Assessment of online continuing dental education in North Carolina

An evaluation of dental continuing professional development programs in the USA and Canada

PURPOSE

This research explores continuing professional development (CPD) requirements for dental regulatory/licensing authorities located in the USA/Canada and their preferences toward different learning and assessment strategies.

METHODS

Data were first retrieved through an environmental scan of CPD requirements posted on the websites for the 62 regulatory/licensing authorities located in the USA/Canada. Subsequently, an electronic questionnaire was distributed to the appropriate contact at each regulatory authority to capture additional data related to knowledge and preferences.

RESULTS

The environmental scan revealed that Canadian CPD programs had a significantly higher (p < 0.05) average of required CPD hours (26.67 ± 5.44) when compared to the USA (18.20 ± 4.23). For the survey component, 35 completed responses were received (response rate 56%). A total of 54% of respondents selected from a Likert scale that they "rarely" incorporate formative assessments, and 68% only "sometimes" or "often" incorporate summative assessments into their CPD programs. Additionally, 63% of respondents "never" incorporated predisposing activities, and 57% "never" incorporated reinforcing activities. It was perceived that renewal fees were insufficient to finance ongoing CPD costs (60%) and external industry sponsorships were required to sustain programs (43%). Respondents indicated that there is an insufficient number of evidence-based courses available in a variety of dental disciplines.

CONCLUSIONS

Formative and summative assessments and predisposing and reinforcing learning activities were not viewed as essential tools in CPD programs. Costs and human resources could be possible obstacles in incorporating learning activities and assessments. Future studies can build from the initial results of this study to improve the quality of learning in CPD programs.

Impact of a Focused Online Teaching Module on Airway Intervention: Can an Online Teaching Module Enable Knowledge Acquisition and Increased Confidence in Airway Management?

OBJECTIVE

Teaching procedural skills via digital platforms is challenging. There is a paucity of literature on the feasibility of implementing an online asynchronous web-based learning (WBL) module for endotracheal intubation in Emergency Medicine. Learners completed a pre-test questionnaire prior to reviewing the module to assess their current knowledge. After completion of the online module, another assessment on airway management competency was completed. The purpose of our pilot study was to determine the feasibility of implementing an online airway module and investigate knowledge acquisition among learners who completed it. Additionally, we compared the relationship between pre-module confidence and knowledge between various training levels of those who completed the module.

METHODS

The study was IRB exempt. We conducted a quasi-experimental pre- and post-test study, where learners took a multiple-choice question-based test before watching content module, and after completion of modules, they went on to complete post-test questions. All responses were collected using Google survey and the data were collected over a period of 6 months. We performed descriptive statistics for the pre- and post-module. Frequency distribution was used for data summarization and chi-square test was used to assess the difference between variables.

RESULTS

We received 366 responses in the pre-test module and 105 in post-test module. Responses were summarized into 5 broad categories which assessed knowledge about airway technique, anatomical landmarks, formulas for selecting blade size, tube size, depth of tube, and case-based scenarios. All questions showed a higher percentage of correct answers in the post-assessment compared to the pre-assessment.

CONCLUSION

The results demonstrated that this WBL airway module resulted in significant knowledge acquisition, as well as increased confidence when approaching airway management. The study demonstrated that a WBL airway module is a feasible method of asynchronous education for healthcare providers in all levels of training.

Distance learning course improves primary care dentists' diagnosis and self-efficacy in the management of oral lesions

Oral cancer represents a public health issue because of its high mortality rate, resulting mainly from diagnostic delays. Insufficient training in oral diagnosis is usually perceived by dentists. Distance learning could be used as an auxiliary tool to bridge that gap. This study evaluated the impact of a distance learning course on oral mucosal lesion diagnosis offered to public healthcare dentists. Participants of an online course answered a pretest/posttest comprising clinical images of 30 clinical cases. Participants were questioned about the diagnosis and informed their decision on the cases (referring the cases to a specialist or managing them themselves), as a parameter of perceived self-efficacy. A total of 442 dentists enrolled in the course. Their pass rate was 97%. Classification of the nature of the lesions, diagnostic hypotheses, sensitivity, and specificity improved by 13.4%, 10.0%, 13.4%, and 6.6%, respectively (p<0.01, Wilcoxon test). Regarding management, there was a 16.6% reduction in the intention to refer cases, while confidence in the diagnosis of benign lesions increased by 40%. A distance learning course may be useful in continuing education actions for primary care dentists, improving their diagnostic abilities and encouraging them in the management of oral lesions. Moreover, this strategy could contribute to disseminating knowledge to remote regions, particularly among primary health care professionals.

