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ORIGINAL ARTICLE
Year : 2014  |  Volume : 12  |  Issue : 2  |  Page : 106-112

Self-perceived competency among postgraduate students of public health dentistry in India: A cross-sectional survey


1 Department of Public Health Dentistry, KVG Dental College, Sullia, Mangalore, Karnataka, India
2 Department of Public Health Dentistry, NIMS, Jaipur, Rajasthan, India
3 Department of Public Health Dentistry, The Oxford Dental College, Bengaluru, India
4 Department of Public Health Dentistry, S J M Dental College and Hospital, Chitradurga, Karnataka, India
5 Department of Oral Pathology, M A Rangoonwala Dental College, Pune, Maharashtra, India

Date of Web Publication6-Sep-2014

Correspondence Address:
Sanjeev Khanagar
Department of Public Health Dentistry, KVG Dental College, Sullia, D. K, Mangalore, Karnataka
India
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Source of Support: None, Conflict of Interest: None


DOI: 10.4103/2319-5932.140272

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  Abstract 

Introduction: The professional profile of the public health dentist is made up of a number of competencies. Evaluation of the student's performance in relation to the specified competencies is an important task for purposes of student evaluation and for assessing the curriculum and making necessary revisions. Aim: The aim was to assess the level of self-perceived competency in dental public health among postgraduate (PG) students in India. Materials and Methods: A cross-sectional study was done among the PG students in the specialty of public health dentistry in India. Their competency was assessed by a questionnaire sent through E-mail. Students assessed their competence in these dental public health functions using a 3 point ordinal scale, 0 indicating "not at all competent," 1 as "competent," and 2 as "very competent." Chi-square has been used for categorical variables. Results: One-hundred and twenty-four PG students responded to the questionnaire. Comparison was made for gender and academic year. Males were significantly competent to comply infection control policies and procedures (P < 0.040*). Third year PG students were significantly competent to comply infection control policies and procedures (P < 0.017) and to adapt their dental practice to the existing laws and regulations (P < 0.45). Conclusion: In the present study, the PG students considered themselves more competent to elaborate the socioeconomic-cultural diagnosis of the community, to participate in epidemiological surveillance system and less competent to adopt ethical principles in all aspects of community oral health activities, to take up initiatives in advocacy issues for health policy and using media effectively.

Keywords: Competency-based dental curricula, dental public health, self-perceived competency


How to cite this article:
Khanagar S, Naganandini S, Rajanna V, Naik S, Rao R, Reddy S. Self-perceived competency among postgraduate students of public health dentistry in India: A cross-sectional survey. J Indian Assoc Public Health Dent 2014;12:106-12

How to cite this URL:
Khanagar S, Naganandini S, Rajanna V, Naik S, Rao R, Reddy S. Self-perceived competency among postgraduate students of public health dentistry in India: A cross-sectional survey. J Indian Assoc Public Health Dent [serial online] 2014 [cited 2024 Mar 29];12:106-12. Available from: https://journals.lww.com/aphd/pages/default.aspx/text.asp?2014/12/2/106/140272


  Introduction Top


Public health dentistry is professional educational program that transforms one's thinking from focusing on the individual patient to focus on the community. The program is designed to prepare health professionals who will, over time, improve the capacity of the health care system to address the health needs of minority and disadvantaged population. The specialty recognizes the role of behavioral and environmental factors as determinants of oral health. The goals of the specialty are to identify and measure the oral health problems and oral health care needs of the community; to identify means by which these needs can be best met within the constraints of resources; to provide and manage services to meet these needs; and to evaluate the extent to which these needs have been met. In this specialty, epidemiological principles are applied to describe and define dental public health problems, as well as to formulate and evaluate oral health programs and policies. This approach aims to achieve significant improvements in the oral health of communities as much as individuals. It also aims to advance the oral health of the population through the practice of evidence-based dentistry, and the effective and efficient management of oral health care services and resources. [1],[2]

The professional profile of the public health dentist is made up of a number of competencies.

The following is a list of the general competencies that an individual must achieve before completing the program.

  • Plan oral health programs for population
  • Select interventions and strategies for the prevention and control of oral diseases and promotion of oral health
  • Develop resources, implement, and manage oral health programs for population
  • Incorporate ethical standards in oral health programs and activities
  • Evaluate and monitor dental care delivery systems
  • Design and understand the use of surveillance systems to monitor oral health
  • Communicate and collaborate with groups and individuals on oral health issues
  • Advocate, implement, and evaluate public health policy, legislation, and regulations to protect and promote the public's oral health
  • Critique and synthesize scientific literature
  • Design and conduct population-based studies to answer oral and public health questions. [3]


Evaluation of the students' performance in relation to the specified competencies is an important task for purposes of student evaluation and for assessing the curriculum and making necessary revisions. In some cases, it is also useful for obtaining information required by accreditation standards. [4],[5],[6],[7]

A commonly used method for assessing competencies is surveying to determine their perceived level of proficiency in specific areas. There are numerous surveys conducted to assess self-perceived levels of competency, but these studies generally cover only the clinical competency side of professional practice, with no reference to dental public health competencies.

