Toward a competency analysis of operative dentistry technique skills.

This research seeks ways to distinguish beginners from competent students based on the manner in which they perform. Five "beginner" students who had passed preclinical operative dentistry technique and six "competent" students one month prior to graduation were videotaped performing an occlusal amalgam preparation on #19 on a typodont. The tapes were scored for time in cutting the preparation and observing it and for "unproductive work" (nonfluencies). The number of changes from one operation to another and the use of instruments as aids in measurement were also recorded. Three processes were identified in every student's performance: rough outline form, making walls parallel and cavosurfaces level, and refinement. All preparations were scored as being clinically acceptable and indistinguishable in quality between the two groups. Beginning students required over twice as long to complete the preparation and changed operations more than twice as often as their competent classmates. Most of these differences between groups occurred in the third, refinement, process. Compared to beginners, competent students showed more evidence of using powerful, internalized schema to guide their performance, were smoother, and seemed less rule-driven.