dental hygiene programs; brainstorm to create new approaches to the problem.
Source: Journal of Dental Hygiene Vol. 81, No. 4, Fall 2007, Page 107 – 107 Copyright by the American Dental Hygenists Association Dental Hygiene Faculty Calibration in the Evaluation of Calculus Detection Kandis V Garland, RDH, BS and Kathleen J Newell, RDH, PhD
The purpose of this pilot study was to explore the impact of a dental hygiene faculty calibration training program on intra- and inter-examiner reproducibility levels on calculus detection using an 11/12 explorer. Inconsistency among clinic faculty members is frustrating for students. After Institutional Review Board approval, 12 dental hygiene faculty members were recruited for participation in the study and randomized to two groups (experimental and control). All subjects provided pre- and post-test measurements twice on three typodonts. Measurements were recorded on answer sheets. The experimental group received 3, 2-hour, training sessions which consisted of practicing a prescribed exploring sequence and technique for calculus detection. Subjects immediately corrected their answers with a key, received feedback from the trainer, and reconciled missed areas. Intra- and inter-examiner reproducibility levels (pre- and post-) were measured using Cohen’s Kappa and compared between experimental and control groups using repeated measures (split-plot) ANOVA. The experimental and control groups did not differ in their change in reproducibility (self-agreement) from pre- to post-training (p = 0.64). Also, the experimental and control groups did not differ in their change in agreement with true presence/absence of simulated calculus from pre- to post-training (p = 0.20). Although the results of this study failed to reject the null hypothesis that training has no effect on the reproducibility levels for simulated calculus detection, further studies of clinical faculty calibration need to be implemented with larger and more representative samples. The impact of calibration on students’ learning and satisfaction should also be examined.
Calibration among faculty has long been an issue in dental hygiene education yet there is still a paucity of research in this area. There are a number of techniques that can be employed to improve calibration but none are perfect. A complete and detailed clinical handbook is a place to start. I am providing a link to a clinic handbook I developed for reference. http://www.etsu.edu/cpah/DAHS/Dental_Hygiene/clinicalmanual.asp The handbook assures that the same policies and procedures apply to everyone. Well defined process and end product evaluations are another way to improve calibration. But what if you have the aforementioned items in place and there are still calibration issues. One calibration issue which instantly comes to mind is calculus detection and grading of skills. How can you be sure that examiners are consistent. If all programs could afford to have the DetecTar we would not have an issue with calculus detection. For those of you who are unfamiliar with DetecTar the link is provided.http://www.dentalcompare.com/details/7513/DetecTar.html The Detectar is relatively new on the market and certainly warrants research regarding its use in training dental hygienists and in calibration efforts.
There are also training programs available in which faculty attends a course to improve calibration. Again budget can be an issue. If you are a program with limited resources you can develop exercises to enhance calibration. One way is to have a model patient and all faculties chart the calculus. Any variances are identified and faculty re-examines and come to consensus. The same patient could be used for calibration of all skills.
For the student it is best to always have an option for a second opinion. Let’s say there is a new instructor who is grading harshly. The best clinic students are getting failing grades in calculus removal. With a second opinion policy the new faculty benefits from the experience of her colleague and the student is not penalized. Calibration can be an issue with any skill demonstration and evaluation of skills. The clinic coordinator needs to provide calibration exercises prior to teaching the skill and monitor faculty use of performance criteria to assure that all faculties are on the same page. In my experience I had a faculty member who chose not to observe any of the process checks and just signed off on oral exams etc. without a thorough assessment. This individual was loved by students but lack of attention to detail compromised student learning and patient care. Remember the days when you hoped you would get a certain instructor because you knew you would ace the procedure. In retrospect ask yourself if you learned anything from that instructor.
As former students and some of you serving as faculty not doubt you could probably identify even more ways to enhance calibration. Please discuss the issue on the discussion board provided.
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