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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.
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.
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| Label | Type | Description | Intervention Names |
|---|---|---|---|
| Hands on Training | Experimental | Hands on Training by a pediatric dentist |
|
| Web Based Training | Active Comparator | Web Based Training for all residents before randomization |
|
| Name | Type | Description | Arm Group Labels | Other Names |
|---|---|---|---|---|
| Hands on training | Other | Hands on training by a pediatric dentist on preventive oral health |
|
| Measure | Description | Time Frame |
|---|---|---|
| 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 | 3 months after Hands-on Training (HOT) |
| 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% | Baseline and 4 months |
| 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% | Baseline and 4 months |
| 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% |
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Inclusion Criteria:
Pediatric Residents in the Continuity Care Clinics at Children's Mercy Hospital during the months of January and February 2007
Exclusion Criteria:
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| Name | Affiliation | Role |
|---|---|---|
| Nasreen J Talib, MD,MPH | Children's Mercy Hospital Kansas City | Principal Investigator |
| Facility | Status | City | State | ZIP | Country | Contacts |
|---|---|---|---|---|---|---|
| Childrens Mercy Hospital | Kansas City | Missouri | 64108 | United States |
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).
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
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| ID | Title | Description |
|---|---|---|
| FG000 | Web Based Training Only (WBT) | This group received only the web based training prior to randomization(control group) |
| FG001 | WBT Plus Hands on Training (HOT) | This group received WBT prior to randomization and additional Hands on Training by a Pediatric Dentist after randomization(intervention group) |
| Title | Milestones | Reasons Not Completed | ||||||||||||
|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|
| Overall Study |
|
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| ID | Title | Description |
|---|---|---|
| BG000 | WBT Only | Control Group Web Based Training only |
| BG001 | WBT+HOT | Web Based Training plus Hands on Training |
| Units | Counts |
|---|---|
| Participants |
|
| Title | Description | Population Description | Parameter Type | Dispersion Type | Unit of Measure | Calculate Percentage | Denominator Units Selected | Denominators | Classes |
|---|---|---|---|---|---|---|---|---|---|
| Age, Categorical | Count of Participants |
| Type | Title | Description | Population Description | Reporting Status | Anticipated Posting Date | Parameter Type | Dispersion Type | Unit of Measure | Calculate Percentage | Time Frame | Units Analyzed | Denominator Units Selected | Arm/Group Information | Denominators | Classes | Analyses | ||||||
|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|
| 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 | Posted | Mean | Standard Deviation | Percentage of correct skills | 3 months after Hands-on Training (HOT) |
|
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Total number of Participants Risk is 0. This is because serious and other non serious adverse events were not collected or assessed. This was an educational intervention
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| ID | Title | Description | Deaths (Affected) | Deaths (At Risk) | Serious Events (Affected) | Serious Events (At Risk) | Other Events (Affected) | Other Events (At Risk) |
|---|---|---|---|---|---|---|---|---|
| EG000 | Web Based Training Only (WBT) | This group received only the web based training prior to randomization(control group) |
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| Title | Organization | Phone | Extension | |
|---|---|---|---|---|
| Nasreen Talib MD, MPH. | Childrens Mercy Hospital | 816-234-3242 | ntalib@cmh.edu |
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| ID | Term |
|---|---|
| D003731 | Dental Caries |
| ID | Term |
|---|---|
| D017001 | Tooth Demineralization |
| D014076 | Tooth Diseases |
| D009057 | Stomatognathic Diseases |
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| Web based training | Other | Web based training alone |
|
|
| At baseline and 6 months |
| BG002 |
| Total |
Total of all reporting groups |
| Participants |
|
| Sex: Female, Male | Count of Participants | Participants |
|
| Level of Training | The level of training during residency, | Number | participants |
|
|
|
| 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% | Only completed paired (pre/post intervention) surveys were analyzed | Posted | Mean | Standard Deviation | Percent change. | Baseline and 4 months |
|
|
|
| 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% | Posted | Mean | Standard Deviation | Percent change | Baseline and 4 months |
|
|
|
| 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% | Analysis per protocol. Subjects dropped from analysis because charts not available within the time frame of the study and incomplete data. | Posted | Mean | Standard Deviation | Percent change | At baseline and 6 months |
|
|
|
| 0 |
| 0 |
| 0 |
| 0 |
| EG001 | WBT Plus Hands on Training (HOT) | This group received WBT prior to randomization and additional Hands on Training by a Pediatric Dentist after randomization(intervention group) | 0 | 0 | 0 | 0 |
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