Assessment of communication and physical exam skills: A comparison of students, faculty and standardized patients

PURPOSE/OBJECTIVES

The objective of this retrospective study was twofold: it aimed to investigate dental students' communication and physical exam self-assessment skills by comparing students' self-evaluations with those completed by faculty and standardized patients (SPs). Second, it aimed to compare faculty and SPs assessment of students' communication skills.

METHODS

At the end of their first year of training, students (n = 127), participated in one SP encounter about an initial dental consultation. Students completed self-assessment before receiving feedback from faculty (n = 19) and SPs (n = 19). The data source included evaluation forms submitted by students, faculty and SPs. The Wilcoxon signed rank test was used to compare the overall scores between groups. Agreement between evaluations items were analyzed with McNemar's test (p < 0.05).

RESULTS

Overall, there were no statistically significant differences in how students and faculty graded for either communication (p = 0.6724) or physical exam (p = 0.1921) skills. However, both students and faculty provided less favorable marks than SPs for communication skills with a statistically significant difference in the overall grading between both students and SPs (p = 0.0146) and between faculty and SPs (p = 0.0045).

CONCLUSIONS

While there was disagreement between students and faculty versus SPs, they weren't meaningful differences in scores and the dissimilarities mainly consisted of ratings of explanation skills. We suggest that, when applicable, dental student's self-evaluations may represent an alternative to faculty assessments of communication and physical exam skills. Nonetheless, we recommend that SPs be included in the assessment of communication skills to provide students with comprehensive feedback that more realistically represents the natural patient-provider relationship.

Effect of self-assessment in a removable prosthodontics preclinical course on skills and competence

PURPOSE

Self-assessment is increasingly implemented in medical professions' curricula. In this research, the authors measure the effects of self-assessment within a preclinical removable prosthodontics course among dental students in a private dental school according to the European qualifications framework descriptors.

MATERIALS AND METHODS

Thirty subjects, all fourth-year dental students, were included in this experiment. Fifteen subjects were included in each of the experimental and control groups during one semester. The experimental group subjects used the study roadmap tool in their preclinical tasks. The control group subjects executed the same preclinical tasks under instructor supervision only. All subjects were filmed, and an autonomy score was given to every subject per session. At the end of the semester, cognitive skills development was compared using the Kember et al. questionnaire while practical skills development was compared using a comparison of grades. Two focus groups were undertaken with experimental group subjects. Qualitative and quantitative data were collected and statistically analyzed (p < 0.005).

RESULTS

Subjects from the experimental group showed development in critical thinking, practical skills, autonomy, and taking responsibility, thus development in the competence level.

CONCLUSION

Implementation of self-assessment within preclinical courses may develop skills and competence among dental students, yet more studies are needed.

Exploring career development through a student-directed practicum to provide individualized learning experiences

INTRODUCTION

The primary objective was to assess the impact of an optional student-directed career development program on career and professional development between the second and third year of a doctor of pharmacy curriculum.

METHODS

Students who completed the student-directed practicum (SDP) completed a nine item pre-/post-survey assessing its impact on their career development within the learning constructs of discovery, application, and reflection. Additional open-ended questions assessed why students participated in the SDP and their perceived benefits of doing so. An additional questionnaire regarding the impact of the practicum was conducted at graduation. Quantitative data were analyzed with Wilcoxon signed-rank test for the pre-/post-survey and descriptive statistics for the graduation survey while qualitative data used a two-cycle open coding process.

RESULTS

Statistically significant increases were noted with those responding with "agree" or "strongly agree" to each of the nine statements in the pre-/post-survey. Students participated to further explore career options, and believed doing so resulted in enhanced career direction and future employability. The graduation survey showed those participating in the SDP had a higher rate of: postgraduate placement (86% vs. 77%), receiving ≥ five residency interview offers (81% vs. 69%), and first or second choice residency match (92% vs. 85%) compared to those who completed an internship outside of the SDP. Students commented that the SDP was a valuable part of their education and helped them take the next steps for their career.

CONCLUSIONS

A student-directed career development experience can positively impact student's career direction and professional development.

