bluuebunny/crossref_metadata_2025 huggingface dataset:
Educational factors associated with clinician knowledge about bacterial endocarditis
Authors: Sadowsky D , Kunzel C
Published: June 2020

This study measured the impact of relatively formal educational experiences (general practice residency and continuing education) and a variety of informal educational opportunities (professional membership activities, dental journals received, patterns of consulting and referral) on a particular body of knowledge (dentists' knowledge about the management of patients at risk for bacterial endocarditis). Data were collected through telephone interviews with 217 dental general practitioners in New York State. Linear regression analyses indicated that age made a significant contribution to the explanation of knowledge level in all models tested. Neither general practice residency experiences nor continuing education exposure in the past year made a significant contribution to the explanation of knowledge. The other more informal educational variables tested sometimes made a significant contribution when controlled for age; however, the explanatory power of these variables often varied according to respondents' locale (urban vs. rural).
Waxing tests as predictors of students' performance in preclinical dentistry
Authors: Walcott AM , Knight GW , Charlick RE
Published: June 2020

Poor prediction of psychomotor performance in dentistry using traditional admissions tests and prior academic performance, as well as the serious consequences of poor performance for both students and faculty, suggest that better predictors are needed. Two tests of waxing skill were incorporated into the first semester freshman dental anatomy course and administered to one class of 131 students. Data were collected for eight preclinical performance measures. Results showed that neither the academic portion of the DAT nor the entering grade point average predicted performance on any of the psychomotor measures at a statistically significant level. In all cases, the first, second, or both waxing tests were better predictors than the perceptual portion of the DAT. These waxing tests may be useful in the early identification of students with psychomotor deficiencies for admissions decisions and/or for designing and evaluating the effectiveness of early instructional intervention strategies on performance.
The cognitive level demands of a dental school's predoctoral, didactic examinations
Authors: Rinchuse DJ , Zullo T
Published: June 2020

A sample of 563 test items was selected from the entire population of predoctoral, written examinations administered by the University of Pittsburgh School of Dental Medicine during the 1983–1984 academic year. Four independent judges classified the sample test items according to the six major levels of the Taxonomy of Educational Objectives (Cognitive Domain) (1956). From the individual classification responses of the four judges, final overall ratings were determined for 518 of the 563 test items. Based upon the final, overall classification ratings for the 518 test items, it was found that 83.9 percent of the items were classified at the Taxonomy's level 1, Knowledge, and 16.1 percent of the test items were classified at the Taxonomy's level 2, Comprehension. No test items were classified at any of the other four levels of the Taxonomy–that is, Application, Analysis, Synthesis, and Evaluation.
Oral biology and the early introduction of clinical dentistry in the dental curriculum
Authors: Gotjamanos T
Published: June 2020

For the past nine years students entering the Dental School in the University of Western Australia have participated in an introductory clinical dentistry program closely integrated with oral biology. This paper outlines the content of the program and discusses its educational advantages. Changing attitudes in Australian universities toward the appointment of full professors in clinical disciplines also are discussed, and reference is made to the way in which these appointments are helping to achieve a closer correlation between basic science and clinical dentistry.
Trends in academic qualifications and performance of dental students
Authors: Kramer GA , DeMarais DR
Published: June 2020

The academic qualifications and dental school performance measures of students enrolled at public and private dental schools during the five‐year period beginning in 1980 were examined. The results indicated that mean DAT academic averages and predental science GPA measures declined significantly over the most recent four years observed. For these qualifications, there were significant differences between those students enrolled at public and private dental schools, with those students enrolled at public schools tending to outperform those at private schools. The results of the analyses of dental school performance measures showed no clear, consistent pattern of decline over the same five‐year period.
Evaluation using sequential trials methods
Authors: Cohen ME , Ralls SA
Published: June 2020

Dental school faculty members, as well as many practitioners, are interested in evaluating products and procedures used in clinical practice. Research design and statistical analysis, however, can pose problems to some, while others would like to avoid detailed consideration of protocol until after a preliminary investigation. Sequential trials methods provide an analytical structure that is both easy to use and statistically valid.
A content analysis of dental capitation plan grievances
Authors: Meetz HK , Freeman HE , Marcus M , Hurst EF
Published: June 2020

