Effects of periodontal instrumentation on quality of life and illness in patients with chronic obstructive pulmonary disease: a pilot study.

PURPOSE: To assess if patients with chronic obstructive pulmonary disease (COPD) receiving periodontal debridement for treatment of chronic periodontitis with ultrasonic or hand instrumentation experienced changes in quality of life or incidents of illness following treatment or no treatment. METHODS: The study design was a 3 group, randomized, controlled pre- and post-test experimental pilot study. Volunteers with COPD and chronic periodontitis (n=30) were recruited from physician offices or fliers and randomly assigned to 1 of 3 groups. Of those, 2 groups had periodontal debridement using either magnetostrictive ultrasonic instrumentation (n=10) or hand instrumentation (n=10). A control group (n=10) received no treatment. Primary outcomes, quality of life and illness were measured by the St. George's Respiratory Questionnaire (SGRQ-A) and Illness Questionnaire, respectively. Subjects completed the questionnaires as pre-tests at baseline and as post-tests 4 weeks post-treatment/no treatment. Repeated measures ANOVA was used to compare groups on continuous variables (p ≤ 0.05) measured by SGRQ-A total scores and symptoms, activities and impacts subscales. Percentages, frequencies and cross tabulations were calculated for categorical data. RESULTS: SGRQ-A and Illness Questionnaire scores showed no significant differences between groups in quality of life or illness following periodontal debridement. Total SGRQ-A scores decreased slightly for all groups with no significant difference among groups (p=0.138) and no interaction (p=0.794). Cross tabulations showed no relationship between indicators of self-reported illness before and after treatment/no treatment. No adverse events were reported. CONCLUSION: Based on this small-scale study, it seems periodontal debridement for chronic periodontitis has no effect on quality of life and illness in patients with COPD, and it may be performed with ultrasonic or hand instruments without adverse events.

Effectiveness of faculty training to enhance clinical evaluation of student competence in ethical reasoning and professionalism.

This study evaluated the short- and long-term effectiveness of faculty training to enhance clinical evaluation of ethical reasoning and professionalism in a baccalaureate dental hygiene program. Ethics, values, and professionalism are best measured in contexts comparable to practice; therefore, authentic evaluation is desirable for assessing these areas of competence. Methods were the following: 1) a faculty development workshop implementing a core values-based clinical evaluation system for assessing students' professional judgment; 2) subsequent evaluation of the clinical faculty's use of core values for grading and providing written comments related to students' professional judgment during patient care for three academic years; and 3) evaluation of program outcomes assessments regarding clinical learning experiences related to ethics and professionalism domains. Results revealed the clinical faculty's evaluation of professional judgment during patient care was enhanced by training; written comments more frequently related to core values defined in the American Dental Hygienists' Association (ADHA) Code of Ethics; and faculty members reported more confidence and comfort evaluating professional judgment after implementation of this evaluation system and receiving training in its application. Students were more positive in outcomes assessments about their competency and learning experiences related to professionalism and ethics. This article shares one approach for enhancing clinical faculty's authentic evaluation of student competence in ethical reasoning and professionalism.

Curriculum evaluation of ethical reasoning and professional responsibility.

This exploratory study evaluated curricular content and evaluation mechanisms related to ethics and professionalism in the baccalaureate dental hygiene program at Idaho State University. Competency-based education requires enhanced student preparation in ethical reasoning, critical thinking, and decision-making. Graduates must integrate concepts, beliefs, principles, and values to fulfill ethical and professional responsibilities. Methods included 1) development of five supporting competencies defining ethics and professionalism to provide a framework for curricular evaluation; 2) assessment of all course content and evaluation methods for each supporting competency; 3) evaluation of students' clinical performance based on professional judgment grades; and 4) survey of junior (n=30) and senior (n=27) students' attitudes about dental hygiene practice related to ethics and professionalism. Results revealed that most courses include content and evaluation related to at least one supporting competency; however, authentic evaluation is weak. Clinical instructors rarely relate evaluations to ethical principles or values. Surveys showed significant differences between junior and senior students' attitudes about ethics and professionalism in six of thirty-four areas (the six were laws and regulations; communication and interpersonal skills; problem solving; professional activities/programs; integrity; and safe work environment). This article shares one approach for evaluating curricular content and evaluation methods designed to develop student competence in ethical reasoning and professionalism. Based upon the study's findings, recommendations are made for curricular enhancement via authentic evaluation and faculty training.