Pamela R. Overman

Relationships among and demographic predictors of dentists' self-reported adherence to national guidelines

How dentists learn about and integrate new procedures and techniques into dental practice are major concerns in innovation research in dentistry. The purposes of this study were to: (1) develop reliable measures of self-reported adherence to different national guidelines; (2) to examine the relationships among the different measures; and (3) to determine if predictors of these adherence behaviours exist. One thousand U.S. general dentists were asked to complete a survey of adherence behaviours to established guidelines in infection control, radiation protection, and antibiotic prophylaxis. Thirty-five percent responded to the mailed survey. Reliable scales were developed in infection control and antibiotic prophylaxis behaviors. Step-wise multiple regression analysis produced several weak predictors of adherence to guidelines in these two areas. Characteristics of early adopters such as office complexity, membership in professional associations, and year of graduation, were consistent with other dental innovation literature. Significant correlations were found between adherence behaviors in infection control and antibiotic prophylaxis. These correlations do support the findings that practitioners who are early adopters of innovation are likely to do so in more than one area.

Critical Thinking in Patient Centered Care

UNLABELLED Health care providers can enhance their critical thinking skills, essential to providing patient centered care, by use of motivational interviewing and evidence-based decision making techniques. BACKGROUND AND PURPOSE The need for critical thinking skills to foster optimal patient centered care is being emphasized in educational curricula for health care professions. The theme of this paper is that evidence-based decision making (EBDM) and motivational interviewing (MI) are tools that when taught in health professions educational programs can aid in the development of critical thinking skills. This paper reviews the MI and EBDM literature for evidence regarding these patient-centered care techniques as they relate to improved oral health outcomes. METHODS Comparisons between critical thinking and EBDM skills are presented and the EBDM model and the MI technique are briefly described followed by a discussion of the research to date. CONCLUSIONS The evidence suggests that EBDM and MI are valuable tools; however, further studies are needed regarding the effectiveness of EBDM and MI and the ways that health care providers can best develop critical thinking skills to facilitate improved patient care outcomes.

Implementation of Portfolios as a Programmatic Global Assessment Measure in Dental Education

Studies of assessment have shown that three elements-multiple assessments, over time, with multiple evaluators-provide the best strategy for global assessment of student competence in a valid and reliable manner, while experts on competency-based education (CBE) have defined the use of portfolios for assessment as a best practice for CBE. The aim of this article is to describe the five-year experience of one U.S. dental schools implementation of portfolio assessment of student competence as a programmatic global assessment strategy and to share the lessons learned. From approval by the Curriculum Committee to the first graduating classs portfolios, the steps and lessons learned along the way are described, in hopes of providing guidance to other schools interested in adopting portfolios for global assessment. This assessment strategy required the collaboration of a broad range of administrators, faculty, and students, as well as a high degree of faculty and student development. Calibration of the summative evaluators resulted in an interrater reliability estimate of 0.81. An important lesson learned was that development of reflective writing was underestimated, resulting in initial failure of 12 (11%) of the portfolios for the Class of 2017. Dental schools interested in adoption of portfolios should expect to invest time in the preparation of faculty and students. However, the result of this investment will be an assessment measure considered a best practice in both the assessment and competency literature.