Evaluating ultrasonic instrumentation curricular change: an observational comparison study.

Background: Ultrasonic instrumentation (USI) has evolved, but it is unclear if dental hygiene curricula have kept pace. This study compares 2 dental hygiene cohorts with differing USI curricula to investigate if a contemporary USI curriculum enhanced students' USI preparation, use, and confidence. Methods: A 2-group observational study compared a "traditional" USI curriculum (TC) cohort to a later "contemporary" USI curriculum cohort (CC). The new curriculum introduced USI earlier, with more and different inserts, and greater USI philosophical emphasis. Questionnaires were administered to students at the onset (T1) and conclusion (T2) of clinical programming. Ethical approval was received from the Multi-College Ethics Review Process. Statistical calculations included frequencies, proportions, means, and Welch's 2-sample, 2-tailed t-test statistics describing and comparing the cohorts' preparation, use of, and confidence in USI (significance threshold 0.05). Results: Sample size fluctuated due to student attrition; response rate ranged from 21.5% (17/79) to 52.9% (36/68). Earlier in programming, CC students were significantly more prepared with water control, fulcruming, and curved inserts than TC students. No significant differences emerged between groups in use of ultrasonic versus hand instruments (USI approximately 60% of clinical time; p > 0.05). Initially, TC students had significantly greater confidence than CC students (p < 0.05). While there was no difference between groups at Time 2, CC cohort's confidence increased statistically significantly from T1 to T2 (p < 0.05). Discussion & Conclusions: Both cohorts demonstrated similar use of USI. The CC cohort was better prepared in some aspects of USI and use of curved inserts. Results reveal an ongoing need for program evaluation to best implement USI curriculum.

Contexte: L'instrumentation ultrasonique (IUS) a évolué, mais il n'est pas clair si les programmes d'études en hygiène dentaire ont tenu le rythme. Cette étude vise à examiner si un programme d'études contemporain sur l'IUS améliore la préparation, l'utilisation et la confiance des étudiants en matière de l'IUS, en comparant 2 cohortes de programmes d'hygiène dentaire ayant un cursus différent sur l'IUS. Méthodologie: Une étude par observation comprenant 2 groupes a comparé une cohorte du programme « conventionnel ¼ (PCV) d'IUS à une cohorte du programme « contemporain ¼ (PC) d'IUS. Le nouveau programme a présenté l'IUS plus tôt, avec une plus grande variété d'embouts, ainsi qu'une plus grande emphase philosophique sur l'IUS. Les étudiants devaient répondre à un questionnaire au début (T1) et à la fin (T2) du programme clinique. L'examen des principes d'éthique du Multi-Collège a donné son approbation éthique. Les calculs statistiques comprenaient les fréquences, les proportions, les moyennes et les statistiques du test t bilatéral à 2 échantillons de Welch décrivant et comparant comment les cohortes préparent et utilisent les IUS et leur niveau de confiance en celles-ci (seuil critique de 0,05). Résultats: Il y a eu une fluctuation de la taille de l'échantillon en raison de l'attrition des étudiants : le taux de réponse était de 21,5 % (17/79) à 52,9 % (36/68). Plus tôt dans la programmation, les étudiants de la cohorte du PC étaient considérablement mieux préparés en matière de contrôle de l'eau, de point d'appui et d'embouts courbés que les étudiants du PCV. Aucune différence significative n'est apparue entre les groupes à l'égard de l'utilisation des instruments à ultrasons par rapport aux instruments manuels (IUS environ 60 % du temps clinique; p > 0,05). Initialement, les étudiants de la cohorte du PCV étaient significativement plus confiants que les étudiants de la cohorte du PC (p < 0,05). Bien qu'il n'y eût aucune différence entre les groupes au temps 2, la confiance de la cohorte du PC a augmenté de manière statistiquement significative entre le T1 et le T2 (p < 0,05). Discussion et conclusions: Les 2 cohortes ont démontré une utilisation similaire de l'IUS. La cohorte du PC était mieux préparée à certains aspects de l'IUS et à l'utilisation d'embouts courbés. Les résultats révèlent un besoin continu d'évaluation de programme pour une meilleure mise en œuvre du programme d'études d'IUS.

