Biomedical subjects
Publications and source records attributed to D W Chambers.
The current program of continuing education is unnecessarily restricted by outdated conceptions of professionalism and learning; thus it fails to serve the needs of dentists today. A new model--professional development--is proposed, based on new ideas about what it means to be a professional and what professionals learn. The central role of practice is emphasized.
Decisions are courses of action that exclude other actions and are based on information that is subject to error. Sometimes that information is evidence gathered about a particular situation; sometimes it is general knowledge about similar situations. A very simple example is used to show that the best decision making strategy is to consistently favor the most likely outcome based on previous experience if one is using baseline information. This is more effective than probability matching or dividing resources evenly. The same advantage of "sticking with the winner" applies when one is making a decision based on evidence. When both baseline information and evidence are available, only one should be used--the one with the highest accuracy. They cannot be combined. The evidence-based dentistry controversy is analyzed from this perspective. It is shown that evidence has the highest accuracy for the controlled circumstances that researchers investigate and that the baseline has the highest accuracy for the natural circumstances that dentists encounter. The relative roles of the baseline and of evidence in decision making are applied to investing in the stock market and for showing that both examination-based relicensure and the current practice of testing for initial licensure are indefensible because they ignore the baseline.
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The believability of a message is grounded in almost everything except the content of the message--there is no self-warranted truth. Credibility is based on the believer's assessment of the form of the message, its source, and especially by triangulation with a reference point. The most common group of reference points are compatibility, authority, collegiality, and performance.
Thirteen teeth in human cadaver sections were accessed and #15 K-files were placed at various lengths in one root canal of each tooth. Using a positioner to ensure duplicate views, radiographs were taken with both Ultraspeed and Ektaspeed Plus X-ray film. Each of the 26 radiographs was coded and then placed in random order. Six endodontic specialists measured the distance from the file tip to the radiographic apex on each film. The results were analyzed by analysis of variance and Cronbach's generalizability theory. It was found that 94% of the variance in measurements was due to differences among the viewers, whereas 5% was due to a combination of viewers and tooth. Only 1% was due to differences between the two types of film. It was concluded that Ektaspeed Plus film may be used for working length radiographs because it requires only approximately 50% of the radiation needed for Ultraspeed film.
The theoretical foundations of competency-based education are described. Among these are definitions of learning in terms of the situations one can function in rather than the accumulation of knowledge or skills, and of professional growth as a succession of stages from novice to expert. Competence is the midpoint on this continuum where individuals are capable of practicing independently and of assuming responsibility for their continued professional growth. Dental education has functioned well at the early stages of this process, but the assumption that "more of the same" will complete the process is questioned. Also considered are the implications of competency in the political context of dentistry, in curriculum design, and for evaluation.
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The marketing mix is the complete offer a seller makes to any potential buyer. In classical marketing theory it is composed of four parts: the product, its price, channels of distribution (colloquially called place in order to have a term beginning with the letter P), and promotion which includes incentives, public relations, and advertising. These are the four P's which every MBA student must master.
A competency system in its whole and its parts is described. Such a system can help dental educators rationally and efficiently organize and articulate educational programs, curricula, and courses. Repeated iterations of standard setting, design of experiences, and appraisal can reduce the need for less desirable rework or remediation and rejection of the objects of the experience such as dismissing students. Such an iterative process is one in which there is constant cyclical improvement which can move a dental education organization to develop a shared vision and become a true learning organization.
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Explore the source record for details and available documents.
This is an introduction to the major concepts in total quality management, a loose collection of management approaches that focus on continuous improvement of processes, guided by routine data collection and adjustment of the processes. Customer focus and involvement of all members of an organization are also characteristics commonly found in TQM. The seventy-five-year history of the movement is sketched from its beginning in statistical work on quality assurance through the many improvements and redefinitions added by American and Japanese thinkers. Essential concepts covered include: control cycles, focus on the process rather than the defects, the GEAR model, importance of the customer, upstream quality, just-in-time, kaizen, and service quality.
Dentists and many staff enjoy characteristics of work associated with high levels of satisfaction and performance. Although value can be added to oral health care professionals' jobs through enlargement, enrichment, rotations, and autonomous work groups, there are limits to these techniques. Controlling work performance by means of rewards is risky. Probably the most effective means of adding value to jobs is through the Quality of Work Life approach, concentrating on job design and placement to make work meaningful and autonomous and to provide feedback.