Some paradoxes in competency-based dental education.

Competency-based dental education was introduced in 1993 and has proven to be a robust innovation, guiding curricular design, clinical education and evaluation, and accreditation. At the same time, it has been irregularly implemented and is understood in different ways. These paradoxes were explored in a survey of academic and clinical deans and chairs of departments of endodontics and restorative dentistry at U.S. and Canadian dental schools. It was confirmed that fewer than half of the respondents can identify the ADEA and ADA definition of competency. Significant differences were reported in the perceived understanding and value placed on competencies and their impact on dental education. Differences were also found to exist in evaluation practices and in how evaluation data are used to determine students' readiness for graduation. It is concluded that the openness of the competency concept is one reason for its longevity and usefulness in dental education.