Our intellectual property

by Lynne H. Slim, RDH, BSDH, MSDH
[email protected]

I just returned from an exciting four days at the ADHA 2010 Annual Session in Las Vegas. What I enjoy most is spending time with fellow ADHA members, and I'm encouraged by the dedication of so many volunteers who work hard to advance the profession.

One such person is Joan K. Fitzgerald, RDH. Unlike some other folks I've met, Joan doesn't hesitate to bare her soul. She talks a lot about "our" (organized dental hygiene's) intellectual property, and she's adamant that we need to claim it and tend to it as our own. Joan is past president of the New Hampshire dental hygiene association and represented the association on the state's inaugural Oral Health Plan in 2003.

I wholeheartedly agree with Joan, and while at the ADHA I was able to witness extraordinary examples of creative, passionate RDHs who are moving dental hygiene higher up on the self-regulation ladder. Our Canadian colleagues work in self-regulated provinces, and they recognize the one important reason for a professional to be self-regulated – to protect the public and improve access to care. The 2010 ADHA House of Delegates approved the following definition of professional autonomy: A profession's authority and responsibility for its own standards of education, regulation, practice, licensure and discipline.

The dental hygiene research poster session really turned me on, and I marveled at the accomplishments of the various presenters. I hope to include a couple of them in future periodontal therapy columns.

Dr. Esther M. Wilkins was also there, and I watched as she made her way through the research poster maze. It's through accomplishments like hers that we have seen tremendous professional growth, and she is always there to encourage and cheer us on.

Many years ago, I read an excellent article on dental hygiene as a female dominated semiprofession.1 Although the pages have yellowed with age, the message is the same: all established professions reveal certain characteristics such as autonomy, self-regulation, and self-control.

Established health professions commit to lifelong learning, and they have a well-established and systematic body of knowledge. An established health profession uses evidence-based decision-making (EBDM) in all domains such as practices and educational institutions. EBDM is the integration of best research evidence with clinical expertise and patient values. Unfortunately, dental hygiene does not yet have an official position statement that supports EBDM as the basis for dental hygiene practice.

One research poster in particular knocked my socks off. (Just kidding, it was too hot in Vegas for socks!) I met Jennifer Stanley, RDH, BSDH, who recently graduated from the University of Michigan with a bachelor's of science degree in dental hygiene. While studying in their e-learning program, Jennifer conducted a survey of RDHs who attended the 2009 North American Dental Hygiene Research Conference.

She was interested in examining these attendees' perceptions of skills and education necessary for baccalaureate degree RDHs to pursue entry-level roles in research, and 97.5% of attendees agreed that it was necessary to have the ability to evaluate and critically analyze professional literature. The same percentage (97.5%) also agreed that possessing knowledge of the scientific method and EBDM was important. Attendees/survey respondents also agreed (97.5%) that understanding the application of scientifically sound technologies and protocols during clinical decision-making is important.

You can read the additional skills and education perceived as important in Table 1. One thing to remember is that the survey was not sent to a random sample of hygienists, and it reflects the perceptions of individuals interested in research, so a potential bias exists with the data. Why is this important to dental hygiene, and why did I include it in my periodontal therapy column this month? Periodontal and other oral health outcomes can be optimized and more cost-effective if we apply EBDM to clinical decision-making. Dedication to EBDM also ensures accountability and transparency in everyday decisions.

For example, let's say a good salesperson convinces you to use a diode as an adjunct to conventional SRP. He suggests that you charge extra for this additional service and tells you it will help the practice's bottom line skyrocket. He tells you that offices are making money hand over fist with this technology, and he wants you to jump on board. How do you search for evidence that this service will benefit the patient? Do you rely on the salesperson's knowledge or do you look at systematic reviews of scientific literature on the subject?

Building our intellectual property and keeping it in our toolbox is part of professional growth. Kudos to those dedicated professionals at ADHA, such as Joan Fitzgerald and Jennifer Stanley, for soldiering on and not looking back.

"There are two primary choices in life: to accept conditions as they exist, or accept responsibility for changing them. "– Denis Waitley

Table 1

For an entry-level role in clinical research, the baccalaureate degreed dental hygienist needs to:

• Possess competency in evaluating and critically analyzing professional literature. (88% strongly agreed)
• Possess knowledge of the scientific method and evidence-based decision making. (83% strongly agreed)
• Understand the application of scientifically sound technologies and protocols during clinical decision making. (75% strongly agreed)
• Possess effective communication and interpersonal skills. (45% strongly agreed)
• Possess the ability to interact effectively with people of different cultures and backgrounds. (50% strongly agreed)
• Be able to identify and apply the foundations and principles of clinical research ethics. (78% strongly agreed)
• Be able to demonstrate knowledge and application of laws, regulations, and standard operating procedures in regulated clinical research. (55% strongly agreed)
• Be able to distinguish and define the responsibilities of sponsors, monitors, and investigators according to the principles of the International Conference of Harmonization, Good Clinical Practice (ICH/GCP) and the Code of Federal Regulations (CFR). (35% strongly agreed)
• Be able to identify and apply regulation guidelines as they relate to informed consent, Institutional Review Boards (IRB)/Independent Ethics Committees (IEC), and financial disclosure. (63% strongly agreed)
• Possess the ability to identify the principles of study design, study closure, and record retention. (58% strongly agreed)
• Possess the ability to identify the principles of study design, study closure, and record retention. (58% strongly agreed)
• Be able to demonstrate knowledge and application of safety reporting requirements as they relate to federal regulations and GCP Guidelines, such as reporting any adverse events, expected/unexpected events, or events that relate to safety in a clinical trial (60% strongly agreed).
• Possess the skills to prepare a manuscript for submission to a peer-reviewed journal. (28% strongly agreed)
• Possess grant writing skills. (8% strongly agreed)

Source: Stanley J, Kinney J, Gwozdek A. Assessment of the skills and eduction necessary for a baccalaureate prepared dental hygienist to pursue an entry-level role in clinical research. 3/19/10.

References:

1. Jones L. Dental hygiene as a female dominated semi-profession. L'Hygieniste Dentaire du Canada 1979; 13(3): 62-66.

Lynne Slim, RDH, BSDH, MSDH, is an award-winning writer who has published extensively in dental/dental hygiene journals. Lynne is the CEO of Perio C Dent, a dental practice management company that specializes in the incorporation of conservative periodontal therapy into the hygiene department of dental practices. Lynne is also the owner and moderator of the periotherapist yahoo group: www.yahoogroups.com/group/periotherapist. Lynne speaks on the topic of conservative periodontal therapy and other dental hygiene-related topics. She can be reached at [email protected] or www.periocdent.com.