Competency based education lead to arrive at the learning outcomes expected from a graduating dentist

1. COMPETENCY IN DENTISTRY
DR. MUZAMMIL MOIN AHMED
Assistant Professor
Division of Periodontics
Department of Preventive Dental Sciences
Buraydah College of Pharmacy and Dentistry
Buraidah, KSA.

2. COMPETENCY
• It is “the behavior expected of the beginning practitioner”.
• A “competency” is a complex behavior or ability essential for the
general dentist to begin independent, unsupervised dental practice.
(American Dental Education Association - ADEA)

3. COMPETENCE VS COMPETENCY
• Competence is the ability to do a task to a predetermined standard.
• Competency is the series of abilities that together make up a competent
person.
(BDJ 2001; 190(7):343-46)

4. STAGES OF COMPETENCE

5. NOVICE
• Mimicking of instructors in the simulation laboratory or diagnostic clinic.
BEGINNER
• With further instruction and practice, students gain some control of parts of a
competency
• become able to demonstrate in ideal, simulated situations when asked to do so.
COMPETENT
• Now able to understand the basis for their decisions
• Possess appropriate professional values
• Ability to provide the dental needs of most patients.
(BDJ 2000; 189(6):324-26)

6. DOMAINS OF COMPETENCY

7. ADEA has identified Six “Domains in the general practice of dentistry
1. Patient Care :
Includes assessment, diagnosis, treatment planing, establishment and
maintenance of oral health.
2. Communication and interpersonal skills:
Skills to interact with patients and their families and supporting staff.
3. Professionalism:
Appropriate ethical and legal standards in providing patient centered care.

8. 4. Practice management:
Demonstrating practice management skills and quality assurance principles.
5. Information management and critical thinking:
Integration of scientific research with clinical expertise and patient values for
optimum evidence-based care.
6. Health promotion:
Appropriate means of prevention, intervention, and educational strategies for all
patients at risk of disease.

9. COMPETENCIES IN DENTISTRY

10. CORE COMPETENCIES
OPERATIONAL NON-OPERATIONAL
Positioning of the patient and infection control Patient – dentist discourse
Local anesthesia Handling of medically compromised patients
Cavity filling Patient Care, oral education & post-operative
explanations.
Root canal therapy Communication skills
Scaling and root planing Treatment planning
Simple extractions and suturing Ethics
Fabrication of fixed and removable prosthesis Informing patient of diagnosis & how to avoid
medical conflicts.
Radiographic technique Dealing with difficulties immediately
(J Dent Sciences 2015; 10:161-66)

11. (J Dent Edu 2008; 72(12):1405-35)

12. COMPETENCIES
INDEPENDENT NON-INDEPENDENT
Professionalism Periodontal surgical procedures
Health promotion and maintenance Placement of endosseous implants
Basic treatment procedures Treatment for complex orofacial trauma and
advanced intraoral infections
Communication skills Complex restorative and prosthetic therapies

13. ESSENTIAL SKILLS FOR DENTAL GENERAL
PRACTITIONER
GENERAL SKILLS
1 History taking and examination
2 Ethics and law, consent and professionalism
3 Communication skills
4 Health and safety
5 Infection control
6 Dental public health measures
7 Medical emergencies including therapeutics
8 Pharmacological management of pain and anxiety
9 Behavior management of anxious adult and child patient
10 Dental radiology
11 Prevention and interception
12 Patient referral
13 Isolation and moisture control
14 Impression making

14. DISCIPLINE SPECIFIC SKILLS
1 Dental material science
2 Pediatric dentistry
3 Orthodontics
4 Operative Dentistry
5 Periodontology
6 Endodontics
7 Prosthodontics – Removable & fixed
8 Oral surgery
9 Oral Medicine
10 Oral Pathology
INTERGRATED SKILLS
1 Integrated dental care

