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Selecting continuing education
COMMENTARIES
that comparing a single operatoranesthetist to drunken driving is counterproductive; I agree, but this was not stated or implied in the article. The safety of anesthesia and sedation cannot be extrapolated from 1 person to the thousands of specialists and general dentists who perform enteral sedation or general anesthesia as the level of training, drugs used, doses administered, and monitoring vary highly across people. Generalizations about the safety of anesthesia and sedation performed by dentists in outpatient settings cannot be reliably estimated, as neither the incidence of serious morbidity and mortality nor the number of cases performed is available to make estimates1 that would provide an overall estimate of safety or problems associated with various clinical practices, such as the single operator-anesthetist. Expert opinion is also problematic for assuring the public if the evidence is inadequate or biased by professional selfinterest. Although a personal experience of greater than 50,000 cases is impressive, it does not generalize to all practitioners and clinical practices. It is unclear how performing an extraction in the oral cavity provides “a huge safety advantage,” as monitoring requires attention to respiration rate, the adequacy of ventilation, blood pressure, and heart rate, all of which are monitored by devices that are located outside of the surgical field. Even a well-trained conscientious anesthetist is likely distracted on occasion by performing a complex dental procedure,
482 JADA 148(7) http://jada.ada.org
such as the surgical extraction of an impacted third molar, which invites the potential for adverse outcomes that may be analogous to the distractions of texting while driving. Raymond Dionne, DDS, MS, PhD Greenville, NC
http://dx.doi.org/10.1016/j.adaj.2017.05.015 Copyright ª 2017 American Dental Association. All rights reserved.
1. Blue Ribbon Panel on Dental Sedation/ Anesthesia Safety of the Texas State Board of Dental Examiners; Luce EB, McNeill RG, Yu DH, Kuba R, Chandler BS, Redden RJ. Report to the Texas Sunset Advisory Commission. January 2017: 8. Available at: http:// www.tsbde.texas.gov/documents/agency% 20publications/BRP%20Final%20Report.pdf. Accessed May 21, 2017.
SELECTING CONTINUING EDUCATION
In his April guest editorial, “Continuing Education: Caveat Emptor,” (JADA. 2017;148[4]:201203), Dr. Gary Heir raised an important question: how can we gauge the quality of continuing education (CE) activities in which we are considering enrolling? Dr. Heir rightly emphasizes the importance of applying critical thinking skills to the process of selecting CE by first assessing our own professional educational needs and seeking CE activities that address these, then by reviewing the credentials of the instructors and seeking information on the scientific basis of the material to be presented. As chair of the Commission for Continuing Education Provider Recognition, the agency that
July 2017
oversees the American Dental Association’s Continuing Education Recognition Program (ADA CERP), I applaud Dr. Heir’s recommendations. Participating in CE activities, rather than simply fulfilling a regulatory requirement, should be viewed as a key component of continuing professional development. As such, selecting and participating in appropriate CE activities is a professional responsibility, essential for continuous improvements in professional practice and patient care. I would also like to add that ADA CERP is a tool designed to assist dental professionals in identifying providers of CE that meet basic standards. Although ADA CERP does not review and approve individual courses, it does review and approve providers of CE that demonstrate that they have procedures in place to identify professional educational needs, build courses that meet those needs, select qualified instructors, provide information on the scientific basis of the content presented, and assess the learning outcomes of the activities. More information about the program and a list of the 450 ADA CERP–recognized providers are available at http://www.ADA. org/CERP. Paul Leary, DMD Chair, Commission for Continuing Education Provider Recognition Private practice Smithtown, NY
http://dx.doi.org/10.1016/j.adaj.2017.05.016 Copyright ª 2017 American Dental Association. All rights reserved.
that comparing a single operatoranesthetist to drunken driving is counterproductive; I agree, but this was not stated or implied in the article. The safety of anesthesia and sedation cannot be extrapolated from 1 person to the thousands of specialists and general dentists who perform enteral sedation or general anesthesia as the level of training, drugs used, doses administered, and monitoring vary highly across people. Generalizations about the safety of anesthesia and sedation performed by dentists in outpatient settings cannot be reliably estimated, as neither the incidence of serious morbidity and mortality nor the number of cases performed is available to make estimates1 that would provide an overall estimate of safety or problems associated with various clinical practices, such as the single operator-anesthetist. Expert opinion is also problematic for assuring the public if the evidence is inadequate or biased by professional selfinterest. Although a personal experience of greater than 50,000 cases is impressive, it does not generalize to all practitioners and clinical practices. It is unclear how performing an extraction in the oral cavity provides “a huge safety advantage,” as monitoring requires attention to respiration rate, the adequacy of ventilation, blood pressure, and heart rate, all of which are monitored by devices that are located outside of the surgical field. Even a well-trained conscientious anesthetist is likely distracted on occasion by performing a complex dental procedure,
482 JADA 148(7) http://jada.ada.org
such as the surgical extraction of an impacted third molar, which invites the potential for adverse outcomes that may be analogous to the distractions of texting while driving. Raymond Dionne, DDS, MS, PhD Greenville, NC
http://dx.doi.org/10.1016/j.adaj.2017.05.015 Copyright ª 2017 American Dental Association. All rights reserved.
1. Blue Ribbon Panel on Dental Sedation/ Anesthesia Safety of the Texas State Board of Dental Examiners; Luce EB, McNeill RG, Yu DH, Kuba R, Chandler BS, Redden RJ. Report to the Texas Sunset Advisory Commission. January 2017: 8. Available at: http:// www.tsbde.texas.gov/documents/agency% 20publications/BRP%20Final%20Report.pdf. Accessed May 21, 2017.
SELECTING CONTINUING EDUCATION
In his April guest editorial, “Continuing Education: Caveat Emptor,” (JADA. 2017;148[4]:201203), Dr. Gary Heir raised an important question: how can we gauge the quality of continuing education (CE) activities in which we are considering enrolling? Dr. Heir rightly emphasizes the importance of applying critical thinking skills to the process of selecting CE by first assessing our own professional educational needs and seeking CE activities that address these, then by reviewing the credentials of the instructors and seeking information on the scientific basis of the material to be presented. As chair of the Commission for Continuing Education Provider Recognition, the agency that
July 2017
oversees the American Dental Association’s Continuing Education Recognition Program (ADA CERP), I applaud Dr. Heir’s recommendations. Participating in CE activities, rather than simply fulfilling a regulatory requirement, should be viewed as a key component of continuing professional development. As such, selecting and participating in appropriate CE activities is a professional responsibility, essential for continuous improvements in professional practice and patient care. I would also like to add that ADA CERP is a tool designed to assist dental professionals in identifying providers of CE that meet basic standards. Although ADA CERP does not review and approve individual courses, it does review and approve providers of CE that demonstrate that they have procedures in place to identify professional educational needs, build courses that meet those needs, select qualified instructors, provide information on the scientific basis of the content presented, and assess the learning outcomes of the activities. More information about the program and a list of the 450 ADA CERP–recognized providers are available at http://www.ADA. org/CERP. Paul Leary, DMD Chair, Commission for Continuing Education Provider Recognition Private practice Smithtown, NY
http://dx.doi.org/10.1016/j.adaj.2017.05.016 Copyright ª 2017 American Dental Association. All rights reserved.