Preventive Oral Health
Conditions
Keywords
educational research,, instructional methods,, Hands on training,, Web based training,, pediatric residents, preventive oral health,, dental caries,, Instructional strategies in Preventive Oral health, Web-based training on Preventive Oral Health, Hands on Training on Preventive Oral Health
Brief summary
The purpose of this study was to compare the effect of the addition of hands on training by a pediatric dentist on the pediatric residents skills, confidence, opinions and practice related to preventive oral health.
Detailed description
Objectives: To compare the addition of Hands on Training (HOT) to Web Based Training (WBT)on residents' skills, confidence, opinions and practice . Methods: Pediatric residents participated in WBT on preventive oral health. Then the WBT subjects were randomly assigned to receive HOT by a dentist, or WBT alone. All subjects were assessed on skills in the performance of an oral exam, by direct observation. Residents' confidence regarding oral health counseling, and their opinions about the importance of the incorporation of oral health into the well child visit, was measured by surveys utilizing a Likert scale. Residents' change in practice was assessed by a retrospective chart audit.
Interventions
OTHERHands on training
Hands on training by a pediatric dentist on preventive oral health
OTHERWeb based training
Web based training alone
Sponsors
Children's Mercy Hospital Kansas City
Study design
Allocation
RANDOMIZED
Intervention model
PARALLEL
Masking
SINGLE (Subject)
Eligibility
Sex/Gender
ALL
Age
22 Years to 50 Years
Healthy volunteers
Yes
Inclusion criteria
Pediatric Residents in the Continuity Care Clinics at Children's Mercy Hospital during the months of January and February 2007
Exclusion criteria
1. Residents on leave of absence 2. Residents who have their Continuity Care Clinics off site 3. Residents refusing consent for inclusion of results in study
Design outcomes
Primary
| Measure | Time frame | Description |
|---|---|---|
| Mean Percentage of Correct Skills | 3 months after Hands-on Training (HOT) | Skills were observed by pediatric dentists for each resident utilizing a six item checklist 3 months after the intervention (HOT) was completed.Each correct skill demonstrated was scored as 1 (16.67%) with a maximum of 6 representing 100%.The mean pecentage of correct skills were measured by direct observation by a pediatric dentist among the WBT alone and WBT+HOT groups |
| Percent Change From Baseline in Confidence at 4 Months | Baseline and 4 months | Confidence was measured by self-administered surveys regarding knowledge and practice of oral health. The surveys used a 4 point Likert scale (1=not confident, 4=very confident).The mean percent of change in the responses of very confident was compared between both groups. The percentage change equals {(mean score at 4 months-mean score at baseline)/ mean score at baseline} \*100% |
| Percent Change From Baseline in Opinions Regarding Incorporating Oral Health Into a Well Child Visit at 4 Months | Baseline and 4 months | Opinions regarding incorporating oral health into a well child visit was measured by self administered surveys. The surveys used a 4 point Likert scale from 1 for (strongly disagree) to 4 for (strongly agree). Mean percentage change in the agree and strongly agree responses by the residents was compared between both groups. The percentage change equals {(mean score at 4 months-mean score at baseline)/ mean score at baseline} \*100% |
| Percent Change From Baseline in Practice of Oral Health Based on Pre and Post Study Chart Audit at 6 Months | At baseline and 6 months | The mean percent change in the documentation of oral health components at a well child visit. This was done by an audit of a random selection of 5 charts of patients who came in for well child visits, completed by each resident at baseline and at 6 months later.We scored this utilizing a 4 item checklist each correct item was scored as 1 (25%), with a maximum of 4(100%). The percentage change used the following formula {(mean score at 6 months-mean score at baseline)/mean score at baseline}\*100% |
Countries
United States
Participant flow
Recruitment details
All Pediatric residents, in the Continuity Clinic Rotation (CCC) at a general pediatric ambulatory clinic, in an urban tertiary care children's hospital, were invited to participate. Residents in any year of training were considered eligible for the study, recruitment took place in January, 2007
Pre-assignment details
59 participants were evaluated for the pre-test knowledge, they were next administered the Web Based Training and were then evaluated for the post-test knowledge. 56 participants were then randomized into two groups, 3 were excluded, (2 refused consent and 1 deviated from the protocol).