The purpose of this study was to assess self-perceived competency among postgraduate (PG) students of public health dentistry in India.

The objectives were to know the PGs ability to elaborate the socioeconomic-cultural diagnosis of the community, to participate in epidemiological surveillance system, ability in management of the prevention, promotion and treatment of all the oral conditions at the individual and community level, ability to conduct research and to contribute to the production and dissemination of scientific knowledge, ability to adopt ethical principles in all aspects of community oral health activities, to take up initiatives in advocacy issues for health policy, and using media effectively (public speaking, debating). [8]


  Materials and Methods Top


This is a descriptive study carried out among PG students of the Department of Public Health Dentistry in India. Their E-mail IDs were taken from the Indian Association of Public Health Dentistry (IAPHD) registration records.

Postgraduates students registered for the IAPHD were included in the study and those not willing to participate were excluded from the study. The study protocol was submitted to the Ethical committee of The Oxford Dental College, Hospital and Research Center, Bangalore, and the ethical clearance was obtained.

A self-administered web-based questionnaire was created. The final version of the questionnaire included 22-items; some of the questions were taken from a study which had similar objectives. [9]

The questions referred to age, gender, and academic year. The questionnaire covered all the objectives of the study. Before the start of the pilot study, its respective psychometric properties (validity and reliability) were assessed as follows: Content validity was assessed by a panel of eight experts made up of staff members from the Department of Public Health Dentistry, The Oxford Dental College, Hospital and Research Center, Bangalore. The purpose was to depict those items with a high degree of agreement among experts. Aiken's V was used to quantify the concordance between experts for each item; values higher than 0.94 were always obtained. [10] A panel of experts recommended to randomly sequence the questions, these modification were made before the pilot study.

Twelve PG students from the Department of Public Health Dentistry, The Oxford Dental College, Hospital and Research Center, Bangalore were enrolled for the pilot study. They completed the 22-item questionnaire. Students participating in the pilot study did not repeat the survey. Correlations between the items as well as between individual items and the overall score were estimated to assess the appropriateness of each of the items. None of the initially developed items was removed from the final questionnaire after analyzing the results of the pilot study. During the pilot study, the ease of the participants in responding to each item was also examined. Finally, the Cronbach's alpha coefficient was used to assess the internal consistency of the questionnaire through the split-half technique. The obtained value (0.817) was higher than the recommended standard, which is (0.80). [11]

The main study was scheduled over a period of 30 days. The data were collected from PG students through a questionnaire, which was sent to them through E-mail. In the questionnaire form, the respondents were informed about the aim of the study as well as the fact that participation in the questionnaire survey was totally voluntary and anonymous. The questionnaire was sent to 145 PG students registered for the IAPHD. A reminder phone call and mail were sent to the PG students.

Postgraduate students were asked to rate their self-perception of proficiency on each dental public health function using a three-point ordinal scale with 1 indicating "not at all competent," 2 indicating "competent," and 3 indicating "very competent." According to this scale, the maximum score is 66 points. This overall score was divided into three equal-length categories: From 22 to 37 indicating "not at all competent," from 38 to 52 indicating "competent," and from 53 to 66 indicating "very competent." According to the Likert-type scale method, these three categories were established to be able to identify which of the three respondents belong as a group. [12]

Descriptive statistical analysis has been carried out in the present study. The statistical software namely SPSS 15.0 Inc. Chicago, IL 60606-6412, Microsoft word, and excel have been used to generate the tables and graphs, Chi-square has been used on the categorical scale between two or more groups, a P ≤ 0.05 was considered to be statistically significant.


  Results Top


The questionnaire was sent to 145 PG students registered for the IAPHD, out of which 124 participated in the study. The response rate was 86%.

Distribution of the study population-based on the academic year

The study population was categorized based on the academic year. 19.4% of the participants were in 1 st year, 30.6% were in 2 nd year, and 50% were in 3 rd year of PG [Table 1].
Table 1: Distribution of the study population based on academic year and gender


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Distribution of the study population-based on their self-perceived competency with gender and academic year comparison

When comparison was made for gender, males were significantly competent to comply infection control policies and procedures (P < 0.040). When comparison was made for the academic year, 3 rd year PG students were significantly competent to comply infection control policies and procedures (P < 0.017) and to adapt the dental practice to the existing laws and regulations (P < 0.45) [Table 2] and [Table 3].
Table 2: Distribution of the study population based on their self-perceived competency and gender


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Table 3: Distribution of the study population based on their self-perceived competency and academic year


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The percentage of answers obtained for the 22 questions were arranged in ascending order, and the first five were considered as less competent areas and last five were considered as more competent areas.