As the health care system becomes more impersonal, competitive, and cost conscious, there is a potential for increased dissatisfaction with health care providers. This paper describes the use of content analysis to examine aspects of patient dissatisfaction with delivery of health services in a capitated dental plan. All written complaints from three regions of California from June 1984 to June 1986 were collected, and a content analysis was performed on these letters. The rates of grievances differ substantially across regions; however, three regions were similar in their grievance patterns. Access to care was the single largest category of concern, and these grievances were registered because patients had to wait for an appointment (35 percent) or had to wait in the office (32 percent) to receive care. Provider technical competence was the second largest category. Significant variables from a logistic regression that predicts complaint status of an eligible member are (1) years covered, (2) age, and (3) income. The grievance rate and grievance categories described in this study can help define new strategies and policies in the overall mission of a dental capitation organization.
Cost effectiveness of prevaccination screening for hepatitis B antibody
Authors: Jacobson JJ , La Turno DE , Johnston FK , Shipman C
Published: June 2020

The cost effectiveness of screening for hepatitis B antibodies prior to instituting a vaccination program was investigated. Prevaccination screening tests for anti‐HBs were performed on sera from 295 faculty and staff. Anti‐HBs positive titers were found for 58 persons, and 43 (14.6 percent) of these had titers high enough to confer immunity. The cost of screening 295 persons was $1,666.64, or $5.65 per participant. By not vaccinating 43 persons, $4,498.23 was saved. A prevaccination screening would be most cost effective if only faculty with patient contact were screened.
Issues in transferring preclinical skill learning to the clinical context
Authors: Chambers DW
Published: June 2020

The relationship between student performance in preclinical technique laboratory courses and in clinic is not straightforward. While American dental education in the preclinical courses is effective in teaching mastery of fundamentals to most students and identifying those who should not proceed to patient care, the prediction from technique laboratory performance of who will do well in clinic is weak. Factors accounting for this poor correlation include differences in the mix of skills required in the two contexts, failure to teach for transfer of skills to new settings, and laboratory education practices that create clinically dysfunctional habits. As a means of understanding the transfer issue, a distinction is made among task as given by the instructor, task as interpreted by the student, and task as negotiated in the interpersonal context of dental education.
Employment considerations of AIDS in dental institutions
Authors: Crumpler DC , Carey M
Published: June 2020

Acquired immunodeficiency syndrome (AIDS) has become one of the most pressing public health issues of this decade. As a member of the health care team, dental professionals are increasingly confronted with the responsibilities of treating AIDS victims, preventing the transmission of HIV and other infectious agents, and being nondiscriminatory employers. Guidelines are currently available to help the dental profession in these first two responsibilities. However, policies governing the employment of health care workers with AIDS have not been established firmly. Therefore, this article focuses on the AIDS employment issue facing dental practitioners, administrators, and educators today. Background information on the current medical status, transmission, epidemiology, and populations‐at‐risk is reviewed. Legal considerations of AIDS in the work place are addressed as to HIV testing, employee rights to gain and/or retain employment, economic considerations, and confidentiality issues.
An expert system for oral diagnosis
Authors: Abbey LM
Published: June 2020

Although dentists are beginning to use computers in their offices for billing, insurance, and word processing, applications in computer‐assisted diagnosis have not developed as rapidly. In medicine, use of computer‐assisted techniques leads to more accurate and timely diagnoses and improves the quality of patient care through reduction in morbidity and increased physician interaction with patients. This article describes and discusses a system which, though developed for medical diagnosis, has very real applicability in dentistry. This PC‐based, expert system takes variable input from the patient and links it with a large fixed database that is designed to deal with a specific patient problem. Output in the form of suggested causes and/or management options is delivered to the practitioner. Several modules have been developed and are ready for clinical use. The module “Periapical Radiolucency” will be described in this article to illustrate some of the characteristics of this system.
Revision of Dental Admission Test standard score scale
Authors: Smith RM , Kramer GA , Kubiak AT
Published: June 2020

In October 1988 the Dental Admission Testing Program will begin reporting DAT scores on a new standard score scale. This scale will be based on the underlying ability metric rather than on the normal distribution that is the basis of the current‐1 to 9 scale. A comparison of the two standard score scales is included, as well as a discussion of the advantages offered by the ability based metric.
Trends in seniors' financial aid counseling and career counseling
Authors: Solomon ES , Whiton J , Stoll D
Published: June 2020

