In the current post-graduate dental clinical training program, various clinical competency evaluation methods have been reported based on a nationwide dental university survey, in an attempt to advance and improve the evaluation methods. However, the point has not yet been reached for establishing clear evaluation standards and task items for a clinical competency evaluation for the overall evaluation at the end of training. Moreover, in post-graduate dental clinical training, multiple training programs are established. Because the same examination is conducted among trainees completing different programs, the evaluation method must be appropriate and standardized, taking into account differences in training content. However, no reports exist regarding an investigation of the evaluation. In the present study, we evaluated the post-graduate dental clinical competency examination as a pilot study with the objective of establishing a clinical competency evaluation for professionalism in dental education. An examination was conducted among clinical dental trainees at the end of their clinical training, based on their programs. The evaluation items included skill examinations as clinical training competency achievement confirmation testing. As a control, an evaluation on knowledge was included among the analysis items. The mean evaluation results for the skill examinations by program indicated no significant differences between programs. In the knowledge examination, the mean evaluation results in one program(clinical training in combined- and cooperative-type facilities)was significantly higher compared with the other programs(p＜0.01). Differences in difficulty level were observed in the evaluation items according to program(p＜0.05, ＜0.01). These results suggest that no significant differences between training programs were found in the scores, although there was a significant between programs in the knowledge evaluation. Therefore, it is considered necessary to establish an appropriate and standardized post-graduate dental clinical competency evaluation by reviewing the method of comparison between programs and by further reducing the differences in difficulty between tasks.
For trainee dentists to focus on clinical training under mentally and physically stable conditions and improve the quality of their work, it is extremely important to provide mental health support and improve the environment by treating trainee dentists as workers. However, very few studies exist regarding occupational stress among trainee dentists. The present study investigated and analyzed occupational stress with the objective of assessing mental health conditions to consider environmental improvements for enhancing mental health among trainee dentists in post-graduate dental education. The questionnaire was administered to dental trainees. It covered potential stress factors;mental and physical reactions to stress and other factors affecting stress responses; stressrelieving factors; and task satisfaction levels. The risk scores in males and females that were obtained using a diagram for the determination of occupational stress(100 for a standard risk)were 111 and 113 for amountcontrol risk, 85 and 74 for risk with support from work fellows, and 94 and 83 for combined health risk, respectively. A significant correlation was found only between the scores for stress responses and stress-relieving factors(p＜0.05). The scores of subjects at high risk for stress responses and stress-relieving factors were significantly different(p＜0.01)from those from subjects at low risk of stress responses and stress-relieving factors. The degrees of stress in the satisfactory task group and the unsatisfactory task group for stress responses (p＜0.001), and for stress-relieving factors (p＜0.01), respectively, showed significant differences. These results suggest that the low combined health risk obtained in trainee dentists indicates that stress possibly from quantitative burdens and insufficient control of tasks is lessened by support from persons the trainees work with, including bosses and colleagues. A correlation was also found between stress responses to tasks and stress-relieving factors as well as an association between degree of task satisfaction and degree of stress. Concrete measures are needed to reduce health risks from quantitative burden and insufficient control of tasks.
Currently, there is a strong need to establish a clinical competency evaluation along with associated criteria, taking into consideration the international trend of quality assurance in higher education promoted in Europe, the United States, and Japan. This is based on the global standards proposed by the World Federation for Medical Education. Cross-sectional studies for each period have been reported regarding education at the pre-graduate clinical practical training and post-graduate clinical training levels. However, no studies on a clinical competency examination as an overall evaluation at the end of pre-graduate clinical practical training and at the end of post–graduate clinical training, or sequential evaluations on pre- and post-graduate dental education have ever been conducted. We report the results of a pilot study on the correlations within the post-graduate clinical competency evaluation as well as the results of comparative examinations between pre-graduate objective structured clinical achievement tests. The objective of this pilot study was to establish an appropriate clinical competency evaluation for professionalism in dental education. An examination was administered to dental trainees at the end of their clinical training. Analysis of the individual evaluation scores indicated a significant correlation with the post-graduate psychomotor domain. The correlation between the total score for postgraduate assignments and the post-graduate prosthetic dentistry score was high. The correlation between the individual evaluation scores for pre- and post-graduate assessment indicated no significant correlation. The present study found no correlation between the evaluations for the same item in the same subject over time before and after graduation,whereas a correlation was observed with the evaluation of the items in the psychomotor domain after postgraduate clinical training. The specific item may represent the entire assessment.
Faculty members of each university are responsible for preparing and implementing shared testing. While the questions for computer-based testing(CBT)are publicly gathered and prepared by each university every year, the effort to prepare questions for CBT is said to be meaningful not only in improving the question preparation skill of the faculty members but also in improving educational awareness and strengthening collaborations among different fields. In the present study, we evaluated the effects on educational activities and the awareness of the faculty members responsible for question preparation.A survey was conducted among faculty subjects who were responsible for CBT question preparation. The rates of positive responses received regarding question preparation for CBT were high, and no significant rate difference was observed between the items. The scores in the basic department group and the clinical department group regarding the level of understanding of the dental education model core curriculum, the level of understanding of the importance of education, and the effect on improving the awareness of education were each significantly higher in the basic department group than in the clinical department group (p＜0.05). Among the overall positive responses, there were no significant differences between the basic department group and the clinical department group, while the negative responses (items needing study and improvement) were significantly different(p＜0.05)between the two groups.These results suggest that the preparation of questions for CBT contributes to increased effects on and consciousness of educational activities, and the effects were particularly high in the basic department group. In addition, in the clinical departments, there was a high rate of items needing study and improvement, as clinical department faculty members have clinical practice as well as education and research to manage, which requires considerable effort and hinders the pursuit of other tasks. The study results also indicated that our facultyʼs system for the preparation of questions needs to be not only maintained but also further improved to increase the understanding and consciousness of education and to reduce the burden of education, as there were some items showing less educational effects, understanding, and change.