15. EVALUATION OF COMPETENCE

16. WHY DO WE HAVE TO ASSESS?
• Increase self-awareness by encouraging self-evaluation and learning
• Encourage achievement of competent core skills.
• Identify and help individuals who are not achieving or progressing
satisfactorily at an early stage.
(BDJ 2001; 190(7):343-46)

17. HOW DO WE ASSESS COMPETENCE ?
• Knowledge
• Skills
• Attitude (interaction with patients and relatives, ethics, reliability,
professional development, teamwork, image or appearance.)
(General Dental Council, UK)

18. ELEMENTS OF EVALUATION
Intellectual competence
physical-technical competence
Interpersonal competence
(BDJ 2000; 189(6):324-26)

19. EVALUATION OF COMPETENCE
CONVENTIONAL METHODS CURRENT METHODS
 Paper Based
Essays, Short Notes, MCQs
 Viva Voce (Oral Examination)
 Clinical, Practical, Patient Diagnosis
Treatment Outcome
 Online Discussions, Group Seminars,
Reflective Portfolios, Academic Feedback.
 OSCE’s and Patient case managed
 Peer assessment, Self-reflection and Patient
Feedback.
 Clinical Chair Side Assessment facilitated
by patient management clinical software
 Learning Management Systems (LMS)
(Int J Dent Clin 2011; 3(2):33-39)

20. (J Dent. Edu. 2008; 72(12):1405-35)

21. (J Dent. Edu. 2008; 72(12):1405-35)

22. (J Dent. Edu. 2008; 72(12):1405-35)

23. • It is the point where responsibility for learning is transferred from
teachers to learners.
• Once basic competency has been achieved, the dental graduate must
take the continuum to higher levels of competency, through continuing
education and postgraduate dental programs.
COMPETENCY CONTINUUM
(BDJ 2000; 189(6):324-26)

24. Evaluated both subjectively and objectively in all clinical areas by:
Non-graded clinical evaluation of chairside
performance
Progress examinations
Comprehensive care program group leader
conferences
Competency examinations
Progress summary reports Professional performance
A “relative value point” system, Program requirements
EVALUATION OF GRADUATING DENTAL
STUDENT
(J Den Edu 2006; 70(5):500-10)

25. • Student performance and deficiencies are noted and summarized daily.
• Provides on-demand feedback and tracking of student which can be
used for continuous quality improvement.
Non-graded clinical evaluation of chairside
performance

26. • Students are divided into groups and assigned to a faculty member who
serves as their group leader.
• That faculty becomes the student’s mentor, advocate, cheerleader,
disciplinarian, and remedial resource director.
• Regular meetings are held monthly (and as otherwise needed) between group
leaders and each student to review performance and other issues that arise.
Comprehensive Care Program (CCP) Group
Leader Conferences

27. • Group leaders receive weekly summaries of the assessment sheets and arrange
conferences/meetings as needed with each student.
• At least once a month a general conference is completed and recorded.
• Student conference results are then summarized in progress reports and
students receive a copy of their progress reports.
• Students failing to meet the standards are remediated by their group leader and
additional patients and/or laboratory exercises may be assigned.
Progress Reports

28. • Students are accountable for all clinic hours.
• Students are required to maintain a minimum “overhead factor” of
particular points per available hour of clinic time.
• Every procedure or activity is assigned a relative value that students “earn”
by participation.
• Relative value point (RVP) deductions may be incurred for errors, time
management faults, and other minor infractions.
A “relative value point” system

29. • These periodic laboratory and clinical examinations comprise particular
percent of the final grade and cover all the specialties.
Competency Examinations
• Structured competency exam is administered cover all the specialties
within the allotted time and without faculty assistance.
Progress Examinations

30. • The requirements for certification for graduation are competency confirmation
from all departments and
1) Completed treatment of all assigned patients as verified by group leaders
2) Minimum production of particular value points per hour of available clinic time.
3) Successful participation in all remedial, progress, and competency examinations.
4) Satisfactory percent of attendance in available clinic hours.
Program Requirements

31. THANK YOU