The responses to questions regarding financial aid counseling show a small but significant increase in the quality of counseling when compared to 1983 responses. The percent of students who received “enough” information increased, while the percent who received “no” information on financial aid decreased. In addition, seniors have a greater awareness of the broad range of topics that concern securing and managing loans. Improvement can also be seen in the schools' effectiveness in providing assistance in career and placement counseling. The percentage of seniors who said the school was “very helpful” in career choice counseling increased from 11.2 percent to 18.6 percent. In placement counseling, the percent who responded in the “very helpful” category almost doubled. Despite the improvement in counseling during the past five years, most seniors say they have not received enough information concerning financial aid, and over 80 percent of the seniors rated their career choice counseling and placement counseling as “limited” or non‐existent. Clearly, from the students' perspective, the schools could be doing a better job of providing counseling services to students.
Future directions for research on materials and design of dental implants
Authors: Smith DC
Published: June 2020

Previous reviews underscore the uncertainties in our knowledge of the influence of material characteristics, design‐shape, and surface texture on the implant material‐tissue interface. Current implant designs are based on intuitive approaches and there are no general principles for prediction of success of implant systems. Data on implant surfaces prepared by customary preparative techniques show that they are highly variable and dependent on processing. The long‐term (years) effects of trace element release from implants is little understood because of past errors in analytical techniques and paucity of relevant data. To place the development of future implant systems on a more rational basis, scientific studies are needed (1) to identify and characterize new and modified materials and surfaces, (2) to validate surface characterization procedures and evaluate tissue responses to standardized surfaces, and (3) to measure trace and subtrace element levels in animal and human tissues over time in order to establish normal and pathologic limits.
Progress in infection control in dental education
Authors: Corbin SB , Scarlett MI , Mitchell EW
Published: June 2020

While guidelines on proper infection control practices for dentistry have been available for over a decade, evidence suggests that recommended infection control practices are not universally employed in dentistry or dental education. A self‐administered written survey was mailed to all U.S. dental schools in spring 1986 to assess the status of infection control curricula, standards, and practices. From the 47 schools that responded it is evident that, while progress is occurring in dental education relative to improved infection control standards and practice, much remains to be accomplished.
The effect of knowledge of the desired outcome on dental motor performance
Authors: Feil PH , Reed T
Published: June 2020

Knowledge of the desired outcome of a series of movements is a critical component of motor performance, since it is used to develop the appropriate motor program and to form a basis for understanding terminal extrinsic feedback and formulating subjective reinforcement. In dentistry, information about the desired outcome is almost always disseminated in a lecture and laboratory manual, and a demonstration often is provided. However, mastery by students usually is not given the importance it deserves. The purpose of this study was to evaluate an instructional strategy designed to increase the students' knowledge of the desired outcome by determining whether such knowledge had an effect on dental motor performance. Two intact groups of first‐year dental students were randomly assigned to a control or experimental treatment. The control treatment included conventional written and oral descriptions of criteria and methods for completing the occlusal (n = 93) and mesio‐occlusal (n = 99) amalgam preparations. The experimental treatment directed the students' attention to critical features of tooth anatomy, and the preparation and methods for assessing performance. Results indicated statistically significant differences (p less than .05) in favor of the experimental group for both performance and degree of agreement with the instructor's evaluation of the mesio‐occlusal amalgam only.
Missing teeth and their replacement in dental school and community practice patients
Authors: Nikoukari H , Gustavsen F
Published: June 2020

This study compared tooth mortality and the pattern of prosthodontic replacement in dental patients at the University of Connecticut Dental School and patients from dental practices in the surrounding area. The dental school data were obtained from the dental records of a randomly selected 20 percent of the total patients registered during a one‐year period. The dental practice data were collected through an epidemiologic monitoring system that has been established with the local dental society. The age and sex distribution of the two samples were similar. The mean number of missing teeth in dental school patients was higher (7.63 vs. 4.87), as was the proportion of edentulous persons (9.8 percent vs. 3.4 percent). The overall rate of tooth replacement in the community sample was higher than in the dental school. The proportion of fixed and removable prosthodontics was similar in the two samples (85 percent removable and 15 percent fixed). The results suggest that individuals available for the teaching of prosthodontic procedures in the dental school have many of the same intraoral conditions related to prosthodontic treatment as do patients in dental practices in the local community.
Hazards of occupational transmission and strategies for prevention of infectious disease in dental education
Authors: McCauley KR , Gerbert BJ , Greene JC , Robertson PB , Littlejohn C , Greenspan D , Greenspan JS
Published: June 2020

The emergence of AIDS has alerted the nation's health care community to the dangers of occupational transmission of infectious disease. This article assesses the risk of occupational transmission in the health care setting and examines two prevention strategies: vaccination programs and infection control protocols. The implementation of these strategies by the School of Dentistry, University of California at San Francisco, is recounted to illustrate an institutional response to the issue of infection control in the dental setting.
Patient debt management and student academic progress
Authors: Cameron CA , Olswang SG
Published: June 2020