Learning gain in web (internet) sourced seminars versus textbook sourced seminars in postgraduate medical students

BACKGROUND

In the past, textbook or printed material was the only source of information for medical students or post-graduate students. After the introduction of internet, knowledge can be accessed easily which is updated with various aids such as animation, videos which improve the learning efficiency. This study was conducted to compare the learning efficiency between textbook-based seminar to that of internet-based seminar in postgraduate students of the department of dermatology.

MATERIALS AND METHODS

It was a non-randamized controlled study. The postgraduate students in the department of dermatology, Jawaharlal Nehru Medical college, DMIMS(DU),Sawangi (Meghe), Wardha, Maharashtra, India were divided into two equal groups by simple randomization method by flipping the coin. Totally 20 seminar topics were divided into two groups (A and B) consisting of 10 seminars in each group. Postgraduate students assigned in group A were asked to prepare seminar solely from textbooks while in group B, students were asked to prepare seminar by referring internet. Feedback form which consists of 7 points, i.e. appearance, completeness of preparation, clarity of presentation, appropriate use of audio visual aids, understanding of subject, ability to answer questions, and overall performance were filled up from faculties and postgraduate students after completion of each seminar. Pretest and post-test were filled up from postgraduate students before and after each seminar respectively. Learning gain was calculated by comparing the scores of pretest and posttest. Paired t-test was used to compare results in the group and unpaired t-test was used to compare results between the two groups.

RESULTS

Faculties' feedback on overall performance was higher (4.59 ± 0.15) in web-based seminars as compared to in textbook-based seminars (3.85 ± 0.1) with significant P = 0.008. Furthermore, postgraduate students' feedback showed statistical significant value of 0.02 in web-based seminars (4.65 ± 0.06) compared to textbook-based seminars (3.2 ± 0.06). Learning gain was significantly higher in web-based seminar compared to textbook-based seminar with P = 0.02.

CONCLUSION

It can be concluded that web-based learning can improve the learning efficiency in postgraduate medical students.

Web-based educational programme for temporomandibular joint assessment with cone-beam computed tomography

OBJECTIVES

To develop and evaluate an educational web-based programme for temporomandibular joint (TMJ) assessment using cone-beam computed tomography (CBCT).

METHODS

A web-based educational programme was designed for TMJ assessment using CBCT images. Fifteen CBCT cases of the TMJ (three-dimensional reconstructed volumes) and an assessment module based on image analysis criteria in the Diagnostic Criteria for Temporomandibular Disorders (DC/TMD) were added to the programme. Thirty-six undergraduate dental students were invited to test the programme by assessing all cases twice: before and after 2 months of training. Participants submitted written subjective evaluations of the programme.

RESULTS

The web-based programme can be accessed on Malmö University webpage (www.cbct-tmj.mau.se). Despite limited CBCT learning in their undergraduate training and not using the programme in the 2-month interval, the students were able to correctly diagnose 80% of the cases at the second assessment. Their diagnoses, however, did not differ significantly from the first assessment. Overall, the students were satisfied with the programme and considered it user-friendly.

CONCLUSION

The web-based educational programme that was developed in the present study and tested by dental students could be a useful educational tool for TMJ assessment using CBCT.

Online discussion for block teaching in postgraduate health professionals' curriculum: the Ethiopian experience

BACKGROUND

Online discussions as a method of instruction are a new approach in Ethiopia. There is no previous study in the Ethiopian context that has assessed students' engagement and learning experience using this instruction method, which may offer a valuable complement to other instruction methods for intensive block teaching in a resource-limited environment. The aim of this study was to assess the value of online discussions in supporting students' engagement and interaction with their peers and teachers in a block teaching postgraduate health professionals' curriculum.

METHODS

The research was conducted at Addis Ababa University College of Health Sciences, School of Medical Laboratory Sciences (SMLS), which has structured the curriculum around intensive block teaching. Between December 2011 and February 2012, two groups of full-time (N = 21) and part-time (N = 52) postgraduate students participated in online discussions as part of a Biostatistics and Research Methods module, in addition to other instructional methods. Every week, the course instructor initiated the online discussion by posting an assignment and articles with a few discussion questions. To evaluate the participants' collective learning experience, the content of the email messages generated during these online discussions was analyzed qualitatively.

