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ORIGINAL ARTICLE
Year : 2015  |  Volume : 13  |  Issue : 4  |  Page : 429-433

Preferences and barriers for continuing professional development among dental practitioners in the twin cities of Hubli-Dharwad, India


1 Department of Public Health Dentistry, Vivekanandha Dental College for Women, Tiruchengode, Tamil Nadu, India
2 Department of Public Health Dentistry, SDM College of Dental Sciences and Hospital, Dharwad, Karnataka, India

Date of Web Publication7-Dec-2015

Correspondence Address:
Prajna Pramod Nayak
Pranavam, Ambalpady, Udupi - 576 101, Karnataka
India
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Source of Support: None, Conflict of Interest: None


DOI: 10.4103/2319-5932.171190

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  Abstract 

Introduction: Advances in the field of dentistry is occurring at an exponential rate, and there is an immense pressure and challenge for the dentist to keep up with it to remain competent across the full spectrum of dental profession. Aim: To assess the frequency of attending the continuing professional development (CPD) courses as well as to assess the preferences and barriers for CPD among dental practitioners in Hubli-Dharwad, India. Materials and Methods: A self-administered questionnaire inquired on the frequency of attending CPD courses, and three questions on preferences and barriers for the same among 112 practitioners. Pearson's Chi-square test was used to find any association with gender and qualification with dependent variables. Results: Consent for the study was given by 92.9% practicing dentists. The mean age was 32.3 years. A majority of practitioners (45.2%) said that they attended CDE courses at least once in 6 months, 32.7% attended at least once in a year, and 22.1% attended rarely or never. A majority of dentists preferred esthetic dentistry. Most preferred methods for CPD courses were hands-on treatment on live patients and hands-on in clinically simulated situations. Lack of time was perceived as the most important barrier. Conclusions: A little less than half of the practitioners attended CPD courses once in 6 months with a substantial number attending very rarely or never. Most of them preferred esthetic dentistry and hands-on courses and lack of time was the most important barrier for attending CPD courses by Hubli-Dharwad dentists.

Keywords: Continuing, dental education, graduate


How to cite this article:
Nayak PP, Prasad K V, Jyothi C, Roopa G S, Sanga R. Preferences and barriers for continuing professional development among dental practitioners in the twin cities of Hubli-Dharwad, India. J Indian Assoc Public Health Dent 2015;13:429-33

How to cite this URL:
Nayak PP, Prasad K V, Jyothi C, Roopa G S, Sanga R. Preferences and barriers for continuing professional development among dental practitioners in the twin cities of Hubli-Dharwad, India. J Indian Assoc Public Health Dent [serial online] 2015 [cited 2020 Jul 16];13:429-33. Available from: http://www.jiaphd.org/text.asp?2015/13/4/429/171190


  Introduction Top


From the ancient times of Hippocrates, doctors have promised to keep up-to-date their knowledge and skills. Aspiring dental practitioners spend 5 years in dental school and 3 years in post-graduation training, if any. For the rest of their careers, which may be as much as 30–40 years long, dental practitioners do not have any accredited education. It is this long-drawn-out time when their professional development is most relevant. Thus, altering the training of practitioners across the continuum of dental education even after years of graduation is imperative.[1],[2] This process is regarded as "continuing professional development (CPD)."

CPD can be defined as the conscious updating of professional knowledge and the improvement of professional competence throughout a person's working life.[3] CPD is aimed at changing the practitioner's skills and attitudes toward improving standards of patient care. It encompasses all types of facilitated learning opportunities, ranging from college degrees to formal coursework, conferences, and informal learning opportunities situated in practice.[4]

In general, CPD refers to educational events that have been approved for CPD credits. In recent years, there is a trend worldwide to feature CPD as a requisite for the renewal of practicing license. In most of the developed countries, recorded involvement in CPD programs is mandatory for renewal of practice licenses.[5],[6] Various institutes have also published comprehensive guidelines for organizers of CPD programs.[7],[8] Furthermore, in India, the Dental Council of India is considering to make them mandatory for renewal of dental licenses.[9]

In India, studies on dental practitioner's attendance in formal CPD programs is very meager. Furthermore, studies on the practitioners' preferences for the topics or methods of CPD activities are scanty.