A survey of the patient debt management policies of all U.S.‐accredited dental and dental hygiene educational programs was taken to assess institutional patient debt management procedures and their relationship to student academic progress. The policies were evaluated to determine the level of compliance with existing standards and to analyze them in light of their legal implications relative to student rights. The results illustrated a vast breadth of policies for both dental and dental hygiene programs, ranging from no relationship between debt management and student progress, to an unspecified relationship, to a formal relationship whereby academic progress is conditional on collection of patient fees. The question of the legal validity of conditioning academic progress on third party payments for services was then examined. It is the opinion of the authors that the translation of a student's successful performance in a clinic setting to an academic failure or incomplete based on a patient's failure to pay for services is likely not legally defendable. Thus, it is essential that policies on fee collection and patient debt management not be tied to issues of student academic progress.
Comparison of two methods designed to improve pediatric dental case presentations utilizing videotapes
Authors: Waggoner WF , Scheid RC
Published: June 2020

This study compared the effectiveness of two methods of teaching the skills required for dentist‐parent pediatric case presentations. Seventy‐two senior dental students were videotaped presenting a child's case presentation to a parent. The students were then randomly assigned to one of two groups. Students in Group 1 viewed and evaluated a model videotape of the principal investigator presenting a case to a parent. Students in Group 2 viewed their previously videotaped presentation. Both groups evaluated performance on the tapes using a list of 25 performance‐specific criteria identified as important for a case presentation. Following this evaluation, 36 students were able to be taped while presenting a second case to another parent. One investigator blindly evaluated each taped presentation using the 25 criteria. Students who viewed the model videotape demonstrated a significant improvement in performance from their first presentation (p = 0.0044). Students who evaluated their own tape showed no significant improvement (p = 0.8830). Students perceived both methods to be helpful, minimally stressful, and requiring little time.
Evaluations of effectiveness and quality of care
Authors: Crall JJ
Published: June 2020

Although technical competency continues to be viewed as an essential prerequisite for practicing dentistry, it is no longer felt to be a sufficient indicator of the effectiveness or quality of care that will be or is provided by a practitioner. Consistent with a broader definition of quality that includes timeliness and appropriateness of treatment, continuity of care, emphasis on prevention, and adequate documentation of services provided, initiatives are being mounted to develop improved methods for evaluating the effectiveness of treatment approaches and quality of care provided for patients. Fundamental to these evaluations are hypotheses relating aspects of the structure, process, and outcome dimensions of dental practice. Evidence for interrelationships among elements of these dimensions generally is weak or lacking entirely. If dentistry is to keep apace with other segments of the health care community, efficient methods must be developed to collect valid and reliable data from practice settings that will facilitate the evaluation of the impact of treatments, providers, and organizational arrangements on the oral health status and general welfare of patients.
Integrating geriatric dentistry into general practice residency programs
Authors: Lloyd PM , Shay K
Published: June 2020

As the proportion of elderly people in society increases, so will the general practitioner's professional contact with the geriatric patient. Such a change will necessitate an alteration in patterns of practice. The “new elderly” are presenting with complicated restorative needs, and they increasingly expect the high quality of dentistry they have received much of their lives. Their expectations will require an enhancement and refinement of the general practitioner's diagnostic and therapeutic skills in geriatric dentistry. Yet the predoctoral dental curriculum is unable to provide the depth of experience and knowledge required. The amount of information that must be assimilated and the type of supervised clinic activities that must be experienced to prepare a student adequately in geriatric oral health care are too extensive to be included in a four‐year program. Under the existing dental educational system, the fully skilled, professionally secure, and clinically astute general practitioner capable of managing the complex needs of the elderly will emerge from the general practice residency.
Effectiveness of a national board review course for dental students
Authors: McCann AL , Schneiderman ED
Published: June 2020

In view of national concerns about student aptitude and overcrowded curricula, the effectiveness of review courses must be evaluated objectively. The present study is a statistical analysis of the impact of a review course on National Board Examination (NBE) Part I performance at the University of Detroit. The performance of dental students who had taken the course between 1985 and 1987 (N = 175) was compared to that of the prior three classes (N = 212). Analysis of covariance (ANCOVA) was used to adjust and compare mean scores on the NBE, using entering GPA and DAT scores, both measures of aptitude, as covariates. Only two of the five NBE scores demonstrated significant improvement. While aptitude contributed as much as 23 percent to NBE performance, the contribution of the review course was limited to 1.5 percent. The review course was most effective in areas that (1) were covered during the greatest number of terms, (2) were presented most recently, or (3) had the least number of topics on the NBE. This strategy for evaluating course effectiveness permits a dental school to easily assess the value of an NBE review course, as well as identify strengths and weaknesses in the curriculum.
The transfer effect of leadup activities
Authors: Feil P , Reed T , Hart JK
Published: June 2020

