Implant dentistry in Australian undergraduate dental curricula: knowledge and competencies for the graduating dentist.

AIMS: The aim of this paper is to define the key competencies (knowledge, skills, attitudes and values) in the field of implant dentistry, necessary for graduating general practitioners in Australia. The authors have produced a headline reference guide to outline the necessary educational outcomes which can be targeted by the undergraduate curricula in dental schools of Australian universities. This paper focuses on competencies and aims to clarify curricula 'endpoints' rather than processes. The process towards achieving these outcomes and the instructional methods and strategies might vary among universities. The authors acknowledge that there are different ways to reach the targeted learning outcomes and that there is a diversity of curricular approaches, structures and methodologies among Australian dental schools, which are enriching and desirable educationally. Specific educational strategies also with regards to the teaching of implant dentistry have been addressed in previous work and will not be covered in this paper. This paper will not address extracurricular courses, special degrees or training after graduation.

On the reliability of a dental OSCE, using SEM: effect of different days.

AIM: The first aim was to study the reliability of a dental objective structured clinical examination (OSCE) administered over multiple days, and the second was to assess the number of test stations required for a sufficiently reliable decision in three score interpretation perspectives of a dental OSCE administered over multiple days. MATERIALS AND METHODS: In four OSCE administrations, 463 students of the year 2005 and 2006 took the summative OSCE after a dental course in comprehensive dentistry. The OSCE had 16-18 5-min stations (scores 1-10), and was administered per OSCE on four different days of 1 week. ANOVA was used to test for examinee performance variation across days. Generalizability theory was used for reliability analyses. Reliability was studied from three interpretation perspectives: for relative (norm) decisions, for absolute (domain) and pass-fail (mastery) decisions. As an indicator of reproducibility of test scores in this dental OSCE, the standard error of measurement (SEM) was used. The benchmark of SEM was set at <0.51. This is corresponding to a 95% confidence interval (CI) of <1 on the original scoring scale that ranged from 1 to 10. RESULTS: The mean weighted total OSCE score was 7.14 on a 10-point scale. With the pass-fail score set at 6.2 for the four OSCE, 90% of the 463 students passed. There was no significant increase in scores over the different days the OSCE was administered. 'Wished' variance owing to students was 6.3%. Variance owing to interaction between student and stations and residual error was 66.3%, more than two times larger than variance owing to stations' difficulty (27.4%). The SEM norm was 0.42 with a CI of +/-0.83 and the SEM domain was 0.50, with a CI of +/-0.98. In order to make reliable relative decisions (SEM <0.51), the use of minimal 12 stations is necessary, and for reliable absolute and pass-fail decisions, the use of minimal 17 stations is necessary in this dental OSCE. CONCLUSIONS: It appeared reliable, when testing large numbers of students, to administer the OSCE on different days. In order to make reliable decisions for this dental OSCE, minimum 17 stations are needed. Clearly, wide sampling of stations is at the heart of obtaining reliable scores in OSCE, also in dental education.

Making a comprehensive diagnosis in a comprehensive care curriculum.

Comprehensive care models in dental education encourage students to deliver patient-centered care. But to deliver effective comprehensive care, a clinician must first make a comprehensive diagnosis. Students of general dentistry are taught to make one or more diagnoses as defined by the dental specialties, and to direct patient care accordingly. Without a comprehensive diagnosis, patients may receive fragmented, poorly prioritized care that is inappropriate to their overall oral health. This paper presents a simple diagnostic classification that can be used to make a comprehensive diagnosis with which to guide the student of general dentistry in planning comprehensive care.