Quality assurance, benchmarking, assessment and mutual international recognition of qualifications

Developing a community of practice for quality assurance within healthcare assessment

BACKGROUND

The Australian Collaboration for Clinical Assessment in Medicine (ACCLAiM) is a voluntary assessment consortium, involving medical schools nationwide. The aims of ACCLAiM are to benchmark student clinical assessment outcomes and to provide quality assurance (QA) of exit-level Objective Structured Clinical Exams (OSCEs). This study aimed to evaluate the impact of the ACCLAiM QA process for optimising OSCE delivery standards at the member schools using a Community of Practice (CoP) framework.

METHODS

A mixed methods sequential explanatory design, involving an online questionnaire and subsequent focus group discussions, was utilised. Questionnaire responses were analysed using descriptive statistics, while thematic analysis was employed for the qualitative data.

RESULTS

Data analysis revealed that school-specific OSCE practices had evolved based on QA feedback, as well as a collaborative sharing of expertise consistent with a CoP model. Extending beyond a QA working group for accountability and demonstration of minimum standards, participation in ACCLAiM QA processes is creating a sustainable socio-academic network focused on quality improvement.

CONCLUSION

Collaborative QA in clinical assessment creates opportunities for optimising standards in OSCE processes and sharing of resources for OSCE assessments. It also allows for professional development and scholarly engagement in assessment research. These benefits contribute to the existence of an emergent CoP model.

Dental students' peer assessment: a prospective pilot study

INTRODUCTION

Peer assessment is increasingly used in health education. The aims of this study were to evaluate the reliability, accuracy, educational impact and student's perceptions of undergraduate pre-clinical and clinical dental students' structured and prospective Peer assessment and peer feedback protocol.

MATERIALS AND METHODS

Two Direct Observation of Procedural Skills (DOPS) forms were modified for use in pre-clinical and clinical peer assessment. Ten year two dental students working in a phantom-heads skills laboratory and 16-year five dental students attending a comprehensive care clinic piloted both peer DOPS forms. After training, pairs of students observed, assessed and provided immediate feedback to each other using their respective peer DOPS forms as frameworks. At the end of the 3-month study period, students anonymously provided their perceptions of the protocol.

RESULTS

Year 2 and year 5 students completed 57 and 104 peer DOPS forms, respectively. The generalizability coefficient was 0.62 for year 2 (six encounters) and 0.67 for year 5 (seven encounters). Both groups were able to differentiate amongst peer-assessed domains and so detect improvement in peers' performance over time. Peer DOPS scores of both groups showed a positive correlation with their mean end-of-year examination marks (r ≥ 0.505, P ≥ 0.051) although this was not statistically significant. There was no difference (P ≥ 0.094) between the end-of-year examination marks of the participating students and the rest of their respective classes. The vast majority of both groups expressed positive perceptions of the piloted protocol.

DISCUSSION

There are no data in the literature on the prospective use of peer assessment in the dental undergraduate setting. In the current study, both pre-clinical and clinical students demonstrated the ability to identify those domains where peers performed better, as well as those which needed improvement. Despite no observable educational impact, most students reported positive perceptions of the peer DOPS protocol.

CONCLUSIONS

The results of this pilot study support the need for and the potential benefit of a larger- and longer-term follow-up study utilising the protocol.

Restructuring an undergraduate dental curriculum to global standards--a case study in an Indian dental school

Globalisation has affected all aspects of life and dentistry is no exception. In the context of today's dentist being a global citizen, undergraduate training in dentistry is set to ensure converging standards so that international recognition of dental qualifications can move forward. The decision of the Dental Council of India to expand the undergraduate dental program to five years provides an opportunity to be part of the endeavor of the Global Dental Congress to achieve converging standards which was initially for the European Union, and now spreading out globally. Economic emergence in Indian subcontinent has resulted in growing oral health care needs both in quality and quantity. To address this issue, the graduating dentist needs to be trained following a competency based curricular model. Access to Internet facilitated the goal of achieving converging standards of dental schools to be feasible because of the instant communication and capacity to share information about training strategies via technology across the globe. Upgrading the undergraduate training to global standards by dental schools in India could be a wise and strategic move both for attracting students to study in India, as well as retaining the graduates after their training. The following is a case study of an Indian dental school set to restructure the undergraduate curriculum to global standards using the 8 steps of Kotter's transformational change. Change in curriculum and the subsequent accreditation of the school in global platform not only attracts prospective students but also results in producing competent dentists. Dental education provided by the institution can result in quality assurance, benchmarking the assessment system to achieve international recognition. This paper highlights the need and importance of facilitation of international convergence with long term aspirations for mutual recognition of international degrees.

