title: Effective educational instruction in preventive oral health: hands-on training versus web-based training.
abstract: OBJECTIVE
  To assess the effect of Web-based training (WBT) on resident knowledge of preventive oral health and compare the addition of hands-on training (HOT) to WBT on resident skills, confidence opinions, and practice.
  
  
  METHODS
  Pediatric residents participated in a WBT on preventive oral health. After the WBT, subjects were randomly assigned to receive HOT by a dentist (WBT + HOT) or WBT alone. All subjects were assessed on knowledge by a pretest/posttest questionnaire and assessed on skills in the performance of an oral examination by direct observation. Residents' confidence regarding oral health counseling and their opinions about the importance of the incorporation of oral health into the well-child visit were measured by surveys that used a Likert scale. Residents' change in practice was assessed by a retrospective chart audit.
  
  
  RESULTS
  Fifty-six residents were included in the analysis (WBT + HOT: 29; WBT: 27). Resident knowledge improved after the WBT from 69% to 81% (95% confidence interval [CI]: 9%-15%). Overall skills improved in the WBT + HOT group participants compared with those in the WBT group (87% vs 73%; difference: 14% [95% CI: 1.2%-26.6%]). Seventy-nine percent of participants in the WBT + HOT group compared with 44% of those in the WBT provided follow-up instructions (relative risk: 0.56 [95% CI: 0.35-0.89]). Resident opinions regarding incorporating preventive oral health into the well-child visit decreased by 33% in the WBT + HOT group compared with 11% in the WBT group (95% CI: 2%-43%). There were no significant differences in confidence regarding preventive oral health and practice between the groups.
  
  
  CONCLUSIONS
  Both instructional methods resulted in increases in knowledge, efficacy, and practice of preventive oral health. The addition of hands-on training by a dental provider increased the overall skills of oral examination, but this increase was largely a result of the provision of follow-up instruction.
authors.affiliation: Children's Mercy Hospital and Clinics, General Pediatrics, 2401 Gilham Rd, Kansas City, MO 64108, USA. ntalib@cmh.edu
authors.forename: Nasreen
authors.initials: N
authors.lastname: Talib
authors.forename: Robin
authors.initials: R
authors.lastname: Onikul
authors.forename: Delsie
authors.initials: D
authors.lastname: Filardi
authors.forename: Stephen
authors.initials: S
authors.lastname: Simon
authors.forename: Vidya
authors.initials: V
authors.lastname: Sharma
mesh_terms: D002648:Child; D003731:Dental Caries / Q000517:prevention & control*; D005260:Female; D006801:Humans; D020407:Internet; D007396:Internship and Residency / Q000379:methods*; D008297:Male; D009909:Oral Health; D010372:Pediatrics / Q000193:education*; D012189:Retrospective Studies