Are new dentists prepared for clinical practice? A survey of the clinical abilities of new dental graduates in the U.S. military

Abstract

Objective: This study aimed to identify new dentists’ competence in preventive and restorative procedures, as self-assessed by the new dentists and evaluated by their clinical supervisors. Justification: Preventive and restorative dental procedures constitute the majority of treatment provided daily in a general dentistry practice. Exploring new dentist proficiency in these foundational skills within one year of dental school graduation provides crucial information regarding the knowledge and skills new dentists attain during dental school. The military dental system is structured so that all new dentists receive close clinical oversight during their first year following graduation. Hypotheses: (1) The majority of dentists who have graduated less than one year prior to this survey will self-assess their skills in basic preventive and restorative dental procedures as “competent” or higher. (2) The majority of supervisor evaluations of new dentists will also average a level of “competent” or higher. (3) New dentists will self-assess their competence levels higher than their supervisors will evaluate them. Methods: An electronic, anonymous Qualtrics survey was sent to U.S. Air Force, Army and Navy new dentists and their clinical supervisors November 2022. Using a modified-Dreyfus model of skill acquisition, new dentists completed a self-assessment of 20 preventive and restorative procedures. Their clinical supervisors also completed a survey evaluating the proficiency level of the new dentists they oversaw. Results: 60 new dentists and 25 supervisors, accounting for 151 new dentists, responded. The proportion of competence ratings at a level of “competent” or higher (“proficient,” “expert”) was estimated, along with a 95% confidence interval, and one-sample chi-square tests were used to compare the proportion against 50%. Supervisors’ ratings of the new dentists’ skill levels were significantly lower than the new dentists’ ratings for 19 of the 20 dental procedures. Supervisors’ ratings of competent or higher were significantly greater than 50% in caries diagnosis and treatment planning, caries risk assessment, Class III anterior composite resins and posterior composite resins. Overall, supervisors rated 71.3% of new dentists at Novice or Beginner skill level. Conclusion: Supervisor ratings of the new dentists’ skill levels were significantly lower than the dentists’ ratings for the majority of procedures. New dentists and supervisors significantly disagreed on new dentists’ skill levels in the treatment of class I and II amalgams, endodontically treated teeth without a post, and crown preparation and delivery. Overall, 28.7% of new dentists were evaluated as competent in preventive and restorative procedures during their first year following dental school graduation.