Self-Reported Antimicrobial Stewardship Practices in Primary Care Using the TARGET Antibiotics Self-Assessment Tool

The self-assessment tool (SAT) is a 16-question self-report of antimicrobial stewardship practices in primary care, available in the TARGET (Treat Antibiotics Responsibly, Guidance Education and Tools) Antibiotics Toolkit. This study analysed responses to the SAT and compared them to previous SAT data (2014-2016). Data from June 2016 to September 2019 were anonymised and analysed using Microsoft Excel and STATA 15. Clinicians reported engaging in positive antimicrobial stewardship (AMS) practices including using antibiotic guidance to inform treatment decisions (98%, 98% 2014-2016), discussing antibiotic prescribing within the practice (73%, 67% 2014-2016), using patient-facing resources (94%, 71% 2014-2016), conducting antibiotic audits in the last two years (98%, 45% 2014-2016), keeping written records and action plans (81%, 62% 2014-2016), using back-up prescribing (99%, 94% 2014-2016) and using clinical coding (80%, 75% 2014-2016). Areas for improvement include developing strategies to avoid patients reconsulting to obtain antibiotics (45%, 33% 2014-2016), undertaking infection-related learning (37%, 29% 2014-2016), ensuring all temporary prescribers have access to antibiotic guidance (55%, 63% 2014-2016) and making patient information leaflets easily available during consultations (31%). The findings offer a unique insight into AMS in primary care over time. The SAT gives primary care clinicians and commissioners an opportunity to reflect on their AMS and learning.

Graduating dentists' perceptions about their professional competence in Finland and Lithuania

AIMS

Efforts to harmonise dental education in Europe have been put into action by the Association for Dental Education in Europe (ADEE). The aim of the study was to explore graduating dentists' perceptions about their professional readiness for clinical work in Finland and Lithuania.

MATERIALS AND METHODS

The survey targeted fifth-year dental students at the University of Oulu and the University of Turku in Finland, and at the Lithuanian University of Health Sciences, Kaunas, Lithuania (Lithuanian and international students) in 2016-2017. The competences were evaluated in the questionnaire in 21 dental procedures based on ADEE competences by options: "I'd manage well," "I'd need more training" or "It would not quite succeed." The option "I'd manage well" was chosen in the analyses.

RESULTS

Students felt that they were most competent in producing and maintaining accurate patient records (91.9%), implementing sterilisation and hygiene in dental practice (91.3%) and working with other members of dental team and health profession (90.0%). The largest differences between Finnish and Lithuanian students were in designing and adjusting occlusal splints (87.0% vs. 14.3%) and in undertaking subgingival scaling (95.7% vs. 57.1%). The biggest differences between Lithuanian and international students were in identifying (and treating) abnormal and anxiety-related patient (73.1% vs. 25.5%) and implementing tobacco cessation (65.3% vs. 31.9%).

CONCLUSIONS

The graduating dental students in Finland and Lithuania manage well in most of the clinical procedures based on the ADEE competences. The students were most confident when dealing with tasks that are common in dental practice.

Agreement between faculty member assessments and student self-assessments in a preclinical endodontic programme

This study aimed to evaluate the agreement between faculty member assessments and student self-assessments regarding the latter's performance in a preclinical endodontic course. The data were collected from 30 undergraduate dental students enrolled in a preclinical endodontic course at Taibah University in Saudi Arabia during 2017-2018 academic year. One course coordinator calibrated the grading method and distributed it to all staff and students. Students were asked to appraise their own performance of a root canal treatment for a tooth with a single canal. After the student self-assessments, two staff members also graded student performance using the same grading scale. The assessment agreement was compared between student and faculty evaluations using a Wilcoxon signed-rank test with a 0.05 significance level. There was a significant difference (P < 0.05) between student and staff member assessment scores. Student scores were lower and had a weak reliability compared to those of staff members.

Implementation of a digital preparation validation tool in dental skills laboratory training

AIM

To describe the implementation of a digital tool for preparation validation and evaluate it as an aid in students' self-assessment.

METHODS

Students at the final semester of skills laboratory training were asked to use a digital preparation validation tool (PVT) when performing two different tasks; preparation of crowns for teeth 11 and 21. The students were divided into two groups. Group A self-assessed and scanned all three attempts at 21 ("prep-and-scan"). Group B self-assessed all attempts chose the best one and scanned it ("best-of-three"). The situation was reversed for 11. The students assessed five parameters of the preparation and marked them as approved (A) or failed (F). These marks were compared with the information from the PVT. The students also completed a questionnaire. Each question was rated from 1 to 5. Teachers' opinions were collected at staff meetings throughout the project.

RESULTS

Most students in the "prep-and-scan" groups showed an increase in agreement between their self-assessment and the information from the PVT, whereas students in the "best-of-three" groups showed lower levels of agreement. All students rated the PVT positively. Most strongly agreed that the tool was helpful in developing skills (mean 4.15), easy to use (mean 4.23) and that it added benefits in comparison to existing assessment tools (mean 4.05). They did not however, fully agree that the tool is time efficient (mean 2.55), and they did not consider it a substitute for verbal teacher feedback. Teachers' feedback suggested advantages of the tool in the form of ease of use, visual aid and increasing interest and motivation during skills laboratory training however, they did not notice a reduction in need of verbal feedback.