Exploring dental hygiene decision making: A quantitative study of potential organizational explanations.

BACKGROUND: To improve public access to oral health care, dental hygienists have been identified for practice expansion, and, therefore, they must demonstrate decision-making capacity. This study aimed to identify and test potentially influential factors in dental hygiene decision making. Organizational and gender factors were hypothesized to be most influential and focused the study. METHODS: A 2-phase mixed methods approach was used. In Phase I, a qualitative decision-making model was developed and subsequently published in 2012. Phase II tested aspects of the model through an electronic survey instrument and key informant interviews. This article reports on the statistical results of the quantitative survey. A third article will report on the qualitative thematic analyses and merged interpretation. RESULTS: The Phase I qualitative model guided the development of the survey instrument. The survey had a 38% response rate; moderate to weak correlations between predictor variables (structural and individual) and clinical decision making were shown. The final statistical model demonstrated that individual characteristics and graduating from a 3-year dental hygiene program were together significantly associated with decision-making capacity. DISCUSSION AND CONCLUSIONS: Individual characteristics and longer education were together shown to be associated with increased decision-making capacity. These findings did not show the organization or gender to be important in influencing decision-making capacity. However, the merging of the quantitative survey and qualitative key informant data will potentially inform how the organization influences the individual dental hygienist.

CONTEXTE: Afin d'améliorer l'accès de la population aux soins de santé buccodentaire, les hygiénistes dentaires ont été désignés pour une expansion de la pratique et doivent par conséquent démontrer une capacité décisionnelle. La présente étude visait à cerner et à vérifier les facteurs influents potentiels dans la prise de décision en hygiène dentaire. L'étude était axée sur l'hypothèse que les facteurs organisationnels et de sexe étaient les plus influents. MÉTHODOLOGIE: Une approche méthodologique mixte en 2 phases a été utilisée. Dans la phase I, un modèle décisionnel qualitatif a été conçu et publié par la suite en 2012. La phase II a évalué des aspects du modèle au moyen d'un outil de sondage électronique et des entrevues d'intervenants clés. Cet article présente les résultats statistiques de ce sondage quantitatif. Un troisième article fera part des analyses thématiques qualitatives et des interprétations fusionnées. RÉSULTATS: La phase I du modèle qualitatif a guidé la conception de l'outil de sondage. Le sondage avait un taux de réponse de 38 %, et des corrélations modérées à faibles entre les variables indépendantes (structurelles et individuelles) et la prise de décision clinique étaient démontrées. Le modèle statistique final a démontré que les caractéristiques individuelles, ainsi que l'obtention d'un diplôme d'un programme d'hygiène dentaire de 3 ans étaient fortement associées à la capacité décisionnelle. DISCUSSION ET CONCLUSIONS: Les caractéristiques individuelles et des études plus longues étaient ensemble associées à une meilleure capacité décisionnelle. Ces résultats n'ont pas montré que l'organisation ou le sexe étaient des facteurs d'influence importants dans la capacité décisionnelle. Cependant, la fusion du sondage quantitatif et des données qualitatives des intervenants clés pourrait éclaircir la façon dont l'organisation influence chaque hygiéniste dentaire.

Factors Influencing Dental Educators As They Develop Problem-Based Learning Cases.

In problem-based learning (PBL) environments, patient cases encourage students' development of critical thinking and problem-solving. Previous research has found that non-structured patient cases fostered students' critical thinking and problem-solving abilities; however, structured cases dominate in dental PBL. The aim of this study was to explore factors influencing educators as they developed cases for a hybrid PBL dental education program in Canada. In this phenomenological study, semi-structured interviews were used to collect seven educators' experiences with PBL case development. Content analyses with conceptual mapping were triangulated with field notes, researcher memos, and member checking to elucidate codes and themes. There were two major themes and 14 subthemes. The major theme-external factors-involved environmental parameters that influenced educators to develop PBL cases with a definitive problem-solving approach and preferred solution. Structured PBL cases dominated because of limited curricular time for students to explore identified learning issues within a three-session framework. The hybrid PBL dental curriculum further influenced educators to develop structured PBL cases such that content was not duplicated by corresponding lectures. The second major theme-internal factors-encompassed the educators' beliefs and values about teaching and student learning. These educators were enthusiastic about PBL as an instructional strategy, but did not appear to support the PBL philosophy wherein students engage in self-directed, self-exploratory learning. Structured PBL case development occurred when educators believed students needed content expert guidance. Structured PBL cases dominated in the hybrid PBL program because the educators felt students needed guidance in solving the cases to meet the learning objectives within the limited curricular time.

