Developing a reliable and valid competency model for assistant dentists in China

BACKGROUND: The shortage of dentists is one of the various medical-resource problems found around the world. More and more countries are improving the provision of oral services by training dental therapists and hygienists. In China, they are called assistant dentists, and they supplement dental services, but thus far, no research has been conducted on the competence of this group. OBJECTIVE: The purpose of this study was to establish a competency model for Chinese assistant dentists. This model can provide a more scientific basis for the education, training, and evaluation of these professionals, as well as provide a reference for the capacity of dental therapists in various countries. METHODS: We established a system of competency characteristics using theoretical analysis and focus group discussions, after which we established an initial competency model by consulting a Delphi panel of 29 experts. Finally, we collected data from 1389 assistant dentists from 14 provinces in China, and the reliability and validity of the model were confirmed by factor analysis of this data. RESULTS: After three rounds of Delphi panels, the competency model came to include seven ability levels and 50 indicators. In exploratory-factor analysis, three indicators were eliminated, and the questionnaire could explain 68.41 % of total variance. In confirmatory-factor analysis, the established model and data fit well (goodness-of-fit index [GFI] = 0.914, root mean square error of approximation [RMSEA] = 0.047). The results showed that the entire model has good reliability and validity. CONCLUSIONS: Our competency model for dental assistants in China includes seven elements. This is consistent with the current health situation in China, and it has distinct Chinese characteristics. Some of our findings, like those reported in other countries with dental therapists, offer ideas for other developing countries.