Is the number of procedures completed a valid indicator of final year student competency in operative dentistry?

Abstract
Introduction Concerns regarding the preparedness of dental graduates often focus on the number of procedures undertaken before qualification. Aims To assess the validity of numerical requirements in determining whether a student has sufficient competency to graduate. Materials and methods In total, 50,821 observations of student activity while on the restorative clinic, for two integrated student cohorts (n = 139), were continuously recorded using the LiftUpp system from their third year to graduation. Analysis of data determined the most frequent type, location and difficulty of the direct restorations provided. Results Four groups of students, categorised by the total number of restorations they provided, were identified. Those with the most restorations (70+) had a statistically significantly greater experience in restoring different tooth surfaces, in different quadrants, on different patients than those with the least (40-49). However, increased numbers did not correlate with increasing difficulty, suggesting that students simply became more adept at easier procedures. Discussion Using a derived measure of 'consistency', it was observed that increased performance consistency was not correlated with greater overall experience. Furthermore, only 4% of students were 100% consistent in their performance in their final year. Conclusions These data suggest that a 'numerical requirements' approach cannot be used, in isolation, as a valid measure of the competency of an individual. Further work is needed to validate consistency as a holistic measurement to characterise the performance of graduates.