Previous literature shows that operative laboratory performance can be significantly improved through leadup training where students complete simulated preparations in plastic blocks. Since the task requirements of most fixed prosthodontic preparations seem similar to those of operative dentistry, it may be hypothesized that leadup training utilizing operative‐like preparations would facilitate performance in the projects of both courses. The objective of this study was to test that hypothesis. The performance of students who had completed the leadup training nine months earlier was compared with that of randomly selected control groups, with replacement, in a subsequent operative and fixed prosthodontics course. Calibrated raters were unaware of group affiliation of products. Analyses of variance showed that students in the experimental group statistically significantly outperformed those in the control group on the two operative preparations which were most like products completed during the leadup training. There was no such difference for any of the three fixed prosthodontics products. It is concluded that transfer of training is highly specific and that leadup training must simulate the criterion in both its cognitive and motor components, if it is to have a facilitating effect.
Expert opinions on nutrition issues in clinical dentistry
Authors: Palmer CA , Dwyer J , Clark RE
Published: June 2020

Diet assessment and counseling are essential components of comprehensive preventive dental care programs. However, the lack of consensus on what constitutes appropriate nutrition services has resulted in diversity in the level and quality of such services to dental patients. Seventy nine nationally recognized experts in dental nutrition were surveyed using the Delphi method to seek consensus on the appropriate scope of nutrition in clinical dentistry.
Continuing progress in infection control in U.S. dental schools
Authors: Merchant VA , Molinari JA
Published: June 2020

A survey was mailed to the deans of all U.S. dental schools in November 1988 requesting information regarding infection control instruction and protocols within the school. Fifty‐five of 59 surveys were returned. Compared to results of previous surveys, schools are paying increased attention to infection control and the application of recommended protocols. The paper contrasts the 1988 data with those of surveys conducted in 1982, 1986, and 1987, and highlights remaining obstacles to implementation of infection control programs within the dental school environment.
Attributes of growth in the U.S. dental economy, 1950–89
Authors: Cordes DW , Doherty NJ
Published: June 2020

Previous research has established dentistry as a growth sector of the U.S. economy. This study examines the economic relationship between dentistry's growth and factors operating on the demand and supply sides of the dental market. Output, defined as real per capita dental expenditures, was hypothesized to be a function of consumer income, dental insurance and the supply of dentists. Data for the period 1950–89, were analyzed using a generalized least squares approach. The analysis supported the hypothesis, indicating a significant relationship between growth in the dental sector and economic market factors. The study concludes that dentistry's real growth since 1950 was: (1) induced by increases in demand, mainly attributable to insurance and to a lesser extent consumer incomes; and (2) supported by increases in supply. The findings provide support for the insurance hypothesis, which suggests that growth in dental insurance has had a significant impact on the dental economy in recent years.
The 1990 Harry Bruce Legislative Fellowship
Authors: Cameron CA
Published: June 2020

The experiences described here recount my involvement in the various legislative processes and measure the tangible knowledge gained. It is most difficult to convey the impact of these experiences on my values and insights. This of course is not an uncommon phenomenon, it's encountered daily in dental education. However, probably one of the most significant outcomes of this experience is my expanded appreciation for the role of the AADS Division of Government Affairs in advocating for the concerns of dental education and the betterment of the oral health in our society. They serve and represent us well. However, their success is only as good as the support we, as dental educators, are willing to provide in the legislative process. A major step to the fulfillment of our obligation is simply understanding that we can play a most important role. The next step is informing the AADS of your interest and willingness to support their efforts and becoming a legislative advocate. And finally, when called upon to assist in a legislative effort you must be prepared to respond in a timely manner. I am satisfied that I have fulfilled my goals for the fellowship experience. It is my assessment that the goals of the Association were also met. I have been fortunate to have the opportunity to immediately implement my new knowledge and skills. Since the completion of my fellowship experience I have stayed in touch with the issues and served as a contact person and resource at my institution.(ABSTRACT TRUNCATED AT 250 WORDS)
Management considerations for an HIV positive dental student; ethical and legal commentary
Authors: Weinstein BD , Keyes GG
Published: June 2020

