New technologies in health care. Part 1: A moral and ethical predicament.
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With the rapid evolution of technology and the development and marketing of new procedures in dentistry, dentists have difficulty keeping pace with all of this new technology and information. How do these clinicians know whether a new product, technique or technological advance is good and should be recommended? At what point do they have an obligation to inform their patients about new procedures supported by research? This first report of a 2-part series investigates the ethical aspects of these issues and describes some of the professional ethical dilemmas and obligations involved when new therapies are offered to the public. (+info)
Evidence-based practice among a group of Malaysian dental practitioners.
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The objective of this study was to assess dentists' knowledge and use of evidence-based practice (EBP), including their attitudes toward and perceptions of barriers that limit the use of EBP. A cross-sectional survey was used with self-administered questionnaires involving dental practitioners in the state of Selangor, Malaysia. One hundred ninety-three replies were returned, for a response rate of 50.3 percent. More than two-thirds (135/193, 69.9 percent) of the respondents had heard of EBP. Out of the 135 respondents who had heard of EBP, a majority agreed it was a decision-making process based on evidence (127/135, 94.2 percent) and involved a series of steps from formulating the research question, locating and assessing the evidence, to applying it if suitable (129/135, 95.6 percent). Out of the 135 respondents who had heard of EBP, a high percentage agreed that EBP improved their knowledge and skills (132/135, 97.8 percent) and treatment quality (132/135, 97.8 percent). For advice, a majority of the 135 respondents frequently consulted friends and colleagues (123/135, 91.1 percent), made referrals (120/135, 88.9 percent), consulted textbooks (112/135, 83.0 percent), and referred to electronic databases (90/135, 66.7 percent). Out of the 135 respondents, many perceived EBP as very important (59/135, 43.7 percent) and important (58/135, 43.0 percent) and were interested to learn further information about EBP (132/135, 97.8 percent). The main reported barriers were lack of time (87/135, 64.4 percent), financial constraints (54/135, 40.0 percent), and lack of knowledge (38/135, 28.1 percent). A majority of the 135 respondents had knowledge of and positive attitudes towards EBP. However, due to barriers, a majority of them preferred colleagues, textbooks, and referrals for advice instead of seeking evidence from electronic databases. (+info)
Survey of systematic review authors in dentistry: challenges in methodology and reporting.
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The study reported in this article had three objectives: 1) identify the challenges faced by authors of dental systematic reviews (SR) during the process of literature search and selection; 2) determine whether dental SR authors' responses to survey questions about their study methodology were consistent with the reported published methodology; and 3) assess whether dental SR authors' evidence-based publication experience was associated with reported methodology. Seventy-eight authors (53 percent) of dental SRs out of 147 potential authors published from 2000 to 2006 responded to an online survey. According to the respondents, the most challenging aspects of literature search and selection were the initial design and performing extended literature searches. Agreement between the protocol identified by SR authors on the survey and the actual protocol described in their publications was fair to moderate. There were virtually no correlations between authors' publication experience, systematic review literature search, and selection thoroughness except for the number of past SRs published, and no differences in thoroughness between SRs written by clinicians (dental practitioners in the community) and dental school faculty members. Dental SR authors do not appear to fully appreciate the importance of extensive literature searches as central to the validity of their systematic review methods and potential findings. (+info)
Promoting the teaching of critical thinking skills through faculty development.
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Practical and effective faculty development programs are vital to individual and institutional success. However, there is little evidence that program outcomes result in instructional changes. The purpose of this study was to determine if and how faculty development would enhance participants' use of critical thinking skills in instruction. Seven faculty members from the University of Florida College of Dentistry and one faculty member from another health science college participated in six weekly two-hour faculty development sessions in spring 2007 that focused on enhancing critical thinking skills in instruction. Kaufman's and Rachal's principles of andragogy (adult learning) were used to design the sessions. Participants used learning journals to respond to four instructor-assigned prompts and provided one presentation to peers. With the use of qualitative methods, eight themes emerged across the learning journals: teaching goals, critical thinking, awareness of learners, planned instructional change, teaching efficacy, self-doubt, external challenges, and changes made. Five of eight participants incorporated critical thinking skills into their presentations at a mean level of 2.4 or higher on a 5-point scale using Paul and Elder's behavioral definition of critical thinking skills. Faculty development opportunities that cause participants to reason through learning journals, peer presentations, and group discussion demonstrated the incorporation of critical thinking concepts in 63 percent of this cohort group's presentations, suggesting that if evidence-based pedagogies are followed, instructional changes can result from faculty development. (+info)
"Providers practice prevention": promoting dental hygienists' use of evidence-based treatment of tobacco use and dependence.
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High rates of tobacco use prompted the development of a provider education program in Kentucky to promote implementation of evidence-based tobacco cessation treatment among registered dental hygienists (R.D.H.s). All R.D.H.s throughout the state were notified of the program and invited to participate. Participants were asked to complete a pre-program survey and post-program evaluation. A follow-up survey was administered one year following program participation. Two hundred and ninety-four R.D.H.s completed the pre- and post-program surveys, and the follow-up survey was completed by 53 percent (N=156) of the initial sample. Analyses exploring the immediate effect (from pre- to post-program) found the program to have had a universally positive impact (p<.05) across knowledge, attitudes, and intended clinical practices regarding tobacco use and treatment. Regarding the program's durable effects (from pre-program to follow-up), statistically significant (p<.05) and positive effects were realized for most of the outcomes, including subjective knowledge, attitudes, and practices. It was concluded that the program serves as an effective introduction to the Treating Tobacco Use and Dependence: Clinical Practice Guideline. Additional intervention might enhance the durability of the program's efficacy and promote more complete adoption of evidence-based tobacco cessation strategies by dental hygienists, leading to an even broader impact on cancer prevention and control of tobacco-related malignancy. (+info)
American Dental Association's Resources to Support Evidence-Based Dentistry.
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The role of basic sciences in diagnostic oral radiology.
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Although it is generally taken for granted that dental education must include both basic science and feature-based knowledge components, little is known about their relative roles in visual interpretation of radiographs. The objectives of this study were twofold. First, we sought to compare the educational efficacy of three learning strategies in diagnostic radiology: one that used basic scientific (pathophysiologic) information, one that used feature lists structured with an organizational tool, and one that used unstructured feature lists. Our second objective was to determine whether basic scientific information provides conceptual coherence or is merely a simple means for organizing feature-based knowledge. Predoctoral dental and undergraduate dental hygiene students (n=96) were randomly assigned into three groups (basic science, structured algorithm, and feature list) and were taught four confusable intrabony entities. The students completed diagnostic and memory tests immediately after learning and one week later, and these data were subjected to a 3x2 repeated measures ANOVA. For the diagnostic test, students in the basic science group outperformed those assigned to the feature list and structured algorithm groups on immediate and delayed testing (p<0.05). A main effect of learning condition was found to be significant. On the memory test, performance was similar across all three groups, and no significant effects were found. The results of this study support the critical role of basic scientific knowledge in diagnostic radiology. This study also refutes the organized learning theory and provides support for the conceptual coherence theory as a possible explanation for the process by which basic science aids in diagnosis. (+info)