Hence, objectives of the present study were: (i) To assess the frequency of attending the CPD courses by the dental practitioners (ii) to assess topics of interest (iii) to assess the preferred methods for CPD courses, and (iv) to assess the perceived barriers for attending the CPD courses in the twin cities of Hubli-Dharwad, India.


  Materials and Methods Top


A cross-sectional survey of dental practitioners registered with the Karnataka State Dental Council of India was conducted using a self-administered questionnaire. The group of dental practitioners included in this study consisted of those practicing in the twin cities of Hubli-Dharwad. The list of dental practitioners was obtained from the local branch of Indian Dental Association. There were 112 practitioners practicing in 87 dental clinics in twin cities. Ethical clearance was obtained from the Institutional Review Board. A brief overview about the study objectives and a questionnaire was given, and those who consented were included in the study. A pilot survey was conducted in advance to confirm the preparations for the survey and clarity of special terms in a questionnaire that could appear unclear to the interviewees. The agreed meaning was explained to the interviewees during an interview to avoid misunderstanding.

A self-administered questionnaire was developed after a review of the literature on similar studies.[10],[11] The questionnaire consisted of three sections: (a) Four questions on respondents' personal and professional background particulars such as age, gender, qualification, and year of graduation/post-graduation, (b) Frequency of attending CDE courses, and (c) three closed-ended questions on professional development.

First question asked the respondents on their topic of interest such as endodontics, esthetic dentistry, implantology, orthodontics, periodontics, crown and bridge, preventive dentistry, and clinical trials (Options: Definitely required, required, neutral, not required, and not at all required). Second question asked the preferred method of continuing dental education activities such as hands-on treatment on live patients, hands-on on simulated clinical situation, live videos, seminars and lectures, symposiums, conferences/workshops, and postgraduation (for dentists) (Options: definitely yes, yes, neutral, no and definitely no). Third question was on the perceived barriers for continuing dental education activities such as lack of time, loss of income, cost, family commitments, CDE activities not conducted on relevant topics, patients accepting me as I am and not interested. For which again, the options were in the five-point Likert scale, from definitely yes, yes, neutral, no to definitely no.

The distributed questionnaires were collected back at the end of the day or on next consecutive days. Examiner went twice repeatedly to ensure maximum participation of respondents.

Statistical analysis

The collected data were processed using Stata 10.0 version (Statacorp 2005. Stata Statistical Software: release 10. College Station, TX: StataCorp LP, USA). P < 0.05 was set to know the significance level. The percentage contribution of each of the significant variable was obtained. The mean values were calculated by employing a 1–5 scale where 1 represented "definitely no" and 5 represented "definitely yes." Responses were analyzed by gender and qualification for significant differences using Pearson's Chi-square tests of significance.


  Results Top


There were 112 practitioners practicing in 87 dental clinics in the twin cities. All the dental practitioners registered with the Karnataka State Dental Council of India were included in the study, out of which, 104 practitioners responded (response rate, 92.9%). The mean age group for the whole study population was 32.3 years. A majority of them (57%) were in the age group of 24–33 years, 36 (34%) in the age group of 34–43 years, and 9 (9%) were above 44 years. In regard to gender distribution, 59 out of 104 (57%) were males and 45 (43%) were females. Regarding their educational qualification, 68 (64.8%) were general practitioners, and 36 (34.6%) were specialists [Table 1].
Table 1: Distribution of study participants according to socio-demographic details

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A little less than half of the total study population (45.2%) said that, they attended CDE courses at least once in 6 months, 32.7% attended at least once in a year, and 22.1% attended rarely or never. [Figure 1] and [Figure 2] give the frequency of CDE courses according to gender and qualification. Females attended CDE courses more frequently than males and general practitioners attended CDE courses more frequently than specialists.
Figure 1: Freqency of attendance in continuing professional development courses by gender

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Figure 2: Frequency of attendance in continuing professional development courses by qualification

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The majority of practitioners preferred esthetic dentistry (mean score 4.57), followed by endodontics (4.40) and least preferred was periodontics (3.57). Comparison of topics of interest for CPD activities among study participants according to gender and educational qualification showed that significantly more number of female practitioners preferred aesthetic dentistry and implantology as compared to males (P = 0.02 and 0.04, respectively). Likewise, the significantly higher proportion of males preferred periodontics as compared to females (P = 0.04). Significantly higher proportion of specialists preferred crown and bridge and periodontics as compared to graduate practitioners (P < 0.05) [Table 2].
Table 2: Comparison of topics of interest for continuing professional development activities among study participants according to gender and educational qualification