This article provides an ethical and legal analysis of a previously reported case involving an HIV‐positive dental student at the Medical College of Georgia. We conclude that the college acted appropriately from an ethical point of view and probably exceeded its legal obligations to accommodate the student.
Informatics futures in dental education and research: quality assurance
Authors: Crall JJ
Published: June 2020

Traditional methods for quality assurance are increasingly being questioned on the grounds of costs and effectiveness. Quality assurance in dentistry has suffered from many of the same problems that have impeded development of the field outside the hospital sector: inadequate data sources, a paucity of broad‐based research demonstrating the effects of various treatment approaches on patient outcomes, and a lack of cost‐effective methods by which to monitor and evaluate care. Informatics holds considerable promise for dealing with those problems in a comprehensive, reliable and efficient manner. Although a considerable shared commitment on the art of academic dentistry will be needed, the anticipated advantages to be gained in terms of advancing the quality of dental education, research and patient care are substantial. The initiatives being undertaken by the AADS Special Committee on Information Technology are most timely. Parallel informatics efforts are being mounted at the national and international level in numerous health care disciplines. The dental academic community should be prepared to take advantage of the opportunities that the field of informatics is expected to yield in the near future so that it can provide leadership in promoting positive changes within the profession.
Comparison of self‐instruction methods for teaching diagnostic testing
Authors: Puskas JC , Fung K , Anderson JD , Birek P , Dempster L , Heft MW , Torneck C , Lewis DW , McCulloch CA
Published: June 2020

In a randomized controlled trial, self‐teaching booklets and computer media were evaluated for teaching diagnostic testing to dental students as a foundation for further development of clinical decision making skills. Effectiveness was assessed by pre‐ and post‐tests. Reliability of these test instruments was examined by analyzing the pre‐ and post‐test scores of 49 first year dental students who received no instruction. Forty‐one second year dental students were exposed to clinical epidemiological principles applied to endodontic diagnosis through either self‐teaching booklets or computer media. No statistically significant difference was found between the mean test scores of the students through self‐teaching booklets and computer media. Although first and second year students showed a statistically significant improvement between the pre‐test and post‐test, the improvement in the second year class was greater. An addendum was later made to the main trial to compare the self‐teaching booklet to the traditional lecture format in teaching endodontic diagnosis. Seventy‐one third year dental students were exposed to these same materials through either a lecture or the self‐teaching booklet and then similarly tested. There was no significant difference between the self‐teaching booklet and traditional lecture for the third year students.
Dentists' sources of information about patient medications and other issues of medical management
Authors: Kunzel C , Sadowsky D
Published: June 2020

The frequency of use of sources of information about medications used for patients and other issues of medical management are analyzed in a national sample of general practice dentists (GPs). Subgroups of urban/rural, solo/nonsolo, and younger/middle‐aged/older dentists are examined for differences between groups. Assessing mean frequency of use for the entire group, the most frequently used sources of medical information are: 1) the consultant network; 2) the patient's physician; and 3) the Physicians' Desk Reference (PDR). Professional meetings, professional journals, and pharmaceutical detail people are the least frequently used sources. Frequency of use of information sources is related to solo/nonsolo status and to age, but not locale.
Setting a standard on the pilot National Board Dental Examination
Authors: Kramer GA , DeMarais DR
Published: June 2020

Norm‐referenced and criterion‐referenced approaches to setting a standard, or minimum passing score, were used with the pilot Part II National Board Dental Examination. The criterion‐referenced approach used with the pilot is based on the Rasch measurement model. The standards and associated failure rates were found to be similar for both approaches. These findings as well as the advantages associated with using the Rasch model suggest that this criterion‐referenced approach to setting a standard on the restructured Part II examination is appropriate.
Legal considerations in clinical decision making
Authors: Ursu SC
Published: June 2020

Decision analysis has wide application across disciplines. The purpose of engaging in formal analysis is to enhance the understanding and description of problems, aiding the decision maker to be more explicit and more comprehensive in the search for a preferred course of action. Legal considerations arise out of clinical decisions. The legal implications are illustrated with actual applicable issues arising out of current dental litigations.
Decision analysis in restorative dentistry
Authors: Anusavice KJ
Published: June 2020

Standardization of clinical decisions in restorative dentistry should be based on the tenets of the Hippocratic Oath. Although there is wide variability in preventive and operative treatment decisions, some of these decisions may lead along parallel courses to similar, clinically ethical outcomes. However, what parameters must be considered in judging the relative magnitude of positive and negative outcomes? This paper proposes several decision‐making strategies for selecting optimum treatment plans for preventive and restorative situations. The caries‐risk level of patients must first be identified in a systematic way and then it must be coupled with treatment options that are consistent with the potential future caries increment. A decision‐tree approach and/or the treatment‐index concept can then be applied to specific clinical conditions and preventive‐restorative options to derive an “expected value” for each possible outcome.
Clinical decision making for temporomandibular disorders
Authors: Mohl ND , Ohrbach R
Published: June 2020

