Introduction and Comparison of Direct Observation of Procedural Skills (DOPS) with Conventional Method of Skill Assessment in Dental Students

Introduction: Procedural competence and professional behaviour are integral components of clinical skills in Dentistry. However till date, most of the clinical procedures performed by undergraduate dental students are only assessed at the end of the procedure. Because of this, there could be a lack of assessment of their actual procedural and patient handling skills. Also, because of lack of a standard format, there could be a lot of ambiguity in assessment scores given by different examiners for same performance. Aim: The aim of this study was to introduce and compare Direct Observation of Procedural Skills (DOPS) with conventional method of case presentation for skill assessment of dental undergraduate students. Materials and Methods: DOPS, as a skill assessment tool was analysed on the basis of its feasibility, acceptability, validity and reliability. Checklist for DOPS assessment of Scaling and Root Planing (SRP) procedure was generated and process of internal validation was completed. Forty final year Bachelor of Dental Surgery (BDS) students participated in this study during their clinical posting in the Department of Periodontology. One of the most routinely performed procedure by the students in the clinical posting; i.e., SRP was selected for skill assessment. Each student performed SRP on patients and was assessed by two assessors using conventional method (CA1 and CA2) and two assessors using DOPS method (DA1 and DA2). Three such assessments were carried out for each student i.e. on day 1, day 2 and after feedback i.e., at the end of their clinical posting of 14 days. Descriptive analysis, ANOVA, Tukey's Post-Hoc and Spearman-Brown formula were used for statistical analysis concerned with reliability as compared to the conventional method. Feedback from students and assessors was used to analyse the feasibility and acceptability of DOPS. Results: Correlation between DOPS examiners (74%, 71%) was significantly higher as compared to correlation between conventional examiners (23%, 55%). According to Spearman-Brown formula, reliability was found to be 80-90% in case of DOPS, and 50-70% in case of conventional method. Based on feedback collected from students and faculty regarding the feasibility and acceptability of DOPS, 97% students and all faculty members chose DOPS over conventional method. Conclusion: According to this study, DOPS seems to be a reliable, valid, acceptable and feasible method of skill assessment in dental students.