title: Referring periodontal patients: clinical decision making by dental and dental hygiene students.
abstract: Referral of periodontal patients requires development of a complex set of decision making skills. This study was conducted to determine criteria used by dental and dental hygiene students regarding the referral of periodontal patients for specialty care. Using mixed methods, a thirteen-item survey was developed to elicit the students' perceptions of their knowledge, confidence regarding managing patients, and clinical reasoning related to periodontal patients. The instrument was administered during the summer prior to (T1) and at the end of the students' final year (T2) of training. Seventy-nine dental students (81 percent of total class) and thirty dental hygiene students (83 percent of total class) completed T1. At T2, forty-two dental (44 percent of total class) and twenty-six dental hygiene students (87 percent of total class) completed the questionnaire. While 90 percent of dental and 96 percent of dental hygiene respondents reported a willingness to refer patients with active disease to specialists, only 40 percent of dental and 36 percent of dental hygiene respondents reported confidence in diagnosing, treating, and appropriately referring such patients. The students' ability to recognize critical disease and risk factors influencing referral was good; however, clinical application of that knowledge indicated a gap between knowledge and applied reasoning. The students' attitudes about the importance of periodontal disease and their perceived competence to identify critical disease risk factors were not significantly related (p>0.05) to correct clinical decisions in the case scenarios. The study concludes that dental and dental hygiene curricula should emphasize both the acquisition and application of knowledge regarding criteria for referral of periodontal patients.
authors.affiliation: School of Medicine, University of Missouri-Kansas City, 1000 East 24 Street, Kansas City, MO 64108;. williamsk@umkc.edu.
authors.forename: Karen B
authors.initials: KB
authors.lastname: Williams
authors.forename: Grayson J
authors.initials: GJ
authors.lastname: Burgardt
authors.forename: John W
authors.initials: JW
authors.lastname: Rapley
authors.forename: Kimberly K
authors.initials: KK
authors.lastname: Bray
authors.forename: Charles M
authors.initials: CM
authors.lastname: Cobb
mesh_terms: D000328:Adult; D001291:Attitude of Health Personnel; D055113:Chronic Periodontitis / Q000145:classification; D002983:Clinical Competence; D003657:Decision Making; D003756:Dental Hygienists / Q000193:education*; D048909:Diabetes Complications; D004497:Education, Dental; D005260:Female; D005792:General Practice, Dental / Q000193:education; D006801:Humans; D008297:Male; D010347:Patient Care Planning; D010510:Periodontal Diseases / Q000175:diagnosis / Q000628:therapy*; D010514:Periodontal Pocket / Q000145:classification; D010517:Periodontics / Q000193:education; D012017:Referral and Consultation; D012307:Risk Factors; D012649:Self Concept; D013335:Students, Dental; D055815:Young Adult
keywords: clinical education; dental education; dental hygiene education; diagnosis; periodontal disease; periodontics; periodontitis; referral