RESULT

A total of 702 emails were exchanged during the three week module, of which 250 emails (35.6%) were posted by full-time students and 452 emails (64.4%) by part-time Continuing Education Program (CEP) students. During the online discussion forum, students identified different statistical data analysis tools and their application for given data sets. In terms of message contents, 67% of full-time and 64% of part-time students' messages were classified as learning experiences. However, a slightly higher proportion of part-time students' posts were social messages. The majority of students in both groups reported high levels of satisfaction with their online experience.

CONCLUSION

Online discussion could be a valuable addition to face-to-face classroom teaching to improve students' engagement and interaction in an intensive block teaching postgraduate curriculum where learners are engaged in a full work load with academic studies.

Treatment approaches and antibiotic use for emergency dental treatment in Turkey

The purpose of this study was to gather information about Turkish general dental practitioners’ treatment approaches towards endodontic emergencies, antibiotic-prescribing habits, and their participation in lifelong learning programs. Questionnaires were given to dentists who attended the 16th National Congress organized by the Turkish Dental Association. From 1,400 questionnaires distributed, 589 (43%) were deemed usable in this study. This survey dealt with questions that were subdivided into two main topics: dental emergency treatment approaches, and antibiotic prescription and information on lifelong learning program participation. The statistical analysis was conducted with a χ² test at a significance level of P<0.05. For irreversible pulpitis cases in vital teeth, most of the dental practitioners (65.3%) preferred single-visit root canal treatments. For teeth presenting a periapical lesion, the preferred treatment approach was root canal treatment (91.5%). The rate of prescription of analgesics and antibiotics was 21.7% in untreated acute apical periodontitis cases and 41% in acute apical abscess cases. Frequently prescribed antibiotics were amoxicillin–clavulanate (61.8%) and amoxicillin (46.5%). There was a tendency for practitioners to attend congresses as their years of professional practice increased (P<0.0001). There have been discrepancies between taught and observed practice. Educational initiatives are needed to prevent inappropriate prescription of antibiotics.

A review of continuing professional development for dentists in Europe(*)

AIM

  To summarise findings from a literature review of dentists' engagement in continuing professional development (CPD) and its effects on improving oral health care for patients.

METHOD

  The search strategy used key terms in a range of databases and an academic literature search engine, complemented by hand searching and citation follow-up.

RESULTS

  One hundred and fourteen papers were reviewed. The majority of dentists engaged in CPD. Factors affecting participation included time since graduation, costs, work and home commitments, postgraduate qualification, interest and convenience. Learning needs identification and reflection on practice were rarely evidenced. Common modes of CPD were courses and journal reading; no one delivery method proved more effective. Few papers directly explored recommendations for topics although suggestions related to common areas of error and gaps in knowledge or skill. Studies of CPD effectiveness and impact-on-practice suggested that courses can result in widespread new learning and considerable self-reported change in practice. However, significant barriers to implementing change in workplace practice were noted and included availability of materials, resources and support from colleagues.

CONCLUSION

  To ensure high standards of care, alongside recommending core or mandatory topics, more attention should be given to reflection on learning needs, the learner's readiness to engage with education and training and the influence of the workplace environment.

Use of online sources of information by dental practitioners: findings from The Dental Practice-Based Research Network

OBJECTIVE

Estimate the proportion of dental practitioners who use online sources of information for practice guidance.

METHODS

From a survey of 657 dental practitioners in The Dental Practice-Based Research Network, four indicators of online use for practice guidance were calculated: read journals online, obtained continuing education (CDE) through online sources, rated an online source as most influential, and reported frequently using an online source for guidance. Demographics, journals read, and use of various sources of information for practice guidance in terms of frequency and influence were ascertained for each.

RESULTS

Overall, 21 percent (n = 138) were classified into one of the four indicators of online use: 14 percent (n = 89) rated an online source as most influential and 13 percent (n = 87) reported frequently using an online source for guidance; few practitioners (5 percent, n = 34) read journals online, fewer (3 percent, n = 17) obtained CDE through online sources. Use of online information sources varied considerably by region and practice characteristics. In general, the four indicators represented practitioners with as many differences as similarities to each other and to offline users.

CONCLUSION

A relatively small proportion of dental practitioners use information from online sources for practice guidance. Variation exists regarding practitioners' use of online source resources and how they rate the value of offline information sources for practice guidance.

