Assessment of diagnostic errors in oral lesions by primary care dentists and its relation to educational paradigm in Egypt: A mixed methods study

Abstract Backgrounds In this sequential mixed methods study, we aimed first; to assess percentage of diagnostic accuracy of a group of Egyptian primary care dentists regarding different common oral lesions (phase 1). Second; to explore oral medicine (OM) domain experts (DEs) opinions on how the education process employed in Egypt can cause the occurrence of oral lesions misdiagnosis reported in phase 1 (phase 2). Methods In phase 1, an online MCQ case scenarios questionnaire with pictures for 15 common oral lesions was sent to dentists in primary care settings in Cairo, Egypt. A score out of 15 was obtained for each participant. Afterwards, in phase 2, qualitative data was obtained from OM DEs by semistructured in-depth interviews. Results Two hundred sixty-five primary care dentists finished the online questionnaire with 54.7% as average score of correct diagnosis. The lowest score was for a case of oral cancer (4.9%). No association between demographic and clinical experience characteristics of participants and the diagnostic score was shown. In phase 2, DEs specified 33 causes related to curriculum, teaching and assessment methods, OM teaching staff, administration along with other causes that need attention if aiming to reduce misdiagnosis by future dentists. Conclusions Misdiagnosis of oral lesions is frequent among Egyptian dentists and the currently implemented process in OM education causes its occurrence. Issues related to curriculum, teaching staff and administrative policies, all represent priorities to be addressed in this context.