Competence in the use of a semi-automated external defibrillator among undergraduate dental students: evaluation and proposal for improvement

The dental clinical setting is inherently stressful and may precipitate medical emergencies, including life-threatening cardiovascular events. Dentists carry both an ethical and legal responsibility to promptly recognize and effectively manage such situations. This responsibility demands not only training in cardiopulmonary resuscitation but also proficiency in the correct use of a semi-automatic external defibrillator. The present study aims to evaluate the competence of final-year dental students in operating a semi-automatic external defibrillator within a simulated scenario, to identify critical deficiencies in performance, and to determine the impact of providing clearer and more precise verbal instructions. A group of final-year dental students from the University of Santiago de Compostela, Spain, participated in a simulation-based assessment using a simulation manikin involving a confirmed cardiorespiratory arrest scenario. In the first phase, students followed the conventional instructions provided by the semi-automatic external defibrillator. Based on the errors detected, a modified set of instructions was developed and applied in the second phase. Ten items, grouped into 3 categories—preparation, electrode placement and shock delivery, and post-shock actions—were evaluated. Of a total of 87 eligible students, 81 (93.1%) participated in the study. In the first phase, 42 students followed the conventional semi-automated external defibrillator instructions, whereas 39 students participated in the second phase using the modified instructions. Performance during the first phase was suboptimal: in 8 out of 10 assessed items, fewer than 10% (range 0-9.5%) of learners correctly completed the required actions. The median time to shock delivery was 143 s (95% CI 129–156 s). In the second phase, significant improvements were observed compared to the first phase in the following items: device activation ( p < 0.001), adherence to instructions ( p < 0.001), electrode connection ( p = 0.006), and safety check prior to shock delivery ( p < 0.001). The median time to shock delivery decreased to 116 s (95% CI 107–124 s) ( p < 0.001). Dental students demonstrate insufficient preparedness for the use of a semi-automatic external defibrillator. However, the provision of clearer verbal instructions markedly improves performance. These findings support the integration of specific training on the use of the semi-automatic external defibrillator into the dental curriculum.