A review of continuing professional development for dentists in Europe

AIM

To summarise findings from a literature review of dentists' engagement in continuing professional development (CPD) and its effects on improving oral health care for patients.

METHOD

The search strategy used key terms in a range of databases and an academic literature search engine, complemented by hand searching and citation follow-up.

RESULTS

One hundred and fourteen papers were reviewed. The majority of dentists engaged in CPD. Factors affecting participation included time since graduation, costs, work and home commitments, postgraduate qualification, interest and convenience. Learning needs identification and reflection on practice were rarely evidenced. Common modes of CPD were courses and journal reading; no one delivery method proved more effective. Few papers directly explored recommendations for topics although suggestions related to common areas of error and gaps in knowledge or skill. Studies of CPD effectiveness and impact-on-practice suggested that courses can result in widespread new learning and considerable self-reported change in practice. However, significant barriers to implementing change in workplace practice were noted and included availability of materials, resources and support from colleagues.

CONCLUSION

To ensure high standards of care, alongside recommending core or mandatory topics, more attention should be given to reflection on learning needs, the learner's readiness to engage with education and training and the influence of the workplace environment.

Web-based elective courses for medical students: an example in pain

OBJECTIVE

Online learning is an efficient new educational method that is able to link teachers with geographically dispersed students and capture the interest of students with interactive materials. Our objective was to describe curricula of new Web-based electives about pain for undergraduate medical education.

DESIGN

We created three interactive Web-based elective courses about pain targeted to medical and dental students. "The Puzzle of Pain" course introduced basic concepts of pain and neurobiology of pain. The humanities-based curriculum of "Empathy and Pain" taught students about emotional aspects of pain and empathetic responses. "The Cochrane Library and Pain" course introduced students to the concept of evidence-based medicine, critical appraisal of the literature, and the hierarchy of evidence in medicine.

OUTCOME MEASURES

We measured program effectiveness with a pretest/posttest instrument and student satisfaction survey.

RESULTS

Mean knowledge scores increased significantly after the program and overall evaluations were positive.

CONCLUSIONS

Delivering the pain electives for medical students in an online format was an efficient educational method, with high student satisfaction scores. Medical educators should consider online electives for medical students in pain studies as well as in other content areas.

Formal and informal continuing education activities and athletic training professional practice

CONTEXT

Continuing education (CE) is intended to promote professional growth and, ultimately, to enhance professional practice.

OBJECTIVE

To determine certified athletic trainers' participation in formal (ie, approved for CE credit) and informal (ie, not approved for CE credit) CE activities and the perceived effect these activities have on professional practice with regard to improving knowledge, clinical skills and abilities, attitudes toward patient care, and patient care itself.

DESIGN

Cross-sectional study.

SETTING

Athletic training practice settings.

PATIENTS OR OTHER PARTICIPANTS

Of a geographic, stratified random sample of 1000 athletic trainers, 427 (42.7%) completed the survey.

MAIN OUTCOME MEASURE(S)

The Survey of Formal and Informal Athletic Training Continuing Education Activities was developed and administered electronically. The survey consisted of demographic characteristics and Likert-scale items regarding CE participation and perceived effect of CE on professional practice. Internal consistency of survey items was determined using the Cronbach alpha (alpha = 0.945). Descriptive statistics were computed for all items. An analysis of variance and dependent t tests were calculated to determine differences among respondents' demographic characteristics and their participation in, and perceived effect of, CE activities. The alpha level was set at .05.

RESULTS

Respondents completed more informal CE activities than formal CE activities. Participation in informal CE activities included reading athletic training journals (75.4%), whereas formal CE activities included attending a Board of Certification-approved workshop, seminar, or professional conference not conducted by the National Athletic Trainers' Association or affiliates or committees (75.6%). Informal CE activities were perceived to improve clinical skills or abilities and attitudes toward patient care. Formal CE activities were perceived to enhance knowledge.

CONCLUSIONS

More respondents completed informal CE activities than formal CE activities. Both formal and informal CE activities were perceived to enhance athletic training professional practice. Informal CE activities should be explored and considered for CE credit.

Online CME: an effective alternative to face-to-face delivery

BACKGROUND

The Pharmacotherapies Accreditation Course (PAC) is a continuing medical education (CME) course designed to prepare practitioners for accreditation as pharmacotherapies prescribers for opioid dependence. The course incorporates a preparation stage, a workshop stage and a clinical placement component. The PAC continues to be successfully delivered in face-to-face mode since 2001. From 2003 onwards, an online alternative of the PAC was also implemented.