Temporomandibular Disorders (TMD) encompass a number of clinical problems that involve the masticatory musculature, the temporomandibular joint (TMJ), or both. In any given patient, there exists the possibility of several overlapping TM disorders, an orofacial pain condition mimicking a TMD, or a concomitant TMD and non‐TMD disorder. Since differential diagnosis involves the determination of which diseases or disorders a patient is suffering from by systematically contrasting the clinical characteristics, differentiation from among multiple possible conditions complicates the diagnostic process, which often must be approached with a certain degree of uncertainty. In addition, the therapeutic decisions that emanate from the diagnostic process have their own predictive uncertainties. These uncertainties can be ameliorated by coupling available clinical research data with structured clinical problem solving methods during the diagnostic‐therapeutic decision making process. It is within this context that this article includes a discussion of the rationale for why the clinician should use decision making methods for TMD, a review of previous attempts at developing decision models for TMD, a discussion of the diagnosis of TMD with particular emphasis on the reliability and validity of their diagnostic criteria, a summary of the efficacy of therapeutic modalities and their application to treatment decisions, a sample decision tree analysis of a TM disorder, and some general recommendations for dental education.
Using patient‐instructors to teach and evaluate interviewing skills
Authors: Stilwell NA , Reisine S
Published: June 2020

The teaching and evaluation of clinical interviewing skills is a continuing challenge for medicine and dentistry. The use of patient‐instructors who provide consistency in presenting scenarios has recently been pioneered in dental education. This program focused primarily on teaching and used patient‐instructors to give individual feedback from the patient's perspective to students after each of five scenarios. Feedback was constructive and behaviorally oriented so that it could be applied immediately to succeeding scenarios. Rating instruments assessed both process and content skills. Results indicated that students improved significantly in interpersonal interviewing skills as they progressed through the exercise. Content skills improved only slightly. Student and faculty reaction was positive. The program is an effective and time efficient means of teaching history taking and interviewing skills as well as an effective evaluation tool.
A survey of instructional technology in dental education
Authors: Cohen PA , Forde EB
Published: June 2020

Little is known about current use of hardware and non‐hardware instructional technologies in dental education. To address this area, the investigators designed a questionnaire to assess support for the development of instructional technology and determine the extent to which different instructional technologies are used in North American dental schools. Responses were received from 59 of 65 dental schools (91 percent). Respondents at most schools judged the administration at their school to be supportive of the development of instructional technology, but in general, did not feel faculty were enthusiastic about or rewarded for developing innovative methods. The most common computer‐based application involves testing and record keeping, which is used extensively in about half the dental schools. Individualized instruction and paper and pencil simulations are used in at least some courses at a majority of dental schools. Schools with available support services apply certain technologies to a significantly greater extent than schools without available support services.
A meta‐analysis of individualized instruction in dental education
Authors: Dacanay LS , Cohen PA
Published: June 2020

Although several dozen studies on individualized instruction in dental education have been conducted over the past 30 years, little has been done to summarize quantitatively these studies. The present investigation used Glass' techniques of meta‐analysis to integrate statistically findings from 34 comparative studies on individualized instruction. A majority of these studies favored individualized over conventional instruction. The overall magnitude of effect, however, was small to moderate. One study characteristic variable–pacing of instruction–related significantly to effect size, with instructor‐paced versions of individualized instruction producing larger achievement gains than student‐paced versions. On average, individualized courses required only three‐quarters of the time needed for conventional teaching. The results suggest that more research is needed in this area, particularly concerning applications of computer‐based instruction, to assess adequately the potential of individualized modes of instruction for dental education.
Changes and challenges in Canadian dental faculties
Authors: Clark DC , Eisner J , Smith RA , Moore G
Published: June 2020

Canadian dental faculty were surveyed to determine changing career interests, sources of satisfaction, and professional development needs. The respondents indicated a desire to change the proportion of time allocated to their major responsibilities in ways that could create serious problems for dental faculties, i.e. more time on research, with less time on teaching and administration. While most reported teaching as a source of satisfaction and happiness, relatively few reported it as recognized and rewarded. The different status accorded to teachers, clinicians, and researchers, as reflected in the division of workload and rewards have created dissatisfaction among faculty, perhaps contributing to the fact that over 50 percent of respondents reported considering leaving academia. Faculties of Dentistry must determine what is required to reestablish a productive and enjoyable balance among their roles as teacher, researcher, and clinician and to determine what type of environment will best support the development of today's dental academics and tomorrow's dentists.
Consent for dental therapy in severely ill patients
Authors: Litch CS , Liggett ML
Published: June 2020

