A Checklist-Based Assessment of Manual Skill Competency in Dental Anaesthesia Using a Simulator: A Prospective, Blinded, Video-Assisted Validation Study.

BACKGROUND: There is a growing need for standardised, objective methods to assess manual skills in dental procedures requiring local anaesthesia. This prospective, video-based observational study aimed to evaluate the manual skills and clinical competence of undergraduate dental students in performing inferior alveolar nerve block (IANB) and posterior superior alveolar nerve block (PSANB) using a validated 18-item, three-point checklist. A secondary objective was to assess the tool's validity and its ability to differentiate between students with different levels of procedural competence. METHODS: In this prospective, blinded study, 23 third-year dental students without prior experience in dental anaesthesia were recruited after completing the required theoretical and simulation-based training. Each student performed IANB and PSANB on a dental anaesthesia simulator across three video-recorded sessions conducted at three-day intervals. Performances were independently assessed by three blinded evaluators using the structured checklist, with inter-rater reliability and concordance with visual sensor data analysed. RESULTS: Significant improvements were observed in both IANB and PSANB scores across the three sessions (p = 0.001 for all comparisons). Students who passed had significantly higher scores than those who failed, and inter-rater reliability was consistently high (ICC > 93%). Concordance between instructor ratings and objective visual sensor data ranged from 76.8% to 94.7%, indicating strong agreement (p < 0.05). CONCLUSION: This validated, checklist-based assessment tool reliably measures technical competence in regional dental anaesthesia and can effectively identify performance differences amongst students. Its integration into dental curricula may support the advancement of competency-based clinical education through objective skill assessment.