AIMS

The aim of this study was to evaluate the effectiveness of an online alternative to an existing face-to-face CME workshop in preparing practitioners for accreditation as a pharmacotherapies prescriber for opioid dependence.

METHODS

Participants were 62 practitioners who undertook the PAC between 2003 and 2006. A pretest/posttest-control group design was used, with outcome measures across the domains of knowledge, skill, and attitudes, together with a course feedback survey for both the online and face-to-face modes of the course.

RESULTS

Results demonstrate that the online CME mode was equally as effective as the face-to face mode in preparing participants for their role in the treatment and management of opioid dependence, and was also rated highly by participants.

CONCLUSIONS

The findings have implications for the effective design and delivery of e-learning environments for professional practice, in terms of equipping participants with requisite clinical knowledge and skills and facilitating the development of attitudes congruent with professional practice.

A comparison of the acceptability and effectiveness of two methods of distance education: CD-ROM and audio teleconferencing

OBJECTIVES

To fulfill a need for convenient and effective continuing education for pharmacists throughout Wisconsin by developing a pharmacy continuing education program using 2 different methods for distance education: audio teleconferencing and CD-ROM.

METHODS

Eighty pharmacists were recruited from a 2003 University of Wisconsin distance education program, 47 of whom participated in the course using the traditional audio teleconference method, and 33 of whom participated using a home study CD-ROM containing the same material presented in the teleconference. Volunteers were required to complete a pretest, a first posttest immediately following completion of the continuing education course, a second posttest 1 month following the conclusion of the course, and an evaluation.

RESULTS

The CD-ROMs were a more acceptable method for distance education than audio teleconferencing and resulted in better retention of the course information.

CONCLUSION

These study results can help coordinators of continuing pharmaceutical education programs to determine the most effective and acceptable method for future distance-education opportunities.

Internet continuing education for health care professionals: an integrative review

INTRODUCTION

The objective was to review key articles and research studies on practices, preferences, and evaluation of on-line continuing education used by health care professionals.

METHODS

Data sources included searches of the MEDLINE, CINAHL, and ERIC databases (January 1990 to June 2004) and manual searches of the Journal of Continuing Education in the Health Professions and the Journal of Continuing Education in Nursing. Articles included reviews and research studies focusing on the use of Internet CE by health care professionals. The articles were categorized according to intervention, subjects, study design, and key findings.

RESULTS

Seventeen articles were eligible and were reviewed. Although in-person CE remains the most frequent and most preferred format, Internet CE is gaining in popularity. Most participants who engage in on-line CE are satisfied with the experience and find it to be an effective learning format. Barriers to on-line CE include technical difficulties and lack of computer knowledge.

DISCUSSION

Although the Internet is an effective and satisfactory educational format, barriers to use of the Internet for CE still exist. Additional studies are needed to measure the impact of Internet CE on practice performance, reduce barriers to on-line CE, and identify appropriate theoretical frameworks for on-line learning.

Helping family physicians improve their cardiac auscultation skills with an interactive CD-ROM

INTRODUCTION

There have been few studies of the cardiac auscultation skills of residents and family physicians. This study assessed a group of family physicians' cardiac auscultation skills and use of a computerized self-instructional program to improve these skills.

METHODS

Forty-two volunteer family physicians participated in an initial assessment of cardiac auscultation skills using test recordings of 12 common heart sounds. They were provided with a CD-ROM instructional program and were asked to devote 15 hours of self-study to the program and to return in 9 months for reassessment.

RESULTS

The 42 family physicians in the initial assessment identified 39% of the heart sounds. Twenty-one returned for reassessment and showed significant improvement. Their initial mean score was 4.3 of 12 (35%), and their final mean score was 8.0 of 12 (67%). They found the CD-ROM program to be a valuable resource. The feature most liked was the unlimited opportunity to review sounds, cases, and tutorials. Most frequent problems related to computer access or skills. Eleven respondents reported using the program to resolve patient problems in their clinical practices.

DISCUSSION

The cardiac auscultation skills of a group of volunteer family physicians showed low initial scores that improved significantly after self-study with a CD-ROM instructional program. The program was a valuable self-instructional aid, and physicians used it as a resource in clinical practice. However, only 50% of the initial group completed the self-study and returned for final assessment. Providing more support and assistance in the initial phase, especially with computer use, may enable completion of similar computerized self-study programs.