Heidi Emmerling, RDH, MA
I think if you polled a group of dental hygienists regarding the need for mandatory continuing education, most would agree that it is a good idea. After all, the thought of someone graduating from dental hygiene school and never cracking a book or magazine from that day forward is a scary thought.
Most would argue that as research brings forth new findings, we need to stay current. As new products emerge, we need to be knowledgeable. As new technology develops, we need to be on the cutting edge. We need to know the latest findings on infection-control procedures, the most current regime for prevention of bacterial endocarditis and the present status of our individual practice act. Without this knowledge, one cannot provide an acceptable standard of care.
However, you also could argue that the issue of continuing education is problematic. First, some have asked whether continuing education really equates with continued competency. For example, if someone graduates from dental hygiene school and sits through the requisite number of hours listening to some corporate speaker drone on and on at rubber chicken luncheons - all done merely to satisfy the state board of dental examiners - does that necessarily mean that the hygienist can actually scale? Not necessarily. But, then again, is the ability to remove plaque and calculus the main component of being a hygienist? Some would say no.
Is the purpose of requiring continuing education to ensure competency in skill or is it to ensure current knowledge? Sometimes, these go hand in hand; sometimes not. Clearly, one does not guarantee the other. In order to ensure continued competency, some have argued that hygienists should retake the clinical board every so often - not a thought many of us would relish. Thus, the issue of continuing education and continued competency is a slippery slope.
Another questionable element of continuing education is a self-serving, entrepreneurial one. Often, organized dentistry or organized dental hygiene is behind promoting increased hours of continuing education. It makes them look terrific in the legislature and gets them in good graces with state boards of dental examiners. Why? Because they are promoting what looks like increased standards of care to consumers and citizens. What`s so wrong with that? Nothing is wrong with increased standards of care ... and increasing the hours of mandatory continuing education often achieves that goal.
However, look at who else benefits from requiring more and more hours of continuing education: the sponsors of CE courses. Most sponsors I`ve seen are - surprise - national, state and local dental and dental hygiene organizations. Therefore, if licensees need to have more hours of continuing education to renew their licenses, dental and dental hygiene organizations can almost be guaranteed more demand and increased attendance at their sponsored CE courses. Again, this is not necessarily a bad thing. It can be argued that consumers benefit by having more educated health-care providers. It also can be argued that hygienists benefit from having increased attendance (increased tuition income) at their organization`s courses. Let`s just not fool ourselves by thinking the motive is purely altruistic.
This brings up several other points. My "soul sister" from the East Coast, Susan Polydoroff, brought this up to me. Shelling out cash for CE courses can add up. Some lucky hygienists brag that their employers, probably in a well-meaning gesture, provide continuing education for them. This often takes the form of the dentist paying for the entire staff to attend a weekend dental organization-sponsored course, like the ADA convention or the Chicago Dental Society Midwinter Meeting, for example. Sounds great. Get all the required CE at no cost. But is it really no cost? Who is trying to thwart our profession every chance they get? Organized dentistry. For that reason, I have never paid to attend a dental-sponsored CE course. After speaking with Susan, I now refuse to attend any dental-sponsored CE course, regardless of who picks up the tab. Susan pointed out that by merely being registered at a course sponsored by a dental organization, that organization can use your name and go to the legislature saying you support it. This gives a new meaning to "there`s no such thing as a free lunch."
Another concern is the quality of continuing education. The education received is only as good as the speakers, but on what basis can we judge their qualifications and knowledge? This lends credence to a proposed resolution brought up at last year`s ADHA convention to establish a national recognition program for continuing-education providers. The only existing, national recognition programs are specific to dentists` continuing education. Minimum standards need to be set. The next obvious question is how?
My final concern about continuing education is what type of material is appropriate? For example, why should the board of dental examiners award CE for a lame course our state sponsored, but not for courses conducted by a hygienist completing her B.S. or M.A. degree? Why should the board of dental examiners award CE for a hygiene-sponsored life insurance salesperson to come speak to our group for an hour, but not for a hygienist who gives a talk to the local nursing home? Some boards of dental examiners put a limit on the number of credits that can be earned by reading articles or by independent study, but do not put a limit on the number of credits that can be earned by listening to corporate-sponsored speakers. I would argue that all of these alternatives are meaningful and contribute to the needs of citizens and consumers, as well as to the profession.
As I`ve raised questions this month, I hope I`m not misunderstood as being a foe of mandatory continuing education. Nothing could be further from the truth. I think continuing education is essential. However, I think boards of dental examiners and licensees could enhance the quality of care provided by examining not only the existing status quo of continuing education, but alternatives to it.
Heidi Emmerling, RDH, MA, is a consulting editor for RDH, a writer, speaker, and clinician from Sparks, Nevada. Her e-mail address is [email protected].
