By JoAnn Gurenlian, RDH, PhD
It is that time of year when I have to renew my dental hygiene licenses. In addition to certifying that I have not committed any crimes, am not a drug addict, and am willing to pay the appropriate fees online by credit card, I must maintain a record of continuing education credits obtained during the appropriate reporting period. Credit hours are astoundingly different by state-some require as few as six hours per licensure cycle, while others are as high as 75 hours.
To satisfy licensure renewal, dental hygienists are required to complete courses in a variety of topics that vary by state and include the following:
- Infectious disease control
- Practice management
- Government relations
- Tort liability
- Risk management
- Chemical dependency/substance abuse
- Tobacco cessation
- Methods of health-care delivery
- Individual state dental practice act/rules and regulations
- Domestic violence
- Medical errors
- Medical emergency
- Abuse and neglect
- Pain management
- Dental public health
- Local anesthesia/nitrous oxide
- Dental radiography
While these subjects are of some interest, the hours of instruction required vary by state. The overarching question one might ask is why are they required? Where is the evidence that demonstrates taking two hours of instruction on child abuse or tort liability or medical errors or any of these topics (other than CPR and medical emergencies) makes one a better health-care provider?
Mind you, I comply with my licensure requirements. In fact, I just took my abuse renewal course online and paid the same fee as I did two years ago. The course was identical to the one I had taken before, verbatim. So, am I taking this to fulfill a requirement, make money for some organization, or do what exactly? If the laws regarding abuse have not changed and the process is exactly the same since 2015, why I am doing this? Can't we just get a one-page update and move on to another topic that might be more relevant? Perhaps we could have courses about new instruments that have been developed, the latest cancer treatments, off-label drugs used in dentistry.
I wouldn't be speaking about this if it were just one course. But what about those states in which half of the courses dictated for the practitioner are all repeats of the same-dare I say it-old information? If the state practice act hasn't changed since 2005, do we really need a two-hour continuing education course every licensure renewal to remind us how behind the times our state boards are? A one-page fact sheet is all that is needed.
Let's face it. This process of mandating continuing education topics to justify licensure renewal is an antiquated system that is unwarranted and certainly not evidence-based. It is time we come up with an alternate solution to demonstrate that we have remained current and informed practitioners. We should create a profile of courses that relate to the dental hygiene process of care: assessment, diagnosis, planning, implementation, evaluation, and documentation. Or if your role as a dental hygienist is in an area other than clinical practice, you could use a portfolio to showcase your continuing education experience during that licensure period for your area of expertise.
Maybe our new approach to rules and regulations changes should be to modify the continuing education mandates. If we believe continuing education is important, keep the hours but forego the required topics. Explore other options for demonstrating continued competence or best practices. Now might be a good time for dental hygiene associations to have discussions about the benefits of continuing education, whether continuing education should be tied to licensure, and alternate ways to demonstrate ongoing professional competence. One thing is certain: Dental hygienists should be the ones having these discussions and making these decisions. As health-care providers responsible for oral health education and disease prevention, we need to determine what continued best practice means and how it should be achieved. RDH
JOANN R. GURENLIAN, RDH, PhD, is president of Gurenlian & Associates, and provides consulting services and continuing education programs to health-care providers. She is a professor and dental hygiene graduate program director at Idaho State University, and past president of the International Federation of Dental Hygienists.