Assessment in postgraduate dental education: an evaluation of strengths and weaknesses

An audit to assess the outcome of a 1-day acupuncture course for dentists

OBJECTIVE

The principal author has, during the last 4 years, given 45 1-day courses in acupuncture involving 450 dentists arranged under the umbrella of continuous post-graduate dental education. There is a paucity of evidence in the published dental literature regarding the outcomes after such courses, and the objective of this work was to analyse the outcome after a 1-day acupuncture course.

MATERIALS AND METHODS

In co-operation with the individual post-graduate centres, a questionnaire was posted to all participants to ascertain whether; (a) the dentist has taken up acupuncture; (b) how often acupuncture was used; (c) any reasons for not incorporating acupuncture into the daily practice. To further evaluate the quality of the course, the following questions were addressed; (d) overall rating of the course; (e) the relevance of the course, assessed on a scale from 1 to 6 (1, highly unfavourable; 6, very high favourable).

MAIN OUTCOME

A total of 209 (51.6%) questionnaires were returned, although 15 (3.7%) were subsequently excluded. The male:female ratio of respondents was 3:2, with an average age of 42 and 19 years of experience in dental practice. As many as 46% of respondents had incorporated acupuncture into their practice and 19% reported using acupuncture several times a month. The conditions treated were control of the gag reflex, stress management, sinusitis, headache and facial pain. The main reasons for not taking up acupuncture was 'the dentist never actually got round to starting' (83%) and lack of appropriate patients (60%). Regarding the evaluation of the course, the assessment forms were obtained from 47% of the participants. Participants from all centres rated the course in the top end, 5.3 of 6.0 possible.

Assessment in dental vocational training: where are we now?

In this paper the author gives his opinion on the existing arrangements for assessment of vocational dental practitioners (VDPs) (outside Scotland), during dental vocational training. He critically evaluates the arrangements in relation to the aims and objectives for dental vocational training. Potential improvements to the existing system are then proposed and new assessment techniques suggested that may help to provide a more robust and relevant educational assessment strategy for dental vocational training in the future.

Implementation of a formal in-training assessment programme in anaesthesiology and preliminary results of acceptability

BACKGROUND

A new reform on postgraduate education in Denmark requires a formal in-training assessment in all specialties. The aim of this study was to survey the implementation and acceptability of the first example of a nation-wide in-training assessment programme for first-year trainees in anaesthesiology developed by a working group under the Danish Society of Anaesthesiology and Intensive Care Medicine.

METHODS

A questionnaire about the implementation of the programme in practice and the characteristics of the trainees was sent to the educational responsible consultant (ERC) in each of the 26 anaesthetic departments in the country with first-year trainees in anaesthesiology. Standard evaluations of the assessment programme were regularly collected from trainees.

RESULTS

Twenty-five (96%) departments returned the questionnaire. In total the departments reported on 100 trainees and 83 of these had been enrolled in the programme. Thirteen departments reported in total on 27 trainees who had completed their first year of training and these departments had applied a median 21 (range 17-21) of the 21 tests included in the entire programme. Time constraints and resistance among senior clinicians were the most frequently cited barriers to implementation. Evaluations from trainees showed a generally positive attitude towards most of the programme. They especially praised the programme's effect on structuring training and having a positive effect on learning.

CONCLUSION

The in-training assessment programme has been widely implemented across the country. The majority of the programme was acceptable to trainees and had a positive effect on structuring training and on fostering learning.

Recommendations for improving the assessment of postgraduate dental education

This paper makes recommendations for the improvement of assessment in postgraduate dental education. The recommendations are based on a twelve-month study conducted in 1998/99 which evaluated the strengths and weaknesses of the existing assessment systems. Evidence was taken from examination syllabi, assessments and records. Semi-structured interviews were conducted with representatives from national bodies and with trainers and trainees in the West Midlands. Strengths in parts of the system include: commitment and professional experience; commissioned work; opportunity to share experience; a monitoring framework; procedures for maintaining standards and examples of broadbased assessments. Weaknesses include: lack of assessment of quality; existence of some forms of unregulated assessment; lack of transparency and lack of clarity between training and assessment. Development is recommended in three broad areas: a competence-based model of assessment; distinguishing assessment from the analysis of educational needs and quality assurance. The introduction of a competence-based model is the most significant and is addressed in some detail. Specific proposals for consideration by national regulatory bodies and education providers include: strengthening the management of assessment; national leadership in the development of a competence model of assessment; widening the assessment base; clearer criteria for inspection; revisions to how vocational training, HO/SHO training and general professional training are assessed and training for trainers.