The validity and reliability of a newly-developed objective structured clinical examination for 4th year dental students (OSCE(D)) were estimated by a range of quantitative and qualitative methods. The OSCE(D) consisted of 17 stations in conservation, periodontology and prosthetics. A blueprint was used to match the OSCE stations to clinical subject areas and to 7 skill clusters of clinical competence. Repeat measures of skills were undertaken in the OSCE(D) to maximise its validity and reliability. The primary purposes of the OSCE(D) were to assess clinical competence and to provide feedback to students. The results indicate that the OSCE(D) was intrinsically valid and a better predictor of performance in the final examination than either a concurrent 4th-year examination or Advanced-level university entry grades. The OSCE(D) scored relatively highly on internal consistency (Cronbach's alpha = 0.68). Intra-domain and inter-domain correlations were high and inter-examiner reliability was relatively high (eta 2 coefficients ranged from 0.00 to 0.10). There were no significant differences between performances in the morning and afternoon sessions of the examination so reproducibility is assumed to be high. Some improvement in individual stations and in inter-examiner reliability are required. A set of recommendations based on the experience of designing and testing a dental OSCE are provided.
Universities now exist in an environment of increasing accountability for their academic performance, both in teaching and research. Dental schools are expected to meet the academic expectations of their parent university and, in addition, to contribute to the health-care needs of the community. Individual staff members must achieve collectively the performance targets required of their school and individually must develop skills and expertise in their academic and clinical activities to merit tenure and promotion. This discussion examines the issues which impact on current problems of recruitment and retention of academic staff in dental schools internationally. The essential issue is career development in a manner which maintains the values that will ensure the credibility of dentistry as a scientifically based discipline and profession, while balancing the achievable academic needs with the added demands of achieving specialist clinical skills. Central to this balance is recognition that scholarship, which provides the bridge between research and teaching, can be broadly defined and that different individuals can be scholarly in a range of ways. Increasingly, schools are recognizing the importance of providing structured opportunities and guidance for career development of younger staff and of the need for flexibility in their criteria for tenure and promotion, recognizing that a diversity of individual strengths and teamworking are necessary both for the collective performance of the institution and the morale and development of the individual.
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