The structure of observed learning outcome (SOLO) taxonomy: a model to promote dental students' learning

Selective memorising of isolated facts or reproducing what is thought to be required - the surface approach to learning - is not the desired outcome for a dental student or a dentist in practice. The preferred outcome is a deep approach as defined by an intention to seek understanding, develop expertise and relate information and knowledge into a coherent whole. The aim of this study was to investigate whether the structure of observed learning outcome (SOLO) taxonomy could be used as a model to assist and promote the dental students to develop a deep approach to learning assessed as learning outcomes in a summative assessment. Thirty-two students, participating in course eight in 2007 at the Faculty of Odontology at Malmö University, were introduced to the SOLO taxonomy and constituted the test group. The control group consisted of 35 students participating in course eight in 2006. The effect of the introduction was measured by evaluating responses to a question in the summative assessment by using the SOLO taxonomy. The evaluators consisted of two teachers who performed the assessment of learning outcomes independently and separately on the coded material. The SOLO taxonomy as a model for learning was found to improve the quality of learning. Compared to the control group significantly more strings and structured relations between these strings were present in the test group after the SOLO taxonomy had been introduced (P < 0.01, one tailed test for both results). The SOLO taxonomy is recommended as a model for promoting and developing a deeper approach to learning in dentistry.

Innovative educational methods and technologies applicable to continuing professional development in periodontology

Continuous professional development (CPD) in Periodontology refers to the overall framework of opportunities that facilitate a life-long learning practice, driven by the learner-practitioner and supported by a variety of institutions and individuals. CPD must address different needs for a great diversity of practitioners. It is clear that no particular methodology or technology is able to successfully accommodate the entire spectrum of CPD in Periodontology. Course designers must choose from and combine a wide array of methodologies and technologies, depending upon the needs of the learners and the objectives of the intended education. Research suggests that 'interactivity', 'flexibility', 'continuity' and 'relevance to learners' practice' are major characteristics of successful CPD. Various methods of mentoring, peer-learning environments and work-based learning have been combined with reflective practice and self-study to form the methodological backbone of CPD courses. Blended learning encompasses a wide array of technologies and methodologies and has been successfully used in CPD courses. Internet-based content learning management systems, portable Internet devices, powerful databases and search engines, together with initiatives such as 'open access' and 'open courseware' provide an array of effective instructional and communication tools. Assessment remains a key issue in CPD, providing learners with valuable feedback and it ensures the credibility and effectiveness of the learning process. Assessment is a multi-level process using different methods for different learning outcomes, as directed by current evidence and best practices. Finally, quality assurance of the education provided must follow CPD courses at all times through a structured and credible process.

Career choice and attitudes towards dental education amongst dental students in Japan and Sweden

The purpose of this study was to identify and compare the perspectives of dental students towards their career choice and dental education in Japan and Sweden. One hundred and fourteen dental students from the Nippon Dental University, Japan and 43 dental students from the Karolinska Institutet, Sweden participated in this study. Information was derived from a self-answered questionnaire consisting of five items for career choice and six items for dental education. Chi-square test and Wilcoxon signed-rank test were used for comparison. Significant differences were detected for 10 questionnaire items between the two countries. Regarding motivation towards the career choice, 44% of Swedish students indicated interpersonal motives related to helping other people, whereas 32% of Japanese students indicated expectations of their family in the dental profession. As future career options, 64% of Japanese and 47% of Swedish students planned to work as general dentists. More Swedish students (37%) preferred specialisation than Japanese students (17%). Nearly three-quarters of the Swedish students were satisfied with the teaching faculty of their school, whilst only 32% of the Japanese students indicated content. The perspectives of dental students were different in Japan and Sweden. This study provides a description of the perspectives of Japanese and Swedish dental students and enables better understanding of career decision and dental curriculum issues.

Assessment of knowledge and competencies related to implant dentistry in undergraduate and postgraduate university education

Learning in academic settings is strongly related to the way the students are tested or examined. Assessment therefore must be integrated in the curriculum design, coordinated and should reflect the learning outcomes of the education. Assessment within the field of implant dentistry must fulfil four major objectives: complete and direct the learning process with feedback (formative), ensure that students are adequately prepared (summative), assess attitudes and skills such as critical thinking, reflection and self-assessment ability, and supply continuous feedback to teachers on curricular content and impact. Different assessment methods should be used to assess different levels of competencies throughout the curriculum. Various forms of written or oral assessment methodologies are applicable at earlier stages in the curriculum. At intermediate levels, interactive assessment methods, such as patient simulations (paper based or virtual) and more could encourage the necessary synthesis of several disciplines and aspects of the theoretical knowledge. At higher levels of competence, documentation of clinical proficiency by means of reflective portfolios and diaries is an appropriate assessment method with both formative and summative potential. The highest level of competence requires performance assessment using structured, objective, clinical criteria. The group strongly encourages the use of reflective forms of assessment methods which engage the students in a process of self-appraisal, identification of individual learning needs and self-directed learning. The ultimate goal of this would be to allow the student to develop a lifelong learning attitude.