Distribution of the study population-based on areas where they considered themselves as very competent

The top five areas in which participants thought they considered themselves more competent were their competency to design, implement, and evaluate community preventive interventions 105 (84.7%), competency to elaborate the socio-economic-cultural diagnosis of the community 101 (81.5%), competency to design, implement, and evaluate community restorative interventions 96 (77.4%), competency to promote health and oral health through creation of healthy settings 95 (76.6%), Competency to elaborate the oral health diagnosis of the community 94 (75.8%) [Table 4].
Table 4: Areas where the study population considered themselves as more competent


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Distribution of the study population-based on areas where they considered themselves as less competent

The top five areas in which participants thought they considered themselves less competent were their competency in carrying out biostatistical tests 57 (46%), competency to develop ways of helping the community toward easy payment plan 65 (52.4%), competency to promote health and oral health through health education 70 (56.5%), competency to take up initiatives in formulating policy and maintaining lobbying 70 (56.5%), Competency to apply ethical and moral standards while carrying out epidemiological researches 73 (58.9%) [Table 5].
Table 5: Areas where the study population considered themselves as less competent


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[Table 6] 12.5% participants from 1st year, 13.2% participants from 2nd year and 9.7% participants from 3rd year considered themselves not at all competent in carrying out most of the public health functions. 75.0% participants from 1st year, 78.9% participants from 2nd year and 79.1% participants from 3rd year considered themselves competent in in carrying out most of the public health functions and 12.5% participants from 1st year, 7.9% participants from 2nd year and 11.3% participants from 3rd year considered themselves very competent in carrying out most of the public health functions.


  Discussion Top


The present study was conducted to evaluate the level of self-perceived competency among PG students of Department of Public Health Dentistry in India.

In community-based dental education, students are not only placed in community settings to treat individual patients, but also challenged to consider dental public health issues, including the administrative aspects of dental services.

At the end of the 3 years course, the PGs should be competent to elaborate the socio-economic-cultural diagnosis of the community, to participate in epidemiological surveillance system, competent in management of the prevention, promotion, and treatment of all the oral conditions at the individual and community level, competent to conduct research and to contribute to the production and dissemination of scientific knowledge, competent to adopt ethical principles in all aspects of community oral Health activities, to take up initiatives in advocacy issues for health policy and using media effectively (public speaking, debating). [8]

There are no previous studies assessing self-perceptions of public health competency; however, some educators have advocated placing more attention on dental public health in the curriculum. Our study is, to our understanding, the first attempt for assessing the level of self-perceived competency in public health dentistry at the PG level.

Community-based dental education, as a component of competency-based dental education, is a type of experiential learning conducted in community settings. [13]

However, this component of the curriculum is not simply practicing clinical dentistry at the community setting; rather, through this experience, students enhance their appreciation and understanding of the larger social, economic, and cultural determinants of dental health care and how such determinants affect the access and delivery of dental care. [13],[14]

The objective of this competency-based curriculum is that the students become capable of recognizing the socio-economic-cultural conditions of the community, as a base to understand the causes and the nature of general and oral health problems, thus, surpassing the simple biomedical approach. [15],[16]

It is expected that the direct interaction with social reality, especially in low-income communities, helps the students to be aware of the socio-economic-cultural conditions in order to adopt a positive attitude and organizational and administrative changes to contribute to the solution of health problems in the community. [15],[16]

Our findings indicate that PGs perceived themselves more competent in performing some public health functions than others. The participants considered themselves more competent were their competency to design, implement, and evaluate community preventive interventions, competency to elaborate the socio-economic-cultural diagnosis of the community, competency to design, implement, and evaluate community restorative interventions, competency to promote health and oral health through creation of healthy settings, Competency to elaborate the oral health diagnosis of the community. These findings may be due to more exposure to community field programs and in comprehensive treatment planning.

The participants considered themselves less competent were their competency in carrying out biostatistical tests, competency to develop ways of helping the community toward easy payment plan, competency to promote health and oral health through health education, competency to take up initiatives in formulating policy and maintaining lobbying, competency to apply ethical and moral standards while carrying out epidemiological researches. These findings may be due to lack of practical application of the theoretical knowledge; it may also be due to the less exposure to community field programs.

When comparison was made for gender, males were significantly competent to comply infection control policies and procedures (P < 0.040). These findings may be due to more exposure to community field programs by the males, and more of exposure to patients outside the clinical settings (research work in the field settings).

