Thirsty for training?

July 1, 1996
Odds are that you want to learn more about communicating with dentists. A study examines what are the most important training needs for dental hygienists. Identifying the key areas in which to seek training will only enhance the profession in the long-term.

Odds are that you want to learn more about communicating with dentists. A study examines what are the most important training needs for dental hygienists. Identifying the key areas in which to seek training will only enhance the profession in the long-term.

Wendy St. Cyr, RDH

An awareness of our profession begs these questions. Who creates curriculum for dental hygiene training programs? Are they aware of practicing hygienists` opinions about what a complete training program should include? Enormous differences exist among accredited dental hygiene programs across the country. Why? How can dental hygienists in Utah be competent enough to learn how to administer local anesthetic while the same training is vehemently opposed in Massachusetts? Why is it that some dental hygienists are perfectly capable of practicing preventive oral health care under general supervision while others, by law, cannot?

These questions and more have led to a survey about clinical training needs for dental hygienists. This article summarizes a study concluded in the spring of 1995. The survey`s final results indicate that communication appears to be the dental hygienists` greatest training need. More specifically, hygienists refer to communication with dentists, professional associations, and other hygienists. Conflict resolution and teamwork are also listed in the top five needs. As Lisa Wagner, staff writer for the ADHA`s Access, states in the December 1995 issue, "...research, education, and communication ... is necessary for the adaptation and growth of the dental hygiene profession."

It is my belief that what appears to be a shortage of qualified, licensed, and practicing registered dental hygienists is, in reality, a communication puzzle just waiting to be solved.

Mary Alice Gaston, professor and program director for the dental hygiene department and assistant dean for student affairs in the College of Allied Health Sciences at the University of Tennessee at Memphis states, "Dental hygienists receive a broad education, and they are able to provide a wide range of treatment under minimal supervision. If you split the technical aspects of dental hygiene from the problem-solving, decision-making, and thinking requirements of the profession, you end up with individuals who can only provide small increments of dental hygiene care and who certainly are not the well-educated professionals consumers have come to know."

Unfortunately, this is exactly what some members of the dental community are advocating.

Communication with dentists - the overwhelming number one response in this survey - must begin now. Dental hygienists must review with dentists accurate documentation regarding their education, experience, and qualifications to provide safe, effective, and professional preventive oral health care. Together, dental hygienists and dentists must address licensure laws and restrictive practice acts that do not allow for growth and change.

In addition, hygienists must educate dentists about the direction of dental hygiene as a profession. Leaders are emerging from the dental hygiene professional pool as a natural progression from the "...command and control style" of leadership to the "...self-managed, team approach emphasizing interdependence, connectedness, collaboration, cooperation, caring, diversity, and a focus on human consciousness."

Most of all, dentists must be made aware of the fact that dental hygienists are not a threat to dentistry.

Survey pinpoints need to communicate

In preparing the survey, a job analysis related to the function of a dental hygienist in various environments was compiled to include as many conceivable training needs as possible. The survey was sent to 50 dental hygienists in various locations. The surveys were anonymous, although a request was made to include a brief background of participants.

Demographics included information on geographical areas of licensure, length of time in practice, type of educational institution attended, number of years of study, degree(s) obtained, interest in continuing education and future areas of study, employment status, and areas of special interest (such as pediatric or geriatric dentistry, periodontics, research, and education or training.).

The actual questionnaire contained six separate segments identified as: clinical skills; humanistic skills and training; communication skills; continuing education; business and management; and personnel and personal skills.

Out of the 50 questionnaires mailed, 39 questionnaires were answered. Almost 50 percent agreed that communication skills on several different levels comprised the highest training needs. More specifically, the top priority listed was communication with dentists.

The following is a list of the top twenty five training needs of dental hygienists as perceived by individual RDHs according to this survey:

1.) Communication with dentists; 2.) conflict resolution; 3.) communication with professional associations; 4.) "burn out" prevention; 5.) "rust out" prevention; 6.) communication with other dental hygienists; 7.) periodontal issues; 8.) sterilization; 9.) legislative issues; 10.) communication with supervisors; 11.) OSHA; 12.) root planing (instrumentation); 13.) AIDS-related issues; 14.) ethic training and promotion; 15.) medical history interpretation; 16.) soft tissue evaluation; 17.) local anesthetic; 18.) wellness promotion; 19.) communication courses; 20.) instrumentation; 21.) teamwork; 22.) office medical emergencies; 23.) patient education and motivation; 24.) medical history review; 25.) communication with other professional associations.

What the teachers and magazines say

The study also tried to determine the clinical training needs as perceived by people involved with the supervision, management, or training of dental hygienists. So an organizational survey through means of interviews was conducted. A minimum of four interviews were required on three different levels of supervision.

The participants were first asked to review the results from the survey of individual hygienists. Afterwards, they were asked:

- Based on your experience and on your opinion, what is the top training need for dental hygienists in school today?

- What is the top training need for graduated and licensed dental hygienists today?

- What teaching or training method do you recommend to address these needs?

- Please state three obstacles to implementing training for these needs?

Without exception, the group interviewed listed research, education, and leadership equally as the most important training needs for dental hygienists - both in school today as well as those graduated and practicing the profession. They believe that, for dental hygiene to be recognized as a preventive oral health-care profession, irrefutable, well-documented, and organized research must be conducted, compiled, and published. The documentation must then be distributed and incorporated into organized dentistry. All agreed that education and training is needed to accomplish these goals.

The interviews resulted in the following list of top ten training needs:

1.) Research; 2.) education and training, or leadership training; 3.) accreditation; 4.) establishing quality standards; 5.) communication with professional organizations; 6.) communication with other hygienists; 7.) communication with dentists; 8.) legislation; 9.) teamwork; 10.) conflict resolution.

The third part of the study determined the training needs for dental hygienists from a societal point of view, and a literature search was conducted with five dental publications. A total of 30 articles were noted and compiled as annotative bibliography.

The ten most important clinical training needs of the dental hygienist from a societal point of view are as follows:

1.) Accreditation process; 2.) Teamwork; 3.) Communication with dentists; 4.) Conflict resolution or communication with professional association; 5.) Leader-ship training; 6.) Communication with other hygienists; 7.) Communication with consumers; 8.) Quality control decisions; 9.) Peer evaluations; 10.) Education and training.

The analysis of training needs as perceived by individual, organizational, and societal participants produced the survey conclusions outlined in the chart above.

As Kathy Eklund of Forsyth School for Dental Hygienists says, "...the profession is challenged. We must evolve to meet the needs of the public." Open communication between dental hygienists and dentists will allow us all to risk proposing new and creative ideas, as well as maintain our integrity and courage necessary to build our ideals."

Wendy St. Cyr, RDH, is based in Sandy, Utah.

Top Ten Training Needs For Dental Hygienists

1.) Communication with dentists.

2.) Communication with professional associations.

3.) Conflict resolution.

4.) Accreditation.

5.) Teamwork.

6.) Communication with other hygienists.

7.) Leadership training.

8.) Quality control.

9.) Establishing quality standards.

10.) "Rust-out" prevention (which attempts to prevent the under utilization of skills).