May 17, 2018
Their most anticipated and stressful practical test is one hour away, but instead of pacing anxiously or stretching in the nearby corridors, the first-year dental students at the University of Michigan are enjoying classical music in a packed lecture hall.
The future dentists are listening to Mozart, Borodin and Josquin. All eyes are fixed on the stage at the School of Dentistry. Some keep them closed, inspired by the pieces. The performers playing two violins, a cello and a viola are four students from the School of Music, Theatre & Dance.
"The performance takes your focus away from the practicals, it clears your mind," said first-year dental student Christine Uggeri of Kalamazoo. "It is nice to be able to step away for a little bit, listen to music and all together bring our energy down until the drills start going and we go back to reality."
Dental students relax at a classical music performance before a major practical exam.
The interdisciplinary musical gathering has two main goals: lower students' anxiety and reduce the rate of mistakes during practicals, when the students are being tested for the first time on using the scariest of tools — the drill.
"I am always trying to find ways to encourage and to support innovative and creative approaches to education," said Elisabeta Karl, clinical assistant professor of dentistry. "A slip of the drill can cause too much damage to the patient's tooth. Any idea to help students perform well is more than welcome."
The project was funded and organized by the Course Development Grant program at the University Musical Society. Shannon Moen, campus engagement specialist for UMS, worked with Karl to design the in-class concerts and recruited the student quartet to play in the class.
Karl first became interested in the potential benefits of music therapy for dental students in 2016, when she read a research article about the effects of music listening on the anxiety of nursing students during their first blood draw experience.
The study found that students who listened to music had a lower mean anxiety score and were more successful in completing the steps correctly. Students who did not listen to music experienced more anxiety during the procedure, decreasing performance and increasing the rate of mistakes.
According to research, anxiety is a psychological reaction against the excessive energy resulting from difficulties overwhelming the individual. It is considered one of the basic human feelings, and often happens when someone perceives the current situation they are in as threatening and endangering. In education, it can be fear of failure and difficulties in relating theory to practice.
Easy to apply and inexpensive, music is a natural method, with no side effects. It plays an important role in physical, psychological, social, emotional and spiritual improvement, not only in hospitals, but also in the field of education.
"I think music in the right context can accomplish many things," said senior music student Teagan Faran. "For this project, we chose specific works to allow the audience to relax. By giving a person something to focus on that only requires passive cognitive energy, it allows them to rest their mind for a moment and gives time for self-reflection."
First-year dental student Christine Uggeri practices her technical skills on a training mannequin. (Photo by Fernanda Pires)
In this class, Clinical Foundations, students develop basic skills in dental instrumentation, principles of operative dentistry, and techniques to repair teeth.
Each skill requires students to perform precise procedures on mannequins.
For John Misch, a dental student from West Bloomfield, the course has high stakes for his future ambitions.
"If we are not doing well during this class, we question ourselves about the career we picked, if we are really meant to do that," he said. "That is why it so important to perform well."
The SMTD quartet played for nearly a half hour under the warm applause of 108 dental students. To measure their anxiety, the students answered a six-item, short-form assessment that used the Spielberger State-Trait Anxiety Inventory before and after the performance.
Eighty-eight percent of the students reported "feeling calmer" after the concert and 96 percent enjoyed the performance. Students also performed better on a specific restorations test, one of the most difficult practicals: in 2017, 44 percent of the students partially failed the test versus 19 percent this year.
"I believe the music was not the only reason dental students performed better, but helped them, for sure," Karl said.
Karl now plans to routinely apply music listening practices prior to clinical foundation skills tests.
"I want to improve their clinical learning experiences and also increase well-being, make the environment friendlier and healthier for them to succeed academically and professionally," she said.
Uggeri noticed the difference, too.
"You cannot forget we work with a 3mm margin," she said. "If you are shaky or a little nervous and accidentally move in the wrong position you cannot put it back, so it is really good to get the jitter out before our practices. I really enjoyed it."