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Most of the practitioners preferred hands-on treatment on live patients (mean score 4.79) and hands-on on simulated clinical situations (mean score 4.33). Least mean score for the preferred method was symposiums (3.78). Comparison of preferred methods for CPD activities among study participants according to gender and educational qualification showed that there were no statistically significant differences between males and females. However, significant differences were found among graduates and specialists in choosing seminars and symposiums as a preferred method, wherein higher proportion of specialists preferred symposiums and seminars and lectures over graduates (<0.001 and 0.02, respectively) [Table 3].
Table 3: Comparison of preferred methods for continuing professional development activities among study participants according to gender and educational qualification

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A majority of the practitioners thought lack of time as a definite barrier (mean score 4.13) followed by irrelevant topics during previous courses (mean score 3.74). The majority of the practitioners were neutral on the cost of CDE courses as a barrier and majority of them said that not being interested is definitely not a barrier for attending CDE courses. Least number of practitioners agreed that not being interested in the professional development was the barrier for their attendance in courses (mean score of 1.85) followed by patients accepting them and hence there was no need for further education (2.91) [Table 4].
Table 4: Comparison of perceived barriers for continuing professional development activities among study participants according to gender and educational qualification

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Comparison of perceived barriers for CPD activities among study participants according to gender and educational qualification shows statistically significant differences among graduates and specialists in perceiving lack of time as prime barrier in attending professional development courses, the mean score being higher in graduates as compared to specialists (P < 0.05).


  Discussion Top


In most of the nations, health care systems are facing important changes, driven by political and economic forces and by the general concern for competent and consistent quality care.[12] Responses to these forces include altering the training of physicians across the continuum of medical and dental education. To achieve this "CPD," there are various Continuing Dental Education courses that have sprung up all over the world, including India. However, the attendance of practitioners in these CPD programs is very meager in India.[13],[14],[15]

A majority of practitioners preferred esthetic dentistry, followed by endodontics, and implantology, as topics for CPD courses that are similar to other studies.[4],[13],[16] In a study conducted by Giriraju et al., a higher proportion of practitioners opted for topics related to recent advances and clinical applications in dentistry.[13] Esthetic dentistry and implantology are the topics, the clinical know-how of which is not incorporated in undergraduate dental education. These are gaining more and more importance in the recent years, with highest research and development occurring in these fields.[4],[10] Significant differences were seen between males and females for selection of esthetic dentistry, implantology, and periodontics as preferred topics. Significant differences were seen between the graduates and specialists for periodontics, esthetic dentistry and crown and bridge as topics of choice, which could be because of interest in furthering their knowledge on more byzantine forms of treatment. Similar findings were found in other studies, where periodontics was also one of the most covered topics during CDE courses.[13]

On asking on what their preferred methods for CPD courses are, most of them preferred hands-on treatment on live patients, followed by hands-on on simulated clinical conditions as was seen in other studies.[7],[14] As hands-on courses give a much clearer depiction of the clinical situation, these could have been the most preferred of all. In contrast to these results, in the study done by Giriraju et al., a majority of practitioners preferred CDE programs to be conducted in the form of Audiovisual presentations followed by hands-on/Workshop programs.[13] Significantly more number of specialists preferred seminars, lectures, and symposiums as compared to graduates. This could be because of higher exposure and hence familiarization to the same during their postgraduate training among specialists.

The majority of the practitioners thought lack of time followed by family commitments as the most important barriers in their attendance in CPD programs as depicted in other studies.[7],[13],[15] Most of the practitioners in India work 6 days a week, which could be the reason for lack of time to pursue CPD or other professional activities. There were no significant differences between males and females regarding the various barriers, but a significant difference was found between the graduates and specialists in perceiving a lack of time as a barrier for attending CDE courses. The reason for the difference in perceived lack of time between and specialists could be relative in nature where specialists, contend the continuing dental education to be an important aspect of dental practice, and hence, less perception as lack of time for the courses.

The limitation of this study is the validity of self-reported data though considerations on this regard are given (such as confidentiality of results).

The present data may guide the organizers of CDE programs such as the professional associations and educational institutions to formulate appropriate approaches and topics during conducting the courses. There is a need for licensing bodies to revolutionize and reform the existing guidelines so as to accomplish maximum participation of practitioners in the CDE programs.