This article provides an overview of legal standards for informed consent, and discusses this in the context of dental care for elderly or severely ill patients. Legal analysis is made on variations in state common law and legislation, focusing on the difference between a practitioner‐oriented approach versus a patient‐oriented approach to informed consent. Analysis is also made regarding advance health care directives in cases of patient incapacity. The purposes of this article are to provide interested dental educators with an understanding of the important legal concepts in this area and the nuances of state law, and to discuss how these can be properly applied in facilities that treat severely ill or geriatric patients.
Perceived mistreatment of graduating dental students: a retrospective study
Authors: Wolf TM , Scurria PL , Bruno AB , Butler JA
Published: June 2020

This study assessed types and sources of perceived mistreatment among graduating dental students. A total of 38 of 46 (83 percent) students anonymously completed a mistreatment questionnaire. All 38 students perceived experiencing at least one type of mistreatment from some source and reported an average of about 35 separate incidents. Psychological mistreatment was most frequent with physical mistreatment reported relatively infrequently. Classmates and clinical faculty were the most frequent sources of mistreatment. Sexual harassment was perceived by about one‐third of the students. The potentially adverse effects of perceived mistreatment were discussed with a view to improving dental education through an emphasis on stress management, environmental change, and self‐responsibility for health designed to enhance the personal growth of each dental student.
Attitudes of dentists toward emerging competencies for health care practitioners
Authors: Shugars DA , Bader JD , O'Neil EH
Published: June 2020

Dentists' attitudes about the importance of formal training in a variety of skills were assessed as a part of the Pew Health Professions Commission initiative to help health professional schools prepare for the future. Through a telephone survey with a 54 percent participation rate, attitudes of a national sample of practitioners were determined concerning the importance of training in 16 competencies that reflect skills, attitudes, and behaviors identified by the commission. Most respondents indicated that competency in treating and preventing disease, practicing ethically, communicating with patients, applying problem solving techniques, and continuing to learn were very important. Conversely, less than half of dentists indicated that competency in managing information, responding to cultural diversity, supporting community agencies, and working in managed care settings were very important. The opinions of graduates since 1980 about their own training in the competencies tended to mirror their ratings of importance. These results demonstrate the continuing need for dental educators to consider prevailing opinion of practicing professionals as a part of any evaluation or planning effort.
Women's health: a national plan for action
Authors: Donahue AH
Published: June 2020

Women's health is a central item on the national health agenda for the 1990s. Renewed attention to the health needs of women has led to a national plan for action with interventions in research, prevention, treatment, training, public information, and public policy. Since research and training are pivotal to the promulgation of any national health agenda, this has particular importance for dental research and dental education. The 38‐goal PHS Action Plan for Women's Health, which directs resources of the U.S. Public Health Service (PHS) toward women's health is coordinated by the Office on Women's Health and implemented through the PHS agencies and offices including the National Institutes of Health (NIH), Centers for Disease Control and Prevention (CDC), and Food and Drug Administration (FDA). It encompasses large scale research interventions like the NIH “Women's Health Initiative” as well as other biomedical, biobehavioral, and health services research programs.
Practice characteristics of graduates of postdoctoral general dentistry programs
Authors: Gatlin LJ , Handelman SL , Meyerowitz C , Solomon E , Iranpour B , Weaver R
Published: June 2020

A mail questionnaire was sent to 900 dentists who completed a Postdoctoral General Dentistry (PGD) program in 1985 and 900 dentists who graduated from dental school in 1985 but did not participate in a PGD program. The response rate was 57 percent. Three‐quarters of the PGD graduates trained in civilian programs with the remainder being equally divided between military and Veterans Administration (VA) programs. Graduates of military programs continued to be employed by the military five years after graduation in contrast to the VA where less than 2 percent of graduates were employed after five years. The percent of dentists who are specialists or are enrolled in specialty programs five years after graduation was approximately 13 percent and the rates were similar for PGD and non‐PGD dentists. The patterns of care in private practice tended to be similar for both groups; however, in institutions GPR graduates provided more treatment for special care patients and patients who were economically disadvantaged. GPR graduates also were more involved in teaching and in hospital activities.