Competency Certification Processes

How Do We Know That Our Dental Students Are Competent and Ready to Perform Certain Procedures on Patients? Having been in dental education for over three decades, I frequently ask myself: “Is this dental student ready to prepare a crown for this patient?” or “Is this resident ready to perform a full-mouth rehabilitation?” These are critical questions that define the safety and quality of care our students provide. Systematically, we rely on competencies and assessments to evaluate whether a learner—whether a predoctoral student or a resident—is ready to perform specific patient care procedures. However, dentistry is not a one-size-fits-all discipline, and different procedures require different benchmarks for competency. For example: • A student learning crown preparation might require six to eight or more practice attempts on a typodont before demonstrating competency. • Intraoral scanning might require three to five attempts on live patients to become efficient. • Tooth polishing, a simpler procedure, may only require one or two practice sessions before competency is achieved. Thus, applying a uniform competency threshold across all procedures can be misleading. If a program uses a rigid numerical requirement (e.g., “X number of procedures = competency”), it risks shifting the focus away from true skill development and progression. Instead of promoting growth and refinement of skills, it creates a checkbox mentality where the learner and faculty may mistakenly assume that completing a fixed number of cases equates to readiness. The Case for Entrustable Professional Activities (EPA) A more effective way to assess readiness is through Entrustable Professional Activities (EPA)—a framework that evaluates a learner’s ability to independently perform a task based on real-world observation rather than just a predefined number of attempts. EPAs consider: • The context of the procedure • The student’s decision-making process • The complexity of the case • The supervising faculty’s confidence in the learner’s ability to perform the task safely and effectively This approach shifts the focus from just completing a requirement to demonstrating competency in a dynamic, patient-centered way. How Should We Implement This? 1. Define clear EPA guidelines for key procedures that align with patient safety and clinical complexity. 2. Encourage progressive assessment, allowing students to develop skills at their own pace while ensuring readiness at every stage. 3. Integrate faculty calibration so that evaluators consistently assess readiness and entrustability. 4. Use technology and data analytics to track skill progression beyond just a number of completed procedures. Ultimately, competency in dental education should not be about rigid numerical thresholds but about ensuring that students are truly entrustable to perform patient care with confidence, skill, and safety. #DentalEducation #CompetencyBasedEducation #EntrustableProfessionalActivities

So you want to get your FEES competency? SPA have not endorsed a competency document, however, we can use competency frameworks from NZSTA and RCSLT as a base. Competency sign-off should be completed by an experienced Speech Pathologist FEES trainer who has completed at least 150 FEES procedures as the endoscopist and proceduralist. There are two pathways to obtaining competency. One that includes nasendoscopy, and the other without. The pathway you choose will depend on your service model. Assessment of competency will involve examining knowledge and observing skill in performing FEES both as the endoscopist (as appropriate) and the proceduralist. For nasendoscopy, knowledge required includes normal anatomy and when to refer on, risk management, optimal positioning of the scope for assessing swallowing, cleaning the scope in situ and other troubleshooting techniques. For assessment of nasendoscopy skill it is suggested that supervised practice of mock FEES procedures is completed on at least 10 non-dysphagic subjects followed by 10-15 directly supervised FEES procedures. Performing FEES on a non-dysphagic subject is very different to performing FEES on a dysphagic client! For FEES interpretation competency, assessment requires knowledge of the equipment, indications for FEES, assessment techniques and compensatory strategies, scoring approaches and using rating scales, interpretation of findings and reporting. It is suggested that 10-15 FEES procedures are performed under direct supervision including production of reports. Once competency is achieved, you need to be credentialled to perform FEES by your employer. It is also recommended to continue to receive non-direct supervision on an ongoing basis. Reach out if you need more info. Pictured here is supervised practice of a FEES procedure on the lovely Natalie Grainger of SPIN Clinic

Although some people use certificate and certification interchangeably, all DEI certification programs are NOT the same. For one, some programs are actually certificates. Certificates are great when the facilitator is skilled and they offer curriculum that you can use. The focus is on completing a continuing education or training course with a reputable organization or university. Certification, on the other hand, demonstrates competence. Like all credentialing processes, there is a rigorous exam that is valid, reliable, and legally defensible. The assessment also applies professional standards and adheres to certification industry best practices. For example: 1. Unlike a certificate course, where anyone can take the class and everyone passes it, there are experience requirements before you can get certified. IDC's certification requires a passing score of 73.0% for the CDP® credential and 74.0% for the CDE® credential. Also, all candidates must submit a professional work that is peer reviewed and approved. 2. Certification programs confer a credential to illustrate that its designees are skilled and qualified. While there are many organizations that appear to use the DEI industry-recognized CDP and CDE for their programs, IDC owns the trademark and Designees or Approved Providers distinguish themselves with the Registered ® symbol. 3. As a member of the Institute for Credentialing Excellence, IDC's global certification process is research-driven and up-to-date-- utilizing the latest terms, data, best practices, and strategies. Candidates demonstrate proficiency in understanding the nuances of global demographics, cultures, and laws in relation to the next generation workplace and marketplace. 4. DEI-industry Subject Matter Experts (SMEs) developed IDC's exam and curriculum-- not a trainer. Since 2009, more than one hundred SME's from around the world have contributed to our biennial updating process. 5. The exam is arranged by domains, while the curriculum is organized by competency. From scenarios that you will face as a DEI leader to a deeper-dive into complex concepts, the content is designed to ensure that DEI leaders are equipped to move the needle forward. 6. After certification Candidates complete the assessments, they are expected to maintain competence with Continuing Education Units (CEUs). This is another use for certificate programs. 7. IDC's extensive peer and professional support system ensures that we deliver valuable technical assistance before, during, and after certification to ensure that DEI leaders around the world are ready for success. IDC is required to represent itself truthfully and does not seek to confuse the industry. There is a purpose for every type of DEI educational program. The reason why we're the #1 certification provider is because employers can trust our professional qualification process and system. Learn more at: https://lnkd.in/eWjt7xg

American Board of Medical Specialties (ABMS) recommends that new pathways for internationally trained physicians should encompass the following key requirements: 1. **Initial Assessment:** A thorough evaluation of knowledge, cognitive and procedural skills, and professional behaviors conducted by an independent organization specializing in the relevant medical/surgical field. 2. **Supervision and Progressive Assessment:** Ongoing observation and evaluation by board-certified physicians throughout the provisional period, utilizing assessment tools established by ACGME-accredited training programs. 3. **Access to Training:** Provision of training opportunities by certified physicians with specialized expertise to address any identified gaps in knowledge and skills. 4. **Final Assessment:** A comprehensive assessment administered by an independent organization to ascertain competency in the specialty before granting an unrestricted medical license. These outlined requirements aim to ensure a structured and rigorous transition process for internationally trained physicians seeking to practice in the medical field. https://lnkd.in/enJUQJxU Project IMG The International Medical Graduates Academy Tisha Titus, MD, MPH Rafael J. Grossmann, MD, MSHS, FACS