The Relationship Between Mock Boards and Clinical Board Examinations in Dental Hygiene Education.

Research on the effectiveness of clinical mock boards for future oral health professionals is conflicting and limited. Despite this, U.S. dental hygiene programs rely on clinical mock board experiences as essential components for preparing students for their clinical board examinations. Differences in programs' mock board characteristics may relate to board exam outcomes. The validity and reliability of mock boards can be questioned when deviations from exam criteria and procedures are made and grading mechanisms are not consistent. The aim of this study was to determine which mock board characteristics were critical in preparing students by exploring the relationships between programs' dental hygiene, local anesthesia, and restorative mock boards and their 2013-14 candidates' performance on the corresponding three Western Regional Examining Board (WREB) licensure exams. Of the 23 U.S. dental hygiene education programs in four states invited to participate, 15 agreed to do so, and 13 consented to have WREB provide their programs' test result data. The mock board coordinators provided data on characteristics of their programs' mock boards with an online questionnaire distributed in 2014. Scores calculated from the responses were compared to performance of the programs' candidates on the corresponding WREB exam. Of the 45 questionnaires (on three exams each x 15 programs), 33 were completed (73.3%). Significant relationships were found between candidates' WREB exam results and the mock boards' intensity scores, remediation, multiple experiences, and examiner calibration scores. The results of this study provide fundamental information about mock board characteristics that may assist educators in facilitating experiences to more effectively prepare students for these high-stakes exams.

Student Veteran perceptions of facilitators and barriers to achieving academic goals.

According to recent estimates, over 1 million Operation Iraqi Freedom/Operation Enduring Freedom (OIF/OEF) Veterans are utilizing the post-9/11 GI Bill to pursue higher education. Data collected by the Department of Defense suggests that greater than 17% of returning Veterans may suffer from mental and physical health disorders, which can negatively affect school performance. The current study explored student Veterans' perceived facilitators and barriers to achieving academic goals. Thirty-one student Veterans completed self-report measures and interviews. Results suggested that Veterans that were reporting problems or symptoms in one mental or physical health domain were likely to be reporting symptoms or problems in others as well. The interview data were coded, and three overarching themes related to barriers and facilitators emerged: person features (e.g., discipline and determination, symptoms and stressors), institutional structure (i.e., what schools and the Department of Veterans Affairs do that was perceived to help or hinder student Veteran success), and policy concerns (i.e., how the structure of the GI Bill affects student Veteran school experience). Results from this research indicate the need for larger studies and program development efforts aimed at enhancing academic outcomes for Veterans.

Cancer deaths and occupational exposure in a group of plutonium workers.

An exploratory epidemiological study was conducted for 319 deceased nuclear workers who had intakes of transuranic radionuclides and histories of employment during the time period from 1943 to 1995. The workers were employed at various facilities throughout the United States, including the Department of Energy defense facilities and uranium mining and milling sites. The majority of individuals were involved in documented radiological incidents during their careers. All had voluntarily agreed to donate their organs or whole body to the United States Transuranium and Uranium Registries. External and internal dose assessments were performed using occupational exposure histories and postmortem concentrations of transuranic radionuclides in critical organs. Statistical data analyses were performed to investigate the potential relationship between radiation exposure and causes of death within this population due to cancers of the lungs, liver, and all sites combined while controlling for the effects of other confounders. No association was found between radiation exposure and death due to cancer (α = 0.05). However, statistically significant associations were found between death due to any type of cancer and smoking (yes or no) (odds ratio = 5.41; 95% CI: 1.42 to 20.67) and rate of cigarette smoking (packs per day) (odds ratio = 2.70; 95% CI: 1.37 to 5.30).

Are medical offices prepared for the next disaster?

Disasters have an enormous economic impact on the United States as well as short- and long-term healthcare implications. Federal and state governments are providing billions of dollars to communities across the nation for emergency preparedness activities. An online poll conducted in July 2008 indicated that most medical practices in the United States, even though they believe they will be impacted by a disaster within the next five years, re port themselves to be inadequately prepared. In light of increased funding since 9/11 and hurricane Katrina, the results of the poll show that the very practices that are the foundation of our healthcare system that see and treat patients on a daily basis are not being included in preparedness efforts.

Ambulatory patient safety. What we know and need to know.

While safety risks are widespread in ambulatory settings, there has been insufficient attention directed at developing the evidence base that is needed to improve ambulatory safety. In this article, the current state of knowledge about ambulatory safety is reviewed. A research agenda in ambulatory safety is proposed, as well as a series of potential interventions that could be used to improve safety in the ambulatory setting.

The impact of financial incentives on physician productivity in medical groups.

OBJECTIVE: To estimate the effect of financial incentives in medical groups--both at the level of individual physician and collectively--on individual physician productivity. DATA SOURCES/STUDY SETTING: Secondary data from 1997 on individual physician and group characteristics from two surveys: Medical Group Management Association (MGMA) Physician Compensation and Production Survey and the Cost Survey Area Resource File data on market characteristics, and various sources of state regulatory data. STUDY DESIGN: Cross-sectional estimation of individual physician production function models, using ordinary least squares and two-stage least squares regression. DATA COLLECTION: Data from respondents completing all items required for the two stages of production function estimation on both MGMA surveys (with RBRVS units as production measure: 102 groups, 2,237 physicians; and with charges as the production measure: 383 groups, 6,129 physicians). The 102 groups with complete data represent 1.8 percent of the 5,725 MGMA member groups. PRINCIPAL FINDINGS: Individual production-based physician compensation leads to increased productivity, as expected (elasticity = .07, p < .05). The productivity effects of compensation methods based on equal shares of group net income and incentive bonuses are significantly positive (p < .05) and smaller in magnitude. The group-level financial incentive does not appear to be significantly related to physician productivity. CONCLUSIONS: Individual physician incentives based on own production do increase physician productivity.

Relative value units: from A to Z, Part 4.

The previous three articles in this series discussed relative value unit (RVU) basics and touched on some of the more practical applications of RVUs for managing a medical practice. 1-3 This fourth and final article illustrates the what, why, when, where and how of benchmarking RVUs. Benchmarking is often defined as a standard of measurement or evaluation, but in its truest sense, it is the ongoing process of establishing a standard of excellence and comparing activities to that standard. Health care has yet to establish true benchmarks, but it does have performance indicators for better-performing practices based on several criteria.