1 Should students know they are being evaluated? why and why not?

2 Should students have to pass more than once? why or why not?

3 What strategies could instructors use to help students who are incredibly nervous during a competency exam?

Competency can be very stressful for students because they are still learning new skills and techniques that they have not yet mastered and are not quiet confident  and proficient in. Yes, I do believe students should know they are being evaluated because it provides motivation for students to learn by preparing for the exam. But especially extrinsic learners, who are motivated by external factors like grade and consequences of failure, it  does provide a greater motivation  to learn. Another reason students should know they are being evaluated is because it provides feedback so students can learn more efficiently and also have the instructor answer all the questions they might have before the commpetency exam. Thus enhancing understanding and reduce nervousness by eleviating some of the pressure students may feel.

Should students have to pass competencies more than once? why or Why not?

I do think students have to pass competencies more than once at least in the very beginning of the program when every thing is still very new because practice makes perfect especially in a discipline like dental hygiene. The more you practice a particular competency the better you get at it. This reinforces the notion that intelligence is incremental and can be developed. Another reason why competencies should be passed more than once is that certain competencies are difficult. An example would be scaling and root planing due to the complexity that each individual patient brings or tenacousness of the tarter, patients medical history, age and how long the tarter has been there makes this procedure challenging. Tarter that has been on the teeth for a long time is generally more difficult to remove. Also competencies like periodontal assessments  and dental charting  that are taught in the first year of the program, these competencies need to be taken more than once to make sure students do not forget what they have learned earlier in the course and to master and also to build on the existing knowledge.

What strategies could  instructors use to help students who are incredibly nervous during a competency exam?

Instructors could help students who are incredibly nervous during a competency by providing mutliple opportunities for evaluating assessment of learning and also by lowering the overall importance of any one competency thereby lowering students anxiety. This makes the student feel safe that even if they perform poorly in one competency exam, he/she can make up with the next exam and still pass the class. It generally helps when students take more than just the traditional midterm and final exam, because it helps students understand and familiarize themselves on how the instructor sets his/her competency exams. The student will also see what the exam will actually look like, what kind of questions or any special procedures prior to the exam, if it was not already clear the first time. Instructors could also help nervous students by communicating their own positive attributions about the students capabilities to learn, which can motivate the student and reduce nervouness during competency exams.

Should clinical faculty only reinforce what is taught in class or text books? How could a clinical faculty member introduce different techniques without negating what students were taught in the classroom or pre-clinic?

I think clinical faculty should not only reinforce what was taught in classroom or textbooks but should include other learning opportunities as they arise but at certain points during the program. For example at the beginning of the program, faculty should teach facts and knowledge from textbooks and classroom because this is the bases on which the rest of the knowledge or practice is going to build on. During pre-clinic  the faculty should teach students proper instrumentation, fulcrum and ergonomics techniques from the textbook to make sure these competencies are mastered before any modifications can be introduced, as they will inevitably come because every patient and circumstances will be different and will need to be treated as a unique  case or individual. The article reading from the “Preceptor handbook” solidify this position by saying “Flexibility is the an important key to coaching and role modeling.”  In pre-clinic during instrumentation I was taught to use the scaler  6/7 straight for anterior teeth which I did until I mastered that instrument. But later on the instructor also taught us S204s can also be used for anterior teeth but that did not come until the first instrument 6/7 was mastered. In the clinic, my instructor allowed me to use the S204s a posterior instrument in certain situations and on different patients for anterior teeth which is a different instrument without negating what I was taught in the classroom or pre-clinic.

How could a faculty member introduce different techniques without negating what students were taught in the classroom or pre-clinic?

I believe the key to that is by allowing the student master the basic skills and technique and be competent in that before any modifications can be introduced. Also, the clinical faculty can observe the student’s performance and modify techniques as need be in different situations.  For example, I was taught to place the patient in a supine position before starting treatment but in case of a medical condition the instructor also introduced a different technique to stand and perform treatment without negating what I was taught in pre-clinic or the classroom instead it demonstrated the principle of coaching to be flexible in your approach to accommodate the particular situation in question.

“While checking in the intra/extra you noticed a lesion on the buccal mucosa. The student has not mentioned it to you and you have not looked at the intra/extral oral exam page yet. What question do you ask and why do you ask that question? What follow up question might you ask? Remember to follow the principles introduced in the readings and discuss how your questions follow those principles”.

I will ask questions that focus on promoting learning and helping students organize their thinking so that they can develop an awareness of where there are deficits in data. I Will also ask questions that are clear so students know what I mean and also adapt to the level of the class so the questions are tailored to the kind of students in the class. Examples of some of the questions are:

Analyse your findings if any from the intra/extra oral examination you completed.

How would you explain/describe your findings if any from the intra/extra oral examination you completed.