When comparison was made for the academic year, 3 rd year PG students were significantly competent to comply infection control policies and procedures (P < 0.017) and to adapt the dental practice to the existing laws and regulations (P < 0.45). These findings may be due to increased theoretical knowledge of the PGs with more of academic exposure to the subject and duration.

These findings showed that there are dental public health functions in which PGs consider their training to be insufficient. This finding should be taken into consideration for the planning of curricular changes in dental education, as has been suggested by other authors. [3]

Although the use of self-administered questionnaires is the most widely reported method for collecting data about self-perceived dental competencies, the possibility of bias (e.g. respondents' overestimation of competencies) in the responses should be considered [Table 7].
Table 6: Distribution of the study population based on the level of competency


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Table 7: Questionnaire


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Nevertheless, some advantages of the use of questionnaires are their ease of administration and confidentiality. These advantages make data collection by questionnaire the first choice in comparison with other methods. [11],[17] However, a self-perceived competence is usually an overestimate. We tend to overestimate our competencies whereas an instructor/teacher would have given a better evaluation of the student competency.


  Conclusion Top


In the present study, the PG students considered themselves more competent to elaborate the socioeconomic-cultural diagnosis of the community, to participate in epidemiological surveillance system.

And considered less competent to adopt ethical principles in all aspects of community oral Health activities, to take up initiatives in advocacy issues for health policy, and using media effectively.

Recommendation

In the present study, PG course has been successful in making the students competent in community dentistry fields.

In order to improve these results, it is recommended to consider the PGs views in course planning and do the curriculum changes according to the felt needs of the PGs.

 
  References Top

1.Preamble to the competency statements for dental public health. J Public Health Dent 1998;58 Suppl 1:119-20.  Back to cited text no. 1
    
2.Burt BA, Eklund SA. Dentistry, Dental Practice, and the Community. St. Louis, United States: Elsevier Saunders; 2005.  Back to cited text no. 2
    
3.Dental public health competencies. J Public Health Dent 1998;58 Suppl 1:121-2.  Back to cited text no. 3
    
4.Greenwood LF, Lewis DW, Burgess RC. How competent do our graduates feel? J Dent Educ 1998;62:307-13.  Back to cited text no. 4
    
5.Rafeek RN, Marchan SM, Naidu RS, Carrotte PV. Perceived competency at graduation among dental alumni of the University of the West Indies. J Dent Educ 2004;68:81-8.  Back to cited text no. 5
    
6.Gerbert B, Badner V, Maguire B, Martinoff J, Wycoff S, Crawford W. Recent graduates' evaluation of their dental school education. J Dent Educ 1987;51:697-700.  Back to cited text no. 6
    
7.Schmidt HG, van der Molen HT. Self-reported competency ratings of graduates of a problem-based medical curriculum. Acad Med 2001;76:466-8.  Back to cited text no. 7
    
8.Revised Ordinance governing MDS course from the academic year 2009-10 onwards. Available from: http://www.rguhs.com. [Last accessed on 2011 Oct 08].  Back to cited text no. 8
    
9.Bernabé E, Ludeña MA, Beltrán-Neira RJ. Self-perceived public health competency among recent dental graduates. J Dent Educ 2006;70:571-9.  Back to cited text no. 9
    
10.Aiken L. Content validity and reliability of single items or questionnaires. Educ Psychol Meas 1980;40:955-9.  Back to cited text no. 10
    
11.Muñiz J. Classical Theory of Tests (Tests Classic Theory). 2 nd ed. Madrid: Ediciones Pyramid; 2000.  Back to cited text no. 11
    
12.Hernandez R, Fernandez C, Baptista L. Methodology the Research (Research Methodology). 2 nd ed. Mexico D.F: McGraw Hill; 1999.  Back to cited text no. 12
    
13.Strauss R, Mofidi M, Sandler ES, Williamson R 3 rd , McMurtry BA, Carl LS, et al. Reflective learning in community-based dental education. J Dent Educ 2003;67:1234-42.  Back to cited text no. 13
    
14.Skelton J, Mullins MR, Kaplan AL, West KP, Smith TA. University of Kentucky community-based field experience: Program description. J Dent Educ 2001;65:1238-42.  Back to cited text no. 14
    
15.Zarate G, Bernal J, Balarezo N, Izquierdo J. The experience in dental education of Cayetano Heredia University of Peru. Educ Med Salud 1978;12:436-56.  Back to cited text no. 15
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16.Mondoñedo J. Community teaching-service experiences in dental education of the Social Dentistry Department. Rev Estomatol Hered 1991;1:27-30.  Back to cited text no. 16
    
17.Anastasi A, Urbina S. Psychological Tests. 7 th ed. México City: Prentice Hall; 1998.  Back to cited text no. 17
    



 
 
    Tables

  [Table 1], [Table 2], [Table 3], [Table 4], [Table 5], [Table 6], [Table 7]


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