  Conclusions Top


A little less than fifty percent of the practitioners attended CPD courses once in 6 months. Most preferred topics for continuing dental education courses were aesthetic dentistry followed by endodontics and implantology. Most preferred methods for continuing dental education courses were hands-on treatment on live patients and hands-on in the clinically simulated situation. Most perceived barriers for continuing dental education activities by dental practitioners were the lack of time, followed by family commitments and no relevant topics in the courses conducted.

Financial support and sponsorship

Nil.

Conflicts of interest

There are no conflicts of interest.

 
  References Top

1.
Weerasinghe J. Continuing professional development (CPD) programmes for dental professionals 'Today's Doctor-Tomorrow's Cure'. Sri Lanka Dent J 2008;38:03-7.  Back to cited text no. 1
    
2.
Buck D, Newton T. Continuing professional development amongst dental practitioners in the United Kingdom: How far are we from lifelong learning targets? Eur J Dent Educ 2002;6:36-9.  Back to cited text no. 2
    
3.
Speck M, Knipe C. Why Can't We Get it Right? Designing High-Quality Professional Development for Standards-Based Schools. 2nd ed. Thousand Oaks: Corwin Press; 2000.  Back to cited text no. 3
    
4.
Chan WC, Ng CH, Yiu BK, Liu CY, Ip CM, Siu HH, et al. A survey on the preference for continuing professional dental education amongst general dental practitioners who attended the 26th Asia Pacific Dental Congress. Eur J Dent Educ 2006;10:210-6.  Back to cited text no. 4
    
5.
Bullock A, Bailey S, Cowpe J, Barnes E, Thomas H, Thomas R, et al. Continuing professional development systems and requirements for graduate dentists in the EU: Survey results from the DentCPD project. Eur J Dent Educ 2013;17 Suppl 1:18-22.  Back to cited text no. 5
    
6.
Hopcraft MS, Manton DJ, Chong PL, Ko G, Ong PY, Sribalachandran S, et al. Participation in continuing professional development by dental practitioners in Victoria, Australia in 2007. Eur J Dent Educ 2010;14:227-34.  Back to cited text no. 6
    
7.
Al-Jarallah K, Premadasa IG. Guidelines to CME Organizers. Kuwait Institute for Medical Specialization; 2003. Available from: http://www.kims.org.kw/cme. [Last accessed on 2014 Jun 18].  Back to cited text no. 7
    
8.
CPD Guidelines. Institute of Personnel Management Sri Lanka. Available from: http://www.ipmlk.org/. [Last accessed on 2014 Jun 18].  Back to cited text no. 8
    
9.
Available from: http://www.karnatakastatedentalcouncil.com/download.aspx?QApplId=Appl120100604020847572. [Last accessed on 2014 Jan 23].  Back to cited text no. 9
    
10.
Best HA, Messer LB. Professional development for dentists: Patterns and their implications. Aust Dent J 2001;46:289-97.  Back to cited text no. 10
    
11.
Selvi F, Ozerkan AG. Information-seeking patterns of dentists in Istanbul, Turkey. J Dent Educ 2002;66:977-80.  Back to cited text no. 11
    
12.
Abbott P, Burgess K, Wang E, Kim K. Analysis of dentists' participation in continuing professional development courses from 2001-2006. Open Dent J 2010;4:179-84.  Back to cited text no. 12
    
13.
Giriraju A, Yavagal PC, Lakshminarayan N. Perceptions about continuing dental education program among private dental practitioners in Davangere City, Karnataka, India-A cross sectional survey. J Indian Assoc Public Health Dent 2013;11:71-6.  Back to cited text no. 13
    
14.
Leggate M, Russell E. Attitudes and trends of primary care dentists to continuing professional development: A report from the Scottish dental practitioners survey 2000. Br Dent J 2002;193:465-9.  Back to cited text no. 14
    
15.
Al-Sudani D. Continuing professional education: Attitudes and needs of Saudi dentists. Saudi Dent J 2000;12:135-9.  Back to cited text no. 15
    
16.
Nieri M, Mauro S. Continuing professional development of dental practitioners in Prato, Italy. J Dent Educ 2008;72:616-25.  Back to cited text no. 16
    


    Figures

  [Figure 1], [Figure 2]
 
 
    Tables

  [Table 1], [Table 2], [Table 3], [Table 4]


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