Participants by arm
| Arm | Count |
|---|---|
| WBT Only Control Group Web Based Training only | 27 |
| WBT+HOT Web Based Training plus Hands on Training | 29 |
| Total | 56 |
Baseline characteristics
| Characteristic | WBT Only | WBT+HOT | Total |
|---|---|---|---|
| Age, Categorical <=18 years | 0 Participants | 0 Participants | 0 Participants |
| Age, Categorical >=65 years | 0 Participants | 0 Participants | 0 Participants |
| Age, Categorical Between 18 and 65 years | 27 Participants | 29 Participants | 56 Participants |
| Level of Training First year Residents | 12 participants | 11 participants | 23 participants |
| Level of Training Second and Third year Residents | 15 participants | 18 participants | 33 participants |
| Sex: Female, Male Female | 19 Participants | 23 Participants | 42 Participants |
| Sex: Female, Male Male | 8 Participants | 6 Participants | 14 Participants |
Adverse events
| Event type | EG000 affected / at risk | EG001 affected / at risk |
|---|---|---|
| deaths Total, all-cause mortality | — / — | — / — |
| other Total, other adverse events | 0 / 0 | 0 / 0 |
| serious Total, serious adverse events | 0 / 0 | 0 / 0 |
Outcome results
Primary
Mean Percentage of Correct Skills
Skills were observed by pediatric dentists for each resident utilizing a six item checklist 3 months after the intervention (HOT) was completed.Each correct skill demonstrated was scored as 1 (16.67%) with a maximum of 6 representing 100%.The mean pecentage of correct skills were measured by direct observation by a pediatric dentist among the WBT alone and WBT+HOT groups
Time frame: 3 months after Hands-on Training (HOT)
| Arm | Measure | Value (MEAN) | Dispersion |
|---|---|---|---|
| WBT Only | Mean Percentage of Correct Skills | 73 Percentage of correct skills | Standard Deviation 27 |
| WBT+HOT | Mean Percentage of Correct Skills | 87 Percentage of correct skills | Standard Deviation 21 |
Primary
Percent Change From Baseline in Confidence at 4 Months
Confidence was measured by self-administered surveys regarding knowledge and practice of oral health. The surveys used a 4 point Likert scale (1=not confident, 4=very confident).The mean percent of change in the responses of very confident was compared between both groups. The percentage change equals {(mean score at 4 months-mean score at baseline)/ mean score at baseline} \*100%
Time frame: Baseline and 4 months
Population: Only completed paired (pre/post intervention) surveys were analyzed
| Arm | Measure | Value (MEAN) | Dispersion |
|---|---|---|---|
| WBT Only | Percent Change From Baseline in Confidence at 4 Months | 14 Percent change. | Standard Deviation 0.33 |
| WBT+HOT | Percent Change From Baseline in Confidence at 4 Months | 19 Percent change. | Standard Deviation 0.38 |
Primary
Percent Change From Baseline in Opinions Regarding Incorporating Oral Health Into a Well Child Visit at 4 Months
Opinions regarding incorporating oral health into a well child visit was measured by self administered surveys. The surveys used a 4 point Likert scale from 1 for (strongly disagree) to 4 for (strongly agree). Mean percentage change in the agree and strongly agree responses by the residents was compared between both groups. The percentage change equals {(mean score at 4 months-mean score at baseline)/ mean score at baseline} \*100%
Time frame: Baseline and 4 months
| Arm | Measure | Value (MEAN) | Dispersion |
|---|---|---|---|
| WBT Only | Percent Change From Baseline in Opinions Regarding Incorporating Oral Health Into a Well Child Visit at 4 Months | -11 Percent change | Standard Deviation 0.33 |
| WBT+HOT | Percent Change From Baseline in Opinions Regarding Incorporating Oral Health Into a Well Child Visit at 4 Months | -33 Percent change | Standard Deviation 0.42 |
Primary
Percent Change From Baseline in Practice of Oral Health Based on Pre and Post Study Chart Audit at 6 Months
The mean percent change in the documentation of oral health components at a well child visit. This was done by an audit of a random selection of 5 charts of patients who came in for well child visits, completed by each resident at baseline and at 6 months later.We scored this utilizing a 4 item checklist each correct item was scored as 1 (25%), with a maximum of 4(100%). The percentage change used the following formula {(mean score at 6 months-mean score at baseline)/mean score at baseline}\*100%
Time frame: At baseline and 6 months
Population: Analysis per protocol. Subjects dropped from analysis because charts not available within the time frame of the study and incomplete data.
| Arm | Measure | Value (MEAN) | Dispersion |
|---|---|---|---|
| WBT Only | Percent Change From Baseline in Practice of Oral Health Based on Pre and Post Study Chart Audit at 6 Months | 26.32 Percent change | Standard Deviation 13.25 |
| WBT+HOT | Percent Change From Baseline in Practice of Oral Health Based on Pre and Post Study Chart Audit at 6 Months | 36.67 Percent change | Standard Deviation 22.42 |