding

Encourage learner questions

Talk to learner, not equipment

Maintain unobstructed view

Maintain eye contact

Exhibit enthusiasm

 

Listen and ask clarifying questions Explain equipment

– Vitapan shade selection system.

(A, B, C – disregard D at first. 1, 2, 3, 4.)

A= Brown

B= Yellow

C= Grey

1= Bright, 4= Dark (spectrum in between the two)

– Removable tabs.

Explain technical terminology

Shade = base colour (represented by letter) plus brightness (represented by number).

Explain safety precautions

– No contact with oral tissues while practicing to ensure infection control.

Ask the student to describe the base colours represented by A, B and C letters.

Ask the student if they have selected a B2 shade and want ato change to a BRIGHTER shade, what shade would they select?

90 seconds
Observe demonstration Silent demonstration

** Removed silent demonstration as peer and formal reviewers did not feel that it added much to the lesson.

 
Observe and listen to demonstration Teacher narrative demonstration

Demonstrate shade selection on the live patient. Talk the student through the four steps of shade selection:

– Select base colour

– Select brightness

– Select and appraise your best guess

– Refine selection (colour and brightness)

60 seconds
Narrate teacher through the skill steps Learner narrative

Ask the learner to talk you through the skill.

Is the learner confident enough to talk through the skill yet?

Does the learner require clarification of any aspect of the skill before attempting narration?

Demonstrate shade selection on the photograph with the student narrating.

– Specifically seek out the use of terms “base colour,” “brightness,” “best guess,” “refine” (or synonyms).

– Ensure that decisions are made using the recommended sequence.

60 seconds
Demonstrate skill

Ask clarifying questions

 

Learner performance

Ask learner to perform the skill

Give the learner the opportunity to demonstrate the skill on either the patient OR photograph at first.

If the learner elects to select a shade on the photograph first, give the option of selecting the shade on the patient next if time permits.

Is the learner confident enough to perform and narrate this skill yet?

Does the learner require clarification of any aspect of the skill before attempting demonstration with narration?

Observe and evaluate performance

– Specifically seek out the use of terms “base colour,” “brightness,” “best guess,” “refine” (or synonyms).

– Ensure that decisions are made using the systematic sequence.

– Point out specific actions that are correct to reinforce use of the approach advocated.

Provide corrective feedback and coaching as necessary

– Refer student back to the 4-step basic sequence when necessary.

– Reinforce basic concepts of colour and brightness as needed.

Praise efforts

Be specific about what was done well.

Ask learner if they have any questions

60 seconds

 

  How will you address any of the anticipated difficulties?

– Find the point in the process where the student becomes disorientated by watching actions closely and listening to their description and tone.

– Try to address gaps in knowledge early on by providing ample opportunities for questions, and allowing the student to dictate the pace and progress of the lesson.

How will you check for understanding?

Ensure the student meets the expectations set at each stage of the lesson.  

– Can first show their understanding of colour and brightness through simple questions based on this understanding.

– Feels able to narrate the teacher demonstration and then perform the skill with narration.

– Accurately describes the systematic process used to come to a shade selection.

– Correctly selects a dental shade by the end of the lesson.

How will you encourage learner questions?

Be specific and encourage questions frequently, for example:

 – So what are the base colours of A, B and C?

– What is the brightest, 1 or 4?

– What would you do if the shade you selected was not bright enough?

– Can you describe how the colours change as I go across the shade tab?

Be positive and encouraging. Do not reprimand students for gaps in knowledge; instead address these problems pragmatically. Praise inquiry and attainment of new knowledge.

30 seconds
CLOSURE (SLLEN)
Lesson Components Learner activities Teacher activities Timeframe
Summarise the session Listen or respond What are the key points of the lesson?

– Why the skill is important in terms of frequency and variety of uses, patient perception and clinician satisfaction.

–  Emphasise the importance of a systematic approach in a pressurized clinical context.

– Use the point above to reiterate the simplicity of the 4 steps practiced today. 1) Colour, 2) Brightness, 3) Best guess, 4) Refine.

30 seconds
Link back to set/objectives) Listen or respond State how the lesson links back to the learning objectives or probe learner on these.

Remind the student of their achievements during the session. They can now…

 

1. Describe the colour and brightness trends represented on a Vitapan shade guide.

2. Demonstrate a systematic approach to shade selection using knowledge of colour and brightness concepts.

3. Correctly identify the shade of a patient’s central incisor tooth.

Give positive feedback on these specific achievements.

30 seconds
Link forward to next lesson Listen What is the next lesson and how is it linked?

– Next session seeks to teach the skill of shade blending to make unique (non-Vitapan) shades. This skill is made easier by proficiency in basic shade selection and may act as a motivator for the student to practice the skill learned in this session before the next session.

15 seconds
Evaluate the learning outcomes (this is often done in the body) Respond to questions How will you evaluate performance (skill and knowledge – based on learning objectives)

See evaluation questions highlighted throughout the BODY.

 
Nothing new   Avoid asking for questions in the closure

Close with positive encouragement towards ultimate outcome of patient and personal satisfaction through successful shade selection.

15 seconds