Editorial
From the Editor Ethics Should Fit the Scope of Practice
L One of the ethics substitutes on offer today may be very solid talking about ethics without checking to see what difference that makes in practice.
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et’s be honest about it. Being ethical is going to cost you something. You may lose friends by suggesting even a slight disapproval of their behavior. Others are taking advantage of insurance loopholes but you are forgoing that benefit. There is a big hit associated with practicing in a community with a high need for oral health care instead of one with preferences for high-end treatments. It would be better if someone else called out a misleading advertiser. Overtreatment is almost becoming widespread enough that we should not “leave anything on the table.” Talking about ethics is always easier. It is a sound bet that dentists know ethical behavior when they see it. I believe this because people tell me that they heard or read good ethics stuff. We are proud to have made presentations at a school. We are learning to talk the language of ethics. American firms spend annually $90 billion to bring and keep employees up to the standard of performance. This does not include the military, the nonprofit sector, or CE programs for independent professionals. Donald Kirkpatrick, a leading name in the field, has misgivings about the wisdom of that investment. The cost is obvious; the payoff is not so clear.
The Kirkpatrick model identifies four levels in training. The most immediate effect, called “reaction” or Level I, is reflected in how participants feel about the experience. Did the speaker appear knowledgeable, was the material interesting, were the Danish fresh? CERP and PACE require that organizations sponsoring CE programs collect this information, which is why all the forms filled out immediately following the course look so similar. Level II in the Kirkpatrick model is “knowledge.” Can participants answer questions about what was covered? The link between reading an article and then answering a few multiplechoice questions is designed to get at this. I have never seen this approach used at a live presentation. Many times dentists already know the answers to the questions, so it is not necessarily a test of “learning.” It is an “open book” test, and some game the system by marking A for all answers, recording the correct responses from the feedback, and then reentering the keyed responses—all without ever looking at the material. You would be shocked to learn how many have earned their CE credits for ethics on the ACD web page this way. The third level in the model is “performance.” What behavior is different following the training? Now we are getting somewhere. All those course objectives that say the participant will “understand X” show
2020
Volume 87, Number 4