Developing reflective health care practitioners: learning from experience in dental hygiene education.

Maintaining competence requires health care practitioners to remain current with research and implement practice changes. Having the capacity to reflect on practice experiences is a key skill, but reflective skills need to be taught and developed. This exploratory qualitative study examined the outcomes of a dental hygiene program requirement for developing reflective practitioners. Using a purposive convenience sample, students were solicited to participate in the study and submit reflective journals at the end of two terms. Eleven of twenty-six students participated in the study, providing sixty-four reflective entries that underwent qualitative thematic analysis. Using a reflective model, we identified themes, developed codes, and negotiated among ourselves to reach consensus. Results showed approximately two-thirds of the participants reached the central range as "reflectors" and most of the remaining fell within the lower range as "non-reflectors." We concluded that dental hygiene students reached similar levels of reflection to other groups and the triggers were varied, appropriate for early learners, and divided between positive and negative cues. However, the small sample represented less than one-half of the class, yielding a potentially biased sample. Therefore, we conclude that the findings provide a departure point for further research with a more cross-cutting sample in order to substantiate reflective educational requirements and validate these findings.

Evidence-based practice in healthcare: an exploratory cross-discipline comparison of enhancers and barriers.

In order to improve health outcomes, healthcare providers need to base practice on current evidence. The purpose of this qualitative study was to explore and compare the understanding and experiences with evidence-based practice (EBP) in three different disciplines. Researchers conducted individual interviews with psychiatrists, nurses, and dental hygienists. The majority of study participants demonstrated an understanding of EBP and were able to identify enhancers and barriers to implementing EBP. Using a grounded theory approach, several major themes acting as enhancers and barriers to EBP emerged and revealed both differences and similarities within and across the three health disciplines. While saturation was not attempted, this exploratory research is important in contributing to understanding the cultural practice milieu in relation to individual characteristics in implementing evidence into practice with the overall aim of improving healthcare delivery and outcomes.

The impact of quality assurance programming: a comparison of two canadian dental hygienist programs.

Quality assurance (QA) and continuing competence (CC) programs aim to ensure acceptable levels of health care provider competence, but it is unknown which program methods most successfully achieve this goal. The objectives of the study reported in this article were to compare two distinct QA/CC programs of Canadian dental hygienists and assess the impact of these two programs on practice behavior change, a proxy measure for quality. British Columbia (BC) and Ontario (ON) were compared because the former mandates continuing education (CE) time requirements. A two-group comparison survey design using a self-administered questionnaire was implemented in randomly selected samples from two jurisdictions. No statistical differences were found in total activity, change opportunities, or change implementation, but ON study subjects participated in significantly more activities that yielded change opportunities and more activities that generated appropriate change implementation, meaning positive and correct approaches to providing care, than BC dental hygienists. Both groups reported implementing change to a similarly high degree. The findings suggest that ON dental hygienists participated in more learning activities that had relevancy to their practice and learning needs than did BC subjects. The findings indicate that the QA program in ON may allow for greater efficiency in professional learning.

An evidence-based model of effective self-assessment for directing professional learning.

An innovative model for conducting meaningful self-assessments is presented to help oral health care professionals efficiently determine what to learn with the goal of remaining competent. A review and analysis of the literature drawing from several databases was conducted to develop the model. Through this process, we identified four key categories: prerequisite competencies, process, applications, and tools that are suggested to occur within a supportive environment to carry out valid self-assessments and to positively influence learning choices and practice improvements.