预防性口腔健康的有效教育指导：实践培训与基于网络的培训。

Children's Mercy Hospital and Clinics, General Pediatrics, 2401 Gilham Rd, Kansas City, MO 64108, USA.

Pediatrics. 2010 Mar;125(3):547-53. doi: 10.1542/peds.2009-0470. Epub 2010 Feb 1.

OBJECTIVE

To assess the effect of Web-based training (WBT) on resident knowledge of preventive oral health and compare the addition of hands-on training (HOT) to WBT on resident skills, confidence opinions, and practice.

METHODS

Pediatric residents participated in a WBT on preventive oral health. After the WBT, subjects were randomly assigned to receive HOT by a dentist (WBT + HOT) or WBT alone. All subjects were assessed on knowledge by a pretest/posttest questionnaire and assessed on skills in the performance of an oral examination by direct observation. Residents' confidence regarding oral health counseling and their opinions about the importance of the incorporation of oral health into the well-child visit were measured by surveys that used a Likert scale. Residents' change in practice was assessed by a retrospective chart audit.

RESULTS

Fifty-six residents were included in the analysis (WBT + HOT: 29; WBT: 27). Resident knowledge improved after the WBT from 69% to 81% (95% confidence interval [CI]: 9%-15%). Overall skills improved in the WBT + HOT group participants compared with those in the WBT group (87% vs 73%; difference: 14% [95% CI: 1.2%-26.6%]). Seventy-nine percent of participants in the WBT + HOT group compared with 44% of those in the WBT provided follow-up instructions (relative risk: 0.56 [95% CI: 0.35-0.89]). Resident opinions regarding incorporating preventive oral health into the well-child visit decreased by 33% in the WBT + HOT group compared with 11% in the WBT group (95% CI: 2%-43%). There were no significant differences in confidence regarding preventive oral health and practice between the groups.

CONCLUSIONS

Both instructional methods resulted in increases in knowledge, efficacy, and practice of preventive oral health. The addition of hands-on training by a dental provider increased the overall skills of oral examination, but this increase was largely a result of the provision of follow-up instruction.

目的

评估基于网络的培训（WBT）对住院医师预防口腔健康知识的影响，并比较在 WBT 基础上增加实践培训（HOT）对住院医师技能、信心、意见和实践的影响。

方法

儿科住院医师参加了预防口腔健康的 WBT。WBT 后，受试者随机分配接受牙医的 HOT（WBT+HOT）或仅接受 WBT。所有受试者均通过预测试/后测试问卷评估知识，并通过直接观察进行口腔检查的技能评估。通过使用李克特量表的调查评估居民对口腔健康咨询的信心及其对将口腔健康纳入儿童健康访视的重要性的看法。通过回顾性图表审核评估居民实践的变化。

结果

56 名居民纳入分析（WBT+HOT：29；WBT：27）。WBT 后，住院医师的知识从 69%提高到 81%（95%置信区间[CI]：9%-15%）。与 WBT 组相比，WBT+HOT 组参与者的整体技能提高（87%对 73%；差异：14%[95%CI：1.2%-26.6%]）。与 WBT 组相比，WBT+HOT 组 79%的参与者提供了随访指导，而 WBT 组只有 44%的参与者提供了随访指导（相对风险：0.56[95%CI：0.35-0.89]）。与 WBT 组相比，WBT+HOT 组居民对将预防口腔健康纳入儿童健康访视的意见减少了 33%，而 WBT 组仅减少了 11%（95%CI：2%-43%）。两组在预防口腔健康和实践方面的信心没有显著差异。