CONCLUSIONS

Within the limitations of the study, our conclusion is that a digital PVT may be a valuable adjunct to other assessment tools in skills laboratory training.

Self-assessment in pharmacy and health science education and professional practice

Self-assessment is an important skill necessary for continued development of a health care professional from student pharmacist throughout their professional career. This paper reviews the literature on student and practitioner self-assessment and whether this skill can be improved upon. Although self-assessment appears to be a skill that can be improved, both students and professionals continue to have difficulty with accurate self-assessment. Experts' external assessment of students should remain the primary method of testing skills and knowledge until self-assessment strategies improve. While self-assessment is important to lifelong learning, external assessment is also important for practitioners' continuing professional development.

Directed Reading: Designing a Professional Development Program for Medical Radiation Technologists

By participating in some form of professional development, medical radiation technologists can increase their skill, knowledge, and competence, leading to improved quality, safety, and standards of practice. Participation will also demonstrate acceptance of the responsibility for medical radiation technologists' own professional development. Over the past 10 years, the profession of medical radiation technology has progressed dramatically, with many changes in technology. The need for medical radiation technologists to keep up-to-date on these advancements is evident. Many medical radiation technologists participate in some form of professional development, and the decision to do so is either mandated at the provincial level or it remains a personal one. Because education is a provincial matter, the continuity of professional development or continuing education for medical radiation technologists across the country does not exist. The purpose of this directed reading is to review the options available to medical radiation technologists for professional development, to provide an overview of professional development programs from various health care professional groups, to outline how to effectively introduce a professional development program to medical radiation technologists, and to recommend the most appropriate program to implement for medical radiation technologists.

The General Level Framework: use in primary care and community pharmacy to support professional development

Objectives

To compare practice pharmacists and community pharmacists based on the use of the General Level Framework (GLF) as a tool to support continuing professional development (CPD).

Setting

Primary care and community pharmacy in London and the East of England.

Method

The study pharmacists were self-selected after distribution of recruitment packs in the study area through local pharmaceutical committees, primary care trusts and two large multiples. Sixty-nine pharmacists used the framework to support their CPD (42 community pharmacists and 27 with a role in primary care pharmacy). Pharmacists made an initial self-assessment against the GLF and then used the framework over a 12-month period to identify learning needs for CPD. Pharmacists identified their desired performance levels for the behaviours in the framework, based on guidance from the project team, and then identified their learning needs by comparing the desired performance level with their self-assessment. Pharmacists were visited at 4 and 8months by a trained facilitator to support their self-assessment and progress with CPD. Final self-assessments were collected at 12months. Assessment ratings for the delivery of patient-care competencies were compared.

Key findings

There was no difference in the probability of either group achieving their desired performance level (log rank = 0.023, 1 df, P = 0.878): pharmacists achieved their desired performance level irrespective of their sector of work, demonstrating the applicability of the GLF to the different sectors of practice. Practice pharmacists had a higher aggregated score for the desired performance levels than the community pharmacists (Mann-Whitney U = 10.500, P &lt; 0.001; median = 133.0 and 119.5 respectively).

Conclusion

Both groups of pharmacists were able to apply the framework to their practice and use it to support their CPD, resulting in increasing self-assessed competency scores over time. The higher desired performance level for practice pharmacists compared with community pharmacists conveys a difference, perceived or actual, between the two roles. Irrespective of the difference in desired performance levels, both groups of pharmacists have improved, to meet their level of expectation, over the 12-month period.

Preparing pharmacy graduates for traditional and emerging career opportunities

Educational programs in pharmacy must focus on educating pharmacists of the future who are prepared to serve as competent and confident health care "providers" whose "practice" can occur in any number of current and future settings; and whose expertise is essential to an interprofessional health care team. Graduates must be able to incorporate a scholarly approach to their practice in identifying patient care problems; practicing in an evidence-based manner; and ensuring safe, effective, and appropriate use of medications. It is time for colleges and schools of pharmacy to implement contemporary teaching and assessment strategies that facilitate effective and efficient student learning that is focused at the graduate professional level, to evolve the content around which the curriculum is organized, and clearly articulate the abilities graduates must have to function effectively in the myriad professional roles in which they may find themselves.