I asked these questions because it tells me if the student remembered to do the exam in the first place. It also allows me to investigate/search for the information and to synthesize what has been learned by the student. For example, in the “Developing Question Skills” article reading, it said the use of questioning skills is essential to systematic investigation in any subject area. The questions I asked above “Analyse/ Explain/ Describe your findings if any from the intra/extra oral examination you completed” require the student to solve the problem through systematic examination of facts/knowledge and application of critical thinking to assess what is present  or not present in the patient’s mouth.These questions balance facts and are thought-provoking. In doing so it demonstrates what the student knows about how normal or abnormal tissue looks like from previous lectures on oral anatomy and pathology.

On the point of what follow up question might you ask?  I will ask different questions in this situation depending  on the outcome of the intra/extra oral exam whether the student saw the lesion on the buccal mucosa or not. If the student saw the lesion my question will be:

How did you describe the buccal mucosa?

What recommendations will you give the patient concerning your findings?

How does the patients health history relates to  your findings?  But if the student did not see the lesion I might ask the following questions:

What areas did you evaluate  in the oral cavity during the intra/extra oral exam?

How did you examine the oral cavity during the intra/extra exam? In an attempt to have the student check, observe and appraise the buccal mucosa without me giving the answer out in case he/she forgot to do the exam.

In this last situation which ask me to: ” discuss how my questions follow those principles introduced in the readings.”

I think my questions follow the principles introduced in this week’s readings because it uses the higher level cognitive domain questions from Bloom’s Taxonomy like analyse (explain/discuss), evaluate, and synthesis. This encourages the student to critically think and problem solve  through systematic examination of knowledge learned  in the pre-clinic study of oral anatomy and oral pathology and transforms  the knowledge into clinical differential diagnosis of diseases and lesions of the oral cavity, is  the first step in successful management of a patient with an oral lesion. Another reason I believe my questions follow these principles introduced in the readings is because the questions evaluate/ examine the buccal mucosa puts the information together in a way that selects and use the appropriate knowledge to solve the problem. If the student identifies the lesion or in the case that the student does not identify the lesion that shows gap in the knowledge application which can be corrected so that the student can build good critical thinking and higher cognitive skills. For example, the article and chapter readings uses Bloom’s Taxonomy to classify questions in different levels of higher cognitive domain which support my questions and  require students to critically think and problem solve.

I still use some of what I learned in school to practice dental hygiene today. For example, in  school I was taught that during the process of calculus removal like  scaling and root planing, I must use an explorer and rads to check for calculus as I scale and  check for any calculus that was missed during the process. I was also taught to take rads after the procedure to make sure all the calculus was gone. I still practice this way today because  it happens automatically that I do not have to think about it. This can be supported by the Educational Strategies Article reading which states that:” knowledge is embedded in subconsciously retrieved memory and “pop” into consciousness without active retrieval when cueing stimuli are detected,” in this case calculus. I also do all the palpitations during the extra oral and intra oral exams the way I learned in school because most of us practice the way we were taught. At the beginning of my career the rads I took after scaling were to analyze and seek information that the calculus was gone which was part of critical thinking according to the reading from article b. But after 13 years of practice, I do this only on very challenging cases. For example, I had a patient last year whose calculus was very tenacious because she had not had any cleanings for 52 years.

“Education is what remains after one has forgotten what one has learned in school.”- Albert Einstein

I think this quote is true because no one can remember everything they have learned in school. When someone acquires the capacity or knowledge to function as entry-level  hygienist and with critical thinking and problem-solving skills learned, one can build upon that knowledge after school  and move into the next level of an expert .This is supported by the Educational Strategies reading for this week.

Yes, I think it is important to teach facts that are relevant to the discipline in question because facts give one the knowledge base needed to help identify what is going on with one’s patient. For example, in school when I was taught the facts about inflammation, my teacher explained that when inflammation is present I should be able to see redness, swollen tissue  and the patient should feel pain at the touch of my fingers. This factual knowledge helps me identify gingivitis when a patient has it. As a clinical instructor, students depend on you for knowledge that is new to them. Furthermore,since the professional is a role model the  student will watch and strive to emulate what he/she observe from you. It is also important to teach critical thinking and problem solving because when the student is out of school and in the real world, he/she will need these skills to tackle different circumstances and challenges that come with different patients to be successful in his/her career. Some of these skills are analyzing, applying standards, logical reasoning, information seeking and transforming knowledge. For example, in the reading from article b, critical thinking is defined as “the reflective process in which individuals assess a situation or evaluate data by using mental capacities characterized by adjectives such as compare, analyze, distinguish, reflect and judge;” therefore, these are very important qualities to have in order for a hygienist to be successful in his/her career.

Yes, we need both because these qualities are setting the standards for the profession. They are also setting the standard for which dental hygienists should practice.Thus, graduating hygienists are prepared for the challenges of the job. This will help  to improve the oral health of the public. Both are important.