Cork University Dental School and Hospital - Masters by Research Theses

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    Proficiency-based progression (PBP) training- the future model for dental operative skills training? A systematic review and meta-analysis of existing literature
    (University College Cork, 2023-01) Kehily, Elaine; Roberts, Anthony; Allen, Finbarr; Gallagher, Anthony G.; Health Research Board
    Objective: To evaluate the effectiveness of proficiency-based progression (PBP) operative training using validated performance metrics, by comparing this to standard, conventional training methods. Data: This systematic review was conducted in accordance with the PRISMA guidelines for the Transparent Reporting of Systematic Reviews and Meta-Analyses. Study quality was assessed using the MERSQI tool and the Cochrane Risk of Bias tool. Results were pooled using biased corrected standardized mean difference and ratio-of-means (ROM). Summary effects were evaluated using a series of fixed and random effects models. The primary outcome was the number of procedural errors performed comparing PBP and non-PBP-based training pathways. In quantitative synthesis testing for procedural errors, a pooled meta-analysis on 87 trainees was conducted using random-effects models. In a ROM analysis, PBP was estimated to reduce the mean rate of errors by 62%, when compared to standard training (ROM 0.38, 95% CI: 0.25; 0.58; p < 0.001) Sources: The electronic databases of PubMed, Embase, Web of Science, MEDLINE and Cochrane library’s CENTRAL were searched from inception to 8/11/2021. Filters activated were Randomized Controlled trials, clinical trial. Study selection: 13 studies were included for review with 11 included in the quantitative synthesis from 174 potentially relevant publications identified by the search strategy. Main inclusion criteria were studies comparing standard surgical/operative training with proficiency-based simulation training using validated metrics based on expert performance. Conclusions: Our meta-analysis found that PBP training improved trainees' performances, by decreasing procedural errors. There is sufficient evidence to explore PBP training for use in dental skills training.